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Factors associated with high brachial–ankle pulse wave velocity in non-hypertensive and appropriately treated hypertensive patients with atherosclerotic risk factors

Authors Ato D, Sawayama T

Received 27 June 2017

Accepted for publication 2 September 2017

Published 10 October 2017 Volume 2017:13 Pages 383—392

DOI https://doi.org/10.2147/VHRM.S144923

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 3

Editor who approved publication: Dr Takashi Kajiya


Dai Ato,1 Toshitami Sawayama2

1Gakujutsu Shien (Academic Support) Co., Ltd. Tokyo, 2Sawayama Clinic, Okayama, Japan

Abstract: While pulse wave velocity (PWV) correlates with blood pressure (BP), its extent differs between patients, and some cases of high PWV in normotensives are present. Moreover, PWV frequently remains high in hypertensive patients despite adequate BP control. The factors associated with such phenomena are yet to be elucidated. Here, we investigated the factors associated with brachial–ankle PWV (baPWV) in 107 patients whose systolic BP was under 140 mmHg at their latest baPWV measurement. There were 64 controlled hypertensives and 43 normotensives. Multivariate regression analysis identified age, hypertension, body mass index (BMI), systolic BP, and heart rate (HR) as independent factors for baPWV. Next, we divided the subjects into groups according to their age (in 5-year increments) and calculated the mean and standard deviation (SD) of the baPWV for each group. For each age group, we defined patients with a baPWV above the mean + SD baPWV for the group as the high-baPWV cohort. Multivariate logistic regression analysis revealed that BMI, hypertension, and smoking were independent determinants of a high-baPWV subject. This represents the first study to report the existence of the hypertensive state itself as one of the independent predictors of high baPWV in normotensive and well-treated hypertensive patients. This finding implies that the hypertensive state itself possibly worsens arterial stiffness independently from aging in spite of adequate BP maintenance. To prevent the early progression of arterial stiffness, the application of an appropriate intervention during the early stages of hypertension is important and the continuation of an appropriate BP treatment is suggested.

Keywords: arterial stiffness, brachial–ankle pulse wave velocity, heart failure, hypertension, peripheral arterial disease

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