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Aortic Stiffness Is an Independent Predictor of All-Cause and Cardiovascular Mortality in Hypertensive Patients
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 (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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“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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- 10.1161/circ.96.1.308 · DOI
- 10.1161/hyp.30.6.1410 · DOI
- 10.1161/hyp.32.3.560 · DOI
- 10.1161/circ.100.4.354 · DOI
- 10.1161/circ.96.12.4254 · DOI
- 10.1161/hyp.34.3.372 · DOI
- 10.1161/hyp.33.5.1111 · DOI
- 10.1161/hyp.33.3.800 · DOI
- 10.1161/hyp.32.3.570 · DOI
- 10.1161/circ.99.18.2434 · DOI
- 10.1161/hyp.26.3.485 · DOI
- 10.1161/circ.37.6.954 · DOI
- 10.1161/hyp.32.3.556 · DOI
- 10.1161/circ.99.20.2677 · DOI
- 10.1161/circ.83.5.2022028 · DOI
- 10.1161/circ.80.1.2610739 · DOI
- 10.1161/circ.100.18.e88 · DOI
- 10.1161/hyp.34.3.375 · DOI
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Self-citation2018 ESC/ESH Guidelines for the management of arterial hypertension
Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., Clement, D. L., Coca, A., de Simone, G., Dominiczak, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy339 · Cited by 10,286
Self-citationExpert consensus document on arterial stiffness: methodological issues and clinical applications
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Self-citation
Metadata
- 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)
- Venue
- Hypertension
- Published
- 2001-05
- Volume
- 37
- Issue
- 5
- Pages
- 1236-1241
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- 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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