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Hypertension. 2001;37:1236-1241

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(Hypertension. 2001;37:1236.)
© 2001 American Heart Association, Inc.


Scientific Contributions

Aortic Stiffness Is an Independent Predictor of All-Cause and Cardiovascular Mortality in Hypertensive Patients

Stéphane Laurent; Pierre Boutouyrie; Roland Asmar; Isabelle Gautier; Brigitte Laloux; Louis Guize; Pierre Ducimetiere; Athanase Benetos

From the Department of Pharmacology and INSERM U 337, Broussais Hospital (S.L., P.B., I.G., B.L., A.B.), Paris; Institut Cardiovasculaire - ICV (R.A.), Paris; Investigations Préventives et Cliniques (L.G., A.B.), INSERM U 258 (L.G., P.D.), Villejuif, Paris, France.

Correspondence to Prof Stéphane Laurent, Service de Pharmacologie, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France. E-mail stephane.laurent{at}egp.ap-hop-paris.fr


*    Abstract
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Abstract—Although various studies reported that pulse pressure, an indirect index of arterial stiffening, was an independent risk factor for mortality, a direct relationship between arterial stiffness and all-cause and cardiovascular mortality remained to be established in patients with essential hypertension. A cohort of 1980 essential hypertensive patients who attended the outpatient hypertension clinic of Broussais Hospital between 1980 and 1996 and who had a measurement of arterial stiffness was studied. At entry, aortic stiffness was assessed from the measurement of carotid-femoral pulse-wave velocity (PWV). A logistic regression model was used to estimate the relative risk of all-cause and cardiovascular deaths. Selection of classic risk factors for adjustment of PWV was based on their influence on mortality in this cohort in univariate analysis. Mean age at entry was 50±13 years (mean±SD). During an average follow-up of 112±53 months, 107 fatal events occurred. Among them, 46 were of cardiovascular origin. PWV was significantly associated with all-cause and cardiovascular mortality in a univariate model of logistic regression analysis (odds ratio for 5 m/s PWV was 2.14 [95% confidence interval, 1.71 to 2.67, P<0.0001] and 2.35 [95% confidence interval, 1.76 to 3.14, P<0.0001], respectively). In multivariate models of logistic regression analysis, PWV was significantly associated with all-cause and cardiovascular mortality, independent of previous cardiovascular diseases, age, and diabetes. By contrast, pulse pressure was not significantly and independently associated to mortality. This study provides the first direct evidence that aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in patients with essential hypertension.


Key Words: arterial stiffness • cardiovascular diseases • mortality • hypertension, essential • pulse wave velocity • distensibility


*    Introduction
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Cardiovascular disease, which remains the leading cause of death in developed countries, is not entirely predicted by classic risk factors. Increased arterial stiffness may increase cardiovascular morbidity and mortality because of an elevation of systolic blood pressure (SBP), which raises left ventricular afterload, and because of a decrease in diastolic blood pressure (DBP), which alters coronary perfusion.1 2 Most epidemiological studies have singled out SBP as a stronger risk factor for stroke and coronary heart disease than DBP.3 4 5 6 7 8 9 10 Recent studies have shown that, independent of mean blood pressure (MBP), brachial pulse pressure (PP) was a strong determinant of coronary heart disease,5 6 7 8 9 10 stroke,4 and cardiovascular events in hypertensive patients and in a general population.5 6 7 8 9 10 Brachial PP is also a strong independent determinant of recurrent events after myocardial infarction in patients with impaired left ventricular function,11 of risk of heart failure in the elderly,12 and of all-cause mortality in a general population.8 9 10 13 Furthermore, in a cross-sectional study,14 aortic pulse-wave velocity (PWV) was shown to be associated with cardiovascular risk, as calculated from the Framingham equations.

Despite these arguments, it remains to be demonstrated whether arterial stiffness, which is a major determinant of PP, has any independent prognostic relevance for all-cause and cardiovascular mortality.15 To the best of our knowledge, only 3 studies16 17 18 have attempted to determine the impact of arterial stiffness on survival. De Simone et al16 have reported that in 294 hypertensive patients, the stroke volume/PP ratio, an index of total arterial compliance, was an independent predictor of cardiovascular events but not of cardiovascular deaths after adjustment for classic risk factors. Blacher et al17 18 have observed an independent relationship between arterial stiffness (estimated either from carotid incremental modulus of elasticity or from aortic PWV) and all-cause and cardiovascular mortality in patients with end-stage renal disease. However, the latter studies17 18 concerned a specific population at high risk of mortality, and a direct relationship between arterial stiffness and all-cause and cardiovascular mortality remained to be determined in hypertensive patients at lower risk.

Arterial stiffness can be assessed noninvasively in large populations by measurement of PWV, a simple and reproducible method.19 20 21 22 According to the Moens-Korteweg equation,1 19 the PWV, which is related to the square root of the elasticity modulus, rises in stiffer arteries. The elastic properties of the aorta and central arteries are the major determinants of systemic arterial impedance, and the PWV measured along the aortic and aortoiliac pathway is the most clinically relevant. In the present study, we tested the hypothesis that aortic stiffness is a predictor of cardiovascular and all-cause mortality in hypertensive patients after classic cardiovascular risk factors have been controlled.


*    Methods
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Subjects and Study Design
The cohort included the 1980 consecutive patients who attended the outpatient hypertension clinic of Hôpital Broussais between April 1980 and December 1996 and who had a determination of arterial stiffness with PWV. Among them, 483 patients were treated with at least 1 antihypertensive drug at the time of the PWV measurement. The others were referred for clinical and biological investigation before treatment. Demographic data with details of cardiovascular risk factors and previous events were collected on the day when PWV was measured. Diabetes and hypercholesterolemia were indicated by a previous diagnosis or by the use of an oral hypoglycemic agent or a cholesterol-lowering agent. Smoking status was defined as current or past versus never.

A nurse measured supine blood pressure in the right arm with the use of a manual sphygmomanometer. After a 10-minute rest period, pressure was measured 3 times, and the mean of the last 2 measurements was calculated. The first and the fifth Korotkoff’s phases were used to define SBP and DBP. Mean BP was calculated as DBP + [(SBP-DBP)/3].

PWV Measurement
PWV was measured along the descending thoracoabdominal aorta using the foot-to-foot velocity method, as previously published and validated.20 22 Briefly, waveforms were obtained transcutaneously over the common carotid artery and the right femoral artery, and the time delay (t) was measured between the feet of the 2 waveforms. The distance (D) covered by the waves was assimilated to the distance measured between the 2 recording sites. PWV was calculated as PWV=D (meters)/t (seconds).20 22 Annual mean values of PWV did not change over the study period, which ruled out any major time or population recruitment effect on the obtained values.

Mortality
The follow-up study period ended on December 31, 1996 (mean follow-up, 9.3 years). Deceased subjects were identified from the French mortality records provided by the Institut National de Statistiques et d’Etudes Economiques. A member of the cohort was considered to have died when the individual had the same first name, last name, gender, and date and place of birth as a person recorded in the Institut National d’Etudes Economiques mortality records during the period of follow-up. This was confirmed by the death certificates. Individuals with incomplete matching (n=42) were contacted by telephone interview or through their general practitioners, and none of them had died. All other subjects were considered to be alive at the end of the follow-up period. On the basis of this procedure, 107 subjects of our cohort died during the follow-up period. Causes of death were then coded from the death certificates, as provided by INSERM SC8. Causes of death were coded according to the International Classification of Disease (ninth revision).

