5. Brachial-Ankle and Regional Pulse Wave Velocity as a Prognostic Impact in Hypertension

Abstract

Background

Many reports have shown that brachial-ankle pulse wave velocity (baPWV) as well as carotid-femoral PWV would be one of the prognostic factors for hypertension. We can evaluate heart-carotid PWV (hcPWV), heart-femoral PWV (hfPWV), femoral-ankle PWV (faPWV) using carotid and femoral sensor of form PWV/ABI. Therefore we examined prognostic impact of each regional PWV on stroke and cardiovascular disease (CVD) compared with baPWV in the cohort study of hypertensive patients.

Methods

This study included 387 patients with essential hypertension (male/female = 218/169, mean age 61.1 ± 11.8, mean follow period 43months) whose ba- and regional PWV could be measured from October, 2000 to December, 2004. We set up stroke (n = 20) and CVD (n = 21) as a primary end point by the questionnaire. We classified the participants by the highest quartile of each PWV; high baPWV group, high hcPWV, high hfPWV and high faPWV; by the lowest quartile of ABI as low ABI group.

Results

There was a significant correlation between baPWV and regional PWV; faPWV (r = 0.560), hcPWV (r = 0.253) and hfPWV (r = 0.506). By Kaplan-Meier analysis, only high baPWV group showed the prognostic impact of stroke and CVD (p = 0.0099) but not high faPWV (p = 0.6982), high hcPWV (p = 0.5740), high hfPWV (p = 0.0773) and low ABI group (p = 0.8008). Only low ABI group showed the prognostic impact on mortality (p = 0.0223), high baPWV on stroke (p = 0.0155) and high hcPWV on CVD (p = 0.0382).

Conclusion

As a further, larger, multicenter cohort study is needed, our study indicated that higher level of baPWV a might be a risk factor of stroke and CVD, but prognostic impact of regional PWV is not still unclear in hypertension.