The relations between emerging biomarkers of preclinical CV disease and established risk algorithms are not well defined.

Aim: this study evaluated the relationships of various tissue CV biomarkers with Framingham risk score (FRS) and its individual determinants.

Methods: in 435 subjects without previous cardiovascular events (287 males, mean age 58±11, 56% diabetics (DM), 48% treated for hypertension (HBP), 51% with dyslipidemic treatment, 27% smokers), we measured radio-frequency based (QIMT® and QAS®, Esaote) carotid intima-media thickness (IMT), wave speed (WS) and local pulse pressure (cPP), carotid-femoral pulse wave velocity (PWV; Complior), LV mass index (LVMI) and relative wall thickness (RWT).

Results: the correlation (p<0.05) between FRS and CV biomarkers was the highest for WS, cPP, and PWV (r=0.50, 0.49, 0.51), lower for LVMI, IMT and RWT (r=0.41, 0.41, 0.21). Age was main independent determinant of WS, PWV and cPP; WS and PWV were also independently related to systolic BP and DM, and cPP to HBP therapy. Main determinant of IMT was DM, followed by age and HBP therapy, and independent determinants of LVMI and RWT were SBP and HBP therapy, respectively. Lipids and smoking were not independently related to any tissue biomarker.

Conclusions: our data indicate that arterial stiffness and local carotid PP reflect mainly the ageing process, and are more tightly related to FRS than structural carotid and LV indices. Carotid IMT or LV mass and geometry are predominantly influenced by the presence of DM or HBP, respectively. Different tissue biomarkers may contribute to a personalized estimate of CV risk.