Data Analysis
A logistic regression analysis was used to estimate the relative risk of all-cause and cardiovascular mortality associated with PWV.23 The adjusted relative risk of experiencing an outcome event during follow-up for an increase in PWV (arbitrarily fixed at 5 m/s) was estimated as the odds ratio (OR). Adjusted ORs were calculated as the antilogarithm of the ß coefficient of the logistic regression of the outcome events. The 95% confidence interval (CI) around the adjusted OR estimates was obtained with the formula antilogarithm (ß±1.96 SE), in which SE is the standard error of ß. Similar calculations of ORs were performed for a 10-year increase in age, a 10 mm Hg increase in blood pressure, and a 10 bpm increase in heart rate (HR). To ensure that any observed association between PWV and a given outcome was not confounded by the presence of classic risk factors, we used a multivariate model of logistic regression that included all cardiovascular risk factors significantly associated with mortality in univariate analysis. Because arterial stiffness is a major determinant of PP (and SBP), we compared a multivariate model that included PWV to models that included either PP or SBP.

Gender (1, male; 2, female), previous history of cardiovascular disease (1, no; 2, yes), diabetes (1, no; 2, yes), hypercholesterolemia (1, no; 2, yes), and smoking status (1, no; 2, yes) were used as dummy variables. All analyses were performed with Statview 6.0 statistical software (Adept Software). Data are expressed as mean±SD. A value of P<0.05 was considered significant.


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All-Cause Mortality
The characteristics of the population are described in Table 1. In the whole population, 107 fatal events occurred. PWV was significantly associated with all-cause mortality in a univariate model of logistic regression analysis (Table 2). Selection of classic risk factors for adjustment of PWV was based on their influence on all-cause mortality in this cohort with univariate models of logistic regression analysis. Previous cardiovascular disease, age, PP, SBP, HR, and diabetes, were significantly associated with all-cause mortality (Table 2), whereas gender, MBP, DBP, smoking, and hypercholesterolemia were not.


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Table 1. Baseline Characteristics of Patients and Fatal Events


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Table 2. Relative Risk of All-Cause Mortality According to PWV and Cardiovascular Risk Factors: Univariate Analysis

In a multivariate model of logistic regression analysis, PWV was significantly associated with all-cause mortality, independent of previous cardiovascular disease, age, HR, and diabetes (Model 1, Table 3). By contrast, PP (or SBP) was not significantly and independently associated with mortality (Models 2 and 3, Table 3). Similar results were observed when a separate analysis was performed in men only. The analysis was not possible in women because of the low mortality rate.


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Table 3. Relative Risk of All-Cause Mortality According to Cardiovascular Risk Factors in Multivariate Analysis: Various Models Including PWV, PP, or SBP

PWV was significantly higher in patients using antihypertensive drugs at baseline than in untreated patients (11.79±3.64 versus 11.39±3.27 m/s, P=0.02). However, this difference was only marginal (+3.5%) and did not affect the relationship between PWV and all-cause mortality. Indeed, when antihypertensive treatment at the original screening (yes/no) was included in a multivariate model of logistic regression analysis, in addition to previous cardiovascular disease, age, and HR, the OR for an increase in PWV of 5 m/s was 1.39 (95% CI, 1.07 to 1.81; P=0.02) for all-cause mortality. This value is similar to that in Table 3, which was obtained without taking into account the administration of antihypertensive drugs.

In the 1798 patients devoid of previous cardiovascular events at entry, PWV significantly predicted all-cause mortality. Indeed, in univariate analysis, the OR for an increase in PWV of 5 m/s was 1.79 (95% CI, 1.45 to 2.14; P<0.001) in this subgroup.

Cardiovascular Mortality
Among the 107 fatal events, 46 were of cardiovascular origin, including 19 deaths from coronary heart disease and 17 fatal strokes. The 10 other fatal cardiovascular events were coded as follows in the death certificates: congestive heart failure (n=3), pulmonary embolism (n=2), hypertension (n=1), diabetes with microvascular disease (n=1), hypotension (n=1), and viral myocarditis (n=1).

PWV was significantly associated with cardiovascular mortality in a univariate model of logistic regression analysis (Table 4). Selection of classic risk factors for adjustment of PWV was based on their influence on cardiovascular mortality in this cohort, in univariate models of logistic regression analysis. Previous cardiovascular disease, age, PP, SBP, and diabetes were significantly associated with all-cause mortality (Table 4), whereas gender, MBP, DBP, HR, smoking, and hypercholesterolemia were not.


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Table 4. Relative Risk of Cardiovascular Mortality According to PWV and Cardiovascular Risk Factors: Univariate Analysis

In a multivariate model of logistic regression analysis, PWV was significantly associated with cardiovascular mortality, independent of previous cardiovascular disease, age, and diabetes (Model 1, Table 5). By contrast, PP was only marginally (P=0.06) associated with cardiovascular mortality (Model 2, Table 5). SBP was significantly and independently associated with cardiovascular mortality (Model 3, Table 5). Similar results were observed when a separate analysis was performed in men only. The analysis was not possible in women because of the low mortality rate.


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Table 5. Relative Risk of Cardiovascular Mortality According to Cardiovascular Risk Factors in Multivariate Analysis: Various Models Including PWV, PP, or SBP

When antihypertensive treatment (yes/no) at the original screening was included in a multivariate model of logistic regression analysis, in addition to previous cardiovascular disease and age, the OR for an increase in PWV of 5 m/s was 1.40 (955 CI, 1.08 to 1.80; P=0.01) for cardiovascular mortality. This value is similar to that in Table 5, which was obtained without taking into account the administration of antihypertensive drugs.

In the 1798 patients devoid of previous cardiovascular events at entry, PWV significantly predicted cardiovascular mortality. Indeed, in univariate analysis, the OR for an increase in PWV of 5 m/s was 1.60 (95% CI, 1.12 to 2.13; P=0.011).


*    Discussion
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The present study is the first one to provide a direct relationship between aortic stiffness and mortality in a large cohort of hypertensive patients. Indeed, PWV was independently associated with all-cause and cardiovascular mortality after adjustment for previous cardiovascular disease, age, and diabetes.

Our group4 8 9 and others5 6 7 10 11 have previously reported the positive independent association between brachial PP, an indirect index of arterial stiffness, and all-cause or cardiovascular mortality. However, these studies provided only indirect arguments for an impact of arterial stiffness on mortality. Indeed, PP was calculated from SBP and DBP, both measured with a sphygmomanometer at the site of the brachial artery. Because of the physiological PP amplification between central and peripheral arteries,1 13 24 25 26 27 28 brachial PP may not reflect aortic PP, which influences left ventricular afterload and coronary perfusion. In addition, factors other than arterial stiffness can influence the value of PP, such as HR, cardiac contractility, and venous pressure.1 13 26 Thus, brachial PP is only a surrogate index of arterial stiffness.

