Page 11 - GUIAS ESC ESH 2018
P. 11
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.
Downloaded from https://academic.oup.com/eurheartj/advance-article-abstract/doi/10.1093/eurheartj/ehy339/5079119
by guest
on 27 August 2018