| Pulse pressure amplification a mechanical biomarker of cardiovascular risk. | |
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MedLine Citation:
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PMID: 20202520 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The aim of this study was to determine whether the carotid/brachial (C/B) ratio is an independent predictor of cardiovascular (CV) risk. BACKGROUND: Brachial and carotid pulse pressure (PP) are independent predictors of CV risk, mainly in elderly patients. Because PP is physiologically lower at the brachial than at the carotid arterial site, PP amplification is represented by the C/B ratio and could independently predict CV risk. METHODS: In a Paris population (n = 834), brachial and carotid PP were measured from sphygmomanometry and pulse wave analysis. With stepwise multiple regression, carotid PP was calculated from a nomogram including age, sex, body height, brachial PP, and plasma glucose. This model was applied to 125,151 subjects, followed for 12 years, during which 3,997 deaths occurred (735 of CV origin). With Cox regression analysis, multi-adjusted hazard ratios (HRs) were calculated for 1 SD increase of brachial PP, calculated carotid PP, and C/B ratio. RESULTS: Brachial PP was significantly associated with both CV and all-cause mortality (HR: 1.16, 95% confidence interval [CI]: 1.13 to 1.19, and HR: 1.13, 95% CI: 1.10 to 1.17, respectively). Calculated carotid PP predicted a similar risk (HR: 1.21, 95% CI: 1.15 to 1.28, and HR: 1.18, 95% CI: 1.12 to 1.25, respectively). Finally, the C/B ratio was a strong risk predictor (HR: 1.22, 95% CI: 1.12 to 1.32, and HR: 1.41, 95% CI: 1.14 to 1.73, respectively). Addition of drug treatment and other confounding variables did not statistically modify the results. CONCLUSIONS: Brachial PP, calculated carotid PP, and C/B PP amplification all predict CV mortality. In contrast to brachial and carotid PP, the C/B ratio is less dependent on blood pressure calibration and thus can be directly applicable to large population studies. |
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Authors:
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Athanase Benetos; Frédérique Thomas; Laure Joly; Jacques Blacher; Bruno Pannier; Carlos Labat; Paolo Salvi; Harold Smulyan; Michel E Safar |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 55 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-05 Completed Date: 2010-03-29 Revised Date: 2010-08-30 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1032-7 Citation Subset: AIM; IM |
Copyright Information:
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Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Geriatrics CHU de Nancy, and INSERM U691, University of Nancy, Nancy, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Age Factors Aged Aged, 80 and over Biological Markers / blood Blood Glucose / metabolism Blood Pressure / physiology* Body Height Brachial Artery / physiopathology* Cardiovascular Diseases / diagnosis, mortality, physiopathology* Carotid Arteries / physiopathology* Cause of Death Female Follow-Up Studies Humans Hypertension / diagnosis, mortality, physiopathology Male Middle Aged Predictive Value of Tests Proportional Hazards Models Reference Values Regression Analysis Risk Assessment / statistics & numerical data Sex Factors Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Blood Glucose |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2010 Mar 9;55(10):1038-40
[PMID:
20202521
]
J Am Coll Cardiol. 2010 Aug 24;56(9):744; author reply 744-5 [PMID: 20723810 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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