Aortic Stiffness Is an Independent Predictor of Fatal Stroke in Essential Hypertension
Top Cited Papers
- 1 May 2003
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 34 (5), 1203-1206
- https://doi.org/10.1161/01.str.0000065428.03209.64
Abstract
Background and Purpose— Pulse pressure is a stronger predictor of cardiovascular events than systolic or diastolic blood pressure in large cohorts of French and North American patients. However, its influence on stroke is controversial. Large-artery stiffness is the main determinant of pulse pressure. The influence of arterial stiffness on the occurrence of stroke has never been demonstrated. Our aim was to establish the relationship between aortic stiffness and stroke death in hypertensive patients. Methods— We included, in a longitudinal study, 1715 essential hypertensive patients who had a measurement of arterial stiffness at entry (ie, between 1980 and 2001) and no overt cardiovascular disease or symptoms. Mean follow-up was 7.9 years. At entry, aortic stiffness was assessed from the carotid-femoral pulse wave velocity. A Cox proportional hazard regression model was used to estimate the relative risk (RR) of stroke and coronary deaths. Results— Mean±SD age at entry was 51±13 years. Twenty-five fatal strokes and 35 fatal coronary events occurred. Pulse wave velocity significantly predicted the occurrence of stroke death in the whole population. There was a RR increase of 1.72 (95% CI, 1.48 to 1.96; P P =0.02) after full adjustment for classic cardiovascular risk factors, including age, cholesterol, diabetes, smoking, mean blood pressure, and pulse pressure. In this population, pulse pressure significantly predicted stroke in univariate analysis, with a RR increase of 1.33 (95% CI, 1.16 to 1.51) for each 10 mm Hg of pulse pressure ( P P =0.10). Conclusions— This study provides the first evidence, in a longitudinal study, that aortic stiffness is an independent predictor of fatal stroke in patients with essential hypertension.Keywords
This publication has 13 references indexed in Scilit:
- Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attackThe Lancet, 2001
- Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)JAMA, 2001
- Functional Arteries Grown in VitroScience, 1999
- The Prevalence and Severity of White Matter Lesions, Their Relationship with Age, Ethnicity, Gender, and Cardiovascular Disease Risk Factors: The ARIC StudyNeuroepidemiology, 1997
- J-shaped relation between change in diastolic blood pressure and progression of aortic atherosclerosisThe Lancet, 1994
- Determinants of carotid intima‐media thickness: a population‐based ultrasonography study in Eastern Finnish menJournal of Internal Medicine, 1991
- Pulse pressure in essential hypertension: clinical and therapeutical implicationsJournal of Hypertension, 1989
- Systolic Blood Pressure, Arterial Rigidity, and Risk of StrokeJAMA, 1981
- Cyclic Stretching Stimulates Synthesis of Matrix Components by Arterial Smooth Muscle Cells in VitroScience, 1976
- The velocity of pulse wave in manProceedings of the Royal Society of London. Series B, Containing Papers of a Biological Character, 1922