Limitation of brachial-ankle pulse wave velocity in assessing the risk of stroke: importance of instantaneous blood pressure.
OBJECTIVE
The carotid-femoral pulse wave velocity is a well-established index of aortic stiffness, and the brachial-ankle pulse wave velocity (baPWV) has recently been developed as a new method for evaluating arterial stiffness. However, whether the baPWV is also useful in evaluating the risk of stroke is currently controversial. Moreover, it is also unknown which types of stroke and neuroradiological findings are associated with increased arterial stiffness. We investigated the association between the baPWV and risk of stroke using a case-control design.


METHODS
This study enrolled 223 stroke patients (aged 65.6 +/- 10.3 years, mean +/- SD) and the same number of age- and sex-matched controls. All of the subjects in this study underwent a structured interview and had their vascular risk factors assessed. We reviewed brain magnetic resonance imaging and magnetic resonance angiography data of stroke patients to assessthe severity of white-matter hyperintensity lesions, number of cerebral microbleeds, and the stenosis of both intracranial and extracranial arteries. The baPWV was measured noninvasively by an oscillometric method.


RESULTS
The baPWV was most affected by the instantaneous systolic blood pressure, and was significantly higher in stroke patients than control subjects (1,721 +/- 395 cm/s vs. 1,657 +/- 366 cm/s, p = 0.03). However, the baPWV did not differ significantly with a specific type of stroke or subtype of ischemic stroke. Multiple regression analysis revealed that the baPWV was not independently associated with increased risk of stroke, or the severity of white-matter hyperintensity lesions or cerebral microbleeds.


CONCLUSIONS
Although the baPWV was significantly higher in stroke patients than control subjects, it was not independently associated with increased risk of stroke or specific subtypes of ischemic stroke or neuroradiological findings.
Choi
Jay Chol
JC
Department of Neurology and Institute of Medical Science, Cheju National University, Jeju, Korea.
Lee
Jung Seok
JS
Kang
Sa-Yoon
SY
Kang
Ji-Hoon
JH
Bae
Jong-Myon
JM
Lee
Dae-Hie
DH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D001161:Arteriosclerosis / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D001916:Brachial Artery / Q000502:physiology*; D001921:Brain / Q000098:blood supply / Q000473:pathology; D002339:Carotid Arteries / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D005263:Femoral Artery / Q000502:physiology; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*