Pulse wave velocity in familial combined hyperlipidemia.
BACKGROUND
In the present cross-sectional study we investigated whether familial combined hyperlipidemia (FCH) is associated with an increased arterial wall stiffness, and whether measures of arterial wall stiffness in FCH family members could contribute to cardiovascular risk stratification.


METHODS
Ninety-eight subjects with FCH and 230 unaffected relatives filled out a questionnaire about their smoking habits, medical history, and medication use. Fasting venous blood was drawn after discontinuation of any lipid-lowering medication. Pulse wave velocity (PWV) and augmentation index (AIx) were determined by applanation tonometry as surrogate markers of arterial stiffness.


RESULTS
Patients with FCH had a significantly increased PWV compared to their unaffected relatives (9.07 +/- 2.75 v 8.28 +/- 2.62 m/sec, P = .005), whereas AIx was not increased (21.6 +/- 12.7 v 15.6 +/- 14.1, P = .96). Age- and gender-adjusted PWV was an equally good predictor of the presence of cardiovascular disease (CVD) in FCH family members as the most predictive combination of age- and gender-adjusted clinical and biochemical risk factors, including total cholesterol, HDL-cholesterol, and systolic blood pressure (area under the receiver operating curve (ROC) [AUC] 0.83 [0.76-0.90] v AUC 0.84 [0.78-0.91], P = .83). Addition of PWV to the multivariable prognostic model, including these age- and gender-adjusted traditional risk factors, did not increase the predictive ability for CVD (AUC 0.84 [0.79-0.89]).


CONCLUSIONS
Patients with FCH are characterized by an increased arterial stiffness. The PWV predicts the presence of CVD equally well as any combination of clinical and traditional biochemical risk factors, but PWV has no additional value in addition to traditional risk factor screening in FCH families.
ter Avest
Ewoud
E
Department of Medicine, Division of General Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. e.teravest@aig.umcn.nl
Holewijn
Suzanne
S
Bredie
Sebastian J H
SJ
van Tits
Lambertus J H
LJ
Stalenhoef
Anton F H
AF
de Graaf
Jacqueline
J
D000328:Adult; D000367:Age Factors; D001158:Arteries / Q000503:physiopathology*; D001783:Blood Flow Velocity; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000503:physiopathology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004548:Elasticity; D006801:Humans; D006950:Hyperlipidemia, Familial Combined / Q000150:complications / Q000503:physiopathology*; D016014:Linear Models; D016015:Logistic Models; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011673:Pulsatile Flow; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012737:Sex Factors