Increased arterial stiffness and cardiovascular risk prediction in controlled hypertensive patients with coronary artery disease: post hoc analysis of FMD-J (Flow-mediated Dilation Japan) Study A

Tatsuya Maruhashi, Junko Soga, Noritaka Fujimura, Naomi Idei, Shinsuke Mikami, Yumiko Iwamoto, Akimichi Iwamoto, Masato Kajikawa, Takeshi Matsumoto, Nozomu Oda, Shinji Kishimoto, Shogo Matsui, Haruki Hashimoto, Yuji Takaeko, Takayuki Yamaji, Takahiro Harada, Yiming Han, Yoshiki Aibara, Farina Mohamad Yusoff, Takayuki HidakaYasuki Kihara, Kazuaki Chayama, Kensuke Noma, Ayumu Nakashima, Chikara Goto, Hirofumi Tomiyama, Bonpei Takase, Takahide Kohro, Toru Suzuki, Tomoko Ishizu, Shinichiro Ueda, Tsutomu Yamazaki, Tomoo Furumoto, Kazuomi Kario, Teruo Inoue, Shinji Koba, Kentaro Watanabe, Yasuhiko Takemoto, Takuzo Hano, Masataka Sata, Yutaka Ishibashi, Koichi Node, Koji Maemura, Yusuke Ohya, Taiji Furukawa, Hiroshi Ito, Hisao Ikeda, Akira Yamashina, Yukihito Higashi

Research output: Contribution to journalArticle

Abstract

The usefulness of brachial–ankle pulse wave velocity (baPWV), an index of arterial stiffness, is not fully known for the management of treated hypertensive patients with a history of coronary artery disease (CAD) who have blood pressure less than 130/80 mmHg, a recommended blood pressure target in the updated major hypertension guidelines. We analyzed data for 447 treated hypertensive patients with CAD enrolled in FMD-J Study A for assessment of the predictive value of baPWV for future cardiovascular events. The primary outcome was a composite of coronary events, stroke, heart failure, and sudden death. During a median follow-up period of 47.6 months, the primary outcome occurred in 64 patients. Blood pressure less than 130/80 mmHg was significantly associated with a lower risk of the composite outcome independent of other cardiovascular risk factors in treated hypertensive patients with CAD (hazard ratio, 0.59; 95% confidence interval (CI), 0.35–0.99; P = 0.04). In treated hypertensive patients with CAD who had blood pressure less than 130/80 mmHg, baPWV above the cutoff value of 1731 cm/s, derived from receiver–operator characteristic curve analysis for the composite outcome was significantly associated with a higher risk of the composite outcome independent of conventional risk factors (hazard ratio, 2.83; 95% CI, 1.02–7.91; P = 0.04). baPWV was an independent predictor of cardiovascular events in treated hypertensive patients with CAD who had blood pressure less than 130/80 mmHg, for whom measurement of baPWV is recommended for cardiovascular risk assessment.

Original languageEnglish
Pages (from-to)781-790
Number of pages10
JournalHypertension Research
Volume43
Issue number8
DOIs
Publication statusPublished - Aug 1 2020

Keywords

  • Arterial stiffness
  • Blood pressure
  • Brachial–ankle pulse wave velocity
  • Coronary artery disease
  • Hypertension

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Maruhashi, T., Soga, J., Fujimura, N., Idei, N., Mikami, S., Iwamoto, Y., Iwamoto, A., Kajikawa, M., Matsumoto, T., Oda, N., Kishimoto, S., Matsui, S., Hashimoto, H., Takaeko, Y., Yamaji, T., Harada, T., Han, Y., Aibara, Y., Mohamad Yusoff, F., ... Higashi, Y. (2020). Increased arterial stiffness and cardiovascular risk prediction in controlled hypertensive patients with coronary artery disease: post hoc analysis of FMD-J (Flow-mediated Dilation Japan) Study A. Hypertension Research, 43(8), 781-790. https://doi.org/10.1038/s41440-020-0420-6