Aortic pulse wave velocity predicts cardiovascular mortality in subjects >70 years of age.
Aortic pulse wave velocity (PWV) is a significant and independent predictor of cardiovascular mortality in subjects with essential hypertension and in patients with end-stage renal disease. Its contribution to cardiovascular risk in subjects 70 to 100 years old has never been tested. A cohort of 141 subjects (mean+/-SD age, 87.1+/-6.6 years) was studied in 3 geriatrics departments in a Paris suburb. Together with sphygmomanometric blood pressure measurements, aortic PWV was measured with a validated automatic device. During the 30-month follow-up, 56 patients died (27 from cardiovascular events). Logistic regressions indicated that age (P=0.005) and a loss of autonomy (P=0.01) were the best predictors of overall mortality. For cardiovascular mortality, aortic PWV was the major risk predictor (P=0.016). The odds ratio was 1.19 (95% confidence interval, 1.03 to 1.37). Antihypertensive drug treatment and blood pressure, including systolic and pulse pressure, had no additive role. In subjects 70 to 100 years old, aortic PWV is a strong, independent predictor of cardiovascular death, whereas systolic or pulse pressure was not. This prospective result will need to be confirmed in an intervention trial.
Meaume
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Geriatrics Department of Charles-Foix Hospital, Limeil-Brevannes, France.
Benetos
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Henry
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Rudnichi
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Safar
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D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000503:physiopathology; D001158:Arteries / Q000503:physiopathology*; D001783:Blood Flow Velocity; D001795:Blood Pressure Determination; D001916:Brachial Artery / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000401:mortality*; D002339:Carotid Arteries / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies; D011673:Pulsatile Flow; D015996:Survival Rate