EARLY DETECTION OF SUBCLINICAL ATHEROSCLEROSIS IN ASYMPTOMATIC SUBJECTS AT HIGH-RISK FOR CARDIOVASCULAR-DISEASE

Subclinical atherosclerosis can be non-invasively detected via calcifi cations, thickening and stiffening of arteries. Coronary calcification s seen with ultrafast computed tomography are frequent in hypertension or hypercholesterolemia and synonymous of coronary atherosis but not of coronary stenosis. Wall thickening detectable by extracoronary ultr asonography may be characterized by an intima-media thickening shown i n hypertension or by a focalized plaque whose the presence in the aort ic or femoral level seem influenced by systolic pressure. Extracoronar y wall thickening may be an aid in the diagnosis of coronary atheroscl erosis, a predictor of coronary event, and a therapeutic target. Wall stiffening, which reflects sclerosis, is detected by pulse wave veloci ty. Its increase in hypertension may be an indicator of atherosclerosi s and can be reversed by certain antihypertensive agents. Clinical car e of at risk individuals might profit from subclinical atherosclerosis which adds objectivity and sensitivity in the individualization of ri sk and the decision to treat.