A new analysis of the ELSA study has shown that the number of plaques at baseline predicted cardiovascular events, with a significant increase in the number of most events with an increase in the number of plaques. Although changes in the intima-media thickness (IMT) were associated with some events, the baseline number of plaques was a more powerful predictor. This analysis was presented by°Dr. Alberto Zanchetti°of the University of Milan at the 15th European Meeting of Hypertension in Milan, held June 7-21, 2005.

Although there were few cardiovascular events in the main ELSA study, these predictive correlations in the substudy were notable. The number of events, the relation between the number of plaques and events, and the p values in the 2334 ELSA study patients is shown in the Table.


Event (#) No Plaque 1 Plaque > 1 Plaque P value
MI (35) 0.66 1.22 3.26 <0.0001
Stroke (38) 0.66 0.95 1.63 0.810
Death (30) 0.78 0.81 2.61 0.0061
Major CV Events (60) 2.10 2.57 6.19 <0.0001
All Major and Minor Events (142) 4.43 5.96 9.45 <0.001

Also, the rates of all cardiovascular events and major cardiovascular events increased with the increasing quintiles of thickness of baseline CBMmax. Further, a significant correlation between CBMmax and a 1 mm increase in baseline IMT was found; a 3.989 relative risk for each 1 mm increase in baseline IMT for composite events and a 4.439 relative risk for cardiac events (p<0.001 for both).