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Outcome Associations of Carotid-Femoral Pulse Wave Velocity Vary With Different Measurement Methods.
MedLine Citation:
PMID:  22874889     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BackgroundThe impact of various methods of travel distance estimation on the prognostic value of pulse wave velocity (PWV) and on the adequacy of cut-offs has never been addressed within a single population of hypertensive patients.MethodsFour carotid-femoral PWVs were calculated from four different travel distances (Direct, Real, Subtracted, and Estimated) divided by the same travel time in 426 hypertensives (mean age 51.2 ± 13.8 years, mean systolic blood pressure 155.6 ± 21.1 mm Hg). The incidence of death from any cause and major cardiovascular events was studied. PWV predictive accuracies were determined using C-index analysis. Hazard ratios (HRs) associated with specific values of PWV were determined with Cox model analyses using cubic splines.ResultsMean PWV ranged from 8.3 ± 2.3 m/s for the Subtracted one to 11.6 ± 3.0 m/s for the Direct one (P < 0.001). When included as continuous variables in a Cox model, the four PWVs were significantly associated with outcome (all P < 0.001), and had similar C-index (0.608-0.617). In multivariable analysis, the HR calculated for a Direct PWV of 12 m/s was neutral (HR = 1.02). In contrast, the same analysis provided HR ranging from 1.79 to 2.90 with the other PWVs.ConclusionsDifferent travel distances markedly impact PWV values and prognostic cut-offs. PWV cut-offs should consequently be ascertained jointly with the method of measurement used. There is an urgent need for standardization of PWV assessment before implementing this parameter in the routine management of hypertensives.American Journal of Hypertension 2012; doi:10.1038/ajh.2012.114.
Authors:
Nicolas Girerd; Liliana Legedz; Vinciane Paget; Muriel Rabilloud; Hugues Milon; Giampiero Bricca; Pierre Lantelme
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-09
Journal Detail:
Title:  American journal of hypertension     Volume:  -     ISSN:  1941-7225     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1] Department of Cardiology, ESH Hypertension Excellence Center, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France [2] Department of Biostatistics, Hospices Civils de Lyon, Lyon, France.
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