Artery Research (Jan 2015)
Pulse pressure measured at the level of the femoral artery, but not at the level of the aorta, carotid and brachial arteries, is associated with the incidence of coronary heart disease events in a population with a high prevalence of type 2 diabetes and impaired glucose metabolism – The Hoorn study
Abstract
Introduction: Central (aortic or carotid) pulse pressure (PP) is more strongly associated with local organ damage and possibly mortality than brachial PP. Aim: To investigate for the first time the association of femoral (f) PP with all-cause mortality, and incident cardiovascular disease (CVD), coronary heart disease (CHD) and cerebrovascular disease (CerVD) events, as well as with markers of renal function (estimated glomerular filtration rate, eGFR, and microalbuminuria). Methods: We used data from a population-based study, by design including 50% type 2 diabetes and impaired glucose metabolism (IGM). The baseline examination included non-invasive PP assessment at the brachial, aorta (Sphygmocor device), carotid and femoral (ultrasound distention waves calibrated by brachial mean and diastolic pressure) arteries. Results: After 7.8 years of follow-up (n = 449, age: 68.9 ± 6.0 males: 52%), 66 participants had died, 102 had a CVD event, 45 a CHD event, and 31 a CerVD event. PP at all sites was associated with incident all-cause mortality and CVD events. Only fPP was, however, associated with incident CHD events, even after adjustment for CVD risk factors (HRs 1.31 [1.07–1.61 95% CIs]). No association between PP and incident CerVD events was found – possibly due to the small number of events. fPP was associated with renal function but this was similar to other PP indices. No interaction between each any local PP index and glucose metabolism status or renal function was present. Conclusion: Beyond anatomical topography, local fPP provide important information related to CVD events. This possibility and the underlying mechanisms should be further investigated.
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