Published Online
on February 2, 2004

A more recent version of this article appeared on March 1, 2004

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Submitted on July 29, 2003
Revised on August 19, 2003

Pulse Pressure Is an Independent Predictor for the Progression of Aortic Wall Calcification in Patients With Controlled Hyperlipidemia

Yoshikazu Miwa^*; Motoo Tsushima; Hisatomi Arima; Yuhei Kawano; and Toshiyuki Sasaguri

From Divisions of Hypertension and Nephrology (Y.M., Y.K.) and Atherosclerosis and Metabolism (M.T.), Department of Internal Medicine, National Cardiovascular Center, Suita; and Departments of Clinical Pharmacology (Y.M., T.S.) and Medicine and Clinical Science (H.A.), Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

^* To whom correspondence should be addressed. E-mail: ymiwa{at}clipharm.med.kyushu-u.ac.jp.

Abstract--Recent epidemiological studies suggested that calcifications of the aorta and the coronary arteries are important predictors for cardiovascular morbidity and mortality. However, the relation between blood pressure components and the progression of vascular wall calcification has remained unclear. We quantified calcium deposits in the abdominal aorta as the percentage of aortic calcification volume (%ACV) using computed tomography in patients with hyperlipidemia. Those who had aortic calcification were treated with lipid-lowering agents and followed-up for >2 years (6.3±3.2 years). The relationship between the components of blood pressure and the increase in %ACV per year (%ACV/year) was assessed in subjects in whom serum lipid levels were well controlled during the follow-up periods. An age- and sex-adjusted correlation analysis showed that %ACV/year was significantly correlated to body mass index (r=0.229, P=0.015), systolic blood pressure (r=0.244, P=0.009), and pulse pressure (r=0.359, P<0.001). A multivariate regression analysis revealed that pulse pressure is an independent and the most sensitive predictor for %ACV/year (=0.389, P<0.001) among the blood pressure components. These results suggested that increase in pulse pressure promotes the progression of vascular calcification.

Key words: hypertension • calcium • aorta • pulse • imaging • risk factors

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