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Background: Arterial stiffness is considered to be an intermediate marker of CV risk with independent prognostic value. The objective of this study is to assess whether the estimation of arterial stiffness can improve CV risk stratification compared to SCORE in patients at Community Pharmacies. Methods: Observational prospective epidemiological study in which consecutive individuals entering a participating Community Pharmacy are offered a voluntary measurement of blood pressure and estimation of pulse wave velocity by oscillometry (AGEDIO, IEM®) to stratify their CV risk according to SCORE compared to the use of arterial stiffness. Results: After nine months of recruitment, data from 923 patients (173 women, 102 men) were collected. 16/122 (13.1%) patients under 40 years and 72/364 (19.8%) over 65 years of age presented pathological stiffness and could be classified as high-risk, even though being out of the age-range of SCORE. Of the 437 (47.3%) patients who were susceptible to calculating SCORE, 42/437 patients (9.6%) presented pathological arterial stiffness. Cholesterol values were available in 281 patients (64.3%). Among them, according to SCORE, only 6 (2.1%) fell into the high-risk category. Conclusions: More than half of the subjects who randomly enter a community pharmacy had ages that make it impossible to calculate the CV risk by SCORE. Among them, arterial damage was detected in 18.1%. Of the other half, 9.6% presented arterial damage and, therefore, high CV risk, when SCORE only detected it in 2.1%. Therefore, estimating arterial stiffness in community pharmacies markedly improves detection of high CV risk compared to SCORE. [ABSTRACT FROM AUTHOR]

Background: 2018 ESC-ESH Guidelines for the Management of Arterial Hypertension recommend pharmacological treatment if patients with grade 1 HTN at low-moderate risk remain hypertensive after a period of lifestyle intervention. Our objective was to assess the predictive value of early vascular aging (EVA) to identifying patients who developed sustained HTN after baseline diagnosis. Methods: Retrospective, descriptive, longitudinal study including all consecutive patients referred to a HTN Unit with suspected naïve HTN without prior pharmacological treatment. EVA was defined according to estimated pulse wave velocity (brachial oscillometry, Mobil-O-Graph (IEM®) in seven age-groups(1). Standard clinical tests were performed at baseline and after 12 months. Results: Since 2010, 335 consecutive patients entered the study, with 201 women (60%), a mean age of 46,4 years (± 13), mean office BP of 130/76 (± 12/9), and ambulatory BP of 122/78 (± 8/7) mmHg. Distribution of BP was 155 (46.3%) patients with high-normal BP, 28 (8,4%) with white-coat HTN, 108 (32.2%) with masked HTN and 44 (13.1%) with established HTN. At baseline, 57% of patients showed EVA, after a mean time of 1.1 year, 65% of participants presented elevated ABPM. In univariate analysis, baseline stiffness (EVA) was associated with elevated ABPM-values in the follow-up visit (OR: 2.0; IC 1.3-3.1; p = 0.003). After adjustment for age, gender and pulse pressure, baseline EVA kept its significant predictive value (OR:2.6; IC 1.6-4.2; p = 0.001). Conclusions: Arterial damage characterized as EVA according to estimated PWV by brachial oscillometry doubles the probability of sustained HTN one year after initial assessment in naïve patients with high-normal BP/grade 1 HTN at low-moderate risk. [ABSTRACT FROM AUTHOR]