The international guidelines for the management of hypertension15 suggested that it would be useful to demonstrate whether arterial stiffness has any independent prognostic relevance for mortality. During the last 20 years, technological progress has allowed arterial stiffness to be determined with simple noninvasive methods and to be used in epidemiological studies. An independent influence of arterial stiffness on survival has recently been demonstrated in patients with end-stage renal disease,17 18 a very specific population at high risk of mortality. This has not been shown in hypertensive patients at lower risk,16 probably because of the small number of patients included in this cohort. Thus, a direct relationship between arterial stiffness and all-cause and cardiovascular mortality remained to be determined in a large population of hypertensive patients.

The present study clearly shows that arterial stiffness may help in the evaluation of the individual risk in hypertensive patients regularly attending the outpatient clinic of a university hospital. Because the population group was only mildly hypertensive at original screening, with the minority on antihypertensive treatment at that time, one might reasonably speculate that the results may apply to the population as a whole. The independent predictability of aortic stiffness can be quantified in the study population: the OR for an increase in PWV of 5 m/s is 1.34 for all-cause mortality (Table 3) and 1.51 for cardiovascular mortality (Table 5). In univariate models of logistic regression analysis, the increased mortality risk because of a 5 m/s increase in PWV is equivalent to that of aging 10 years (Table 2 and 4).

Several mechanisms may explain the association between increased PWV and cardiovascular mortality.1 2 3 4 5 6 7 8 9 10 11 12 Arterial stiffness is a cause of premature return of reflected waves in late systole, increasing central pulse pressure and the load on the ventricle, reducing ejection fraction, and increasing myocardial oxygen demand.1 Arterial stiffness is associated with left ventricular hypertrophy in normotensive and hypertensive patients.4 29 Left ventricular hypertrophy is a known risk factor for congestive heart failure and cardiovascular events.30 The elevation of SBP, which raises left ventricular afterload and myocardial work, and the decrease in DBP, which reduces coronary perfusion, result in subendocardial ischemia.1 31 Arterial stiffness is correlated with atherosclerosis,32 33 probably through the effects of cyclic stress on arterial wall thickening.28 34

Because 483 patients among 1980 were being treated with antihypertensive drugs at the time of PWV measurement, the patients might have lower blood pressure and PWV levels than without treatment. Thus, the predictive value of PWV, observed in the whole population, might not apply to this sub-group. However, when antihypertensive treatment was added to the multivariate model of logistic regression analysis of Table 3, the independent OR for an increase in PWV of 5 m/s remained significant and of similar value than in the original model for both all-cause and cardiovascular mortality.

The subgroup of 182 patients among 1980, who had a history of cardiovascular disease at the baseline PWV examination, might have introduced a bias in the determination of the predictive power of PWV in the whole population, particularly in patients devoid of previous cardiovascular disease at entry, even after adjustment to previous cardiovascular disease in multivariate analysis. Thus, we reanalyzed the subgroup of 1798 patients devoid of previous cardiovascular disease at entry. Univariate analyses in these patients showed that aortic PWV remained significantly predictive of cardiovascular and all-cause deaths.

As expected, we observed significant univariate associations between cardiovascular deaths and either previous cardiovascular disease, age, PP, SBP, and diabetes, with a predominant predictive power for the history of cardiovascular disease.35 The lack of univariate association between MBP and cardiovascular deaths was not unexpected because the present cohort included only patients referred for hypertension, thus reducing the range of MBP values. The lack of prognostic value of DBP on cardiovascular deaths was also not unexpected in the present cohort. Indeed, previous studies10 35 reported a positive association between cardiovascular mortality and DBP before 60 years of age and a negative association thereafter. Thus, the findings of the present study underline the predominant role of PP over MBP, as previously published.8 9

In the present cohort, arterial stiffness had an independent predictive power with respect to all-cause and cardiovascular deaths, whereas PP was not significantly and independently associated with all-cause mortality (Table 3) and was only marginally associated with cardiovascular mortality (Table 5). The stronger independent predictive value of PWV may be explained by pathophysiological considerations (PP amplification, multiplicity of PP determinants), as seen above. In addition, the lack of independent predictive value of PP may be due to the smaller size of the present cohort than previously published ones4 8 9 10 36 and/or to the lower mortality rate of our hypertensive population compared with patients with impaired left ventricular function11 or elderly patients.36 Nevertheless, the present study shows that a direct measurement of stiffness may be of greater help than an indirect index (PP) in the evaluation of the individual risk in a cohort of hypertensive patients regularly attending the outpatient clinic of an university hospital.

We conclude that aortic stiffness is significantly associated with the risk of all-cause and cardiovascular mortality in patients with essential hypertension. Measurement of aortic stiffness retains predictive power with respect to all-cause and cardiovascular deaths, even after classic risk factors have been taken into consideration.


*    Acknowledgments
 
This study received financial support from the French Medicine Agency (AFSSAPS) and Institut National de la Santé et de la Recherche Médicale (INSERM). The authors are grateful to Jean-François Morcet for his help in analyzing the data.

Received June 1, 2000; first decision July 5, 2000; accepted October 16, 2000.


*    References
up arrowTop
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up arrowIntroduction
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*References
 
1. Nichols WW, O’Rourke MF. McDonald’s Blood Flow in Arteries: Theoretical, Experimental and Clinical Principles. 3rd ed., London, England: Oxford University Press; 1990:77–142,216–269, 283–359,398–37.

2. Safar ME. Pulse pressure in essential hypertension: clinical and therapeutical implications. J Hypertens. 1989;7:769–776.[Medline] [Order article via Infotrieve]

3. Kannel WB, Wolf PA, McGee DL, Dawber TR, McNamara P, Castelli WP. Systolic blood pressure, arterial rigidity, and risk of stroke. JAMA. 1981;245:1225–1229.[Abstract/Free Full Text]

4. Darné B, Girerd X, Safar M, Cambien F, Guize L. Pulsatile versus steady component of blood pressure: a cross-sectional analysis of a prospective analysis of cardiovascular mortality. Hypertension. 1989;13:392–400.[Abstract/Free Full Text]

5. Madhavan S, Ooi WL, Cohen H, Alderman MH. Relation of pulse pressure and blood pressure reduction to the incidence of myocardial infarction. Hypertension. 1994;23:395–401.[Abstract/Free Full Text]

6. Franklin SS, Gustin W 4th, Wong ND, Larson MG, Weber MA, Kannel WB, Levy D. Hemodynamic patterns of age-related changes in blood pressure: The Framingham Heart Study. Circulation. 1997;96:308–315.[Abstract/Free Full Text]

7. Alderman MH, Cohen H, Madhavan S. Distribution and determinants of cardiovascular events during 20 years of successful antihypertensive treatment. J Hypertens. 1998;16:761–769.[Medline] [Order article via Infotrieve]

8. Benetos A, Safar M, Rudnichi A, Smulyan H, Richard JL, Ducimetiere P, Guize L. Pulse pressure: a predictor of long-term cardiovascular mortality in a French male population. Hypertension. 1997;30:1410–1415.[Abstract/Free Full Text]

9. Benetos A, Rudnichi A, Safar m, Guize L. Pulse pressure and cardiovascular mortality in normotensive and hypertensive subjects. Hypertension. 1998;32:560–564.[Abstract/Free Full Text]

10. Franklin SS, Khan SA, Wong SA, Larson MG, Levy D. Is pulse pressure useful in predicting coronary heart disease? The Framingham Heart Study. Circulation. 1999;100:354–360.[Abstract/Free Full Text]

11. Mitchell GF, Moye LA, Braunwald E, Rouleau JL, Bernstein V, Geltman EM, Flaker GC, Pfeffer M, for the SAVE Investigators. Sphygmomanometric determined pulse pressure is a powerful independent predictor of recurrent events after myocardial infarction in patients with impaired left ventricular function. Circulation. 1997;96:4254–4260.[Abstract/Free Full Text]

12. Chae CU, Pfeffer MA, Glynn RJ, Mitchell GF, Taylor JO, Hennekens CH. Increased pulse pressure and risk of heart failure in the elderly. JAMA. 1999;281:934–639.

