Related Experiment Video
Updated: May 12, 2025
Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness
Published on: May 3, 2018
Arterial Stiffness, Central Blood Pressure, and the Risk of Incident Stroke in Hypertensive Adults
Tianyu Cao1,2, Zaihua Cheng1, Yaping Wei3
1Department of Cardiology, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Insights
Hypertensive patients with high central systolic blood pressure (cSBP) and arterial stiffness (cfPWV) face significantly increased stroke risk. Tailored treatment strategies are crucial for managing this elevated risk.
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Stroke Prevention
Background:
- Arterial stiffness and central systolic blood pressure (cSBP) are potential stroke risk factors in hypertensive individuals.
- The combined impact of elevated cSBP and arterial stiffness on stroke risk remains incompletely understood.
Purpose of the Study:
- To investigate the association between elevated central systolic blood pressure (cSBP) and carotid-femoral pulse wave velocity (cfPWV) with incident stroke risk.
- To determine if combined elevation of cSBP and cfPWV poses a greater stroke risk than either factor alone.
Main Methods:
- A cohort study involving 6663 participants without prior cardiovascular disease.
- Noninvasive measurement of cSBP using the A-Pulse CASPro device and cfPWV using a Pulse Pen device.
- Incident stroke was the primary outcome, assessed over a median follow-up of 4.4 years.
Main Results:
- Patients with both elevated cSBP and cfPWV exhibited a significantly higher risk of incident stroke (HR 1.78) compared to a reference group.
- Elevated cSBP and cfPWV independently showed no statistically significant increase in stroke risk compared to the reference group.
- A significant additive interaction was observed between elevated cSBP and cfPWV regarding stroke risk (RERI 0.55).
Conclusions:
- Hypertensive patients with concurrent elevations in cSBP and cfPWV face a substantially higher risk of incident stroke.
- Clinical attention and personalized treatment strategies are warranted for hypertensive patients with combined elevated cSBP and arterial stiffness.
Background And Aims:
Whether hypertensive patients with elevated arterial stiffness and central systolic blood pressure (cSBP) are exposed to higher stroke risk is unclear.
Methods:
A total of 6663 participants without a history of cardiovascular disease were enrolled in this study. cSBP was measured noninvasively using the A-Pulse CASPro device; carotid-femoral pulse wave velocity (cfPWV) was collected using a Pulse Pen device. The primary outcome was incident stroke.
Results:
Over 4.4 years (median), 454 incident strokes occurred (15.92 per 1000 person-years). Compared to the reference group (cSBP < 137 mmHg and cfPWV < 10 m/s), patients with elevated cSBP and cfPWV had a significantly increased risk of incident stroke (HR 1.78 [95% CI 1.39, 2.27]), and were the only group showing statistical significance versus those with solely increased cSBP (HR 1.13 [95% CI 0.87, 1.48]) or cfPWV (HR 1.15 [95% CI 0.87, 1.52]) after adjusting for covariates; p for trend < 0.001. Consistent findings were identified in multiple sensitivity and exploratory analyses. The additive interaction between elevated cSBP and cfPWV was significant, with a relative excess risk due to interaction of 0.55 [95% CI 0.05-1.03]. The association between elevated cSBP and cfPWV with incident stroke risk was more robust among patients who were taking non-guideline recommended antihypertensive medication at baseline (HR 3.03) than among those who took recommended regimens (HR 1.58).
Conclusions:
Hypertensive patients with elevated cSBP and cfPWV have a significantly higher risk of incident stroke than those with lower or solely increased cSBP and cfPWV. Greater clinical attention and tailored treatment strategies are needed.
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