Arterial stiffness and cardiovascular events: The Framingham Heart Study

By Gary F. Mitchell, Shih-Jen Hwang, Ramachandran S. Vasan, Martin G. Larson, Michael J. Pencina, N. Hamburg, J. Vita, Daniel Levy, Emelia J. Benjamin. Circulation, 2010

2,122 citations recorded by the source corpus.

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.

Subfields: Biomedical Engineering, Cardiology and Cardiovascular Medicine, Pulmonary and Respiratory Medicine

View Paper: https://www.semanticscholar.org/paper/c5d080b1a4d135528dd0ebbe90b35ac3823e7a2a

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In Cardiology and Cardiovascular Medicine

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Citations in the corpus

• Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. (2012, background): “Since that time, many other studies provided either longitudinal [2,4,21] or cross-sectional [7] data supporting this cut-off value.”
• Central blood pressure: current evidence and clinical importance. (2014, result): “In contrast, Mitchell et al.(52) failed to show any additional value of”
• The 2015 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. (2013, background): “In addition, a substantial proportion of patients at intermediate risk could be reclassified into a higher or lower CV risk, when arterial stiffness is measured [51,195,196].”
• Triglyceride-glucose index as a marker in cardiovascular diseases: landscape and limitations (2022, background): “Mounting evidence has suggested that AS is a powerful predictor for the future risk of CVDs such as ACS, heart failure (HF), and ischaemic or haemorrhagic stroke [42, 43].”
• ESH / ESC Guidelines for the management of arterial hypertension (2013, background): “In addition, a substantial proportion of patients at intermediate risk could be reclassified into a higher or lower CV risk, when arterial stiffness is measured.(51,195,196)”