13. O’Rourke M, Frohlich ED. Pulse pressure: is it a clinically useful risk factor? Hypertension. 1999;34:372–374.[Free Full Text]

14. Blacher J, Asmar R, Djane S, London G, Safar M. Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients. Hypertension. 1999;33:1111–1117.[Abstract/Free Full Text]

15. 1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension. J Hypertens. 1999;17:151–183.[Medline] [Order article via Infotrieve]

16. de Simone G, Roman MJ, Koren MJ, Mensah GA, Ganau A, Devereux RB. Stroke volume/pulse pressure ratio and cardiovascular risk in arterial hypertension. Hypertension. 1999;33:800–805.[Abstract/Free Full Text]

17. Blacher J, Pannier B, Guerin A, Marchais SJ, Safar ME, London GM. Carotid arterial stiffness as a predictor of cardiovascular and all-cause mortality in end-stage renal disease. Hypertension. 1998;32:570–574.[Abstract/Free Full Text]

18. Blacher J, Guerin A, Marchais SJ, Safar M, London G. Impact of aortic stiffness on survival in end-stage renal disease. Circulation. 1999;99:2434–2439.[Abstract/Free Full Text]

19. Bramwell JC, Hill AV. The velocity of the pulse wave in man. Proc R Soc Lond B Biol Sci. 1922;93:298–306.[Free Full Text]

20. Asmar RG, Brunel PC, Pannier BM, Lacolley PJ, Safar ME. Arterial distensibility and ambulatory blood pressure monitoring in essential hypertension. Am J Cardiol. 1988;61:1066–1070.[Medline] [Order article via Infotrieve]

21. Lehman ED, Watts GF, Gossling RG. Aortic distensibility and hypercholesterolemia. Lancet. 1992;340:1171–1172.

22. Asmar R, Benetos A, Topouchian J, Laurent P, Pannier B, Brisac AM, Target R, Levy B. Assessment of arterial distensibility by automatic pulse wave velocity measurement: validation and clinical application studies. Hypertension. 1995;26:485–490.[Abstract/Free Full Text]

23. Fleiss JL. The design and analysis of clinical experiments. New York, NY: John Wiley; 1986:241–260.

24. Kroeker EJ, Wood EH. Comparison of simultaneously recorded central and peripheral arterial pressure pulses during rest, exercise, and tilted position in man. Circ Res. 1955;3:623–632.[Abstract/Free Full Text]

25. Rowell LB, Brengelmann GL, Blackmon JR, Bruce RA, Murray JA. Disparities between aortic and peripheral pulse pressures induced by upright exercise and vasomotor changes in man. Circulation. 1968;37:954–964.[Abstract/Free Full Text]

26. Stergiopoulos N, Westerhof N. Determinants of pulse pressure. Hypertension. 1998;32:556–559.[Abstract/Free Full Text]

27. Jondeau G, Boutouyrie P, Lacolley P, Laloux B, Dubourg O, Bourdarias JP, Laurent S. Central aortic pulse pressure is a major determinant of aortic dilatation in Marfan syndrome. Circulation. 1999;99:2677–2681.[Abstract/Free Full Text]

28. Boutouyrie P, Bussy C, Lacolley P, Girerd X, Laloux B, Laurent S. Association between local pulse pressure, mean blood pressure and large artery remodeling. Circulation. 1999;100:1087–1093.

29. Girerd X, Laurent S, Pannier B, Asmar R, Safar M. Arterial distensibility and left ventricular hypertrophy in patients with sustained essential hypertension. Am Heart J. 1991;122:1210–1214.[Medline] [Order article via Infotrieve]

30. Levy D, Garrison R, Savage D, Kannel W, Castelli W. Pronostic implications of echocardiographically determined left ventricular mass in the Framingham study. N Engl J Med. 1990;322:1561–1566.[Abstract]

31. Watanabe H, Ohtsuka S, Kakihana M, Sugishita Y. Coronary circulation in dogs with an experimental decrease in aortic compliance. J Am Coll Cardiol. 1993;21:1497–1506.[Abstract]

32. Farrar DJ, Bond MG, Riley WA, Sawyer JK. Anatomic correlated of aortic pulse wave velocity and carotid artery elasticity during atherosclerosis progression and regression in monkeys. Circulation. 1991;83:1754–1763.[Abstract/Free Full Text]

33. Hirai T, Sasayama S, Kamasaki T, Yagi S. Stiffness of systemic arteries in patients with myocardial infarction. Circulation. 1989;80:78–86.[Abstract/Free Full Text]

34. Lyon RT, Runyon-Hass A, Davis HR, Glagov S, Zarins CK. Protection from atherosclerotic lesion formation by reduction of artery wall motion. J Vacs Surg. 1987;5:59–67.

35. Gueyffier F, Boissel JP, Pocock S, Boutitie F, Coope J, Cutler J, Ekbom T, Fagard R, Friedman L, Kerlikowske K, Perry M, Prineas R, Schron E. Identification of risk factors in hypertensive patients. Circulation. 1999;100:e88–e94.[Abstract/Free Full Text]

36. Domanski MJ, Davis BR, Pfeffer MA, Kastantin M, Mitchell GF. Isolated systolic hypertension: prognostic information provided by pulse pressure. Hypertension. 1999;34:375–380. [Abstract/Free Full Text]




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Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents: Recommendations for Standard Assessment for Clinical Research: A Scientific Statement From the American Heart Association
Hypertension, November 1, 2009; 54(5): 919 - 950.
[Abstract] [Full Text] [PDF]


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Nephrol Dial TransplantHome page
M. Hornum, P. Clausen, J. Kjaergaard, J. M. Hansen, E. R. Mathiesen, and B. Feldt-Rasmussen
Pre-diabetes and arterial stiffness in uraemic patients
Nephrol. Dial. Transplant., October 21, 2009; (2009) gfp558v1.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Physiol. Heart Circ. Physiol.Home page
K. Yamamoto, H. Kawano, Y. Gando, M. Iemitsu, H. Murakami, K. Sanada, M. Tanimoto, Y. Ohmori, M. Higuchi, I. Tabata, et al.
Poor trunk flexibility is associated with arterial stiffening
Am J Physiol Heart Circ Physiol, October 1, 2009; 297(4): H1314 - H1318.
[Abstract] [Full Text] [PDF]


