Key result
Increased aortic stiffness was associated with reduced glomerular filtration rate, whereas increased carotid stiffness was associated with left ventricular hypertrophy.
Why the study?
Is increased aortic and/or carotid stiffness associated with specific target organ damage in patients with essential hypertension?
Cross-Sectional (n=314)
Is increased aortic and/or carotid stiffness associated with specific target organ damage in patients with essential hypertension?
Aortic and carotid stiffness are differentially associated with target organ damage in hypertensive patients, with aortic stiffness linked to renal damage and carotid stiffness to cardiac damage.
Answers are grounded in this paper and cite their sources.
May identify site-specific organ risk in hypertension; leaves open causal role and therapeutic implications.
OBJECTIVE: The objective of the study is to investigate in the hypertensive population the possible differential association between increased aortic and/or carotid stiffness and organ damage in multiple districts, such as the kidney, the vessels, and the heart. METHODS: In 314 essential hypertensive patients, carotid-femoral pulse wave velocity (cfPWV, by applanation tonometry) and carotid stiffness (from ultrasound images analysis), together with left ventricular hypertrophy, carotid intima-media thickness, urinary albumin-creatinin ratio, and glomerular filtration rate were measured. Increased cfPWV and carotid stiffness were defined according to either international reference values or the 90th percentile of a local control group (110 age and sex-matched healthy individuals). RESULTS: When considering the 90th percentile of a local control group, increased cfPWV was associated with reduced glomerular filtration rate, either when carotid stiffness was increased [odds ratio (OR) 13.27 (confidence limits (CL) 95% 3.86-45.58)] or not [OR 7.39 (CL95% 2.25-24.28)], whereas increased carotid stiffness was associated with left ventricular hypertrophy, either when cfPWV was increased [OR 2.86 (CL95% 1.15-7.09)] or not [OR 2.81 (CL95% 1.13-6.97)]. No association between increased cfPWV or carotid stiffness and target organ damage was found when cutoffs obtained by international reference values were used. The concomitance of both increased cfPWV and carotid stiffness did not have an additive effect on organ damage. CONCLUSION: Aortic and carotid stiffness are differentially associated with target organ damage in hypertensive patients. Regional arterial stiffness as assessed by cfPWV is associated with renal organ damage and local carotid stiffness with cardiac organ damage.
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Bruno et al. (2016) conducted a cross-sectional in Essential hypertension (n=314). Increased aortic and carotid stiffness vs. Normal stiffness (based on 90th percentile of healthy controls) was evaluated on Reduced glomerular filtration rate (when both cfPWV and carotid stiffness are increased) (OR 13.27, 95% CI 3.86-45.58). Increased aortic stiffness was associated with reduced glomerular filtration rate, whereas increased carotid stiffness was associated with left ventricular hypertrophy.
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