Criteria for Vascular Risk Factors

Appendix e-1: Criteria for vascular risk factors:

World Health Organization guidelines for the management of hypertension were followed to identify subjects with diagnosis of previous known hypertension (current antihypertensive treatmentor blood pressure values > 140/90 mm Hg in subjects not taking antihypertensive medication, based on multiple blood pressure measurements, taken on several separate occasions) (1); diabetes mellitus was defined based on previous diagnosis and/or current treatment with insulin or oral hypoglycemic medications, or at least 8-hour fasting plasma glucose  7.0 mmol/L or 126 mg/dL (2); hyperlipidemias were defined as total cholesterol >200, LDL >130, HDL <35 mg/dL, and triglyceride >200 mg/dL, in at least two measurements (3); myocardial infarction, documented by history, ECG or cardiac enzymes (4); angina pectoris (5,6); heart failure (7); atrial fibrillation (8); lower limb arteriopathy and peripheral vascular disease (9); history of stroke and/or TIA (10).

1. 1999 World Health Organization - International Society of Hypertension Guidelines for the Management of Hypertension. Guidelines subcommittee. J Hypertens. 1999;17:151-183.

2. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 1997;20:1183-1197.

3. National Cholesterol Education Program. Second Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). Circulation. 1994;89:1333-1445.

4. Alpert JS, Thygesen K, Antman E, Bassand JP. Myocardial infarction redefined – a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. J Am Coll Cardiol. 2000;36:959-969.

5. Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM, Grunwald MA, Levy D, Lytle BW, O'Rourke RA, Schafer WP, Williams SV, Ritchie JL, Cheitlin MD, Eagle KA, Gardner TJ, Garson A Jr, Russell RO, Ryan TJ, Smith SC Jr. ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Chronic Stable Angina). J Am Coll Cardiol. 1999;33:2092-2197.

6. Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS, Jones RH, Kereiakes D, Kupersmith J, Levin TN, Pepine CJ, Schaeffer JW, Smith EE 3rd, Steward DE, Theroux P, Alpert JS, Eagle KA, Faxon DP, Fuster V, Gardner TJ, Gregoratos G, Russell RO, Smith SC Jr. ACC/AHA guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Unstable Angina). J Am Coll Cardiol .2000;36:970-1062.

7. The Task Force on Heart Failure of the European Society of Cardiology. Guidelines for the diagnosis of heart failure. Eur Heart J. 1995;16:741-751.

8. Falk RH. Atrial fibrillation. N Engl J Med .2001;344:1067-1078.

9. Weitz JI, Byrne J, Clagett GP, Farkouh ME, Porter JM, Sackett DL, Strandness DE, Jr, Taylor LM. Diagnosis and treatment of chronic arterial insufficiency of the lower extremities: a critical review. Circulation 1996;94:3026-3049.

10. Hatano S. Experience from a multicentre stroke register: a preliminary report. Bull WHO 1976;54:541-553.