Home page
HypertensionHome page
Y. Matsui, K. Eguchi, M. F. O'Rourke, J. Ishikawa, H. Miyashita, K. Shimada, and K. Kario
Differential Effects Between a Calcium Channel Blocker and a Diuretic When Used in Combination With Angiotensin II Receptor Blocker on Central Aortic Pressure in Hypertensive Patients
Hypertension, October 1, 2009; 54(4): 716 - 723.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
M. Cecelja, B. Jiang, K. McNeill, B. Kato, J. Ritter, T. Spector, and P. Chowienczyk
Increased wave reflection rather than central arterial stiffness is the main determinant of raised pulse pressure in women and relates to mismatch in arterial dimensions: a twin study.
J. Am. Coll. Cardiol., August 18, 2009; 54(8): 695 - 703.
[Abstract] [Full Text] [PDF]


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Ann Rheum DisHome page
M Wong, S P Oakley, L Young, B Y Jiang, A Wierzbicki, G Panayi, P Chowienczyk, and B Kirkham
Infliximab improves vascular stiffness in patients with rheumatoid arthritis
Ann Rheum Dis, August 1, 2009; 68(8): 1277 - 1284.
[Abstract] [Full Text] [PDF]


Home page
Age AgeingHome page
F. Fantin, C. J. Bulpitt, S. Bonapace, J. D. Cameron, and C. Rajkumar
Is vascular stiffness associated with the diameter of the abdominal aorta?
Age Ageing, July 1, 2009; 38(4): 466 - 469.
[Full Text] [PDF]


Home page
J AndrolHome page
F. Dockery, C. J. Bulpitt, S. Agarwal, C. Vernon, and C. Rajkumar
Effect of Androgen Suppression Compared With Androgen Receptor Blockade on Arterial Stiffness in Men With Prostate Cancer
J Androl, July 1, 2009; 30(4): 410 - 415.
[Abstract] [Full Text] [PDF]


Home page
HypertensionHome page
N. Dhaun, I. M. MacIntyre, V. Melville, P. Lilitkarntakul, N. R. Johnston, J. Goddard, and D. J. Webb
Blood Pressure-Independent Reduction in Proteinuria and Arterial Stiffness After Acute Endothelin-A Receptor Antagonism in Chronic Kidney Disease
Hypertension, July 1, 2009; 54(1): 113 - 119.
[Abstract] [Full Text] [PDF]


Home page
J. Clin. Endocrinol. Metab.Home page
S. P. L. Rice, N. Agarwal, H. Bolusani, R. Newcombe, M. F. Scanlon, M. Ludgate, and D. A. Rees
Effects of Dehydroepiandrosterone Replacement on Vascular Function in Primary and Secondary Adrenal Insufficiency: A Randomized Crossover Trial
J. Clin. Endocrinol. Metab., June 1, 2009; 94(6): 1966 - 1972.
[Abstract] [Full Text] [PDF]


Home page
Int J EpidemiolHome page
C. E Bolton, J. R Cockcroft, R. Sabit, M. Munnery, C. M McEniery, I. B Wilkinson, S. Ebrahim, J. E Gallacher, D. J Shale, and Y. Ben-Shlomo
Lung function in mid-life compared with later life is a stronger predictor of arterial stiffness in men: The Caerphilly Prospective Study
Int. J. Epidemiol., June 1, 2009; 38(3): 867 - 876.
[Abstract] [Full Text] [PDF]


Home page
Eur J EchocardiogrHome page
H. Pavlopoulos and P. Nihoyannopoulos
Pulse pressure/stroke volume: a surrogate index of arterial stiffness and the relation to segmental relaxation and longitudinal systolic deformation in hypertensive disease
Eur J Echocardiogr, June 1, 2009; 10(4): 519 - 526.
[Abstract] [Full Text] [PDF]


Home page
Eur J EchocardiogrHome page
F. Natale, M. A. Tedesco, R. Mocerino, V. de Simone, G. M. Di Marco, L. Aronne, M. Credendino, C. Siniscalchi, P. Calabro, M. Cotrufo, et al.
Visceral adiposity and arterial stiffness: echocardiographic epicardial fat thickness reflects, better than waist circumference, carotid arterial stiffness in a large population of hypertensives
Eur J Echocardiogr, June 1, 2009; 10(4): 549 - 555.
[Abstract] [Full Text] [PDF]


Home page
HypertensionHome page
A. O. Robb, N. L. Mills, J. N. Din, I. B.J. Smith, F. Paterson, D. E. Newby, and F. C. Denison
Influence of the Menstrual Cycle, Pregnancy, and Preeclampsia on Arterial Stiffness
Hypertension, June 1, 2009; 53(6): 952 - 958.
[Abstract] [Full Text] [PDF]


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LupusHome page
A Cypiene, M Kovaite, A Venalis, J Dadoniene, R Rugiene, Z Petrulioniene, L Ryliskyte, and A Laucevicius
Arterial wall dysfunction in systemic lupus erythematosus
Lupus, May 1, 2009; 18(6): 522 - 529.
[Abstract] [PDF]


Home page
Eur J EndocrinolHome page
M. Yaron, Y. Greenman, J. B Rosenfeld, E. Izkhakov, R. Limor, E. Osher, G. Shenkerman, K. Tordjman, and N. Stern
Effect of testosterone replacement therapy on arterial stiffness in older hypogonadal men
Eur. J. Endocrinol., May 1, 2009; 160(5): 839 - 846.
[Abstract] [Full Text] [PDF]


Home page
Psychosom. Med.Home page
C. Vlachopoulos, P. Xaplanteris, N. Alexopoulos, K. Aznaouridis, C. Vasiliadou, K. Baou, E. Stefanadi, and C. Stefanadis
Divergent Effects of Laughter and Mental Stress on Arterial Stiffness and Central Hemodynamics
Psychosom Med, May 1, 2009; 71(4): 446 - 453.
[Abstract] [Full Text] [PDF]


Home page
HypertensionHome page
S. G. Anderson, T. A.B. Sanders, and J. K. Cruickshank
Plasma Fatty Acid Composition as a Predictor of Arterial Stiffness and Mortality
Hypertension, May 1, 2009; 53(5): 839 - 845.
[Abstract] [Full Text] [PDF]


Home page
HypertensionHome page
T. E. Brinkley, B. J. Nicklas, A. M. Kanaya, S. Satterfield, E. G. Lakatta, E. M. Simonsick, K. Sutton-Tyrrell, S. B. Kritchevsky, and for the Health, Aging, and Body Composition Study
Plasma Oxidized Low-Density Lipoprotein Levels and Arterial Stiffness in Older Adults: The Health, Aging, and Body Composition Study
Hypertension, May 1, 2009; 53(5): 846 - 852.
[Abstract] [Full Text] [PDF]


Home page
HypertensionHome page
G. Deley, G. Picard, and J. A. Taylor
Arterial Baroreflex Control of Cardiac Vagal Outflow in Older Individuals Can Be Enhanced by Aerobic Exercise Training
Hypertension, May 1, 2009; 53(5): 826 - 832.
[Abstract] [Full Text] [PDF]


Home page
J. Appl. Physiol.Home page
M. Garcia and G. S. Kassab
Right coronary artery becomes stiffer with increase in elastin and collagen in right ventricular hypertrophy
J Appl Physiol, April 1, 2009; 106(4): 1338 - 1346.
[Abstract] [Full Text] [PDF]


