Document Detail


The combined effect of aortic stiffness and pressure wave reflections on mortality in the very old with cardiovascular disease: the PROTEGER Study.
MedLine Citation:
PMID:  21471975     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aortic stiffness (pulse wave velocity, PWV) and pressure wave reflections (augmentation index, AI) are two interrelated markers of mortality. Their potential synergistic effect on mortality has never been studied. We sought to investigate the association as well as the combined effect of PWV and AI on mortality in a cohort (PROTEGER Study) of very old (>70 years, mean age (±s.d.): 85.4±7.4 years). Aortic PWV and pressure wave AI were assessed by pulse wave analysis; carotid structure and cardiac function were analyzed by ultrasound. The analysis was performed in 259 patients who had all the data available. Neither PWV nor AI was, in separate, predictors of mortality (log-rank test: P=0.278 and P=0.433, respectively, Kaplan-Meier analysis). No linear association was found between PWV and AI (P=0.278). To investigate the possible synergistic effect of PWV and AI on mortality, the population was analyzed according to the tertiles of PWV and AI. Subjects with combined high PWV (third tertile) and moderate-to-high AI (second and third tertiles) had lower survival compared with the rest of the population (Kaplan-Meier survival curve, log-rank test: P=0.030). Cox regression analysis showed that this effect was independent from age, gender, blood pressure, cardiac/carotid parameters and other confounders, except creatinine and insulin resistance. The present study provides further insight on the pathophysiological association between large artery stiffness and pressure wave reflections, suggesting that when both are elevated they may increase the mortality in the elderly.Hypertension Research advance online publication, 7 April 2011; doi:10.1038/hr.2011.33.
Authors:
Athanase D Protogerou; Michel E Safar; Theodoros G Papaioannou; Yi Zhang; Davide Agnoletti; Dimitrios Papadogiannis; Jacques Blacher
Related Documents :
8903625 - Mechanical effects of respiration and stepping on systolic arterial pressure variabilit...
9362255 - Synchronous and baroceptor-sensitive oscillations in skin microcirculation: evidence fo...
8832125 - Estimation of baroreflex sensitivity using transfer function analysis: normal values an...
6626075 - Heart rate variability, cardiac mechanics, and subjectively evaluated stress during sim...
10434235 - Studies on the pharmacokinetics and pharmacodynamics of propranolol in hyperlipidemia.
22727135 - Optimal use of negative pressure wound therapy in treating pressure ulcers.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-07
Journal Detail:
Title:  Hypertension research : official journal of the Japanese Society of Hypertension     Volume:  -     ISSN:  1348-4214     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9307690     Medline TA:  Hypertens Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Hypertension Center and Cardiovascular Research Laboratory, 1st Department of Propaedeutic and Internal Medicine, Laiko Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Influence of blood pressure on cardio-ankle vascular index (CAVI) examined based on percentage chang...
Next Document:  Angiotensin II and aldosterone-induced neuronal damage in neurons through an astrocyte-dependent mec...