scholarly journals Reversed L-shaped Association Between Baseline Brachial-ankle Pulse Wave Velocity and Short-Term Risk of First Stroke in Patients With Hypertension: A Population-based Cohort Study

2020 ◽  
Author(s):  
Lihua Hu ◽  
Chonglei Bi ◽  
Lishun Liu ◽  
Yun Song ◽  
Yue Zhang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Cox Proportional Hazards ◽  
Short Term ◽  
Cvd Risk ◽  
Value Analysis ◽  
Increased Risk

Abstract Background: Brachial–ankle pulse wave velocity (baPWV) is available as a noninvasive measure of arterial stiffness. However, little information is available on the association between baPWV and the short-term risk of stroke in patients with hypertension. Therefore, our current study aimed to assess the association between baseline baPWV and short-term risk of first stroke. We were particularly interested in identifying those individuals at high risk of developing stroke among patients with hypertension.Methods: From January 1, 2017, to December 31, 2017, a total of 9787 individuals without preexisting stroke from the China Hypertension Registry Study were included in this analysis. Follow-up continued until December 31, 2018. The primary outcome was first stroke. The crude and adjusted risks of first stroke were estimated by hazard ratios (HRs) and 95% CIs using Cox proportional hazards models, without or with adjusting for pertinent covariates, respectively.Results: During a median follow-up of 20.8 months, there were 138 total first strokes including 123 first ischemic strokes and 15 first hemorrhagic strokes. Smooth curve showed that the relationship between baPWV and risk of first stroke and first ischemic stroke was curvilinear and reversed L-shaped. High baPWV levels (≥ 21.31 m/s) was associated with increased risk of first stroke (HR = 1.52; 95% CI: 1.05-2.21) and first ischemic stroke (HR = 1.53; 95% CI: 1.03-2.26) compared to low baPWV levels (< 21.31 m/s). E-value analysis suggested robustness to unmeasured confounding. Our findings may propose the applicability of baPWV measurement for prediction of stroke development, especially in subjects with a low cardiovascular (CVD) risk.Conclusions: High baPWV levels (≥ 21.31 m/s) were associated with increased the short-term risk of first stroke among Chinese hypertensive adults, compared to low baPWV levels, supporting a reversed L-shaped association. Our findings warrant additional investigation.

Abstract 507: Change in Pulse Wave Velocity and Short Term Development of Cardiovascular Events in the Hemodialysis Population

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Yazan Daaboul ◽  
Serge Korjian ◽  
Balsam El-Ghoul ◽  
Salam Samad ◽  
Pascale Salameh ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Cox Regression ◽  
Hemodialysis Patients ◽  
Short Term ◽  
Coronary Syndrome ◽  
Increased Risk

Objectives: It has previously been demonstrated that single elevated measurements of carotid-femoral pulse wave velocity (CFPWV) among end-stage renal disease (ESRD) patients are associated with an increased risk of cardiovascular (CV) events. However, the association between single measurements of CFPWV and CV events was mostly driven by the high incidence of late events beyond 12 months of follow-up. The present prospective study aims to compare single measurements of CFPWV vs. the 2-year change in CFPWV (delta CFPWV) and their association with short-term development of CV events through 12 months in hemodialysis patients. Methods: Patients on hemodialysis were enrolled for a first measurement of CFPWV (CFPWV t=0 ) followed by a second measurement (CFPWV t=1 ) 2 years ± 1 month later. Patients were then followed up for an additional 12 months for the development of CV events (CV death, acute coronary syndrome, acute ischemic peripheral event necessitating intervention, or stroke). Results: Both CFPWV t=0 and CFPWV t=1 were measured for a total of 66 hemodialysis patients. During the 12-month follow-up period, 13 patients developed a total of 15 events, almost half (7/15) of which were fatal, 4/15 attributed to acute coronary syndrome (ACS), and 4/15 attributed to acute ischemic peripheral artery disease (PAD) necessitating intervention. No stroke events were recorded over the 12-month follow-up duration. Delta CFPWV (CFPWV t=1 - CFPWV t=0 ) was significantly associated with the development of CV events through 12 months with and without adjustment for CV risk factors, including blood pressure parameters (unadjusted: HR=1.22; p=0.001 vs. adjusted: HR=1.14; p=0.002). When delta CFPWV was substituted for either CFPWV t=0 or CFPWV t=1 in both the unadjusted and adjusted Cox regression models, neither measurement was associated with the development of new CV events. Conclusions: The change in CFPWV, but not single measurements of CFPWV, was significantly associated with the short-term development of CV events through 12 months.