Home page
Circ Cardiovasc GenetHome page
K. V. Tarasov, S. Sanna, A. Scuteri, J. B. Strait, M. Orru, A. Parsa, P.-I Lin, A. Maschio, S. Lai, M. G. Piras, et al.
COL4A1 Is Associated With Arterial Stiffness by Genome-Wide Association Scan
Circ Cardiovasc Genet, April 1, 2009; 2(2): 151 - 158.
[Abstract] [Full Text] [PDF]


Home page
HypertensionHome page
S. Sakuragi, K. Abhayaratna, K. J. Gravenmaker, C. O'Reilly, W. Srikusalanukul, M. M. Budge, R. D. Telford, and W. P. Abhayaratna
Influence of Adiposity and Physical Activity on Arterial Stiffness in Healthy Children: The Lifestyle of Our Kids Study
Hypertension, April 1, 2009; 53(4): 611 - 616.
[Abstract] [Full Text] [PDF]


Home page
Arch Intern MedHome page
J. A. Chirinos, S. S. Franklin, R. R. Townsend, and L. Raij
Body Mass Index and Hypertension Hemodynamic Subtypes in the Adult US Population
Arch Intern Med, March 23, 2009; 169(6): 580 - 586.
[Abstract] [Full Text] [PDF]


Home page
Am J EpidemiolHome page
C. A. Peralta, R. Katz, M. Madero, M. Sarnak, H. Kramer, M. H. Criqui, and M. G. Shlipak
The Differential Association of Kidney Dysfunction With Small and Large Arterial Elasticity: The Multiethnic Study of Atherosclerosis
Am. J. Epidemiol., March 15, 2009; 169(6): 740 - 748.
[Abstract] [Full Text] [PDF]


Home page
QJMHome page
B. Ilyas, N. Dhaun, D. Markie, P. Stansell, J. Goddard, D.E. Newby, and D.J. Webb
Renal function is associated with arterial stiffness and predicts outcome in patients with coronary artery disease
QJM, March 1, 2009; 102(3): 183 - 191.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Clin. Nutr.Home page
K. M Dickinson, J. B Keogh, and P. M Clifton
Effects of a low-salt diet on flow-mediated dilatation in humans
Am. J. Clinical Nutrition, February 1, 2009; 89(2): 485 - 490.
[Abstract] [Full Text] [PDF]


Home page
PediatricsHome page
K. Kallio, E. Jokinen, M. Hamalainen, M. Saarinen, I. Volanen, T. Kaitosaari, J. Viikari, T. Ronnemaa, O. Simell, and O. T. Raitakari
Decreased Aortic Elasticity in Healthy 11-Year-Old Children Exposed to Tobacco Smoke
Pediatrics, February 1, 2009; 123(2): e267 - e273.
[Abstract] [Full Text] [PDF]


Home page
Diabetes and Vascular Disease ResearchHome page
N. Bjarnegard, H. J Arnqvist, T.;r. Lindstro;m, L. Jonasson, and T. Lanne
Long-term hyperglycaemia impairs vascular smooth muscle cell function in women with type 1 diabetes mellitus
Diabetes and Vascular Disease Research, January 1, 2009; 6(1): 25 - 31.
[Abstract] [PDF]


Home page
Nephrol Dial TransplantHome page
O. Cseprekal, E. Kis, P. Schaffer, T. E. H. Othmane, B. Cs. Fekete, A. Vannay, A. J. Szabo, A. Remport, A. Szabo, T. Tulassay, et al.
Pulse wave velocity in children following renal transplantation
Nephrol. Dial. Transplant., January 1, 2009; 24(1): 309 - 315.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll Cardiol ImgHome page
J. Sugawara, K. Hayashi, T. Yokoi, and H. Tanaka
Age-associated elongation of the ascending aorta in adults.
J. Am. Coll. Cardiol. Img., November 1, 2008; 1(6): 739 - 748.
[Abstract] [Full Text] [PDF]


Home page
Ther Adv Cardiovasc DisHome page
R. D. Smith and P. J. Levy
Review: New techniques for assessment of vascular function
Therapeutic Advances in Cardiovascular Disease, October 1, 2008; 2(5): 373 - 385.
[Abstract] [PDF]


Home page
ANGIOLOGYHome page
I. Wakabayashi and H. Masuda
Relationships Between Vascular Indexes and Atherosclerotic Risk Factors in Patients With Type 2 Diabetes Mellitus
Angiology, October 1, 2008; 59(5): 567 - 573.
[Abstract] [PDF]


Home page
Anesth. Analg.Home page
D. Nyhan and D. E. Berkowitz
Perioperative Blood Pressure Management: Does Central Vascular Stiffness Matter?
Anesth. Analg., October 1, 2008; 107(4): 1103 - 1106.
[Full Text] [PDF]


Home page
Am. J. Physiol. Heart Circ. Physiol.Home page
S. R. Lammers, P. H. Kao, H. J. Qi, K. Hunter, C. Lanning, J. Albietz, S. Hofmeister, R. Mecham, K. R. Stenmark, and R. Shandas
Changes in the structure-function relationship of elastin and its impact on the proximal pulmonary arterial mechanics of hypertensive calves
Am J Physiol Heart Circ Physiol, October 1, 2008; 295(4): H1451 - H1459.
[Abstract] [Full Text] [PDF]


Home page
ANGIOLOGYHome page
S.-H. Lee, S. Choi, J.-H. Jung, and N. Lee
Effects of Atrial Fibrillation on Arterial Stiffness in Patients With Hypertension
Angiology, August 1, 2008; 59(4): 459 - 463.
[Abstract] [PDF]


Home page
HypertensionHome page
G. Schillaci, G. V.L. De Socio, G. Pucci, M. R. Mannarino, J. Helou, M. Pirro, and E. Mannarino
Aortic Stiffness in Untreated Adult Patients With Human Immunodeficiency Virus Infection
Hypertension, August 1, 2008; 52(2): 308 - 313.
[Abstract] [Full Text] [PDF]


Home page
ANGIOLOGYHome page
A. G. Ruitenbeek, T. J.M. van der Cammen, A. H. van den Meiracker, and F. U.S. Mattace-Raso
Age and Blood Pressure Levels Modify the Functional Properties of Central but Not Peripheral Arteries
Angiology, July 1, 2008; 59(3): 290 - 295.
[Abstract] [PDF]


Home page
Age AgeingHome page
S. V. Getov, R. W. Lee, F. Dockery, and C. Rajkumar
Androgens, ageing and vascular function
Age Ageing, July 1, 2008; 37(4): 361 - 363.
[Full Text] [PDF]


Home page
Am. J. Physiol. Regul. Integr. Comp. Physiol.Home page
T. Otsuki, S. Maeda, M. Iemitsu, Y. Saito, Y. Tanimura, R. Ajisaka, and T. Miyauchi
Systemic arterial compliance, systemic vascular resistance, and effective arterial elastance during exercise in endurance-trained men
Am J Physiol Regulatory Integrative Comp Physiol, July 1, 2008; 295(1): R228 - R235.
[Abstract] [Full Text] [PDF]


Home page
Journal of Renin-Angiotensin-Aldosterone SystemHome page
G. Grassi, F. Quarti-Trevano, and G. Mancia
Review: Cardioprotective effects of telmisartan in uncomplicated and complicated hypertension
Journal of Renin-Angiotensin-Aldosterone System, June 1, 2008; 9(2): 66 - 74.
[Abstract] [PDF]


