Arteriosclerosis, Thrombosis, and Vascular Biology. 2001;21:2046-2050
doi: 10.1161/hq1201.100226
doi: 10.1161/hq1201.100226
© 2001 American Heart Association, Inc.
Atherosclerosis and Lipoproteins |
Aortic Pulse Wave Velocity Predicts Cardiovascular Mortality in Subjects >70 Years of Age
From the Geriatrics Departments of Charles-Foix Hospital (S.M., A.L., C.B.) and Emile Roux Hospital (O.F.H.), Limeil-Brevannes; the Department of Internal Medicine (M.E.S.) and INSERM U337 (A.B.), Broussais Hospital, Paris; and Co Source Outsourcing Services (A.R.), COVANCE, Rueil-Malmaison, France.
Correspondence to Professeur Michel Safar, Médecine Interne 1, Hôpital Broussais, 96 rue Didot, 75674 Paris Cedex 14, France. E-mail michel.safar{at}brs.ap-hop-paris.fr
Aortic pulse wave velocity (PWV) is a significant and independent predictor of cardiovascular mortality in subjects with essential hypertension and in patients with end-stage renal disease. Its contribution to cardiovascular risk in subjects 70 to 100 years old has never been tested. A cohort of 141 subjects (mean±SD age, 87.1±6.6 years) was studied in 3 geriatrics departments in a Paris suburb. Together with sphygmomanometric blood pressure measurements, aortic PWV was measured with a validated automatic device. During the 30-month follow-up, 56 patients died (27 from cardiovascular events). Logistic regressions indicated that age (P=0.005) and a loss of autonomy (P=0.01) were the best predictors of overall mortality. For cardiovascular mortality, aortic PWV was the major risk predictor (P=0.016). The odds ratio was 1.19 (95% confidence interval, 1.03 to 1.37). Antihypertensive drug treatment and blood pressure, including systolic and pulse pressure, had no additive role. In subjects 70 to 100 years old, aortic PWV is a strong, independent predictor of cardiovascular death, whereas systolic or pulse pressure was not. This prospective result will need to be confirmed in an intervention trial.
Key Words: very old (>70 years) subjects • aortic pulse wave velocity • cardiovascular mortality • drug treatment of hypertension • pulse pressure
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C. M. McEniery, M. Schmitt, A. Qasem, D. J. Webb, A. P. Avolio, I. B. Wilkinson, and J. R. Cockcroft Nebivolol Increases Arterial Distensibility In Vivo Hypertension, September 1, 2004; 44(3): 305 - 310. [Abstract] [Full Text] [PDF]
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T. L. Medley, T. J. Cole, A. M. Dart, C. D. Gatzka, and B. A. Kingwell Matrix Metalloproteinase-9 Genotype Influences Large Artery Stiffness Through Effects on Aortic Gene and Protein Expression Arterioscler Thromb Vasc Biol, August 1, 2004; 24(8): 1479 - 1484. [Abstract] [Full Text] [PDF]
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I. B. Wilkinson, S. S. Franklin, and J. R. Cockcroft Nitric Oxide and the Regulation of Large Artery Stiffness: From Physiology to Pharmacology Hypertension, August 1, 2004; 44(2): 112 - 116. [Full Text] [PDF]
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S. Stork, A. W. van den Beld, C. von Schacky, C. E. Angermann, S. W.J. Lamberts, D. E. Grobbee, and M. L. Bots Carotid Artery Plaque Burden, Stiffness, and Mortality Risk in Elderly Men: A Prospective, Population-Based Cohort Study Circulation, July 20, 2004; 110(3): 344 - 348. [Abstract] [Full Text] [PDF]
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 J.M. Dijk, Y. van der Graaf, D.E. Grobbee, J.D. Banga, M.L. Bots, and on behalf of the SMART Study Group Increased Arterial Stiffness Is Independently Related to Cerebrovascular Disease and Aneurysms of the Abdominal Aorta: The Second Manifestations of Arterial Disease (SMART) Study Stroke, July 1, 2004; 35(7): 1642 - 1646. [Abstract] [Full Text] [PDF]
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G. F. Mitchell, H. Parise, E. J. Benjamin, M. G. Larson, M. J. Keyes, J. A. Vita, R. S. Vasan, and D. Levy Changes in Arterial Stiffness and Wave Reflection With Advancing Age in Healthy Men and Women: The Framingham Heart Study Hypertension, June 1, 2004; 43(6): 1239 - 1245. [Abstract] [Full Text] [PDF]
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Yasmin, C. M. McEniery, S. Wallace, I. S. Mackenzie, J. R. Cockcroft, and I. B. Wilkinson C-Reactive Protein Is Associated With Arterial Stiffness in Apparently Healthy Individuals Arterioscler Thromb Vasc Biol, May 1, 2004; 24(5): 969 - 974. [Abstract] [Full Text]