scholarly journals Association between estimated pulse wave velocity and the risk of stroke in middle-aged men

2020 ◽  
pp. 174749302096376
Author(s):  
Sae Young Jae ◽  
Kevin S Heffernan ◽  
Sudhir Kurl ◽  
Setor K Kunutsor ◽  
Jari A Laukkanen
Keyword(s):  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Hemorrhagic Stroke ◽  
Pulse Wave ◽  
Middle Aged ◽  
Cerebrovascular Events ◽  
Increased Risk ◽  
Hemorrhagic Events ◽  
Emerging Risk

Background Increased aortic stiffness, assessed as carotid-femoral pulse wave velocity (cfPWV), contributes to cerebrovascular damage and is predictive of cerebrovascular events. Aims and methods We sought to examine the association between estimated pulse wave velocity (ePWV), a proxy of carotid-femoral pulse wave velocity, and stroke and its subtypes (ischemic and hemorrhagic) in a prospective cohort of 2666 men (aged mean 53.1, range 42–61 years) enrolled in the Kuopio Ischemic Heart Disease cohort study. Results During a median 28-year follow-up, 471 incident stroke (397 ischemic and 94 hemorrhagic) events occurred. After adjusting for several established and emerging risk factors including age and pulse pressure, comparing the p versus bottom quartiles of ePWV, there was an increased risk of stroke (hazard ratio [HR] 2.37, 95% Confidence Interval [CI]: 1.57–3.58), ischemic stroke (HR 2.23, 95% CI, 1.42–3.50), and hemorrhagic stroke (HR 3.57, 95% CI, 1.45–8.76). Conclusion These findings demonstrate that ePWV is independently associated with the risk of stroke in middle-aged men.

MO754THE INTERRELATIONSHIP BETWEEN FLUID OVERLOAD AND VASCULAR STIFFNESS IN HEMODIALYSIS PATIENTS: A SCOPING REVIEW

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Aya Lafta ◽  
Aminu Bello ◽  
Sara Davison ◽  
Stephanie Thompson ◽  
Branko Braam
Keyword(s):  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Scoping Review ◽  
Observational Studies ◽  
Pulse Wave ◽  
Fluid Overload ◽  
Augmentation Index ◽  
Extracellular Fluid ◽  
Vascular Stiffness

