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Cited by 3,856Cardiovascular Health and Disease PreventionBlood Pressure and Hypertension StudiesCardiovascular Function and Risk Factors

Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients

Laurent, Stéphane, Boutouyrie, Pierre, Asmar, Roland, Gautier, Isabelle, Laloux, Brigitte, Guize, Louis, Ducimetiere, Pierre, Benetos, Athanase·2001·Hypertension
DOI 10.1161/01.hyp.37.5.1236
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Abstract

Although various studies reported that pulse pressure, an indirect index of arterial stiffening, was an independent risk factor for mortality, a direct relationship between arterial stiffness and all-cause and cardiovascular mortality remained to be established in patients with essential hypertension. A cohort of 1980 essential hypertensive patients who attended the outpatient hypertension clinic of Broussais Hospital between 1980 and 1996 and who had a measurement of arterial stiffness was studied. At entry, aortic stiffness was assessed from the measurement of carotid-femoral pulse-wave velocity (PWV). A logistic regression model was used to estimate the relative risk of all-cause and cardiovascular deaths. Selection of classic risk factors for adjustment of PWV was based on their influence on mortality in this cohort in univariate analysis. Mean age at entry was 50+/-13 years (mean+/-SD). During an average follow-up of 112+/-53 months, 107 fatal events occurred. Among them, 46 were of cardiovascular origin. PWV was significantly associated with all-cause and cardiovascular mortality in a univariate model of logistic regression analysis (odds ratio for 5 m/s PWV was 2.14 [95% confidence interval, 1.71 to 2.67, P<0.0001] and 2.35 [95% confidence interval, 1.76 to 3.14, P<0.0001], respectively). In multivariate models of logistic regression analysis, PWV was significantly associated with all-cause and cardiovascular mortality, independent of previous cardiovascular diseases, age, and diabetes. By contrast, pulse pressure was not significantly and independently associated to mortality. This study provides the first direct evidence that aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in patients with essential hypertension.

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  • Large-artery stiffness and wave reflections are important determinants of left ventricular function, coronary blood flow, and mechanical integrity of arteries.

    “Large-artery stiffness and wave reflections are important determinants of left ventricular (LV) function, coronary blood flow, and mechanical integrity of arteries and have been identified as markers of cardiovascular disease and independent prognosticators of cardiovascular risk (4 -12).”

    From Smoking and caffeine have a synergistic detrimental effect on aortic stiffness and wave reflections (2004) · cites this paper as [10]

  • Large-artery stiffness and wave reflections have been identified as markers of cardiovascular disease and independent prognosticators of cardiovascular risk.

    “Large-artery stiffness and wave reflections are important determinants of left ventricular (LV) function, coronary blood flow, and mechanical integrity of arteries and have been identified as markers of cardiovascular disease and independent prognosticators of cardiovascular risk (4 -12).”

    From Smoking and caffeine have a synergistic detrimental effect on aortic stiffness and wave reflections (2004) · cites this paper as [10]

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Research works printed but not linked: 5

  1. Lehman ED, Watts GF, Gossling RG. Aortic distensibility and hypercho- lesterolemia. Lancet. 1992;340:1171-1172.
  2. Jondeau G, Boutouyrie P, Lacolley P, Laloux B, Dubourg O, Bourdarias JP, Laurent S. Central aortic pulse pressure is a major determinant of aortic dilatation in Marfan syndrome. Circulation. 1999;99:2677-2681.
  3. Levy D, Garrison R, Savage D, Kannel W, Castelli W. Pronostic impli- cations of echocardiographically determined left ventricular mass in the Framingham study. N Engl J Med. 1990;322:1561-1566.
  4. Hirai T, Sasayama S, Kamasaki T, Yagi S. Stiffness of systemic arteries in patients with myocardial infarction. Circulation. 1989;80:78 -86.
  5. Gueyffier F, Boissel JP, Pocock S, Boutitie F, Coope J, Cutler J, Ekbom T, Fagard R, Friedman L, Kerlikowske K, Perry M, Prineas R, Schron E. Identification of risk factors in hypertensive patients. Circulation. 1999; 100:e88 -e94.

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Authors
Laurent, S., Boutouyrie, P., Asmar, R., Gautier, I., Laloux, B., Guize, L., Ducimetiere, P., & Benetos, A.
Affiliations
  • From the Department of Pharmacology and INSERM U 337, Broussais Hospital (S.L., P.B., I.G., B.L., A.B.), Paris; Institut Cardiovasculaire - ICV (R.A.), Paris; Investigations Préventives et Cliniques (L.G., A.B.), INSERM U 258 (L.G., P.D.), Villejuif, Paris, France.
  • Inserm (FR)
ORCID
Venue
Hypertension
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2001-05
Volume
37
Issue
5
Pages
1236-1241
ISSN
  • 0194-911X (ISSN-L)
  • 1524-4563
DOI
10.1161/01.hyp.37.5.1236
OpenAlex
W2125914602
Cited by
3,856
References
38
Citations by year
2026: 73 · 2025: 82 · 2024: 111 · 2023: 97 · 2022: 127 · 2021: 149 · 2020: 140 · 2019: 150 · 2018: 169 · 2017: 180 · 2016: 200 · 2015: 194 · 2014: 227 · 2013: 201 · 2012: 232
FWCI
58.78
Type
journal article
Language
en
Open access
closed
Locations
  • Hypertension (publishedVersion)
  • PubMed (publishedVersion)
Funders
Institut National de la Santé et de la Recherche Médicale
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords
aortic stiffness, pulse wave velocity, carotid-femoral pulse wave velocity, essential hypertension, all-cause mortality, cardiovascular mortality, pulse pressure, arterial stiffness, cardiovascular risk factors
MeSH terms
Adult, Aorta, Elasticity, Female, Humans, Hypertension, Male, Middle Aged, Mortality, Prognosis

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