title: Arterial stiffness from monitoring of timing of korotkoff sounds predicts the occurrence of cardiovascular events independently of left ventricular mass in hypertensive patients.
abstract: Several studies have established that the increase in arterial stiffness (AS) is a cardiovascular risk factor but to date no studies have evaluated in hypertensive patients its prognostic value in comparison with another powerful risk factor, left ventricular mass (LVM) as measured by echocardiography. We prospectively evaluated the prognostic value of AS and LVM in patients with essential hypertension. The population studied comprised 793 patients (56% men) aged 54±14 years. For 519 patients, baseline measurements were made before any antihypertensive treatment, for 274 patients, the measurement were obtained during the follow-up period under antihypertensive treatment. AS was assessed from ambulatory monitoring of blood pressure and timing of Korottkoff sounds. Left ventricular mass was measured in 523 patients. After a mean follow-up of 97 months, 122 cardiovascular events were recorded in the whole population and 74 in the group with LVM determination. AS as continuous or discontinuous variable was independently related to cardiovascular events. The existence or not of antihypertensive treatment at the time of its measurement did not affect its prognostic value. When LVM was forced in the model, AS remained significantly related to cardiovascular events. Thus, AS has an independent prognostic value in the hypertensive, whether measured before or after the administration of antihypertensive treatment. This prognostic value persists after taking LVM into account.
authors.affiliation: Department of Cardiology and Hypertension, University Hospital of Bordeaux, Bordeaux, France. philippe.gosse@chu-bordeaux.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Gosse
authors.forename: Antoine
authors.initials: A
authors.lastname: Cremer
authors.forename: Georgios
authors.initials: G
authors.lastname: Papaioannou
authors.forename: Sunthareth
authors.initials: S
authors.lastname: Yeim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001314:Auscultation; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult
keywords: QKD; ambulatory BP monitoring; arterial stiffness; cardiovascular events; left ventricular mass