Key Points
- Determine whether direct measurement of aortic stiffness via carotid-femoral pulse-wave velocity independently predicts all-cause and cardiovascular mortality in patients with essential hypertension.
- Evaluated a cohort of 1,980 patients with essential hypertension attending a hospital outpatient clinic between 1980 and 1996, with an average follow-up of 112 ± 53 months.
- Aortic stiffness was measured at entry via carotid-femoral pulse-wave velocity (PWV).
- Logistic regression models estimated relative risk for all-cause and cardiovascular mortality, adjusting for age, diabetes, and prior cardiovascular disease.
- During follow-up, 107 fatal events occurred, of which 46 were attributable to cardiovascular causes.
- In univariate logistic regression, each 5 m/s increase in PWV was significantly associated with all-cause mortality (OR 2.14, 95% CI 1.71 to 2.67, P < 0.0001) and cardiovascular mortality (OR 2.35, 95% CI 1.76 to 3.14, P < 0.0001).
- In multivariate models, PWV remained an independent predictor of all-cause and cardiovascular death, whereas pulse pressure was not independently associated with mortality.
Structured PICO
Does aortic stiffness predict all-cause and cardiovascular mortality in patients with essential hypertension?
PPopulation1,980 patients with essential hypertension attending an outpatient hypertension clinic, mean age 50+/-13 years.
IInterventionAortic stiffness assessed by carotid-femoral pulse-wave velocity (PWV)
OOutcomeAll-cause and cardiovascular mortalityhard clinical
Aortic stiffness, measured by carotid-femoral pulse-wave velocity, is a strong, independent predictor of all-cause and cardiovascular mortality in patients with essential hypertension.