Home page
Clin. Cancer Res.Home page
N. Steeghs, H. Gelderblom, J. o. t Roodt, O. Christensen, P. Rajagopalan, M. Hovens, H. Putter, T. J. Rabelink, and E. de Koning
Hypertension and Rarefaction during Treatment with Telatinib, a Small Molecule Angiogenesis Inhibitor
Clin. Cancer Res., June 1, 2008; 14(11): 3470 - 3476.
[Abstract] [Full Text] [PDF]


Home page
HypertensionHome page
J. Karalliedde, A. Smith, L. DeAngelis, V. Mirenda, A. Kandra, J. Botha, P. Ferber, and G. Viberti
Valsartan Improves Arterial Stiffness in Type 2 Diabetes Independently of Blood Pressure Lowering
Hypertension, June 1, 2008; 51(6): 1617 - 1623.
[Abstract] [Full Text] [PDF]


Home page
HypertensionHome page
J. S. Orr, C. L. Gentile, B. M. Davy, and K. P. Davy
Large Artery Stiffening With Weight Gain in Humans: Role of Visceral Fat Accumulation
Hypertension, June 1, 2008; 51(6): 1519 - 1524.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
S. S. Najjar, A. Scuteri, V. Shetty, J. G. Wright, D. C. Muller, J. L. Fleg, H. P. Spurgeon, L. Ferrucci, and E. G. Lakatta
Pulse Wave Velocity Is an Independent Predictor of the Longitudinal Increase in Systolic Blood Pressure and of Incident Hypertension in the Baltimore Longitudinal Study of Aging
J. Am. Coll. Cardiol., April 8, 2008; 51(14): 1377 - 1383.
[Abstract] [Full Text] [PDF]


Home page
J. Am. Soc. Nephrol.Home page
M. Delahousse, M. Chaignon, L. Mesnard, P. Boutouyrie, M. E. Safar, T. Lebret, M. Pastural-Thaunat, L. Tricot, A. Kolko-Labadens, A. Karras, et al.
Aortic Stiffness of Kidney Transplant Recipients Correlates with Donor Age
J. Am. Soc. Nephrol., April 1, 2008; 19(4): 798 - 805.
[Abstract] [Full Text] [PDF]


Home page
ThoraxHome page
N L Mills, J J Miller, A Anand, S D Robinson, G A Frazer, D Anderson, L Breen, I B Wilkinson, C M McEniery, K Donaldson, et al.
Increased arterial stiffness in patients with chronic obstructive pulmonary disease: a mechanism for increased cardiovascular risk
Thorax, April 1, 2008; 63(4): 306 - 311.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Clin. Nutr.Home page
J. B Keogh, G. D Brinkworth, M. Noakes, D. P Belobrajdic, J. D Buckley, and P. M Clifton
Effects of weight loss from a very-low-carbohydrate diet on endothelial function and markers of cardiovascular disease risk in subjects with abdominal obesity
Am. J. Clinical Nutrition, March 1, 2008; 87(3): 567 - 576.
[Abstract] [Full Text] [PDF]


Home page
Ther Adv Cardiovasc DisHome page
M. E. Safar
Review: Pulse pressure, arterial stiffness and wave reflections (augmentation index) as cardiovascular risk factors in hypertension
Therapeutic Advances in Cardiovascular Disease, February 1, 2008; 2(1): 13 - 24.
[Abstract] [PDF]


Home page
Endocr. Rev.Home page
B. Biondi and D. S. Cooper
The Clinical Significance of Subclinical Thyroid Dysfunction
Endocr. Rev., February 1, 2008; 29(1): 76 - 131.
[Abstract] [Full Text] [PDF]


Home page
HypertensionHome page
L. Ghiadoni, G. Penno, C. Giannarelli, Y. Plantinga, M. Bernardini, L. Pucci, R. Miccoli, S. Taddei, A. Salvetti, and S. Del Prato
Metabolic Syndrome and Vascular Alterations in Normotensive Subjects at Risk of Diabetes Mellitus
Hypertension, February 1, 2008; 51(2): 440 - 445.
[Abstract] [Full Text] [PDF]


Home page
CJASNHome page
S. S. DeLoach and R. R. Townsend
Vascular Stiffness: Its Measurement and Significance for Epidemiologic and Outcome Studies
Clin. J. Am. Soc. Nephrol., January 1, 2008; 3(1): 184 - 192.
[Abstract] [Full Text] [PDF]


Home page
ANGIOLOGYHome page
S. Celik, S. Kaplan, R. Yilmaz, T. Erdogan, and A. Kiris
Relationship Between Aortic Stiffness and the Development of Coronary Collateral in Patients With Coronary Artery Disease
Angiology, January 1, 2008; 58(6): 671 - 676.
[Abstract] [PDF]


Home page
Nephrol Dial TransplantHome page
M. M. Lemos, A. D. B. Jancikic, F. M. R. Sanches, D. M. Christofalo, S. A. Ajzen, M. H. Miname, R. D. Santos, F. C. Fachini, A. B. Carvalho, S. A. Draibe, et al.
Pulse wave velocity a useful tool for cardiovascular surveillance in pre-dialysis patients
Nephrol. Dial. Transplant., December 1, 2007; 22(12): 3527 - 3532.
[Abstract] [Full Text] [PDF]


Home page
ChestHome page
C. T.-J. Gan, J.-W. Lankhaar, N. Westerhof, J. T. Marcus, A. Becker, J. W. R. Twisk, A. Boonstra, P. E. Postmus, and A. Vonk-Noordegraaf
Noninvasively Assessed Pulmonary Artery Stiffness Predicts Mortality in Pulmonary Arterial Hypertension
Chest, December 1, 2007; 132(6): 1906 - 1912.
[Abstract] [Full Text] [PDF]


Home page
Vasc MedHome page
M. F. O'Rourke
Arterial aging: pathophysiological principles
Vascular Medicine, November 1, 2007; 12(4): 329 - 341.
[Abstract] [PDF]


Home page
CJASNHome page
M. Yoshida, H. Tomiyama, J. Yamada, Y. Koji, K. Shiina, M. Nagata, and A. Yamashina
Relationships among Renal Function Loss within the Normal to Mildly Impaired Range, Arterial Stiffness, Inflammation, and Oxidative Stress
Clin. J. Am. Soc. Nephrol., November 1, 2007; 2(6): 1118 - 1124.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Physiol. Endocrinol. Metab.Home page
A. J. Sommerfield, I. B. Wilkinson, D. J. Webb, and B. M. Frier
Vessel wall stiffness in type 1 diabetes and the central hemodynamic effects of acute hypoglycemia
Am J Physiol Endocrinol Metab, November 1, 2007; 293(5): E1274 - E1279.
[Abstract] [Full Text] [PDF]


Home page
Exp. Biol. Med.Home page
D. P. Casey, D. T. Beck, and R. W. Braith
Progressive Resistance Training Without Volume Increases Does Not Alter Arterial Stiffness and Aortic Wave Reflection
Experimental Biology and Medicine, October 1, 2007; 232(9): 1228 - 1235.
[Abstract] [Full Text] [PDF]


