P-384: The impact of echocardiography and carotid ultrasonography on risk evaluation in people with high-normal and high blood pressure: Results from ICEBERG study

Background: Accurate detection of organ damage poses a problem in the management of hypertensive patients, and an important part of the patient's status remains hidden like the underwater part of an ICEBERG. The screening of patients by echocardiography (Echo) and carotid ultrasonography (USG) might improve accurate risk classification. Objectives: The primary purpose of Intensive / Initial Cardiovascular Examination regarding Blood pressure levels: Evaluation of Risk Groups (ICEBERG) study protocol is to determine the impact of different laboratory tests on cardiovascular risk stratification of subjects with blood pressure levels ≥130/85 mmHg. This report focuses on the impact of Echo and carotid USG on risk evaluation. Methods: This report includes the data of subjects with BP ≥130/85 mmHg, enrolled at 20 cardiology centers. 164 subjects were included in the analysis. All subjects were assessed by Echo and carotid USG (evaluated by two blinded experienced observers). Left ventricular hypertrophy (LVH) was defined as left ventricular mass index (LVMI) ≥125 g/ m2 for male (M) and ≥110 g/m2 for female (F). Vascular target organ damage was defined as carotid intima media thickness (CIMT) ≥0.9 mm and/or atherosclerotic plaque presence. Results: The study subjects were 50.1±11.3 years old (F/M ratio 1.3). 42.4% of the subjects were interpreted as having LVH by Echo. Increased CIMT or the presence of atherosclerotic plaque was detected in 39.7% of the men and 13.8% of the women. 82.8% of the subjects were classified into high (H) or very high (VH) added risk group, initially. Further 4.9% switched from lesser risk groups to H/VH added risk group, when Echo was performed. This proportion increased by 6.8%, when carotid USG was taken into account. Conclusion: Since the presence of any target organ damage changes the risk class of the people with high normal and high blood pressure, screening with Echo and carotid USG might prevent them from being undertreated.