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Pulse-Wave Velocity, Flow-Mediated Dilation, and Carotid Intima-Media Thickness to Assess Cardiovascular Risk in Population with Metabolic Syndrome
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Pulse pressure and subclinical cardiovascular disease in the multi-ethnic study of atherosclerosis

Ginger J Winston1, Walter Palmas, Joao Lima

  • 1Division of Clinical Epidemiology and Evaluative Sciences Research, Department of Medicine, Weill Cornell Medical College, New York, NY, USA.

American Journal of Hypertension
|February 8, 2013
PubMed

Insights

Brachial pulse pressure (PP) is independently linked to subclinical cardiovascular disease markers like carotid intima-media thickness and left-ventricular mass index (LVMI). These associations vary significantly by gender, age, and race/ethnicity.

Area of Science:

  • Cardiovascular Medicine
  • Epidemiology
  • Public Health

Background:

  • Brachial pulse pressure (PP) is associated with subclinical cardiovascular disease (CVD) markers.
  • Previous studies have not clarified if these associations are independent of traditional risk factors or mean arterial pressure (MAP).
  • The influence of gender, age, and race/ethnicity on these associations remains unknown.

Purpose of the Study:

  • To determine if brachial PP is independently associated with subclinical CVD.
  • To investigate whether traditional cardiovascular risk factors and MAP modify the PP-CVD marker relationship.
  • To examine if gender, age, and race/ethnicity modify these associations.

Main Methods:

  • Multivariate linear regression models were used to analyze data from the Multi-Ethnic Study of Atherosclerosis.
  • The study assessed relationships between brachial PP and common carotid intima-media thickness (CC-IMT), internal carotid intima-media thickness (IC-IMT), and left-ventricular mass index (LVMI).
  • Models were adjusted for Framingham risk factors, medication use, study site, and MAP.

Main Results:

  • Associations between brachial PP and CC-IMT, IC-IMT, and LVMI remained significant after full adjustment.
  • Significant interactions were observed between PP and gender, age, and race/ethnicity for the subclinical CVD markers.
  • The strength of the association between PP and CC-IMT was modified by race/ethnicity.

Conclusions:

  • Brachial PP is an independent predictor of subclinical CVD, even after accounting for traditional risk factors and MAP.
  • The relationship between brachial PP and subclinical CVD markers is significantly influenced by gender, age, and race/ethnicity.
  • These findings highlight the importance of considering demographic factors when assessing cardiovascular risk associated with PP.
Abstract

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