Arterial Stiffness and Cardiovascular Events: The Framingham Heart Study
Open accessAbstract
Background— Various measures of arterial stiffness and wave reflection have been proposed as cardiovascular risk markers. Prior studies have not assessed relations of a comprehensive panel of stiffness measures to prognosis in the community. Methods and Results— We used proportional hazards models to analyze first-onset major cardiovascular disease events (myocardial infarction, unstable angina, heart failure, or stroke) in relation to arterial stiffness (pulse wave velocity [PWV]), wave reflection (augmentation index, carotid-brachial pressure amplification), and central pulse pressure in 2232 participants (mean age, 63 years; 58% women) in the Framingham Heart Study. During median follow-up of 7.8 (range, 0.2 to 8.9) years, 151 of 2232 participants (6.8%) experienced an event. In multivariable models adjusted for age, sex, systolic blood pressure, use of antihypertensive therapy, total and high-density lipoprotein cholesterol concentrations, smoking, and presence of diabetes mellitus, higher aortic PWV was associated with a 48% increase in cardiovascular disease risk (95% confidence interval, 1.16 to 1.91 per SD; P =0.002). After PWV was added to a standard risk factor model, integrated discrimination improvement was 0.7% (95% confidence interval, 0.05% to 1.3%; P <0.05). In contrast, augmentation index, central pulse pressure, and pulse pressure amplification were not related to cardiovascular disease outcomes in multivariable models. Conclusions— Higher aortic stiffness assessed by PWV is associated with increased risk for a first cardiovascular event. Aortic PWV improves risk prediction when added to standard risk factors and may represent a valuable biomarker of cardiovascular disease risk in the community.
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Arterial stiffness has been shown to provide added value in stratification of patients.
“Arterial stiffness has been shown to provide added value in stratification of patients.”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [162]
Aortic pulse wave velocity has emerged as the strongest and most consistent predictor of cardiovascular events and risk with aging.
“aortic PWV has emerged as the strongest and most consistent predictor of cardiovascular events and risk with aging (126, 185).”
From Inorganic nitrite supplementation for healthy arterial aging (2014) · cites this paper as [126]
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- Authors
- Mitchell, G. F., Hwang, S.-J., Vasan, R. S., Larson, M. G., Pencina, M. J., Hamburg, N. M., Vita, J. A., Levy, D., & Benjamin, E. J.
- Affiliations
- National Heart, Lung, and Blood Institute (US)
- ORCID
- Venue
- Circulation
- Published
- 2010-02-02
- Volume
- 121
- Issue
- 4
- Pages
- 505-511
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC2836717
- OpenAlex
- W2161841978
- Cited by
- 2,225
- References
- 41
- Citations by year
- 2026: 108 · 2025: 138 · 2024: 144 · 2023: 133 · 2022: 154 · 2021: 171 · 2020: 162 · 2019: 124 · 2018: 154 · 2017: 150 · 2016: 167 · 2015: 144 · 2014: 134 · 2013: 107 · 2012: 114
- FWCI
- 74.64
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (n01hc25195-41-0-1, 5r01hl080124-05)
- National Institute on Aging (R01AG028321, AG-028321)
- National Heart, Lung, and Blood Institute (R01-HL080124, HL-076784, 2K24 HL 04334, N01‐HC25195, HL 080124, K24HL004334, HL077447, N01-HC-025195, R01HL077447, R01HL076784, HL070100, R01HL070100, HL071039, R01HL060040, R01HL071039)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Keywords
- arterial stiffness, pulse wave velocity, wave reflection, cardiovascular risk prediction, cardiovascular events, myocardial infarction, stroke, heart failure, aortic stiffness, augmentation index, central pulse pressure, Framingham Heart Study
- MeSH terms
- Aged, Angina, Unstable, Aorta, Blood Flow Velocity, Blood Pressure, Brachial Artery, Carotid Arteries, Elasticity, Female, Femoral Artery, Follow-Up Studies, Heart Failure, Humans, Male, Middle Aged, Myocardial Infarction, Risk Factors, Cohort Studies, Biomarkers, Proportional Hazards Models, Stroke
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