Aortic Stiffness Is an Independent Predictor of All-Cause and Cardiovascular Mortality in Hypertensive Patients
ABSTRACT—Although various studies reported that pulse pressure, an indirect index of arterial stiffening, was an independent risk factor for mortality, a direct relationship between arterial stiffness and all-cause and cardiovascular mortality remained to be established in patients with essential hy...
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| Veröffentlicht in: | Hypertension (Dallas, Tex. 1979) Tex. 1979), 2001-05, Vol.37 (5), p.1236-1241 |
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| container_title | Hypertension (Dallas, Tex. 1979) |
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| creator | Laurent, Stéphane Boutouyrie, Pierre Asmar, Roland Gautier, Isabelle Laloux, Brigitte Guize, Louis Ducimetiere, Pierre Benetos, Athanase |
| description | ABSTRACT—Although various studies reported that pulse pressure, an indirect index of arterial stiffening, was an independent risk factor for mortality, a direct relationship between arterial stiffness and all-cause and cardiovascular mortality remained to be established in patients with essential hypertension. A cohort of 1980 essential hypertensive patients who attended the outpatient hypertension clinic of Broussais Hospital between 1980 and 1996 and who had a measurement of arterial stiffness was studied. At entry, aortic stiffness was assessed from the measurement of carotid-femoral pulse-wave velocity (PWV). A logistic regression model was used to estimate the relative risk of all-cause and cardiovascular deaths. Selection of classic risk factors for adjustment of PWV was based on their influence on mortality in this cohort in univariate analysis. Mean age at entry was 50±13 years (mean±SD). During an average follow-up of 112±53 months, 107 fatal events occurred. Among them, 46 were of cardiovascular origin. PWV was significantly associated with all-cause and cardiovascular mortality in a univariate model of logistic regression analysis (odds ratio for 5 m/s PWV was 2.14 [95% confidence interval, 1.71 to 2.67, P |
| doi_str_mv | 10.1161/01.hyp.37.5.1236 |
| format | Article |
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A cohort of 1980 essential hypertensive patients who attended the outpatient hypertension clinic of Broussais Hospital between 1980 and 1996 and who had a measurement of arterial stiffness was studied. At entry, aortic stiffness was assessed from the measurement of carotid-femoral pulse-wave velocity (PWV). A logistic regression model was used to estimate the relative risk of all-cause and cardiovascular deaths. Selection of classic risk factors for adjustment of PWV was based on their influence on mortality in this cohort in univariate analysis. Mean age at entry was 50±13 years (mean±SD). During an average follow-up of 112±53 months, 107 fatal events occurred. Among them, 46 were of cardiovascular origin. PWV was significantly associated with all-cause and cardiovascular mortality in a univariate model of logistic regression analysis (odds ratio for 5 m/s PWV was 2.14 [95% confidence interval, 1.71 to 2.67, P <0.0001] and 2.35 [95% confidence interval, 1.76 to 3.14, P <0.0001], respectively). In multivariate models of logistic regression analysis, PWV was significantly associated with all-cause and cardiovascular mortality, independent of previous cardiovascular diseases, age, and diabetes. By contrast, pulse pressure was not significantly and independently associated to mortality. This study provides the first direct evidence that aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in patients with essential hypertension.