Abstract

MASSON, Walter et al. Estimation of Cardiovascular Risk and Detection of Subclinical Carotid Atheromatosis in Middle-aged Postmenopausal Women. Rev. argent. cardiol. [online]. 2013, vol.81, n.4, pp.322-328. ISSN 1850-3748.

Background Cardiovascular disease in women increases after menopause. Traditional risk scores underestimate the risk in postmeno-pausal women. The diagnosis of carotid atherosclerotic plaque (CAP) could improve risk stratification. Objectives The aim of the study was: 1) To estimate cardiovascular risk in middle-aged postmenopausal women in primary preven-tion. 2) To find CAP prevalence. 3) To assess the precision of risk scores used to detect CAP. Methods The level of agreement between the 10-year Framingham risk score (10-FRS) and the score recommended by the World Health Organization (WHOS) was assessed. Ultrasound was used to determine CAP occurrence. A ROC analysis was performed. Results The study included a total of 334 women with mean age 57 ± 5 years. According to 10-FRS and WHOS, 96% and 91% of the population were respectively classified as "low risk". An adequate level of agreement between both scores was found (kappa 0.31). CAP occurred in 29% of cases. Score estimated risk correlated with CAP prevalence. Women with CAP presented higher incidence of hypertension and smoking, evidencing a more frequent "metabolic" pattern than women without CAP. The area under the curve of 10-FRS to detect CAP was 0.79 (95% CI 0.73-0.84), with an optimal cut-off point = 3%. Conclusions In this population, mostly classified as low risk, there was considerable CAP prevalence. A carotid ultrasound might help to stratify cardiovascular risk when 10-FRS is = 3%.

Keywords : Postmenopausal Women; Cardiovascular Risk Assessment; Atherosclerotic Plaque.

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