Biomarkers and Silent Cardiac Disease in Primary Prevention Time to Unmask the Damage?⁎

Forty percent of middle-aged and elderly persons in the United Kingdom are treated for hypertension and/or dyslipidemia,aiming for primary prevention of adverse cardiovascular events (1). Despite treatment,rates of adverse cardiovascular events remain significant over long-term follow-up. This mandates efforts to improve risk stratification to guide deployment of resources for surveillance and proactive management and in fostering better adherence to therapy. At present,there is no generally accepted approach to refining risk stratification in those on appropriate therapy for primary prevention of cardiovascular events who have met accepted blood pressure and blood lipid targets. Asymptomatic changes in cardiac structure and function carry adverse prognostic significance (2,3). Awareness of the presence of such “silent” cardiac target organ damage (cTOD) may foster enhanced rates of optimized management. However,comprehensive cardiac testing in those receiving primary preventive therapy is economically and logistically challenging,and an initial screening with adequately sensitive and specific biomarkers may allow targeting of detailed assessments to those with an acceptably high yield of actionable findings.
Journal of the American College of Cardiology Current Issue

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