The need for better stratification of cardiovascular (CV) risk in primary and secondary prevention has prompted numerous studies of vascular biomarkers. A critical review of peripheral, non-coronary, vascular biomarkers in CV prevention and their potential integration into clinical practice was published by the European Society of Cardiology (ESC) Working Group on peripheral circulation in 2015. Among seven evaluated vascular biomarkers, the best evidence of the potential benefits showed carotid ultrasound (intima-media thickness and carotid plaques), ankle - brachial index (ABI) and carotid - femoral pulse wave velocity. It is important to emphasize that so far, there is no evidence that one vascular biomarker is superior to the other. (1, 2)

In this lecture we will show the most important data on the three vascular biomarkers, their limitations and weaknesses, and recommendations on the use of vascular biomarkers according to the ESC guidelines on CV prevention. In conclusion, routine measurement of vascular biomarkers in the assessment of CV risk is not recommended. Rational use of vascular biomarkers primarily in people with moderate CV risk may improve prevention of CV diseases.