Factors Influencing Cardiovascular Prognosis (Pythia-GR)

Inclusion criteria

• Age > 50 years volunteers (2 towns of 15000 residents one in the north and one in the south of Greece)
• End points
• 5-10 years cardiovascular morbidity and mortality

Measurements at baseline

• Anthropometrics

  • Age (M>55 years; W>65 years)
  • Weight-height- BMI
  • Abdominal obesity (Waist circumference>102 cm(M), >88cm (W) Family history
  • Family history of premature CV disease (M at age<55 years; W at age<65 years)

History

• Smoking
• Diabetes Mellitus,
• Established Heart disease: myocardial infarction; angina; coronary revascularization; heart failure
• Established renal disease [diabetic nephropathy; renal impairment (serum creatinine M>133, W>124 mmol/l); proteinuria (> 300 mg/24 h)]
• Cerebrovascular disease: ischaemic stroke; cerebral haemorrhage; transient ischaemic attack
• Peripheral artery disease
• Advanced retinopathy: haemorrhages or exudates, papilloedema
• Treatment

Measurements

• Measurements Blood pressure

  • Clinic BP
  • 24h ABPM
  • Home BP

Heart

• Electrocardiographic LVH
• Echocardiographic LVH

Vessels

• Carotid wall thickening or plaque
• Carotid-femoral pulse wave velocity
• Ankle/brachial BP index

Lipids or other risk factors

• Total cholesterol, Tg, HDL, LDL
• Plasma creatinine, estimated glomerular filtration rate
• Fasting plasma glucose or postload plasma glucose
• Microalbuminuria and albumin-creatinine ratio

• Glucose tolerance test

  • Follow up each 3 year with all the above measurements