Stroke Clinical Trial
Official title:
Improving Intermediate Risk Management. MARK Study
Cardiovascular risk functions fail to identify more than 50% of patients who develop cardiovascular disease. This is especially evident in the intermediate-risk patients in which clinical management becomes difficult. The purpose of this study is to analyze if ankle-brachial index (ABI), measures of arterial stiffness, postprandial glucose, glycosylated hemoglobin, self-measured blood pressure and presence of comorbidity are independently associated to incidence of vascular events and whether they can improve the predictive capacity of current risk equations in the intermediate-risk population.
Primary prevention of cardiovascular diseases is a priority in public health policy of
developed and developing countries. The fundamental strategy consists in identifying people
in a high risk situation in which preventive measures are effective and efficient. However,
specificity and sensitivity of risk equations are modest, which means that approximately 50%
of the patients who are likely to develop a vascular event and would benefit from preventive
measures are not considered at high risk. While 30% of the subjects considered at risk don't
really benefit from preventive measures. Moreover, decisions which imply thousands of people
and can determine drug treatment indications are taken every day in primary care centers.
These decisions are based mostly on the result of estimations about the probability to
develop a vascular disease in 10 years. Improvement of these predictions in our country will
have an immediate, clinical and welfare impact and a short term public health effect.
The purpose of this study is to analyze if ankle-brachial index (ABI), measures of arterial
stiffness, postprandial glucose, glycosylated hemoglobin, self-measured blood pressure and
presence of comorbidity are independently associated to incidence of vascular events and
whether they can improve the predictive capacity of current risk equations in the
intermediate-risk population.
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