(Hypertension. 1999;33:1111-1117.)
© 1999 American Heart Association, Inc.
Scientific Contributions |
Aortic Pulse Wave Velocity as a Marker of Cardiovascular Risk in Hypertensive Patients
From the Department of Internal Medicine and Inserm U 337, Broussais Hospital, Paris, France.
Correspondence to Pr M. Safar, Service de Médecine Interne, 96, rue Didot, Hôpital Broussais, 75014 Paris, France. E-mail michel.safar{at}brs.ap-hop-paris.fr
Abstract—Large artery damage is a major contributory factor to cardiovascular morbidity and mortality of patients with hypertension. Pulse wave velocity (PWV), a classic evaluation of arterial distensibility, has never been ascertained as a cardiovascular risk marker. To determine the factors influencing aortic PWV and the potential predictor role of this measurement, we studied a cohort of 710 patients with essential hypertension. Atherosclerosis alterations (AA) were defined on the basis of clinical events. Calculation of cardiovascular risks, by use of Framingham equations, was performed in subjects without AA. PWV was higher in the presence of AA (14.9±4.0 versus 12.4±2.6 m/s, P<0.0001), even after adjustments on confounding factors and was the first determinant (P<0.0001) of the extent of atherosclerosis assessed as the sum of the atherosclerotic sites. In patients without AA, all cardiovascular risks increased constantly with PWV. Furthermore, at a given age, aortic PWV was the best predictor of cardiovascular mortality. The odds ratio of being in a high cardiovascular mortality risk group (>5% for 10 years) for patients in the upper quartile of PWV was 7.1 (95% confidence intervals 4.5 to 11.3). The presence of a PWV >13 m/s, taken alone, appeared as a strong predictor of cardiovascular mortality with high performance values. This study shows that aortic PWV is strongly associated with the presence and extent of atherosclerosis and constitutes a forceful marker and predictor of cardiovascular risk in hypertensive patients.
Key Words: atherosclerosis • hypertension, essential • aortic stiffness • cardiovascular risk
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 K. L. Kwok, D. K. K. Ng, and Y. F. Cheung BP and Arterial Distensibility in Children With Primary Snoring Chest, May 1, 2003; 123(5): 1561 - 1566. [Abstract] [Full Text] [PDF]
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M Kidawa, M Krzeminska-Pakula, J Z Peruga, and J D Kasprzak Arterial dysfunction in syndrome X: results of arterial reactivity and pulse wave propagation tests Heart, April 1, 2003; 89(4): 422 - 426. [Abstract] [Full Text] [PDF]
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J. J. Oliver and D. J. Webb Noninvasive Assessment of Arterial Stiffness and Risk of Atherosclerotic Events Arterioscler. Thromb. Vasc. Biol., April 1, 2003; 23(4): 554 - 566. [Abstract] [Full Text] [PDF]
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H. Ohnishi, S. Saitoh, S. Takagi, J.-i. Ohata, T. Isobe, Y. Kikuchi, H. Takeuchi, and K. Shimamoto Pulse Wave Velocity as an Indicator of Atherosclerosis in Impaired Fasting Glucose: The Tanno and Sobetsu Study Diabetes Care, February 1, 2003; 26(2): 437 - 440. [Abstract] [Full Text] [PDF]
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E. G. Lakatta and D. Levy Arterial and Cardiac Aging: Major Shareholders in Cardiovascular Disease Enterprises: Part I: Aging Arteries: A "Set Up" for Vascular Disease Circulation, January 7, 2003; 107(1): 139 - 146. [Full Text] [PDF]
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A. Mahmud and J. Feely Effect of Smoking on Arterial Stiffness and Pulse Pressure Amplification Hypertension, January 1, 2003; 41(1): 183 - 187. [Abstract] [Full Text] [PDF]
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J Amar, B Chamontin, J Ferrieres, N Danchin, O Grenier, C Cantet, and J-P Cambou Hypertension control at hospital discharge after acute coronary event: influence on cardiovascular prognosis--the PREVENIR study Heart, December 1, 2002; 88(6): 587 - 591. [Abstract] [Full Text] [PDF]
