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Prognostic impact of regional arterial stiffness in hypertensive patients

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Abstract

Many reports have shown that brachial–ankle pulse wave velocity (baPWV) and carotid–femoral PWV are prognostic factors for cardiovascular diseases. We evaluated heart–carotid PWV, heart–femoral PWV (hfPWV), and femoral–ankle PWV (faPWV) using carotid and femoral sensors. Our objectives were to reveal correlations among PWVs and to determine the clinical importance of the respective PWVs in predicting the cardiovascular events. This prospective cohort study included 338 patients with essential hypertension (mean age 61.3 ± 0.7, mean follow-up period 6.5 ± 0.1 years) whose regional PWVs were measured. Primary end points were stroke, cardiovascular diseases (CVD), and death. Kaplan–Meier analysis showed that subjects with higher faPWV and baPWV had a significantly higher incidence of stroke (p = 0.0288 and 0.0277, respectively), subjects with higher hfPWV had a significantly higher incidence of CVD (p = 0.0212), subjects with higher baPWV and hfPWV had a significantly higher incidence of stroke + CVD (p = 0.0070 and 0.0463, respectively), and subjects with higher baPWV had a significantly higher mortality rate (p = 0.0367). Cox proportional hazard model revealed that baPWV was a significant risk factor for stroke + CVD after adjustment for traditional risk factors (relative risk: 14.50, p = 0.0288). Higher baPWV may be a risk factor for stroke and CVD, but the prognostic impact of regional PWVs is still unclear in patients with hypertension.

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References

  1. Blacher J, Asmar R, Djane S, London GM, Safar ME (1999) Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients. Hypertension 33:1111–1117

    Article  CAS  PubMed  Google Scholar 

  2. Weber T, Auer J, O’Rourke MF, Kvas E, Lassnig E, Berent R, Eber B (2004) Arterial stiffness, wave reflections, and the risk of coronary artery disease. Circulation 109:184–189

    Article  PubMed  Google Scholar 

  3. Rossi A, Bonapace S, Cicoira M, Conte L, Anselmi A, Vassanelli C (2013) Aortic stiffness: an old concept for new insights into the pathophysiology of functional mitral regurgitation. Heart Vessels 28:606–612

    Article  PubMed  Google Scholar 

  4. Mineoka Y, Fukui M, Tanaka M, Tomiyasu K, Akabame S, Nakano K, Yamazaki M, Hasegawa G, Oda Y, Nakamura N (2012) Relationship between cardio-ankle vascular index (CAVI) and coronary artery calcification (CAC) in patients with type 2 diabetes mellitus. Heart Vessels 27:160–165

    Article  PubMed  Google Scholar 

  5. Mitchell GF, Parise H, Benjamin EJ, Larson MG, Keyes MJ, Vita JA, Vasan RS, Levy D (2004) Changes in arterial stiffness and wave reflection with advancing age in healthy men and women: the Framingham Heart Study. Hypertension 43:1239–1245

    Article  CAS  PubMed  Google Scholar 

  6. Terai M, Ohishi M, Ito N, Takagi T, Tatara Y, Kaibe M, Komai N, Rakugi H, Ogihara T (2008) Comparison of arterial functional evaluations as a predictor of cardiovascular events in hypertensive patients: the Non-Invasive Atherosclerotic Evaluation in Hypertension (NOAH) study. Hypertens Res 31:1135–1145

    Article  PubMed  Google Scholar 

  7. Smulyan H, Asmar RG, Rudnicki A, London GM, Safar ME (2001) Comparative effects of aging in men and women on the properties of the arterial tree. J Am Coll Cardiol 37:1374–1380

    Article  CAS  PubMed  Google Scholar 

  8. Taniwaki H, Kawagishi T, Emoto M, Shoji T, Kanda H, Maekawa K, Nishizawa Y, Morii H (1999) Correlation between the intima-media thickness of the carotid artery and aortic pulse-wave velocity in patients with type 2 diabetes. Vessel wall properties in type 2 diabetes. Diabetes Care 22:1851–1857

    Article  CAS  PubMed  Google Scholar 

  9. Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, Ducimetiere P, Benetos A (2001) Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 37:1236–1241

    Article  CAS  PubMed  Google Scholar 

  10. Cortez-Cooper MY, Supak JA, Tanaka H (2003) A new device for automatic measurements of arterial stiffness and ankle-brachial index. Am J Cardiol 91(1519–1522):A9

    Google Scholar 

  11. Yamashina A, Tomiyama H, Takeda K, Tsuda H, Arai T, Hirose K, Koji Y, Hori S, Yamamoto Y (2002) Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res 25:359–364