</description><identifier>ISSN: 0194-911X</identifier><identifier>EISSN: 1524-4563</identifier><identifier>DOI: 10.1161/01.hyp.37.5.1236</identifier><identifier>PMID: 11358934</identifier><identifier>CODEN: HPRTDN</identifier><language>eng</language><publisher>Philadelphia, PA: American Heart Association, Inc</publisher><subject>Adult ; Aorta - physiopathology ; Arterial hypertension. Arterial hypotension ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Clinical manifestations. Epidemiology. Investigative techniques. Etiology ; Elasticity ; Female ; Humans ; Hypertension - diagnosis ; Hypertension - mortality ; Male ; Medical sciences ; Middle Aged ; Mortality ; Prognosis</subject><ispartof>Hypertension (Dallas, Tex. 1979), 2001-05, Vol.37 (5), p.1236-1241</ispartof><rights>2001 American Heart Association, Inc.</rights><rights>2001 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. 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A cohort of 1980 essential hypertensive patients who attended the outpatient hypertension clinic of Broussais Hospital between 1980 and 1996 and who had a measurement of arterial stiffness was studied. At entry, aortic stiffness was assessed from the measurement of carotid-femoral pulse-wave velocity (PWV). A logistic regression model was used to estimate the relative risk of all-cause and cardiovascular deaths. Selection of classic risk factors for adjustment of PWV was based on their influence on mortality in this cohort in univariate analysis. Mean age at entry was 50±13 years (mean±SD). During an average follow-up of 112±53 months, 107 fatal events occurred. Among them, 46 were of cardiovascular origin. PWV was significantly associated with all-cause and cardiovascular mortality in a univariate model of logistic regression analysis (odds ratio for 5 m/s PWV was 2.14 [95% confidence interval, 1.71 to 2.67, P <0.0001] and 2.35 [95% confidence interval, 1.76 to 3.14, P <0.0001], respectively). In multivariate models of logistic regression analysis, PWV was significantly associated with all-cause and cardiovascular mortality, independent of previous cardiovascular diseases, age, and diabetes. By contrast, pulse pressure was not significantly and independently associated to mortality. This study provides the first direct evidence that aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in patients with essential hypertension.</description><subject>Adult</subject><subject>Aorta - physiopathology</subject><subject>Arterial hypertension. Arterial hypotension</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Clinical manifestations. Epidemiology. Investigative techniques. Etiology</subject><subject>Elasticity</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - mortality</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Prognosis</subject><issn>0194-911X</issn><issn>1524-4563</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkc-LEzEUx4Mobq3ePUkQ8TY1v2dyLGW1hRULKugpZDJvaNZ0Zkwyu_S_N6UFxRzySPi8D4_3Reg1JStKFf1A6Opwmla8XskVZVw9QQsqmaiEVPwpWhCqRaUp_XGDXqR0TwgVQtTP0Q2lXDaaiwUa12PM3uGv2ff9ACnhXcJ2wLuhgwnKNWS8j9B5l8eIxx6vQ6g2dk5QqA5vbOz8-GCTm4ON-HOR2eDzCfsBb08TxAxD8g-A9zb74kov0bPehgSvrnWJvn-8_bbZVndfPu0267vKyTJXVUOvCXNtKxitNWjHmp73ulVtB-WDKEUa0YAQre5KrS2jUitOLLWdcprzJXp_8U5x_D1Dyubok4MQ7ADjnExNGqkbJgv49j_wfpzjUGYzjEhOZK1UgcgFcnFMKUJvpuiPNp4MJeachCHUbH_uDa-NNOckSsubq3duj9D9bbiuvgDvrkDZng19tIPz6R8xE6SYlkhcsMcxZIjpV5gfIZoD2JAPhpQjmGoqVsIlsrwqco6Z_wH0q6CC</recordid><startdate>200105</startdate><enddate>200105</enddate><creator>Laurent, Stéphane</creator><creator>Boutouyrie, Pierre</creator><creator>Asmar, Roland</creator><creator>Gautier, Isabelle</creator><creator>Laloux, Brigitte</creator><creator>Guize, Louis</creator><creator>Ducimetiere, Pierre</creator><creator>Benetos, Athanase</creator><general>American Heart Association, Inc</general><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>200105</creationdate><title>Aortic Stiffness Is an Independent Predictor of All-Cause and Cardiovascular Mortality in Hypertensive Patients</title><author>Laurent, Stéphane ; Boutouyrie, Pierre ; Asmar, Roland ; Gautier, Isabelle ; Laloux, Brigitte ; Guize, Louis ; Ducimetiere, Pierre ; Benetos, Athanase</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5934-7ef902cbb42179e9c28f3f9b6bde1790660848e44b9d48e7a2159630a1ad6c933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adult</topic><topic>Aorta - physiopathology</topic><topic>Arterial hypertension. Arterial hypotension</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Clinical