Aortic pulse pressure and extent of coronary artery disease in percutaneous transluminal coronary angioplasty candidates

Philippe, François; Chemaly, Elie R.; Blacher, Jacques; Mourad, Jean‐Jacques; Dibié, Alain; Larrazet, Fabrice; Laborde, F; Safar, Michel E.

doi:10.1016/s0895-7061(02)02961-8

Cited by 58 publications

(38 citation statements)

References 19 publications

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“…20 Accordingly, central measures of blood pressure, including PP, have found significant associations with prevalent coronary artery disease and incident CVD. 21,22 Similarly, previous studies have demonstrated a significant association between reduced arterial compliance and coronary artery disease 23,24 and CAC. 25 This is especially relevant given the age distribution of our participants who were all postmenopausal and 50 years of age or older at the time of the baseline blood pressure measurements.…”

Section: Discussionmentioning

confidence: 70%

Association Between Different Measures of Blood Pressure and Coronary Artery Calcium in Postmenopausal Women

et al. 2008

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Abstract-The aim of this study was to determine the magnitude and significance of the associations among coronary artery calcium (CAC) and systolic blood pressure, diastolic blood pressure, pulse pressure, and mean arterial pressure. Women 50 to 59 years of age at baseline in the Women's Health Initiative clinical trial of conjugated equine estrogen underwent computed tomography scanning of the chest after the end of the trial. Blood pressures were measured twice with the participant in the seated position using a conventional mercury sphygmomanometer. The study included 1064 women with a mean age of 55.1 (2.8) years. The prevalence of a CAC score Ͼ0, Ն10, and Ͼ100 was 47%, 39%, and 19%, respectively. There was a linear association between the log-odds of any CAC and systolic blood pressure, whereas there was a curvilinear and inverse association with diastolic blood pressure. For any value of diastolic blood pressure, the probability of CAC increased with higher levels of systolic blood pressure, whereas for any given value of systolic blood pressure, the probability of any CAC decreased with higher levels of diastolic blood pressure. Also, a pulse pressure Ն55 mm Hg was associated with a higher odds (1.95; 95% CI, 1.24 to 3.06) for having any CAC, whereas individuals with isolated systolic hypertension had a 73% higher odds for CAC Ͼ0 (95% CI, 1.03 to 2.90; Pϭ0.04).In postmenopausal women, higher levels of pulse pressure and systolic blood pressure were strong determinants of CAC, whereas diastolic blood pressure was inversely related. Key Words: calcium Ⅲ coronary Ⅲ pulse pressure Ⅲ women Ⅲ coronary artery disease Ⅲ atherosclerosis Ⅲ postmenopausal I n a regulated process similar to skeletal bone formation, 1 calcium is deposited in atherosclerotic plaques. 2 With the advent of computed tomography (CT), these calcified atheromatous plaques can be detected throughout the vasculature. 3 Moreover, because of decreases in the acquisition time required to obtain the images, these calcium deposits can also be visualized in the coronary arteries. 4 The extent of calcified coronary atherosclerotic plaques is highly correlated with both the total atheromatous plaque burden 5 and the percentage of stenosis 6 in that vascular bed as well as being a strong and independent predictor of incident coronary heart disease (CHD) events in both men and women. 7,8 Coronary artery calcium (CAC) is increasingly advocated as a component of individual cardiovascular disease (CVD) risk stratification procedures. 9 Accordingly, knowledge of the differential associations between risk factors for CAC and CHD is clinically relevant. Previous studies have found significant associations among several CVD risk factors (age, male sex, cigarette smoking, diabetes, and family history) of CHD and the presence and extent of CAC, 10,11 whereas the associations for different cholesterol fractions are more modest. 12 Notably, hypertension has been shown to be strongly associated with the presence of CAC. 13 However, previous reports have not typical...

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Section: Discussionmentioning

confidence: 70%

Association Between Different Measures of Blood Pressure and Coronary Artery Calcium in Postmenopausal Women

et al. 2008

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“…11,16,17 Invasive intra-aortic SBP and DBP were measured at the time of coronary angiography using a fluid-filled catheter at baseline before any injection of contrast medium as previously documented. 13 Aortic PP was calculated as the difference between aortic SBP and aortic DBP.…”

Section: Methodsmentioning

confidence: 99%

“…Left ventricular EF was measured on the 301 right anterior oblique projection, using the commercial software available at each of the participating centres. [10][11][12][13][14][15][16] All measurements were performed in the morning and at stable room temperature, after an overnight fast. Brachial BP measurements were performed by traditional mercury sphygmomanometer in the supine position after a 15 min rest in the laboratory, using the first and the fifth Korotkoff sounds for SBP and DBP, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…K Several studies have shown a significant association between aortic PP (but not aortic systolic blood pressure (SBP)) with the presence and extent of atherosclerotic stenosis of the coronary arteries 11,13,15,16 in patients with normal cardiac function.…”

Section: Conflict Of Interestmentioning

confidence: 99%

“…[10][11][12][13] Several of them have shown a significant association between aortic PP (but not aortic SBP) or aortic stiffness with the presence and extent of atherosclerotic stenosis of the coronary arteries. 11,13,14 However such investigations were mainly documented in subjects with preserved cardiac function, as judged from ejection fractions (EFs). Studies in populations at high CV risk and consistently reduced EF are more difficult to interpret.…”

Section: Introductionmentioning

confidence: 99%

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Aortic pulse pressure and atherosclerotic structural alterations of coronary arteries

Mourad

Danchin²,

Rudnichi

et al. 2009

J Hum Hypertens

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Pulse pressure (PP) is an independent predictor of myocardial infarction, mainly above 50 years of age. In subjects with preserved ejection fraction (EF), aortic PP predicts the severity of coronary atherosclerosis. Comparable findings in subjects with reduced EF have not been evaluated. In 1337 subjects with severe coronary ischaemic disease, intra-aortic and brachial blood pressures were measured together with EF and coronary angiography to evaluate cardiac function, the presence of coronary stenosis and/or occlusions or calcifications. The presence (odds ratio±95% CI) of coronary calcification was marginally but not significantly associated (P ¼ 0.06) to increased aortic PP (1.32 (0.97-1.80)), whereas that of coronary occlusion was significantly associated (Po0.01) with decreased aortic PP (0.62 (0.42-0.91)), even after adjustment to EF and heart rate. Increased aortic PP did not correlate with stenosis number. No comparable predictive value was observed using intra-aortic or non-invasive brachial systolic blood pressure (SBP) or diastolic blood pressure (DBP). In high cardiovascular risk populations, even in the presence of reduced EF and high heart rate, intra-aortic PP, but not SBP or DBP, is a significant predictor of coronary occlusions and possibly calcifications, but not stenosis.

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Arterial Stiffness, Central Blood Pressure and Coronary Heart Disease

Jankowski

Blacher

Weber

2014

Blood Pressure and Arterial Wall Mechanics in Cardiovascular Diseases

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Aortic pulse pressure and extent of coronary artery disease in percutaneous transluminal coronary angioplasty candidates

Abstract: In this study, aortic pulse pressure was a significant risk factor for the extent of coronary artery disease. There was only a borderline significant association of restenosis to the steady, but not pulsatile, component of aortic BP in the stent era.

Cited by 58 publications

References 19 publications

Association Between Different Measures of Blood Pressure and Coronary Artery Calcium in Postmenopausal Women

Association Between Different Measures of Blood Pressure and Coronary Artery Calcium in Postmenopausal Women

Aortic pulse pressure and atherosclerotic structural alterations of coronary arteries

Arterial Stiffness, Central Blood Pressure and Coronary Heart Disease

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