Renal Resistive Index and 10-Year Risk of Cardiovascular Disease Predicted by Framingham Risk Score and Pooled Cohort Equations: An Observational Study in Hypertensive Individuals Without Cardiovascular Disease

Introduction: The renal resistive index (RRI) has been widely shown to be related with subclinical vascular damage in individuals with essential hypertension, as well as in other populations. However, limited data exist regarding the association between RRI and cardiovascular (CV) events in hypertensive individuals. Additionally, it is unclear whether the 10-year risk of CV disease, as predicted by validated score equations, is associated with impaired intrarenal hemodynamics. Aim: The aim of our study was to analyze the relationship between RRI and both the FS and ASCVD in hypertensive individuals with no history of CV events. Methods: A total of 742 individuals with essential hypertension (40–75 years) were enrolled. RRI was assessed in all patients using Duplex–Doppler ultrasonography, and the 10-year risk of cardiovascular disease was calculated using both the Framingham risk score (FS) and atherosclerotic cardiovascular disease risk score (ASCVD) through validated equations. Results: Higher RRI values were observed in patients with calculated CV risk ≥ 20% compared to those with lower risk (all p < 0.001). RRI was closely associated with both FS and ASCVD scores in the overall cohort (all p < 0.001), with no significantly differences between groups with glomerular filtration rate ≥ or < 60 mL/min/1.73m2. In multivariate analyses, these associations remained significant after adjusting for traditional risk factors included in the FS and ASCVD equations (p = 0.007 and p = 0.047, respectively). Receiver-operating characteristic curves indicated that RRI values >0.67 and >0.65 were associated with a high CV risk (≥ 20%), as calculated through FS and ASCVD equations, respectively. Conclusion: RRI can be considered a marker of overall CV risk in hypertensive patients, independent of renal function.