Abstract Background and Aims Fluid overload and vascular stiffness are two independent predictors of cardiovascular events in hemodialysis (HD) patients. To date, observational and interventional studies that investigated the effect of inter- and intradialytic fluid overload changes on vascular stiffness in HD patients are very limited. We performed a scoping review to explore existing reports about effects of fluid overload on vascular stiffness in adults receiving HD treatment and to identify knowledge gaps for future research. Method We followed the framework originally developed by Arksey and O’Malley. We searched Medline, Embase, CINAHL, and Cochrane Database of systematic reviews from inception to October 29, 2019. References of review papers were screened for relevant studies not identified from the initial search until saturation is achieved. Results Of 666 eligible studies, nineteen studies met the inclusion criteria. These included clinical observational studies (n=16) and randomized controlled trials (n=3). In general, most of the identified studies had small sample size and short term of follow up. Studies use different definitions of fluid overload and vascular stiffness. Measures of relative fluid overload like the ratio of extracellular fluid/intracellular fluid, fluid overload/extracellular fluid, and/or extracellular fluid/total body fluid were used as a representative of fluid status. Pulse wave velocity and augmentation index were used interchangeably as vascular stiffness measures. The accumulated findings were inconsistent and inconclusive. There was no consensus whether intradialytic fluid volume changes affected vascular stiffness. In the majority of the observational studies, a decrease in pulse wave velocity or augmentation index correlated with a decrease in blood pressure after fluid correction by HD treatment. The randomized clinical trials used different methods and technologies for the correction of fluid overload, thereby, results were conflicting. Conclusion Current literature is insufficient to justify whether fluid overload changes have a direct effect on vascular stiffness in HD patients. The findings were conflicting which limits the comparisons of studies and generalization of findings. These knowledge gaps urge the need for further clinical studies to enhance the understanding and to improve the quality of research in this topic. This includes standardized definitions and methodologies as well as longer term of follow up.

Determinants of Follow-up Changes of Brachial Ankle Pulse Wave Velocity in Korean Women

2012 ◽  
Vol 18 (4) ◽  
pp. 154 ◽  
Author(s):  
Dae Young Kim ◽  
Sung Yeol Kong ◽  
Sung Ja Lee ◽  
Ha Do Song ◽  
Eun Jin Han ◽  
...  
Keyword(s):  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Korean Women

Comparison of Biofeedback Pulse Wave Velocity and Progressive Relaxation in Essential Hypertensives

1977 ◽  
Vol 44 (3) ◽  
pp. 839-843 ◽  
Author(s):  
Peter Walsh ◽  
Alexander Dale ◽  
David E. Anderson
Keyword(s):  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Clinical Effectiveness ◽  
Progressive Relaxation ◽  
Biofeedback Training ◽  
Behavioral Treatments ◽  
Blood Pressures ◽  
Biofeedback Treatment

In a study undertaken to evaluate the clinical effectiveness of two behavioral treatments for essential hypertension (biofeedback on arterial pulse-wave velocity and progressive relaxation) 24 hypertensive subjects were randomly assigned to either a relaxation or biofeedback treatment group for 5 weekly sessions. In a second stage of the study 16 of the original subjects received both biofeedback and relaxation treatments during 5 additional weekly sessions. Results indicated that biofeedback and relaxation were equally effective in initial lowering of blood pressure in hypertensives. Although biofeedback training led to superior reductions at the 3-mo. follow-up point, after 1 yr. the blood pressures of both groups were not only equal but well below those presented at the beginning of the study.

scholarly journals Changes in Ankle Brachial Pulse Wave Velocity during a Five-Year Follow-up Period in Older Japanese Adults: Sub-analysis Results of the Health Research Volunteer Study in Japan

2013 ◽  
Vol 52 (1) ◽  
pp. 21-27 ◽  
Author(s):  
Nobutaka Doba ◽  
Yasuharu Tokuda ◽  
Hirofumi Tomiyama ◽  
Nathan E. Goldstein ◽  
Toshio Kushiro ◽  
...  
Keyword(s):  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Health Research ◽  
Pulse Wave ◽  
Japanese Adults ◽  
Volunteer Study

Abstract 2646: Aortic Arch Plaques and Risk of Vascular Events in Subjects Without Prior Stroke

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Cesare Russo ◽  
Zhezhen Jin ◽  
Ralph L Sacco ◽  
Shunichi Homma ◽  
Tatjana Rundek ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Aortic Arch ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Study Cohort ◽  
Vascular Events ◽  
Increased Risk ◽  
Prior Stroke

