Hypertension. 2002;39:10-15
doi: 10.1161/hy0102.099031
doi: 10.1161/hy0102.099031
(Hypertension. 2002;39:10.)
© 2002 American Heart Association, Inc.
Scientific Contributions |
Aortic Stiffness Is an Independent Predictor of Primary Coronary Events in Hypertensive Patients
A Longitudinal Study
From the Department of Pharmacology and INSERM EMI 0107, Hôpital Européen Georges Pompidou (P.B., A.I.T., I.G., P.L., S.L.); Institut de Formation et de Recherche Cardiovasculaire (R.A.); and INSERM U 258, IPC Center (A.B.), Paris, France.
Correspondence to Professeur Stéphane Laurent, Service de Pharmacologie, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, 20 Rue Leblanc, 75908 Paris Cedex 15, France. E-mail stephane.laurent{at}egp.ap-hop-Paris.fr
Arterial stiffness may predict coronary heart disease beyond classic risk factors. In a longitudinal study, we assessed the predictive value of arterial stiffness on coronary heart disease in patients with essential hypertension and without known clinical cardiovascular disease. Aortic stiffness was determined from carotid-femoral pulse wave velocity at baseline in 1045 hypertensives. The risk assessment of coronary heart disease was made by calculating the Framingham risk score according to the categories of gender, age, blood pressure, cholesterol, diabetes, and smoking. Mean age at entry was 51 years, and mean follow-up was 5.7 years. Coronary events (fatal and nonfatal myocardial infarction, coronary revascularization, and angina pectoris) and all cardiovascular events served as outcome variables in Cox proportional-hazard regression models. Fifty-three coronary events and 97 total cardiovascular events occurred. In univariate analysis, the relative risk of follow-up coronary event or any cardiovascular event increased with increasing level of pulse wave velocity; for 1 SD, ie, 3.5 m/s, relatives risks were 1.42 (95% confidence interval [CI], 1.10 to 1.82; P<0.01) and 1.41 (95% CI, 1.17 to 1.70; P<0.001), respectively. Framingham score significantly predicted the occurrence of coronary and all cardiovascular events in this population (P<0.01 and P<0.0001, respectively). In multivariate analysis, pulse wave velocity remained significantly associated with the occurrence of coronary event after adjustment either of Framingham score (for 3.5 m/s: relative risk, 1.34; 95% CI, 1.01 to 1.79; P=0.039) or classic risk factors (for 3.5 m/s: relative risk, 1.39; 95% CI, 1.08 to 1.79; P=0.01). Parallel results were observed for all cardiovascular events. This study provides the first direct evidence in a longitudinal study that aortic stiffness is an independent predictor of primary coronary events in patients with essential hypertension.
Key Words: arterial stiffness • cardiovascular morbidity • cardiovascular mortality • coronary heart disease
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 S.-H. H. Juo, T. Rundek, H.-F. Lin, R. Cheng, M.-Y. Lan, J. S. Huang, B. Boden-Albala, and R. L. Sacco Heritability of Carotid Artery Distensibility in Hispanics: The Northern Manhattan Family Study Stroke, November 1, 2005; 36(11): 2357 - 2361. [Abstract] [Full Text] [PDF]
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F.A. Sayed-Tabatabaei, M.J.E. van Rijn, A.F.C. Schut, Y.S. Aulchenko, E.A. Croes, M.C. Zillikens, H.A.P. Pols, J.C.M. Witteman, B.A. Oostra, and C.M. van Duijn Heritability of the Function and Structure of the Arterial Wall: Findings of the Erasmus Rucphen Family (ERF) Study Stroke, November 1, 2005; 36(11): 2351 - 2356. [Abstract] [Full Text] [PDF]
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S. Van Doornum, G. McColl, and I. P. Wicks Tumour necrosis factor antagonists improve disease activity but not arterial stiffness in rheumatoid arthritis Rheumatology, November 1, 2005; 44(11): 1428 - 1432. [Abstract] [Full Text] [PDF]
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A. K. Natoli, T. L. Medley, A. A. Ahimastos, B. G. Drew, D. J. Thearle, R. J. Dilley, and B. A. Kingwell Sex Steroids Modulate Human Aortic Smooth Muscle Cell Matrix Protein Deposition and Matrix Metalloproteinase Expression Hypertension, November 1, 2005; 46(5): 1129 - 1134. [Abstract] [Full Text] [PDF]
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 C. Meyer, B. P. McGrath, and H. J. Teede Overweight Women with Polycystic Ovary Syndrome Have Evidence of Subclinical Cardiovascular Disease J. Clin. Endocrinol. Metab., October 1, 2005; 90(10): 5711 - 5716. [Abstract] [Full Text] [PDF]
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J A Vita Endothelial function and clinical outcome Heart, October 1, 2005; 91(10): 1278 - 1279. [Full Text] [PDF]
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J. T. Powell, R. J. Turner, M. Sian, R. Debasso, and T. Lanne Influence of fibrillin-1 genotype on the aortic stiffness in men J Appl Physiol, September 1, 2005; 99(3): 1036 - 1040. [Abstract] [Full Text] [PDF]
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 R. R. Sankatsing, S. W. Fouchier, S. de Haan, B. A. Hutten, E. de Groot, J. J.P. Kastelein, and E. S.G. Stroes Hepatic and Cardiovascular Consequences of Familial Hypobetalipoproteinemia Arterioscler Thromb Vasc Biol, September 1, 2005; 25(9): 1979 - 1984. [Abstract] [Full Text] [PDF]
