Aortic pulse wave velocity as a prognostic tool of hypertension in obesity

Abstract

Objective. The aim was to assess the role of the aortic pulse wave velocity (PWVao) as additional predictor of hypertension (HTN) development in men with obesity.Design and methods. 526 men without HTN (according to ambulatory blood pressure monitoring (ABPM) without therapy) (age 45,1 ± 5,0 years) with abdominal obesity (waist circumference > 94 cm) and SCORE < 5 %, without cardiovascular diseases and diabetes mellitus were examined. The diagnostic tests included the lipid and glucose profiles, creatinine, albuminuria evaluation, echocardiography, carotid ultrasound, bifunctional ABPM (portable recorder BPLab®) with average daily PWVao assessment. Patients with subclinical carotid atherosclerosis (n = 98) were excluded from the follow-up. Follow-up examination including ABPM was conducted on average after 46,3 ± 5,1 months.Results. Data of 406 subjects were available for analysis. HTN defined as average daily BP ≥ 130/80 mm Hg was found in 157 patients (38,7 %). The mathematical model included the following parameters: age, body mass index, mean daily systolic BP and mean daily PWVao. Among these predictors a PWVao was characterized by the highest standardized regression coefficient (0,461, p < 0,001). The area under the ROC-curve was 0,945 (95 % confidence interval 0,920–0,971, р < 0,001). At the selected cut-off point of PWVao 7,7 m/s the sensitivity and specificity of the model were 85,4 % and 96,8 %, respectively.Conclusions. The mathematical model for assessing the probability of HTN development in patients with obesity which includes the PWVao is characterized by a high overall percentage of correct classifications with comparability with actual data. Bifunctional ABPM with the PWVao evaluation in patients with obesity is the preferred method for additional prognostic assessment.