BACKGROUND: Aortic arch plaques (AAP) are a risk factor for cardiovascular embolic events. However, the risk of vascular events associated with AAP in the general population is unclear. AIM: To assess whether AAP detected by transesophageal echocardiography (TEE) are associated with an increased risk of vascular events in a stroke-free cohort. METHODS: The study cohort consisted of stroke-free subjects over age 50 from the Aortic Plaques and Risk of Ischemic Stroke (APRIS) study. AAP were assessed by multiplane TEE, and considered large if ≥ 4 mm in thickness. Vascular events including myocardial infarction, ischemic stroke and vascular death were recorded during the follow-up. The association between AAP and outcomes was assessed by univariate and multivariate Cox proportional hazards models. RESULTS: A group of 209 subjects was studied (mean age 67±9 years; 45% women; 14% whites, 30% blacks, 56% Hispanics). AAP of any size were present in 130 subjects (62%); large AAP in 50 (24%). Subjects with AAP were older (69±8 vs. 63±7 years), had higher systolic BP (146±21 vs.139±20 mmHg), were more often white (19% vs. 8%), smokers (20% vs. 9%) and more frequently had a history of coronary artery disease (26% vs. 14%) than those without AAP (all p<0.05). Lipid parameters, prevalence of atrial fibrillation and diabetes mellitus were not significantly different between the two groups. During the follow up (94±29 months) 30 events occurred (13 myocardial infarctions, 11 ischemic strokes, 6 vascular deaths). After adjustment for other risk factors, AAP of any size were not associated with an increased risk of combined vascular events (HR 1.07, 95% CI 0.44 to 2.56). The same result was observed for large AAP (HR 0.94, CI 0.34 to 2.64). Age (HR 1.05, CI 1.01 to 1.10), body mass index (HR 1.08, CI 1.01 to 1.15) and atrial fibrillation (HR 3.52, CI 1.07 to 11.61) showed independent association with vascular events. In a sub-analysis with ischemic stroke as outcome, neither AAP of any size nor large AAP were associated with an increased risk. CONCLUSIONS: In this cohort without prior stroke, the incidental detection of AAP was not associated with an increased risk of future vascular events. Associated co-factors may affect the AAP-related risk of vascular events reported in previous studies.

Abstract WP265: Association Between Brachial-Ankle Pulse Wave Velocity and Aortic Atheroma in Acute Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Jaewook Jeong ◽  
Jin Kyo Choi ◽  
Young Dae Kim ◽  
Ji Hoe Heo ◽  
Hyo Suk Nam
Keyword(s):  
Ischemic Stroke ◽  
Pulse Wave Velocity ◽  
Acute Ischemic Stroke ◽  
Wave Velocity ◽  
Aortic Stiffness ◽  
Pulse Wave ◽  
Mean Value ◽  
Noninvasive Technique ◽  
Aortic Atheroma ◽  
Aortic Plaques

Background and Purpose: Aortic plaques are associated with both larger artery and small artery atherosclerosis. However, association between aortic plaque and aortic stiffness in ischemic stroke is unknown. Brachial-ankle pulse wave velocity (baPWV) is a noninvasive technique to measure aortic stiffness. In the present study, we hypothesized that presence of aortic plaques is associated with increased baPWV. Methods: We reviewed 1099 patients diagnosed with acute ischemic stroke, who had both transesophageal echocardiography (TEE) and brachial-ankle pulse wave velocity (baPWV) measurements. Aortic plaques were classified as complex aortic plaques (CAP) or simple aortic plaques (SAP). CAP were defined as plaques protruding into the lumen ≥4 mm and of mobile lesions located in the proximal aorta. SAP represented plaques <4 mm in the proximal aorta and plaques located in the descending aorta of any sizes. Patients were classified into 4 groups; patients who have CAP only, those who have SAP only, those who have both CAP and SAP, and those without aortic plaques. Results: Among the 1099 patients, aortic atheroma was found in 689 (62.7%) patients. Twenty one (1.9%) patients had only CAP, 142 (12.9%) patients had both SAP and CAP, while 526 (47.9%) patients had SAP without CAP. Mean value of baPWV was 1982±580 cm/sec. baPWV was significantly increased in patients with any aortic atheromas than those without atheromas (2095±577 cm/sec vs. 1793±535 cm/sec, p <0.001). Analysis of variance showed that baPWV was significantly increased in patients with SAP only (p<0.001) and SAP and CAP (p<0.001) compared to those without any aortic atheroma, whereas CAP only patients were not associated with baPWV (p = 0.131). Conclusion: We found that baPWV was associated with SAP but not CAP in acute ischemic stroke patients. These feature suggests that SAP represent generalized atherosclerosis and aortic stiffness, whereas CAP represent the sole mechanism of stroke.