Home page
Nephrol Dial TransplantHome page
F. Verbeke, W. Van Biesen, P. Peeters, L. M. Van Bortel, and R. C. Vanholder
Arterial stiffness and wave reflections in renal transplant recipients
Nephrol. Dial. Transplant., October 1, 2007; 22(10): 3021 - 3027.
[Abstract] [Full Text] [PDF]


Home page
RadiologyHome page
J. Zhang, J. G. Fletcher, T. J. Vrtiska, A. Manduca, J. L. Thompson, M. L. Raghavan, R. J. Wentz, and C. H. McCollough
Large-Vessel Distensibility Measurement with Electrocardiographically Gated Multidetector CT: Phantom Study and Initial Experience
Radiology, October 1, 2007; 245(1): 258 - 266.
[Abstract] [Full Text] [PDF]


Home page
Psychosom. Med.Home page
V. K. Yeragani, R. Kumar, K. J. Bar, P. Chokka, and M. Tancer
Exaggerated Differences in Pulse Wave Velocity Between Left and Right Sides Among Patients With Anxiety Disorders and Cardiovascular Disease
Psychosom Med, October 1, 2007; 69(8): 717 - 722.
[Abstract] [Full Text] [PDF]


Home page
HypertensionHome page
A. Benjo, R. E. Thompson, D. Fine, C. W. Hogue, D. Alejo, A. Kaw, G. Gerstenblith, A. Shah, D. E. Berkowitz, and D. Nyhan
Pulse Pressure Is an Age-Independent Predictor of Stroke Development After Cardiac Surgery
Hypertension, October 1, 2007; 50(4): 630 - 635.
[Abstract] [Full Text] [PDF]


Home page
Eur J EndocrinolHome page
F. Anan, T. Masaki, Y. Umeno, T. Iwao, H. Yonemochi, N. Eshima, T. Saikawa, and H. Yoshimatsu
Correlations of high-sensitivity C-reactive protein and atherosclerosis in Japanese type 2 diabetic patients
Eur. J. Endocrinol., September 1, 2007; 157(3): 311 - 317.
[Abstract] [Full Text] [PDF]


Home page
Diabetes and Vascular Disease ResearchHome page
M. Marre and A. Leye
Effects of perindopril in hypertensive patients with or without type 2 diabetes mellitus, and with altered insulin sensitivity
Diabetes and Vascular Disease Research, September 1, 2007; 4(3): 163 - 173.
[Abstract] [PDF]


Home page
HypertensionHome page
E. Zintzaras, G. Kitsios, D. Kent, N. J. Camp, L. Atwood, P. N. Hopkins, and S. C. Hunt
Genome-Wide Scans Meta-Analysis for Pulse Pressure
Hypertension, September 1, 2007; 50(3): 557 - 564.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
M. F. O'Rourke and J. Hashimoto
Mechanical Factors in Arterial Aging: A Clinical Perspective
J. Am. Coll. Cardiol., July 3, 2007; 50(1): 1 - 13.
[Abstract] [Full Text] [PDF]


Home page
Eur J EndocrinolHome page
D. A Stakos, D. P Schuster, E. A Sparks, S. B. Meis, C. F Wooley, K. Osei, and H. Boudoulas
Association between glycosylated hemoglobin, left ventricular mass and aortic function in nondiabetic individuals with insulin resistance
Eur. J. Endocrinol., July 1, 2007; 157(1): 63 - 68.
[Abstract] [Full Text] [PDF]


Home page
HypertensionHome page
M. J. Roman, R. B. Devereux, J. R. Kizer, E. T. Lee, J. M. Galloway, T. Ali, J. G. Umans, and B. V. Howard
Central Pressure More Strongly Relates to Vascular Disease and Outcome Than Does Brachial Pressure: The Strong Heart Study
Hypertension, July 1, 2007; 50(1): 197 - 203.
[Abstract] [Full Text] [PDF]


Home page
HypertensionHome page
M. Flamant, S. Placier, C. Dubroca, B. Esposito, I. Lopes, C. Chatziantoniou, A. Tedgui, J.-C. Dussaule, and S. Lehoux
Role of Matrix Metalloproteinases in Early Hypertensive Vascular Remodeling
Hypertension, July 1, 2007; 50(1): 212 - 218.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
D. Levy, S.-J. Hwang, A. Kayalar, E. J. Benjamin, R. S. Vasan, H. Parise, M. G. Larson, T. J. Wang, J. Selhub, P. F. Jacques, et al.
Associations of Plasma Natriuretic Peptide, Adrenomedullin, and Homocysteine Levels With Alterations in Arterial Stiffness: The Framingham Heart Study
Circulation, June 19, 2007; 115(24): 3079 - 3085.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart JHome page
Authors/Task Force Members:, G. Mancia, G. De Backer, A. Dominiczak, R. Cifkova, R. Fagard, G. Germano, G. Grassi, A. M. Heagerty, S. E. Kjeldsen, et al.
2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)
Eur. Heart J., June 11, 2007; (2007) ehm236v1.
[Full Text] [PDF]


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ANGIOLOGYHome page
K. G. Moulakakis, D. P. Sokolis, D. N. Perrea, T. Dosios, I. Dontas, M. V. Poulakou, C. A. Dimitriou, G. Sandris, and P. E. Karayannacos
The Mechanical Performance and Histomorphological Structure of the Descending Aorta in Hyperthyroidism
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HypertensionHome page
G. F. Mitchell, M. E. Dunlap, W. Warnica, A. Ducharme, J. M. O. Arnold, J.-C. Tardif, S. D. Solomon, M. J. Domanski, K. A. Jablonski, M. M. Rice, et al.
Long-Term Trandolapril Treatment Is Associated With Reduced Aortic Stiffness: The Prevention of Events With Angiotensin-Converting Enzyme Inhibition Hemodynamic Substudy
Hypertension, June 1, 2007; 49(6): 1271 - 1277.
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ChestHome page
L. F. Drager, L. A. Bortolotto, A. C. Figueiredo, B. C. Silva, E. M. Krieger, and G. Lorenzi-Filho
Obstructive Sleep Apnea, Hypertension, and Their Interaction on Arterial Stiffness and Heart Remodeling
Chest, May 1, 2007; 131(5): 1379 - 1386.
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Eur Heart JHome page
C. Tsioufis, K. Dimitriadis, M. Selima, C. Thomopoulos, C. Mihas, I. Skiadas, D. Tousoulis, C. Stefanadis, and I. Kallikazaros
Low-grade inflammation and hypoadiponectinaemia have an additive detrimental effect on aortic stiffness in essential hypertensive patients
Eur. Heart J., May 1, 2007; 28(9): 1162 - 1169.
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HypertensionHome page
G. Schillaci, G. Parati, M. Pirro, G. Pucci, M. R. Mannarino, L. Sperandini, and E. Mannarino
Ambulatory Arterial Stiffness Index Is Not a Specific Marker of Reduced Arterial Compliance
Hypertension, May 1, 2007; 49(5): 986 - 991.
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N. A. Jatoi, P. Jerrard-Dunne, J. Feely, and A. Mahmud
Impact of Smoking and Smoking Cessation on Arterial Stiffness and Aortic Wave Reflection in Hypertension
Hypertension, May 1, 2007; 49(5): 981 - 985.
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