See if you have an incompetent doctor, one who knows nothing about this because s/he doesn't follow research! And then fire your board of directors since they don't know how to run a stroke hospital!
Arterial stiffness (32 posts to December 2014) The latest here:
Spain’s Cardiovascular Risk Standards Introduce Vascular Age
Cardiovascular disease (CV) remains the leading cause of death in Spain, contributing to disability and healthcare costs. The Spanish Society of Arteriosclerosis released the 2026 edition of its standards for global CV risk control, which is an updated clinical reference designed to guide prevention, diagnosis, and management.
The document, updated every 2 years, combines current evidence and incorporates recent advances in CV research and clinical practice. One of the most notable changes in the 2026 update is the replacement of the traditional concept of CV risk with the concept of vascular age, which is presented in a newly updated risk table intended to improve communication with patients.
These standards were first introduced in 2020 and have become important references for clinicians involved in vascular risk management.
More than 30 professionals from multiple specialties contributed to the latest update, including experts in internal medicine, endocrinology, primary care, clinical laboratory medicine, and cardiology.
Comprehensive Risk Assessment
Because atherosclerosis has a multifactorial origin, standards emphasize a comprehensive approach to CV risk assessment.
Suggested for you
This document reviews the full clinical pathway for patients with vascular disease, including the initial evaluation and diagnostic testing, criteria for diagnosis, methods for estimating vascular risk, recommendations for both lifestyle and pharmacologic management, and criteria for referral and discharge.
It also proposes organizational recommendations for dedicated vascular risk clinics to offer practical guidance to healthcare professionals in managing these patients in daily clinical practice.
Role of Family History
These standards highlight the importance of obtaining detailed family histories of first-degree relatives when evaluating CV risk.
This is particularly relevant for conditions linked to atherosclerotic vascular disease and major CV risk factors, such as suspected familial hypercholesterolemia or premature vascular disease.
Family history was more significant when events occurred at younger ages (< 55 years in men and < 65 years in women).
In addition to general medical history, such as allergies or earlier surgical procedures, clinicians are recommended to investigate the history of atherosclerotic vascular disease and major risk factors, including diabetes, hypertension, dyslipidemia, smoking, and obesity.
When present, the age of onset and details of current or earlier treatments should be recorded, regardless of their indication.
Diagnostic Evaluation
According to a consensus document developed by 15 Spanish scientific societies, the evaluation should include a basic lipid profile.
Clinicians should also conduct a targeted smoking history test, including the Fagerström test, to assess nicotine dependence in individuals who smoke.
Diagnostic evaluations may also include additional tests tailored to individual patient profiles.
For individuals without proven atherosclerotic vascular disease but with CV risk factors, calculating vascular risk is a key step. This estimation informs major clinical decisions, such as when to initiate lipid-lowering therapy and what treatment targets should be pursued.
Imaging for Subclinical Disease
José María Mostaza, MD, PhD, from the Hospital Carlos III, Madrid, Spain, and the first author of the document, noted that the section on imaging for subclinical CV disease has been substantially expanded.
The updated guidelines clarify how carotid ultrasound, femoral ultrasound, and coronary artery calcium scoring can improve CV risk estimation.
These imaging approaches may help detect early vascular changes before the development of a clinical disease.
Key Innovations in the 2026 Edition
Another new feature of the 2026 standards is the introduction of an updated table on vascular age.
Clinicians can estimate the age of a patient’s arteries based on their risk profiles instead of communicating abstract risk percentages.
According to Mostaza, many patients find CV risk percentages difficult to understand. Telling a 50-year-old patient that their arteries resemble those of a 70-year-old often makes the message clearer.
The new edition also incorporates updated recommendations from the Spanish Society of Arteriosclerosis on diet and CV prevention, as well as clinical practice recommendations derived from the society’s consensus on lipoprotein(a).
In addition, the standards integrate guidance from various international and national guidelines published in the past 2 years. These include the 2025 European update on dyslipidemia, American guidelines on hypertension, Spanish guidelines on obesity, the American Diabetes Association standards, Canadian guidelines on tobacco cessation, and European guidelines on atrial fibrillation.
Ferrer, part of Grupo Ferrer Internacional SA, provided support for the publication and administrative support for updating the Spanish Society of Arteriosclerosis 2026. However, the company had no role in drafting or deciding the content of the document.
This story was translated from El Medico Interactivo, part of the Medscape Professional Network.
