Clinical usefulness and limitations of brachial-ankle pulse wave velocity in the evaluation of cardiovascular complications in hypertensive patients.
The goal of this study was to clarify the clinical usefulness and limitations of brachial-ankle pulse wave velocity (PWV) to evaluate hypertensive complications, in comparison with carotid-femoral PWV. Patients with essential hypertension (n=296, male/female=161/135; age=61.1+/-0.7 years) were enrolled. We measured brachial-ankle PWV, femoral-ankle PWV and carotid-femoral PWV simultaneously, and evaluated target organ damage and associated clinical conditions (cerebrovascular and cardiovascular disease) using the World Health Organization classification modified in 1999. Carotid-femoral PWV (p<0.0001; r=0.521) and brachial-ankle PWV (p<0.0001; r=0.478) but not femoral-ankle PWV were significantly correlated with age. Carotid-femoral PWV was significantly higher in patients with associated clinical conditions compared with that in patients with target organ damage (p<0.05) and those with no complications (p<0.0001). Brachial-ankle PWV was significantly higher in patients with associated clinical conditions (p<0.05) and target organ damage (p<0.05) compared to those with no complications, but there was no significant difference in brachial-ankle PWV between these two groups. Moreover, femoral-ankle PWV was significantly lower in patients with associated clinical conditions compared with that in patients with target organ damage (p<0.05). These data suggest that brachial-ankle PWV could underestimate arterial stiffness in hypertensive patients with a history of cardiovascular events.
Ito
Norihisa
N
Department of Geriatric Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
Ohishi
Mitsuru
M
Takagi
Takashi
T
Terai
Minako
M
Shiota
Atsushi
A
Hayashi
Norihiro
N
Rakugi
Hiromi
H
Ogihara
Toshio
T
D000842:Ankle; D001916:Brachial Artery / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology; D002339:Carotid Arteries / Q000503:physiopathology; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011674:Pulse / Q000379:methods*; D012372:ROC Curve