Transient myocardial ischemia in hypertensive patients over age 60 was associated with higher aortic pulse wave velocity compared to those without ischemia (10.6 vs 9.5 m/s, P=0.036).
Cross-Sectional (n=74)
Is arterial stiffness (PWV) or wave reflection (AIx) increased in hypertensive patients with transient myocardial ischemia?
Aortic pulse wave velocity, but not augmentation index, is significantly elevated in hypertensive patients with transient myocardial ischemia, suggesting it is a better indicator of cardiovascular risk in this population.
Absolute Event Rate: 10.6% vs 9.5%
p-value: p=0.036
OBJECTIVE: We have recently shown that mean pulse pressure is higher in patients with transient myocardial ischemia. Pulse pressure elevation might be an important consequence of increased arterial stiffness. The aim of this study was to prove if arterial stiffness is changed in patients with transient myocardial ischemia who bear a high cardiovascular risk. Additionally we investigated whether arterial stiffness or wave reflection is the best indicator for transient myocardial ischemia. Aortic pulse wave velocity (PWV) is a measure of arterial stiffness, and augmentation index (AIx) an indication of arterial wave reflection. Both are indicators for cardiovascular risk. METHODS: PWV (carotid-femoral) and AIx (SphygmoCor) were assessed in 74 hypertensive patients. Transient myocardial ischemia was detected using an ST-triggered 24-h ambulatory blood pressure monitoring device. RESULTS: ST-segment depressions were recorded in 30 of 74 patients. There were no significant differences with regard to age, mean arterial pressure, systolic blood pressure, diastolic blood pressure or heart rate. PWV was seen to be higher in patients with transient myocardial ischemia (10.6 versus 9.5 m/s, P = 0.036). There was no significant difference in AIx between the two groups. PWV (r = 0.36, P = 0.002) but not AIx correlated with pulse pressure. CONCLUSIONS: PWV is higher in hypertensive individuals (age > 60 years) with transient myocardial ischemia, suggesting that PWV is an indicator of increased cardiovascular risk. Although AIx is known to be associated with several cardiovascular diseases, it was not seen to be associated with silent myocardial ischemia. Our results suggest that the clinical significance of parameters of arterial stiffness and arterial wave reflection change with age, with a higher clinical importance of PWV indicated in patients over the age of 60.
Baulmann et al. (Wed,) conducted a cross-sectional in Hypertension (n=74). Transient myocardial ischemia vs. No transient myocardial ischemia was evaluated on Aortic pulse wave velocity (PWV) (p=0.036). Transient myocardial ischemia in hypertensive patients over age 60 was associated with higher aortic pulse wave velocity compared to those without ischemia (10.6 vs 9.5 m/s, P=0.036).