Τίτλος:
Determinants of the aortic pulse wave velocity index in hypertensive and diabetic patients: Predictive and therapeutic implications
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objective: Aortic stiffness may provide information to classical risk factors information regarding cardiovascular risk. Aortic pulse wave velocity (PWV) can be measured by applanation tonometry but also theoretical PWV was calculated according to age, blood pressure, heart rate and sex. We aim to highlight biological and hemodynamic determinants of the aortic PWV index, that is the individually calculated [(measured PWVtheoretical PWV)/ theoretical PWV] difference, in hypertensive diabetic patients. Methods: A cross-sectional study was conducted in 514 patients, involving normotensive and hypertensive patients and people with and without diabetes. Biological parameters were measured during day-hospital for cardiovascular screening. Hemodynamic parameters were determined by applanation tonometry. Multivariate regression analyses evaluated the PWV index determinants. Results: Hypertensive and/or diabetic population presents higher PWV index in correlation with the presence of proteinuria (P¼0.0428) and previous cardiovascular events (P¼0.0227). Hypertensive diabetic patients present a higher PWV index than the other patients (P<0.05). Presence of insulin therapy (P¼0.0101) and the type 1 diabetes (P¼0.0065) were positively and independently modulating PWV index in hypertensive diabetic patients. HDL cholesterol levels (P¼0.0245) and absence of carotid (P¼0.0468) plaques were independently modulating PWV index with a negative correlation in hypertensive without diabetes patients. C reactive protein levels were significantly associated with increased PWV index in hypertensive patients (P¼0.0074) and in hypertensive and/ or diabetic population (P¼0.0184). Conclusion: PWV index was correlated with numerous cardiovascular risk factors, in addition of being a marker of age and hypertension. Therefore, this index appears as a cardiovascular risk integrator. Its use could be interesting in cardiovascular risk assessment and reduction strategies. © 2018 Wolters Kluwer Health, Inc. All rights reserved.
Συγγραφείς:
Vallée, A.
Yannoutsos, A.
Temmar, M.
Tubiana, C.D.
Spinu, I.
Zhang, Y.
Protogerou, A.
Henry-Bonniot, G.
Sosner, P.
Safar, M.E.
Blacher, J.
Περιοδικό:
JOURNAL OF HYPERTENSION
Εκδότης:
Lippincott Williams and Wilkins
Λέξεις-κλειδιά:
angiotensin receptor antagonist; antidiabetic agent; antihypertensive agent; beta adrenergic receptor blocking agent; C reactive protein; calcium channel blocking agent; cholesterol; creatinine; glucose; glycosylated hemoglobin; hemoglobin A1c; high density lipoprotein cholesterol; hydroxymethylglutaryl coenzyme A reductase inhibitor; thiazide diuretic agent; antidiabetic agent; C reactive protein; high density lipoprotein cholesterol; insulin, age; ankle brachial index; arterial stiffness; Article; blood pressure; body height; cardiovascular disease; cardiovascular procedure; cardiovascular risk; carotid artery obstruction; cerebrovascular accident; cerebrovascular disease; coronary artery disease; creatinine blood level; creatinine clearance; cross-sectional study; diabetes mellitus; diabetic patient; epicardium; fasting; female; follow up; glucose blood level; heart infarction; heart muscle revascularization; heart rate; hemodynamic parameters; high density lipoprotein cholesterol level; human; hypertension; hypertensive patient; insulin dependent diabetes mellitus; insulin treatment; major clinical study; male; medical history; outpatient department; peripheral vascular disease; prediction; priority journal; protein blood level; proteinuria; pulse wave; retrospective study; revascularization; risk factor; sex; smoking habit; tonometry; adult; aged; aorta; blood; complication; insulin dependent diabetes mellitus; metabolism; middle aged; pathophysiology; pulse wave, Adult; Aged; Aorta; C-Reactive Protein; Cholesterol, HDL; Cross-Sectional Studies; Diabetes Mellitus, Type 1; Female; Humans; Hypertension; Hypoglycemic Agents; Insulin; Male; Middle Aged; Pulse Wave Analysis; Vascular Stiffness
DOI:
10.1097/HJH.0000000000001828