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 I. B Wilkinson and J. R Cockcroft Commentary: Birthweight arterial stiffness and blood pressure: in search of a unifying hypothesis Int. J. Epidemiol., February 1, 2004; 33(1): 161 - 162. [Full Text] [PDF]
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M. E. Safar, G. M London, and G. E. Plante Arterial Stiffness and Kidney Function Hypertension, February 1, 2004; 43(2): 163 - 168. [Abstract] [Full Text] [PDF]
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G. F. Mitchell, Y. Lacourciere, J.-P. Ouellet, J. L. Izzo Jr, J. Neutel, L. J. Kerwin, A. J. Block, and M. A. Pfeffer Determinants of Elevated Pulse Pressure in Middle-Aged and Older Subjects With Uncomplicated Systolic Hypertension: The Role of Proximal Aortic Diameter and the Aortic Pressure-Flow Relationship Circulation, September 30, 2003; 108(13): 1592 - 1598. [Abstract] [Full Text] [PDF]
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C. O'Sullivan, J. Duggan, S. Lyons, J. Thornton, M. Lee, and E. O'Brien Hypertensive Target-Organ Damage in the Very Elderly Hypertension, August 1, 2003; 42(2): 130 - 135. [Abstract] [Full Text] [PDF]
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 T. L. Medley, B. A. Kingwell, C. D. Gatzka, P. Pillay, and T. J. Cole Matrix Metalloproteinase-3 Genotype Contributes to Age-Related Aortic Stiffening Through Modulation of Gene and Protein Expression Circ. Res., June 13, 2003; 92(11): 1254 - 1261. [Abstract] [Full Text] [PDF]
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H. J. Teede, B. P. McGrath, L. DeSilva, M. Cehun, A. Fassoulakis, and P. J. Nestel Isoflavones Reduce Arterial Stiffness: A Placebo-Controlled Study in Men and Postmenopausal Women Arterioscler Thromb Vasc Biol, June 1, 2003; 23(6): 1066 - 1071. [Abstract] [Full Text] [PDF]
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S. Laurent, S. Katsahian, C. Fassot, A.-I. Tropeano, I. Gautier, B. Laloux, and P. Boutouyrie Aortic Stiffness Is an Independent Predictor of Fatal Stroke in Essential Hypertension Stroke, May 1, 2003; 34(5): 1203 - 1206. [Abstract] [Full Text] [PDF]
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M. Zureik, J.-M. Bureau, M. Temmar, C. Adamopoulos, D. Courbon, K. Bean, P.-J. Touboul, A. Benetos, and P. Ducimetiere Echogenic Carotid Plaques Are Associated With Aortic Arterial Stiffness in Subjects With Subclinical Carotid Atherosclerosis Hypertension, March 1, 2003; 41(3): 519 - 527. [Abstract] [Full Text] [PDF]
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 E. Kimoto, T. Shoji, K. Shinohara, M. Inaba, Y. Okuno, T. Miki, H. Koyama, M. Emoto, and Y. Nishizawa Preferential Stiffening of Central Over Peripheral Arteries in Type 2 Diabetes Diabetes, February 1, 2003; 52(2): 448 - 452. [Abstract] [Full Text] [PDF]
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M. S. Anthony Phytoestrogens and Cardiovascular Disease: Where's the Meat? Arterioscler Thromb Vasc Biol, August 1, 2002; 22(8): 1245 - 1247. [Full Text] [PDF]
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Y. T. van der Schouw, A. Pijpe, C. E.I. Lebrun, M. L. Bots, P. H.M. Peeters, W. A. van Staveren, S. W.J. Lamberts, and D. E. Grobbee Higher Usual Dietary Intake of Phytoestrogens Is Associated With Lower Aortic Stiffness in Postmenopausal Women Arterioscler Thromb Vasc Biol, August 1, 2002; 22(8): 1316 - 1322. [Abstract] [Full Text] [PDF]
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G. F. Mitchell, J. L. Izzo Jr, Y. Lacourciere, J.-P. Ouellet, J. Neutel, C. Qian, L. J. Kerwin, A. J. Block, and M. A. Pfeffer Omapatrilat Reduces Pulse Pressure and Proximal Aortic Stiffness in Patients With Systolic Hypertension: Results of the Conduit Hemodynamics of Omapatrilat International Research Study Circulation, June 25, 2002; 105(25): 2955 - 2961. [Abstract] [Full Text] [PDF]
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 J. Blacher and M. Safar Specific aspects of high blood pressure in the elderly Journal of Renin-Angiotensin-Aldosterone System, March 1, 2002; 3(1_suppl): S10 - S15. [PDF]
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