title: Pulse wave velocity and carotid atherosclerosis in white and Latino patients with hypertension.
abstract: BACKGROUND
  Preventive cardiology has expanded beyond coronary heart disease towards prevention of a broader spectrum of cardiovascular diseases. Ethnic minorities are at proportionately greater risk for developing extracoronary vascular disease including heart failure and cerebrovascular disease.
  
  
  METHODS
  We performed a cross sectional study of Latino and White hypertension patients in a safety-net healthcare system. Framingham risk factors, markers of inflammation (hsCRP, LPpLA2), arterial stiffness (Pulse wave velocity, augmentation index, and central aortic pressure), and endothelial function (brachial artery flow-mediated dilatation) were measured. Univariate and multivariable associations between these parameters and an index of extracoronary atherosclerosis (carotid intima media thickness) was performed.
  
  
  RESULTS
  Among 177 subjects, mean age was 62 years, 67% were female, and 67% were Latino. In univariate analysis, markers associated with carotid intima media thickness (IMT) at p<0.25 included pulse wave velocity (PWV), augmentation index (AIx), central aortic pressure (cAP), and LpPLA2 activity rank. However, AIx, cAP, and LpPLA2 activity were not significantly associated with carotid IMT after adjusting for Framingham risk factors (all p>.10). Only PWV retained a significant association with carotid IMT independent of the Framingham general risk profile parameters (p=.016). No statistically significant interactions between Framingham and other independent variables with ethnicity (all p>.05) were observed.
  
  
  CONCLUSIONS
  In this safety net cohort, PWV is a potentially useful adjunctive atherosclerotic risk marker independent of traditional risk factors and irrespective of ethnicity.
authors.affiliation: Cardiology Division, Denver Health Medical Center, Denver, USA. mkrantz@dhha.org
authors.forename: Mori J
authors.initials: MJ
authors.lastname: Krantz
authors.forename: Carlin S
authors.initials: CS
authors.lastname: Long
authors.forename: Patrick
authors.initials: P
authors.lastname: Hosokawa
authors.forename: Elhum
authors.initials: E
authors.lastname: Karimkahani
authors.forename: Miriam
authors.initials: M
authors.lastname: Dickinson
authors.forename: Raymond O
authors.initials: RO
authors.lastname: Estacio
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Masoudi
authors.forename: Edward P
authors.initials: EP
authors.lastname: Havranek
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D002340:Carotid Artery Diseases / Q000208:ethnology* / Q000503:physiopathology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006630:Hispanic or Latino / Q000208:ethnology*; D006801:Humans; D006973:Hypertension / Q000208:ethnology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D044465:White People / Q000208:ethnology*