title: Prognostic impact of regional arterial stiffness in hypertensive patients.
abstract: Many reports have shown that brachial-ankle pulse wave velocity (baPWV) and carotid-femoral PWV are prognostic factors for cardiovascular diseases. We evaluated heart-carotid PWV, heart-femoral PWV (hfPWV), and femoral-ankle PWV (faPWV) using carotid and femoral sensors. Our objectives were to reveal correlations among PWVs and to determine the clinical importance of the respective PWVs in predicting the cardiovascular events. This prospective cohort study included 338 patients with essential hypertension (mean age 61.3 ± 0.7, mean follow-up period 6.5 ± 0.1 years) whose regional PWVs were measured. Primary end points were stroke, cardiovascular diseases (CVD), and death. Kaplan-Meier analysis showed that subjects with higher faPWV and baPWV had a significantly higher incidence of stroke (p = 0.0288 and 0.0277, respectively), subjects with higher hfPWV had a significantly higher incidence of CVD (p = 0.0212), subjects with higher baPWV and hfPWV had a significantly higher incidence of stroke + CVD (p = 0.0070 and 0.0463, respectively), and subjects with higher baPWV had a significantly higher mortality rate (p = 0.0367). Cox proportional hazard model revealed that baPWV was a significant risk factor for stroke + CVD after adjustment for traditional risk factors (relative risk: 14.50, p = 0.0288). Higher baPWV may be a risk factor for stroke and CVD, but the prognostic impact of regional PWVs is still unclear in patients with hypertension.
authors.affiliation: Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka (B6), Suita, Osaka, 565-0871, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kawai
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ohishi
authors.forename: Miyuki
authors.initials: M
authors.lastname: Onishi
authors.forename: Norihisa
authors.initials: N
authors.lastname: Ito
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Takeya
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Oguro
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Takami
authors.forename: Koichi
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Hiromi
authors.initials: H
authors.lastname: Rakugi
mesh_terms: D055109:Ankle Brachial Index; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D012307:Risk Factors; D020521:Stroke / Q000401:mortality / Q000503:physiopathology; D013997:Time Factors; D059289:Vascular Stiffness