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D. M. Tham, B. Martin-McNulty, Y.-X. Wang, V. Da Cunha, D. W. Wilson, C. N. Athanassious, A. F. Powers, M. E. Sullivan, and J. C. Rutledge Angiotensin II injures the arterial wall causing increased aortic stiffening in apolipoprotein E-deficient mice Am J Physiol Regulatory Integrative Comp Physiol, December 1, 2002; 283(6): R1442 - R1449. [Abstract] [Full Text] [PDF]
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C. S. Hayward, A. P. Avolio, M. F. O'Rourke, P. Lantelme, C. Mestre, M. Lievre, A. Gressard, and H. Milon Arterial Pulse Wave Velocity and Heart Rate * Response: Heart Rate and Pulse Wave Velocity Hypertension, December 1, 2002; e9(6): . [Full Text] [PDF]
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Y.F. Cheung, G. C.F. Chan, and S.Y. Ha Arterial Stiffness and Endothelial Function in Patients With {beta}-Thalassemia Major Circulation, November 12, 2002; 106(20): 2561 - 2566. [Abstract] [Full Text] [PDF]
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A. Singhal, I. S. Farooqi, T. J. Cole, S. O'Rahilly, M. Fewtrell, M. Kattenhorn, A. Lucas, and J. Deanfield Influence of Leptin on Arterial Distensibility: A Novel Link Between Obesity and Cardiovascular Disease? Circulation, October 8, 2002; 106(15): 1919 - 1924. [Abstract] [Full Text] [PDF]
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K. Obuobie, J. Smith, L. M. Evans, R. John, J. S. Davies, and J. H. Lazarus Increased Central Arterial Stiffness in Hypothyroidism J. Clin. Endocrinol. Metab., October 1, 2002; 87(10): 4662 - 4666. [Abstract] [Full Text] [PDF]
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 Y F Cheung, P A Brogan, C B Pilla, M J Dillon, and A N Redington Arterial distensibility in children and teenagers: normal evolution and the effect of childhood vasculitis Arch. Dis. Child., October 1, 2002; 87(4): 348 - 351. [Abstract] [Full Text] [PDF]
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R. Asmar, P. Gosse, J. Topouchian, G. N'tela, A. Dudley, and G. L Shepherd Effects of telmisartan on arterial stiffness in Type 2 diabetes patients with essential hypertension Journal of Renin-Angiotensin-Aldosterone System, September 1, 2002; 3(3): 176 - 180. [Abstract] [PDF]
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I. Wakabayashi, R. Kobaba-Wakabayashi, and H. Masuda Relation of Drinking Alcohol to Atherosclerotic Risk in Type 2 Diabetes Diabetes Care, July 1, 2002; 25(7): 1223 - 1228. [Abstract] [Full Text] [PDF]
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J.-J. Mourad, G. Ducailar, A. Rudnicki, M. Lajemi, A. Mimran, and M. E Safar Age-related increase of pulse pressure and gene polymorphisms in essential hypertension: a preliminary study Journal of Renin-Angiotensin-Aldosterone System, June 1, 2002; 3(2): 109 - 115. [Abstract] [PDF]
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P. Lantelme, C. Mestre, M. Lievre, A. Gressard, and H. Milon Heart Rate: An Important Confounder of Pulse Wave Velocity Assessment Hypertension, June 1, 2002; 39(6): 1083 - 1087. [Abstract] [Full Text] [PDF]
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M. O'Rourke Target organ damage: use of pulse wave analysis as a manifestation of aortic degeneration in the assessment of hypertension Vascular Medicine, May 1, 2002; 7(2): 83 - 85. [PDF]
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J. Blacher and M. Safar Specific aspects of high blood pressure in the elderly Journal of Renin-Angiotensin-Aldosterone System, March 1, 2002; 3(1_suppl): S10 - S15. [PDF]
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J. Ribstein, G. Du Cailar, and A. Zanchetti Cardiac and renal damage in the elderly hypertensive Journal of Renin-Angiotensin-Aldosterone System, March 1, 2002; 3(1_suppl): S16 - S24. [PDF]
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C. J. G. Kelly, A. Speirs, G. W. Gould, J. R. Petrie, H. Lyall, and J. M. C. Connell Altered Vascular Function in Young Women with Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., February 1, 2002; 87(2): 742 - 746. [Abstract] [Full Text] [PDF]
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