5. BRACHIAL-ANKLE AND REGIONAL PULSE WAVE VELOCITY AS A PROGNOSTIC IMPACT IN HYPERTENSION

Abstract

Background: Many reports have shown that brachial-ankle pulse wave velocity (baPWV) as well as carotid-femoral PWV would be one of the prognostic factors for hypertension. We can evaluate heart-carotid PWV (hcPWV), heart-femoral PWV (hfPWV), femoral-ankle PWV (faPWV) using carotid and femoral sensor of form PWV/ABI. Therefore we examined prognostic impact of each regional PWV on stroke and cardiovascular disease (CVD) compared with baPWV in the cohort study of hypertensive patients. Methods: This study included 387 patients with essential hypertension (male/female=218/169, mean age 61.1±11.8, mean follow period 43months) whose ba- and regional PWV could be measured from October, 2000 to December, 2004. We set up stroke (n=20) and CVD (n=21) as a primary end point by the questionnaire. We classified the participants by the highest quartile of each PWV; high baPWV group, high hcPWV, high hfPWV and high faPWV; by the lowest quartile of ABI as low ABI group. Results: There was a significant correlation between baPWV and regional PWV; faPWV (r=0.560), hcPWV (r=0.253) and hfPWV (r=0.506). By Kaplan-Meier analysis, only high baPWV group showed the prognostic impact of stroke and CVD (p=0.0099) but not high faPWV (p=0.6982), high hcPWV (p=0.5740), high hfPWV (p=0.0773) and low ABI group (p=0.8008). Only low ABI group showed the prognostic impact on mortality (p=0.0223), high baPWV on stroke (p=0.0155) and high hcPWV on CVD (p=0.0382). Conclusion: As a further, larger, multicenter cohort study is needed, our study indicated that higher level of baPWV a might be a risk factor of stroke and CVD, but prognostic impact of regional PWV is not still unclear in hypertension.