Arterial Stiffness as a Predictor of the Index of Atherosclerotic Cardiovascular Disease in Hypertensive Patients

Abstract

Objective: The aim of this study was to evaluate the predictive value of carotid-femoral pulse wave velocity (cfPWV) and cardiovascular disease in the hypertensive population in China and to determine the specific cfPWV cut-off value for assessing future cardiovascular disease (CVD) risk. Methods: This cross-sectional study included 630 hospital patients with primary hypertension and multiple cardiovascular risk factors or complications involving damage to clinical target organs. The study was conducted between July 2007 and October 2008. Atherosclerotic cardiovascular disease (ASCVD) risk calculations were computed according to criteria presented by the American College of Cardiology and the American Heart Association. Patients were stratified by a predefined risk threshold of 10% and divided into two groups: ASCVD ≥ 10% or ASCVD < 10%. cfPWV was used as a marker of arterial stiffness. A receiver operating characteristics (ROC) curve was applied to establish the optimal cfPWV cut-off point to differentiate between participants with and without ASCVD risk. Results: In the study cohort of 630 patients (age 63.55.2 ± 8.6 years, 61.7% male) with primary hypertension, the pressure indices (augmented pressure, augmentation index [AIx], aortic pulse pressure, aortic systolic pressure [SBP]) and Framingham Risk Scores (FRS) were greater in females than in males (p < 0.001); ASCVD risk scores and peripheral diastolic pressure (DBP) were higher in males (p < 0.05). All hemodynamic indices showed a significant positive correlation with ASCVD risk scores and FRS; AIx was not correlated with ASCVD risk scores. In multivariate logistic analysis, cfPWV was significantly associated with ASCVD risk (OR: 1.324, 95% confidence interval: 1.119–1.565, p < 0.001) after adjusting for age, gender, smoking, body mass index, total cholesterol, fasting blood glucose, antihypertensive treatment, statin treatment, and DBP. In the ROC analysis, the area under the curve was 0.758 and 0.672 for cfPWV and aortic SBP (p < 0.001 and p < 0.001, respectively); the optimal critical value of cfPWV and aortic SBP was 12.45 m/s (sensitivity 63.2%, specificity 77.8%) and 124.5 mmHg (sensitivity 63.9%, specificity 65.3%). Conclusions: cfPWV is significantly correlated with the risk of ASCVD. The best cut-off value of cfPWV for assessing future CVD risk in the hypertensive population in China is 12.45 m/s.

“The impact of statins addind to the fixed combination antihypertensive therapy on the arterial stiffness in patients with moderate and severe hypertension"

“…Authors found the strong association between the arterial stiffness measured as PWV with the atherosclerotic cardiovascular disease (ASCVD) risk. Authors indicated that PWV 12.45 m/s was a good predictor of high CVD risk [ 35 ].…”

Correlation analysis of central arterial pressure parameters and the severity of atherosclerotic lesions in coronary arteries: A retrospective study

“…[ 10 , 11 ] Recent studies have suggested that CAP, independent of peripheral arterial pressure, holds significant predictive value for the occurrence, development, and clinical outcomes of cardiovascular diseases, making it a crucial risk factor for cardiovascular conditions. [ 12 , 13 ] Roman et al found a notable increase in the cardiovascular event rate among individuals with CAP values exceeding 50 mm Hg. [ 14 ] Furthermore, a meta-analysis conducted by Vlachopoulos et al identified pulse pressure, particularly CPP, as an independent predictor of cardiovascular events and all-cause mortality.…”

The predictive value of arterial stiffness combined with hypertension in the index of atherosclerotic cardiovascular disease

“…Whereas, study indicated AS, as target organ damage of hypertension, increased the risk of ASCVD 10, 11 , hinting that ASCVD may be attributable to hypertension and its vascular damage. However, the mediating effect analysis indicated that AS appeared to precede the increase in blood pressure 7 .…”