Page 11 - GUIAS ESC ESH 2018
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ESC/ESH Guidelines                                                                                11



            Table 4  Factors influencing cardiovascular risk in patients with hypertension


              Demographic characteristics and laboratory parameters
                a
              Sex (men >women)
                 a
              Age
              Smoking (current or past history) a
                         a
              Total cholesterol and HDL-C
              Uric acid

              Diabetes a
              Overweight or obesity
              Family history of premature CVD (men aged <55 years and women aged <65 years)
              Family or parental history of early-onset hypertension

              Early-onset menopause
              Sedentary lifestyle
              Psychosocial and socioeconomic factors
              Heart rate (resting values >80 beats/min)

              Asymptomatic HMOD
              Arterial stiffening:
              Pulse pressure (in older people) >_60 mmHg
              Carotid–femoral PWV >10 m/s
              ECG LVH (Sokolow–Lyon index >35 mm, or R in aVL >_11 mm; Cornell voltage duration product >2440 mm.ms, or Cornell voltage >28 mm in
              men or >20 mm in women)
                                                2.7
                                                                       2.7
              Echocardiographic LVH [LV mass index: men >50 g/m ; women >47 g/m 2.7  (height in m ); indexation for BSA may be used in normal-weight
                               2
              patients; LV mass/BSA g/m >115 (men) and >95 (women)]
                                                                                                           b
              Microalbuminuria (30–300 mg/24 h), or elevated albumin–creatinine ratio (30–300 mg/g; 3.4–34 mg/mmol) (preferentially on morning spot urine)
                                               2
              Moderate CKD with eGFR >30–59 mL/min/1.73 m (BSA) or severe CKD eGFR <30 mL/min/1.73 m 2b
              Ankle-brachial index <0.9
              Advanced retinopathy: haemorrhages or exudates, papilloedema
              Established CV or renal disease
              Cerebrovascular disease: ischaemic stroke, cerebral haemorrhage, TIA
              CAD: myocardial infarction, angina, myocardial revascularization

              Presence of atheromatous plaque on imaging
              Heart failure, including HFpEF
              Peripheral artery disease

              Atrial fibrillation

            BSA = body surface area; CAD = coronary artery disease; CKD = chronic kidney disease; CV = cardiovascular; CVD = cardiovascular disease; ECG = electrocardiogram; eGFR
            = estimated glomerular filtration rate; HDL-C = HDL cholesterol; HFpEF = heart failure with preserved ejection fraction; HMOD = hypertension-mediated organ damage; LV
            = left ventricular; LVH = left ventricular hypertrophy; PWV = pulse wave velocity; SCORE = Systematic COronary Risk Evaluation; TIA = transient ischaemic attack.
            a
            CV risk factors included in the SCORE system.
            b
            Proteinuria and reduced eGFR are independent risk factors.
            See Table 6 for CV risk modifiers.


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