Aging, environmental and genetic factors decrease the elasticity of arterial walls. This increased stiffness leads to elevated blood pressure.
Researchers from Hpital Europen Georges Pompidou in Paris followed 1,715 patients with mild hypertension, but without overt signs of cardiovascular disease, for an average of 7.9 years. Each participant had some degree of arterial stiffness. Arterial stiffness was gauged by measuring how long it took a pulse wave to move from the heart to other parts of the body (pulse wave velocity or PWV). Stiffer arteries had higher PWV numbers. There were 157 deaths, including 25 from strokes and 35 from coronary events.
Researchers calculated the relative risk for fatal stroke compared to PWV. They found a 72 percent increase in relative risk for fatal stroke for each four meters per second in PWV. That's "equivalent to seven years of aging," says lead author Stphane Laurent, M.D.
The predictive value of PWV remained significant after adjusting for classic cardiovascular risk factors including age, elevated cholesterol, diabetes, smoking and high blood pressure.
Several mechanisms may explain the association. Aortic stiffness may increase pulse pressure (the difference between the upper and lower numbers in a blood pressure reading) thereby increasing the likelihood of heart disease and stroke; or the stiffness measurement may reflect damage in the artery wall, Laurent says.
Researchers conclude that aortic stiffness can gauge the fatal stroke risk of hypertensive patients. However, large clinical trials using antihypertensive drugs that relieve arteria
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Contact: Carole Bullock
carole.bullock@heart.org
214-706-1279
American Heart Association
3-Apr-2003