    Article  PubMed  Google Scholar 

  12. Nakamura M, Yamashita T, Yajima J, Oikawa Y, Sagara K, Koike A, Kirigaya H, Nagashima K, Sawada H, Aizawa T; Shinken Database Study Group (2010) Brachial-ankle pulse wave velocity as a risk stratification index for the short-term prognosis of type 2 diabetic patients with coronary artery disease. Hypertens Res 33:1018–1024

    Article  Google Scholar 

  13. Takase H, Dohi Y, Toriyama T, Okado T, Tanaka S, Sonoda H, Sato K, Kimura G (2011) Brachial-ankle pulse wave velocity predicts increase in blood pressure and onset of hypertension. Am J Hypertens 24:667–673

    Article  PubMed  Google Scholar 

  14. Turin TC, Kita Y, Rumana N, Takashima N, Kadota A, Matsui K, Sugihara H, Morita Y, Nakamura Y, Miura K, Ueshima H (2010) Brachial-ankle pulse wave velocity predicts all-cause mortality in the general population: findings from the Takashima study, Japan. Hypertens Res 33:922–925

    Article  PubMed  Google Scholar 

  15. Ito N, Ohishi M, Takagi T, Terai M, Shiota A, Hayashi N, Rakugi H, Ogihara T (2006) Clinical usefulness and limitations of brachial-ankle pulse wave velocity in the evaluation of cardiovascular complications in hypertensive patients. Hypertens Res 29:989–995

    Article  PubMed  Google Scholar 

  16. Ohishi M, Tatara Y, Ito N, Takeya Y, Onishi M, Maekawa Y, Kato N, Kamide K, Rakugi H (2011) The combination of chronic kidney disease and increased arterial stiffness is a predictor for stroke and cardiovascular disease in hypertensive patients. Hypertens Res 34:1209–1215

    Article  PubMed  Google Scholar 

  17. Tanaka H, Munakata M, Kawano Y, Ohishi M, Shoji T, Sugawara J, Tomiyama H, Yamashina A, Yasuda H, Sawayama T, Ozawa T (2009) Comparison between carotid–femoral and brachial–ankle pulse wave velocity as measures of arterial stiffness. J Hypertens 27:2022–2027

    Article  CAS  PubMed  Google Scholar 

  18. Smith A, Karalliedde J, De Angelis L, Goldsmith D, Viberti G (2005) Aortic pulse wave velocity and albuminuria in patients with type 2 diabetes. J Am Soc Nephrol 16:1069–1075

    Article  PubMed  Google Scholar 

  19. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R (2002) Prospective studies collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 360:1903–1913

    Article  PubMed  Google Scholar 

  20. Toyama K, Sugiyama S, Oka H, Iwasaki Y, Sumida H, Tanaka T, Tayama S, Jinnouchi H, Ogawa H (2012) Combination treatment of rosuvastatin or atorvastatin, with regular exercise improves arterial wall stiffness in patients with coronary artery disease. PLoS One 7:e41369

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Shige H, Dart A, Nestel P (2001) Simvastatin improves arterial compliance in the lower limb but not in the aorta. Atherosclerosis 155:245–250

    Article  CAS  PubMed  Google Scholar 

  22. Kimoto E, Shoji T, Shinohara K, Inaba M, Okuno Y, Miki T, Koyama H, Emoto M, Nishizawa Y (2003) Preferential stiffening of central over peripheral arteries in type 2 diabetes. Diabetes 52:448–452

    Article  CAS  PubMed  Google Scholar 

  23. Pannier B, Guérin AP, Marchais SJ, Safar ME, London GM (2005) Stiffness of capacitive and conduit arteries: prognostic significance for end-stage renal disease patients. Hypertension 45:592–596

    Article  CAS  PubMed  Google Scholar 

  24. Kimoto E, Shoji T, Shinohara K, Hatsuda S, Mori K, Fukumoto S, Koyama H, Emoto M, Okuno Y, Nishizawa Y (2006) Regional arterial stiffness in patients with type 2 diabetes and chronic kidney disease. J Am Soc Nephrol 17:2245–2252

    Article  PubMed  Google Scholar 

  25. Mahmud A, Feely J (2004) Arterial stiffness and the renin-angiotensin-aldosterone system. J Renin Angiotensin Aldosterone Syst 5:102–108

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This study was funded by a Grant-in-Aid (no. 16590684) from the Ministry of Education, Science, and Culture and by a grant from the Japan Arteriosclerosis Prevention Fund.

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Correspondence to Mitsuru Ohishi.

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Kawai, T., Ohishi, M., Onishi, M. et al. Prognostic impact of regional arterial stiffness in hypertensive patients. Heart Vessels 30, 338–346 (2015). https://doi.org/10.1007/s00380-014-0485-8

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  • DOI: https://doi.org/10.1007/s00380-014-0485-8

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