Influence of arterial stiffness on cardiovascular outcome in patients without high blood pressure

Keishi Ichikawa, Satoru Sakuragi, Takahiro Nishihara, Masahiro Tsuji, Atsushi Mori, Fumi Yokohama, Tadashi Wada, Daiji Hasegawa, Kenji Kawamoto, Machiko Tanakaya, Yusuke Katayama, Hiroshi Itoh

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVE: Although blood pressure (BP) is a major determinant of arterial stiffness, whether high pulse wave velocity (PWV) adversely influences cardiac parameters and cardiovascular (CV) outcome in patients without high BP remains unclear. METHODS: Outpatients without high BP (n=320), defined as systolic BP ≥140 mm Hg, were enrolled in this retrospective study. At baseline, all patients underwent echocardiography and multidetector CT to determine the coronary artery calcification (CAC) score. Arterial stiffness was assessed based on brachial-ankle PWV (baPWV), from which patients were classified into two groups: those with high (≥18 m/s, n=89) and low baPWV (<18 m/s, n=231). Cardiac parameters and CV event incidence during the follow-up period were compared between these groups. RESULTS: In multivariable linear regression analysis, baPWV was significantly associated with CAC score and serum N-terminal pro-brain natriuretic peptide hormone level, after adjustment for confounding factors. In multivariable logistic regression analysis, baPWV ≥18 m/s was significantly associated with CAC score ≥400 (OR 2.466, 95% CI 1.012 to 6.009, p=0.0471). Kaplan-Meier analysis showed that the high-baPWV group experienced more CV events during the 575 days of follow-up (20% vs 6%, p=0.0003). CONCLUSIONS: High baPWV was associated with greater CAC and a high risk of a future CV event, especially coronary artery disease, even in patients without high BP.

Original languageEnglish
Pages (from-to)318-323
Number of pages6
JournalHeart (British Cardiac Society)
Volume104
Issue number4
DOIs
Publication statusPublished - Feb 1 2018

Fingerprint

Vascular Stiffness
Ankle
Arm
Hypertension
Coronary Vessels
Pulse Wave Analysis
Blood Pressure
Regression Analysis
Natriuretic Peptides
Brain Natriuretic Peptide
Kaplan-Meier Estimate
Echocardiography
Coronary Artery Disease
Linear Models
Outpatients
Retrospective Studies
Logistic Models
Incidence
Serum

Keywords

  • Coronary Artery Disease
  • Hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Influence of arterial stiffness on cardiovascular outcome in patients without high blood pressure. / Ichikawa, Keishi; Sakuragi, Satoru; Nishihara, Takahiro; Tsuji, Masahiro; Mori, Atsushi; Yokohama, Fumi; Wada, Tadashi; Hasegawa, Daiji; Kawamoto, Kenji; Tanakaya, Machiko; Katayama, Yusuke; Itoh, Hiroshi.

In: Heart (British Cardiac Society), Vol. 104, No. 4, 01.02.2018, p. 318-323.

Research output: Contribution to journalArticle

Ichikawa, K, Sakuragi, S, Nishihara, T, Tsuji, M, Mori, A, Yokohama, F, Wada, T, Hasegawa, D, Kawamoto, K, Tanakaya, M, Katayama, Y & Itoh, H 2018, 'Influence of arterial stiffness on cardiovascular outcome in patients without high blood pressure', Heart (British Cardiac Society), vol. 104, no. 4, pp. 318-323. https://doi.org/10.1136/heartjnl-2017-311751
Ichikawa, Keishi ; Sakuragi, Satoru ; Nishihara, Takahiro ; Tsuji, Masahiro ; Mori, Atsushi ; Yokohama, Fumi ; Wada, Tadashi ; Hasegawa, Daiji ; Kawamoto, Kenji ; Tanakaya, Machiko ; Katayama, Yusuke ; Itoh, Hiroshi. / Influence of arterial stiffness on cardiovascular outcome in patients without high blood pressure. In: Heart (British Cardiac Society). 2018 ; Vol. 104, No. 4. pp. 318-323.
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AU - Ichikawa, Keishi

AU - Sakuragi, Satoru

AU - Nishihara, Takahiro

AU - Tsuji, Masahiro

AU - Mori, Atsushi

AU - Yokohama, Fumi

AU - Wada, Tadashi

AU - Hasegawa, Daiji

AU - Kawamoto, Kenji

AU - Tanakaya, Machiko

AU - Katayama, Yusuke

AU - Itoh, Hiroshi

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N2 - OBJECTIVE: Although blood pressure (BP) is a major determinant of arterial stiffness, whether high pulse wave velocity (PWV) adversely influences cardiac parameters and cardiovascular (CV) outcome in patients without high BP remains unclear. METHODS: Outpatients without high BP (n=320), defined as systolic BP ≥140 mm Hg, were enrolled in this retrospective study. At baseline, all patients underwent echocardiography and multidetector CT to determine the coronary artery calcification (CAC) score. Arterial stiffness was assessed based on brachial-ankle PWV (baPWV), from which patients were classified into two groups: those with high (≥18 m/s, n=89) and low baPWV (<18 m/s, n=231). Cardiac parameters and CV event incidence during the follow-up period were compared between these groups. RESULTS: In multivariable linear regression analysis, baPWV was significantly associated with CAC score and serum N-terminal pro-brain natriuretic peptide hormone level, after adjustment for confounding factors. In multivariable logistic regression analysis, baPWV ≥18 m/s was significantly associated with CAC score ≥400 (OR 2.466, 95% CI 1.012 to 6.009, p=0.0471). Kaplan-Meier analysis showed that the high-baPWV group experienced more CV events during the 575 days of follow-up (20% vs 6%, p=0.0003). CONCLUSIONS: High baPWV was associated with greater CAC and a high risk of a future CV event, especially coronary artery disease, even in patients without high BP.

AB - OBJECTIVE: Although blood pressure (BP) is a major determinant of arterial stiffness, whether high pulse wave velocity (PWV) adversely influences cardiac parameters and cardiovascular (CV) outcome in patients without high BP remains unclear. METHODS: Outpatients without high BP (n=320), defined as systolic BP ≥140 mm Hg, were enrolled in this retrospective study. At baseline, all patients underwent echocardiography and multidetector CT to determine the coronary artery calcification (CAC) score. Arterial stiffness was assessed based on brachial-ankle PWV (baPWV), from which patients were classified into two groups: those with high (≥18 m/s, n=89) and low baPWV (<18 m/s, n=231). Cardiac parameters and CV event incidence during the follow-up period were compared between these groups. RESULTS: In multivariable linear regression analysis, baPWV was significantly associated with CAC score and serum N-terminal pro-brain natriuretic peptide hormone level, after adjustment for confounding factors. In multivariable logistic regression analysis, baPWV ≥18 m/s was significantly associated with CAC score ≥400 (OR 2.466, 95% CI 1.012 to 6.009, p=0.0471). Kaplan-Meier analysis showed that the high-baPWV group experienced more CV events during the 575 days of follow-up (20% vs 6%, p=0.0003). CONCLUSIONS: High baPWV was associated with greater CAC and a high risk of a future CV event, especially coronary artery disease, even in patients without high BP.

KW - Coronary Artery Disease

KW - Hypertension

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