Abstract 545: Modification Over Time of Pulse Wave Velocity Parallel to Changes in Both Office and 24h-ambulatory Peripheral BP as well as Aortic BP

Hypertension ◽  
2014 ◽  
Vol 64 (suppl_1) ◽  
Author(s):  
Anna Oliveras ◽  
Julián Segura ◽  
Carmen Suárez ◽  
Luis García-Ortiz ◽  
María Abad ◽  
...  
Keyword(s):  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Target Organ Damage ◽  
Measurement Techniques ◽  
Organ Damage ◽  
Applanation Tonometry ◽  
Target Organ ◽  
Over Time

Aim: to assess the relationship of changes in pulse wave velocity (PWV), a marker of target organ damage, with the variation in BP over time, as assessed by three different methods of measurement: office and 24h-ambulatory peripheral BP as well as aortic BP. Methods: Observational prospective study in hypertensive subjects with impaired glucose metabolism consecutively recruited from Spanish Hypertension Units. Aortic BP and carotid-femoral PWV were evaluated by radial applanation tonometry (Sphygmocor®) at baseline ( b ) and after 12 months of follow-up ( fu ). Peripheral BP measurements were also recorded at baseline and at 12 months follow-up: office BP was obtained as the average of triplicate measurements taken at 1 min-intervals after 5 min of seated rest, using validated oscillometric devices; 24h-ambulatory BP recordings were taken with a validated device (Spacelabs®-90207) at 20-minute intervals throughout both the self-reported awake and asleep periods. Clinical and anthropometric features were also recorded. PWV variation (Δ) over time was calculated as follows: Δ PWV= [(PWV fu - PWV b ) / PWV b ] x 100. BP variation over time was calculated with the same formula applied to BP values obtained with the different measurement techniques. Correlations (Spearman “Rho”) of Δ PWV and Δ BP were calculated. Results: n=209 patients; mean age: 61.8 ± 11.2 y; 39% (81 of 209) were female; 80% (167 of 209) had type 2 diabetes. Other risk factors: hypertension: 100%; dyslipidemia: 69% (144 of 209); smokers: 13% (28 of 209); body mass index: 30.9 ± 4.4 Kg/m 2 . Baseline office systolic/diastolic BP (mmHg): oSBP = 143 ± 20; oDBP = 82 ± 12. Follow-up office systolic/diastolic BP (mmHg): oSBP = 136 ± 20; oDBP = 79 ± 12. Baseline PWV: 10.01 ± 3.5 m/s. Follow-up PWV: 10.19 ± 3.21 m/s. Δ PWV correlated with: Δ oSBP (Rho=0.212; p=0.002), Δ 24h-SBP (Rho=0.254; p<0.001), Δ daytime-BP (Rho=0.232; p=0.001), Δ nighttime-BP (Rho=0.320; p<0.001) and Δ aortic-SBP (Rho=0.320; p<0.001). Conclusion: Modification over time of PWV, a marker of target organ damage, parallel to changes in systolic BP, both office and 24h-ambulatory peripheral BP variation as well as aortic BP variation, at 12 months of follow-up. Among them, aortic SBP and nighttime peripheral SBP both showed the best correlation.

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