title: Aortic stiffness is an independent predictor of stroke in hypertensive patients.
abstract: BACKGROUND
  Cardiovascular disease remains the leading cause of death in developed countries and is not entirely predicted by classic risk factors. Increased arterial stiffness is an important determinant of cardiovascular morbidity and mortality.
  
  
  OBJECTIVE
  To assess whether Aortic Pulse Wave Velocity (PWV) predicts the occurrence of stroke in hypertensive patients
  
  
  METHODS
  A cohort, observational and prospective study, including 1133 hypertensive patients (586 men), with a mean age 51.05 ± 12.64 years, was designed. PWV with the Complior method was performed in all patients, as well as a detailed clinical evaluation and blood pressure measurement.
  
  
  RESULTS
  The cumulative incidence of stroke in hypertensive patients with increased PWV was 3.25% (CI: 1.97% -5.25%), compared with 0.78% (CI: 0.28% -1.87%) in hypertensive patients with normal PWV (Risk Ratio (RR) =4.15; CI:1.53-11.26). In a multivariate analysis, adjusting the model to classical cardiovascular risk factors, PWV was an independent predictor of stroke, with a Hazard Ratio (HR) = 1.40 (CI:1.13-1.73, p<0.001), indicating a 40% increase in the risk of stroke per 1m/s increment in PWV. The addition of PWV to a model consisting of conventional cardiovascular risk factors significantly improved the discriminative capacity for stroke (Harrell's C increased from 0.68 to 0.71 after the inclusion of the PWV; p<0.01).
  
  
  CONCLUSIONS
  Aortic PWV is a risk factor for stroke in hypertensive patients, and its integration into clinical follow-up programs in patients whose cardiovascular risk is manifest is strongly recommended.
authors.affiliation: Escola Superior de Tecnologia da Saúde de Coimbra - Departamento de Cardiopneumologia1, Coimbra, Portugal. telmopereira@spc.pt
authors.forename: Telmo
authors.initials: T
authors.lastname: Pereira
authors.forename: João
authors.initials: J
authors.lastname: Maldonado
authors.forename: Liliana
authors.initials: L
authors.lastname: Pereira
authors.forename: Jorge
authors.initials: J
authors.lastname: Conde
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000503:physiopathology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis / Q000379:methods*; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000517:prevention & control; D059289:Vascular Stiffness / Q000502:physiology*; D055815:Young Adult