Abstract 12622: Aortic Pulse Wave Velocity is Associated With Measures of Sub-Clinical Disease in Several Arterial Beds
Introduction: Arterial stiffness is associated with adverse cardiovascular events in patients with hypertension.
Hypothesis: We hypothesized that aortic pulse wave velocity (aPWV), an established marker of arterial stiffness, is associated with measures of sub-clinical vascular disease: coronary artery calcification (CAC), ankle-brachial index (ABI), brain white matter hyperintensity (WMH) and urine albumin-creatinine ratio (UACR).
Methods: Subjects (n = 874) from hypertensive sibships underwent measurement of aPWV by ECG-gated waveforms of the right carotid and femoral arteries obtained by applanation tonometry. We excluded 51 patients with history of myocardial infarction or stroke and 8 patients with technically difficult aPWV studies, leaving 815 subjects (mean age 58 years, 58% women, 71% hypertensive, 11% diabetic) for the final analysis. CAC was measured by electron beam computed tomography. ABI was measured using a standard protocol. The volume of WMH was quantified by brain magnetic resonance imaging. UACR was expressed as mg albumin/gm creatinine. WMH was log-transformed, and UACR and CAC were log-transformed after adding 1. The associations of aPWV with CAC, ABI, WMH and UACR were assessed by multivariable regression with backward elimination using generalized estimating equations to account for the presence of sibships. Adjustment variables included age, sex, conventional risk factors for vascular disease, and use of aspirin and statins. (Table)
Results: Mean (± SD) PWV was 9.8±3.1 m/s. After adjustment for relevant covariates, higher aPWV was associated with greater CAC and WMH and lower ABI. No association was noted between aPWV and UACR (Table).
Conclusions: aPWV was independently associated with sub-clinical vascular disease in coronary, cerebral and peripheral arterial beds. Prospective studies are required to ascertain whether arterial de-stiffening helps prevent target organ damage in the setting of hypertension.
- © 2010 by American Heart Association, Inc.