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 C. Williams, B. A Kingwell, K. Burke, J. McPherson, and A. M Dart Folic acid supplementation for 3 wk reduces pulse pressure and large artery stiffness independent of MTHFR genotype Am. J. Clinical Nutrition, July 1, 2005; 82(1): 26 - 31. [Abstract] [Full Text] [PDF]
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J. N. Cohn, D. A. Duprez, and G. A. Grandits Arterial Elasticity as Part of a Comprehensive Assessment of Cardiovascular Risk and Drug Treatment Hypertension, July 1, 2005; 46(1): 217 - 220. [Abstract] [Full Text] [PDF]
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J. Bellien, R. Joannides, M. Iacob, P. Arnaud, and C. Thuillez Calcium-Activated Potassium Channels and NO Regulate Human Peripheral Conduit Artery Mechanics Hypertension, July 1, 2005; 46(1): 210 - 216. [Abstract] [Full Text] [PDF]
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M. J. Roman, R. B. Devereux, J. E. Schwartz, M. D. Lockshin, S. A. Paget, A. Davis, M. K. Crow, L. Sammaritano, D. M. Levine, B.-A. Shankar, et al. Arterial Stiffness in Chronic Inflammatory Diseases Hypertension, July 1, 2005; 46(1): 194 - 199. [Abstract] [Full Text] [PDF]
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M. F. O'Rourke and M. E. Safar Relationship Between Aortic Stiffening and Microvascular Disease in Brain and Kidney: Cause and Logic of Therapy Hypertension, July 1, 2005; 46(1): 200 - 204. [Abstract] [Full Text] [PDF]
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J. M. Dijk, A. Algra, Y. van der Graaf, D. E. Grobbee, M. L. Bots, and on behalf of the SMART study group Carotid stiffness and the risk of new vascular events in patients with manifest cardiovascular disease. The SMART study Eur. Heart J., June 2, 2005; 26(12): 1213 - 1220. [Abstract] [Full Text] [PDF]
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S. Laurent Arterial stiffness: intermediate or surrogate endpoint for cardiovascular events? Eur. Heart J., June 2, 2005; 26(12): 1152 - 1154. [Full Text] [PDF]
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A. E. DeVan, M. M. Anton, J. N. Cook, D. B. Neidre, M. Y. Cortez-Cooper, and H. Tanaka Acute effects of resistance exercise on arterial compliance J Appl Physiol, June 1, 2005; 98(6): 2287 - 2291. [Abstract] [Full Text] [PDF]
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S. Laurent, P. Boutouyrie, and P. Lacolley Structural and Genetic Bases of Arterial Stiffness Hypertension, June 1, 2005; 45(6): 1050 - 1055. [Abstract] [Full Text] [PDF]
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 Y. Fujiwara, P. H. M. Chaves, R. Takahashi, H. Amano, H. Yoshida, S. Kumagai, K. Fujita, D. G. Wang, and S. Shinkai Arterial Pulse Wave Velocity as a Marker of Poor Cognitive Function in an Elderly Community-Dwelling Population J. Gerontol. A Biol. Sci. Med. Sci., May 1, 2005; 60(5): 607 - 612. [Abstract] [Full Text] [PDF]
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D A Stakos, D P Schuster, E A Sparks, C F Wooley, K Osei, and H Boudoulas Long term cardiovascular effects of oral antidiabetic agents in non-diabetic patients with insulin resistance: double blind, prospective, randomised study Heart, May 1, 2005; 91(5): 589 - 594. [Abstract] [Full Text] [PDF]
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D. M. Sengstock, P. V. Vaitkevicius, and M. A. Supiano Arterial Stiffness Is Related to Insulin Resistance in Nondiabetic Hypertensive Older Adults J. Clin. Endocrinol. Metab., May 1, 2005; 90(5): 2823 - 2827. [Abstract] [Full Text] [PDF]
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 H. H. Dao, R. Essalihi, C. Bouvet, and P. Moreau Evolution and modulation of age-related medial elastocalcinosis: Impact on large artery stiffness and isolated systolic hypertension Cardiovasc Res, May 1, 2005; 66(2): 307 - 317. [Abstract] [Full Text] [PDF]
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J. A. Chirinos, J. P. Zambrano, S. Chakko, A. Veerani, A. Schob, H. J. Willens, G. Perez, and A. J. Mendez Aortic Pressure Augmentation Predicts Adverse Cardiovascular Events in Patients With Established Coronary Artery Disease Hypertension, May 1, 2005; 45(5): 980 - 985. [Abstract] [Full Text] [PDF]
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H. Senzaki, C.-H. Chen, H. Ishido, S. Masutani, T. Matsunaga, M. Taketazu, T. Kobayashi, N. Sasaki, S. Kyo, and Y. Yokote Arterial Hemodynamics in Patients After Kawasaki Disease Circulation, April 26, 2005; 111(16): 2119 - 2125. [Abstract] [Full Text] [PDF]
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B. Pannier, A. P. Guerin, S. J. Marchais, M. E. Safar, and G. M. London Stiffness of Capacitive and Conduit Arteries: Prognostic Significance for End-Stage Renal Disease Patients Hypertension, April 1, 2005; 45(4): 592 - 596. [Abstract] [Full Text] [PDF]
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J. Dernellis and M. Panaretou Aortic Stiffness Is an Independent Predictor of Progression to Hypertension in Nonhypertensive Subjects Hypertension, March 1, 2005; 45(3): 426 - 431. [Abstract] [Full Text] [PDF]
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S. C. Millasseau, A. D. Stewart, S. J. Patel, S. R. Redwood, and P. J. Chowienczyk Evaluation of Carotid-Femoral Pulse Wave Velocity: Influence of Timing Algorithm and Heart Rate Hypertension, February 1, 2005; 45(2): 222 - 226. [Abstract] [Full Text] [PDF]
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