manifestations. Epidemiology. Investigative techniques. Etiology</topic><topic>Elasticity</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension - diagnosis</topic><topic>Hypertension - mortality</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Prognosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Laurent, Stéphane</creatorcontrib><creatorcontrib>Boutouyrie, Pierre</creatorcontrib><creatorcontrib>Asmar, Roland</creatorcontrib><creatorcontrib>Gautier, Isabelle</creatorcontrib><creatorcontrib>Laloux, Brigitte</creatorcontrib><creatorcontrib>Guize, Louis</creatorcontrib><creatorcontrib>Ducimetiere, Pierre</creatorcontrib><creatorcontrib>Benetos, Athanase</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Hypertension (Dallas, Tex. 1979)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Laurent, Stéphane</au><au>Boutouyrie, Pierre</au><au>Asmar, Roland</au><au>Gautier, Isabelle</au><au>Laloux, Brigitte</au><au>Guize, Louis</au><au>Ducimetiere, Pierre</au><au>Benetos, Athanase</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Aortic Stiffness Is an Independent Predictor of All-Cause and Cardiovascular Mortality in Hypertensive Patients</atitle><jtitle>Hypertension (Dallas, Tex. 1979)</jtitle><addtitle>Hypertension</addtitle><date>2001-05</date><risdate>2001</risdate><volume>37</volume><issue>5</issue><spage>1236</spage><epage>1241</epage><pages>1236-1241</pages><issn>0194-911X</issn><eissn>1524-4563</eissn><coden>HPRTDN</coden><abstract>ABSTRACT—Although various studies reported that pulse pressure, an indirect index of arterial stiffening, was an independent risk factor for mortality, a direct relationship between arterial stiffness and all-cause and cardiovascular mortality remained to be established in patients with essential hypertension. A cohort of 1980 essential hypertensive patients who attended the outpatient hypertension clinic of Broussais Hospital between 1980 and 1996 and who had a measurement of arterial stiffness was studied. At entry, aortic stiffness was assessed from the measurement of carotid-femoral pulse-wave velocity (PWV). A logistic regression model was used to estimate the relative risk of all-cause and cardiovascular deaths. Selection of classic risk factors for adjustment of PWV was based on their influence on mortality in this cohort in univariate analysis. Mean age at entry was 50±13 years (mean±SD). During an average follow-up of 112±53 months, 107 fatal events occurred. Among them, 46 were of cardiovascular origin. PWV was significantly associated with all-cause and cardiovascular mortality in a univariate model of logistic regression analysis (odds ratio for 5 m/s PWV was 2.14 [95% confidence interval, 1.71 to 2.67, P <0.0001] and 2.35 [95% confidence interval, 1.76 to 3.14, P <0.0001], respectively). In multivariate models of logistic regression analysis, PWV was significantly associated with all-cause and cardiovascular mortality, independent of previous cardiovascular diseases, age, and diabetes. By contrast, pulse pressure was not significantly and independently associated to mortality. This study provides the first direct evidence that aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in patients with essential hypertension.</abstract><cop>Philadelphia, PA</cop><cop>Hagerstown, MD</cop><pub>American Heart Association, Inc</pub><pmid>11358934</pmid><doi>10.1161/01.hyp.37.5.1236</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | Journals@Ovid Ovid Autoload; MEDLINE; American Heart Association Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Aorta - physiopathology Arterial hypertension. Arterial hypotension Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Clinical manifestations. Epidemiology. Investigative techniques. Etiology Elasticity Female Humans Hypertension - diagnosis Hypertension - mortality Male Medical sciences Middle Aged Mortality Prognosis |
| title | Aortic Stiffness Is an Independent Predictor of All-Cause and Cardiovascular Mortality in Hypertensive Patients |
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