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Relative Contributions of Arterial Stiffness and Hypertension to Cardiovascular Disease: The Framingham Heart Study

Teemu J Niiranen1, Bindu Kalesan2,3, Naomi M Hamburg4,5,6

  • 1National Heart, Blood and Lung Institute's and Boston University's Framingham Heart Study, Framingham, MA teemu.niiranen@thl.fi.

Journal of the American Heart Association
|December 3, 2016
PubMed

Insights

High arterial stiffness is common in treated hypertensive patients, contributing to residual cardiovascular disease (CVD) risk. Arterial stiffness measurements may help assess CVD risk in both hypertensive and non-hypertensive individuals.

Area of Science:

  • Cardiovascular Medicine
  • Hypertension Research
  • Vascular Biology

Background:

  • Arterial stiffness is a potential predictor of outcomes, but its role in community-dwelling treated hypertensives is unclear.
  • Limited data exist on arterial stiffness and cardiovascular disease (CVD) risk across the full blood pressure spectrum.

Purpose of the Study:

  • To investigate the prevalence and implications of abnormal arterial stiffness in treated hypertensives.
  • To examine the association between arterial stiffness and CVD risk across varying blood pressure levels.

Main Methods:

  • Carotid-femoral pulse wave velocity (PWV) and CVD risk factors were measured in 2127 Framingham Offspring Cohort participants.
  • Participants were categorized by hypertension status and PWV (high/low) and followed for CVD events over a median of 12.6 years.

Main Results:

  • A high prevalence of elevated PWV was observed in treated hypertensives (60% controlled, 90% uncontrolled).
  • Multivariable-adjusted CVD event risk increased progressively from normotension with low PWV to hypertension with high PWV (HR 2.25).

Conclusions:

  • Elevated arterial stiffness is frequent in treated hypertensives, potentially explaining residual CVD risk.
  • High PWV is associated with increased CVD risk in both hypertensive and non-hypertensive individuals, suggesting clinical utility for its measurement.
Abstract

Keywords:
antihypertensive agentarterial stiffnesscardiovascular diseaseepidemiologyhypertension

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