Objective: Discriminating between patients at high and low cardiovascular risk can be difficult. Screening for the presence of subclinical organ damage may provide additional benefits in predicting cardiovascular events. We aimed to assess the agreement of markers of organ damage with traditional risk scoring methods.

Methods: We performed a comprehensive analysis of vascular health on a cohort of 50 patients recruited from Blood Pressure and Cardiovascular Risk Factor clinics. This included pulse wave analysis, pulse wave velocity (PWV), carotid intima-media thickness (cIMT), brachial flow-mediated dilatation and ankle-brachial pressure index. Patients were subdivided according to the ASSIGN score into low, intermediate and high cardiovascular risk.

Results: PWV (8.63, 8.25 and 11.9 m/s) and cIMT (0.67, 0.73 and 0.91 mm) were the only vascular parameters to display a statistically significant (p<0.001) difference according to risk category (low, intermediate and high). Both correlated with age (r=0.589, p<0.001; and r=0.646, p<0.001; respectively) and with each other (r=0.585, p<0.001). When we calculated means and 95% confidence intervals for each risk category we identified 6 low risk, 11 intermediate risk and 6 high risk patients who had test values outwith the ranges expected of their group. For patients with higher or lower values there was no discordance between PWV and cIMT.

Conclusion: PWV and cIMT were the only markers to distinguish between low and high risk patients. We identified patients with higher or lower values than expected according to their risk category, which could reflect higher or lower risk than originally estimated. These findings require prospective studies.