Relationship of fibrinogen with arterial stiffness and wave reflections.
BACKGROUND
Increased levels of fibrinogen have been related to target organ damage and cardiovascular outcomes. Arterial elastic properties are important determinants of cardiovascular performance and predictors of the corresponding risk. This study investigated whether the fibrinogen level is associated with arterial stiffness and wave reflections.


METHODS
We studied 229 consecutive, non-diabetic patients with uncomplicated, never-treated essential hypertension (mean age 51 years, 149 men) and an age-matched control group of 159 normotensive individuals (mean age 50 years, 83 men). Carotid-femoral and carotid-radial pulse wave velocity (PWVc-f and PWVc-r) were measured as indices of elastic-type, aortic stiffness and muscular type, medium-sized arterial stiffness, respectively. The heart rate-corrected augmentation index (AIx75) was estimated as a composite marker of wave reflections and arterial stiffness. Plasma fibrinogen was measured using immunonephelometry.


RESULTS
The fibrinogen level and arterial function indices (PWVc-f, PWVc-r, AIx75) were significantly higher in hypertensive patients than controls. In the whole population, fibrinogen level correlated with PWVc-f and AIx75 in univariable analysis, but not with PWVc-r. In multivariable analysis, an independent association was established between fibrinogen level and PWVc-f after adjusting for age, sex, mean pressure, heart rate, height, body mass index, smoking status, and total cholesterol. In contrast, no significant relationship was observed between fibrinogen and AIx75 after adjusting for confounders.


CONCLUSIONS
The plasma fibrinogen level is independently associated with aortic stiffening. This finding underlines the important role of fibrinogen as a marker of arterial damage, and implies a possible contribution of this compound to the pathophysiology of cardiovascular disease.
Vlachopoulos
Charalambos
C
Hypertension Unit, 1st Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece. cvlachop@otenet.gr
Pietri
Panagiota
P
Aznaouridis
Konstantinos
K
Vyssoulis
Gregory
G
Vasiliadou
Carmen
C
Bratsas
Athanasios
A
Tousoulis
Dimitris
D
Xaplanteris
Panagiotis
P
Stefanadi
Elli
E
Stefanadis
Christodoulos
C
D000328:Adult; D001158:Arteries / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology; D016022:Case-Control Studies; D004548:Elasticity; D005260:Female; D005340:Fibrinogen / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011674:Pulse; D012307:Risk Factors
D015415:Biomarkers; D005340:Fibrinogen