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Arterial Stiffness and Cardiovascular Events in Hypertensives

  • Hypertension (M Safar, Section Editor)
  • Published:
Current Cardiovascular Risk Reports Aims and scope Submit manuscript

Abstract

A major reason for measuring arterial stiffness routinely in clinical practice in hypertensive patients comes from the recent demonstration that arterial stiffness has predictive value for cardiovascular events, which is independent of classical risk scores. In primary prevention, some “imaging biomarkers,” such as arterial stiffness, enhance risk prediction to a higher extent than “circulating biomarkers.” The aim of the present brief review is to address the concept of “surrogate endpoint” and to determine whether aortic stiffness meets the criteria that are requested by international guidelines: (1) Proof of concept: Do novel marker levels differ between subjects with and without outcome? (2) Prospective validation: Does the novel marker predict development of future outcomes in a prospective cohort or nested case-cohort study? (3) Incremental value: Does the novel marker add predictive information to established, standard risk markers? (4) Clinical utility: Does the novel risk marker change predicted risk sufficiently to change recommended therapy? (5) Clinical outcomes: Does use of the novel risk marker improve clinical outcomes, especially when tested in a randomized clinical trial? (6) Cost-effectiveness: Does use of the novel risk marker improve clinical outcomes sufficiently to justify the additional costs? In conclusion, although aortic stiffness meets the first 4 criteria, there is still a need for studies comparing aortic stiffness-guided therapeutic strategies with classic guidelines-guided strategies for preventing cardiovascular events.

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Source of Funding

INSERM (Institut National de la Santé et de la Recherche Médicale), Assistance-Publique Hôpitaux de Paris, Université Paris Descartes.

Conflict of Interest

S. Laurent declares that he has no conflict of interest.

P. Boutouyrie declares that he has no conflict of interest.

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Authors and Affiliations

  1. INSERM U970; Department of Pharmacology and Hôpital Européen Georges Pompidou, Université Paris-Descartes, Assistance-Publique Hôpitaux de Paris, Paris, France

    Stéphane Laurent & Pierre Boutouyrie

  2. Department of Pharmacology and INSERM U970, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, 20, rue Leblanc, 75015, Paris, France

    Stéphane Laurent

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  1. Stéphane Laurent
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  2. Pierre Boutouyrie
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Correspondence to Stéphane Laurent.

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Laurent, S., Boutouyrie, P. Arterial Stiffness and Cardiovascular Events in Hypertensives. Curr Cardiovasc Risk Rep 7, 238–243 (2013). https://doi.org/10.1007/s12170-013-0313-1

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  • DOI: https://doi.org/10.1007/s12170-013-0313-1

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