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Abstract

Atherosclerosis is an emerging major risk factor for cardiovascular events in hypertensive patients. Carotid plaque score (PS) and carotid-femoral pulse wave velocity (cfPWV) have been shown to be good surrogate markers of systemic atherosclerosis. There are reports indicating that cfPWV is independently associated with carotid plaques. However, the relation between PS and brachial-ankle PWV (baPWV), which includes the information form the more distal limb, is not fully investigated. We investigated the association between baPWV and carotid PS in uncomplicated hypertensive patients.

We enrolled 104 hypertensive outpatients (42 males and 62 females, 40–92 years old, 86.5% medicated) based on 2 consecutive office blood pressures (OBPs) (SBP≥140mmHg or DBP≥90mmHg) at two visits with at least 2 week interval. And at the third study visit, we measured 3 consecutive OBPs. baPWV was used to assess aortic stiffness and measured using a volume-plethysmographic device (form PWV/ABI; Colin Co., Ltd., Japan). Carotid PS was assessed using 7.5-MHz B-mode ultrasonography. Lesions with an Intima-media thickness ≥1.1mm were defined as atheromatous plaques. Its score was calculated as summing all plaque thicknesses in both carotid systems. The associations of PS with age, sex, height, body mass index, hypercholesterolemia, diabetes, smoking habits, baPWV, mean 3 consecutive OBPs (mean BP) and pulse pressure (mean PP) were assessed by multiple regression analysis.

The table summarizes the results (β and p-values). Only baPWV show significant association with PS.

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Multiple Regression Analysis of PS

Variablesβp-value
Age(years)0.1380.293
Men gender−0.1340.384
Height(cm)0.0390.800
body mass index(kg/m2)−0.0800.480
Hypercholesterolemia0.1310.198
Diabetes0.0600.558
Smoking habits0.1010.343
baPWV(cm/sec)0.3400.020
mean BP(mmHg)−0.1820.142
mean PP (mmHg)0.1090.408
Variablesβp-value
Age(years)0.1380.293
Men gender−0.1340.384
Height(cm)0.0390.800
body mass index(kg/m2)−0.0800.480
Hypercholesterolemia0.1310.198
Diabetes0.0600.558
Smoking habits0.1010.343
baPWV(cm/sec)0.3400.020
mean BP(mmHg)−0.1820.142
mean PP (mmHg)0.1090.408

β standardized coefficient.

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Multiple Regression Analysis of PS

Variablesβp-value
Age(years)0.1380.293
Men gender−0.1340.384
Height(cm)0.0390.800
body mass index(kg/m2)−0.0800.480
Hypercholesterolemia0.1310.198
Diabetes0.0600.558
Smoking habits0.1010.343
baPWV(cm/sec)0.3400.020
mean BP(mmHg)−0.1820.142
mean PP (mmHg)0.1090.408
Variablesβp-value
Age(years)0.1380.293
Men gender−0.1340.384
Height(cm)0.0390.800
body mass index(kg/m2)−0.0800.480
Hypercholesterolemia0.1310.198
Diabetes0.0600.558
Smoking habits0.1010.343
baPWV(cm/sec)0.3400.020
mean BP(mmHg)−0.1820.142
mean PP (mmHg)0.1090.408

β standardized coefficient.

In conclusion, baPWV is independently associated with carotid atherosclerosis in hypertensive patients. baPWV could be used as an alternative indicator to carotid PWV for assessing systemic atherosclerosis.

plaque score, pulse wave velocity, atherosclerosis
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© American Journal of Hypertension, Ltd. 2005
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