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Hypertension. 2002;39:10-15
doi: 10.1161/hy0102.099031
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(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

Pierre Boutouyrie; Anne Isabelle Tropeano; Roland Asmar; Isabelle Gautier; Athanase Benetos; Patrick Lacolley; Stéphane Laurent

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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CirculationHome page
T. Willum Hansen, J. A. Staessen, C. Torp-Pedersen, S. Rasmussen, L. Thijs, H. Ibsen, and J. Jeppesen
Prognostic Value of Aortic Pulse Wave Velocity as Index of Arterial Stiffness in the General Population
Circulation, February 7, 2006; 113(5): 664 - 670.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
M. C. H. Leung, I. T. Meredith, and J. D. Cameron
Aortic stiffness affects the coronary blood flow response to percutaneous coronary intervention
Am J Physiol Heart Circ Physiol, February 1, 2006; 290(2): H624 - H630.
[Abstract] [Full Text] [PDF]


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HypertensionHome page
K. Kisters, B. Gremmler, M. Hausberg, and S. Laurent
Magnesium and Arterial Stiffness * Response
Hypertension, February 1, 2006; 47(2): e3 - e3.
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Eur Heart JHome page
T. Weber, J. Auer, M. F. O'Rourke, E. Kvas, E. Lassnig, G. Lamm, N. Stark, M. Rammer, and B. Eber
Increased arterial wave reflections predict severe cardiovascular events in patients undergoing percutaneous coronary interventions
Eur. Heart J., December 2, 2005; 26(24): 2657 - 2663.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
S. A. Hope, D. B. Tay, I. T. Meredith, and J. D. Cameron
Waveform dispersion, not reflection, may be the major determinant of aortic pressure wave morphology
Am J Physiol Heart Circ Physiol, December 1, 2005; 289(6): H2497 - H2502.
[Abstract] [Full Text] [PDF]


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StrokeHome page
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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StrokeHome page
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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Rheumatology (Oxford)Home page
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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HypertensionHome page
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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J. Clin. Endocrinol. Metab.Home page
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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HeartHome page
J A Vita
Endothelial function and clinical outcome
Heart, October 1, 2005; 91(10): 1278 - 1279.
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J. Appl. Physiol.Home page
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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Arterioscler. Thromb. Vasc. Bio.Home page
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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Am. J. Clin. Nutr.Home page
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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HypertensionHome page
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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HypertensionHome page
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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HypertensionHome page
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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HypertensionHome page
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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Eur Heart JHome page
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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Eur Heart JHome page
S. Laurent
Arterial stiffness: intermediate or surrogate endpoint for cardiovascular events?
Eur. Heart J., June 2, 2005; 26(12): 1152 - 1154.
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J. Appl. Physiol.Home page
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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HypertensionHome page
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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Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
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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HeartHome page
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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J. Clin. Endocrinol. Metab.Home page
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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Cardiovasc ResHome page
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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HypertensionHome page
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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CirculationHome page
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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HypertensionHome page
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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HypertensionHome page
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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HypertensionHome page
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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Ann Rheum DisHome page
S Van Doornum, G McColl, and I P Wicks
Atorvastatin reduces arterial stiffness in patients with rheumatoid arthritis
Ann Rheum Dis, December 1, 2004; 63(12): 1571 - 1575.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
X. Lu, A. Pandit, and G. S. Kassab
Biaxial incremental homeostatic elastic moduli of coronary artery: two-layer model
Am J Physiol Heart Circ Physiol, October 1, 2004; 287(4): H1663 - H1669.
[Abstract] [Full Text] [PDF]