Cross-sectional and 4-year longitudinal associations between brachial pulse pressure and common carotid intima-media thickness in a general population - The EVA study

Background and Purpose-The cross-sectional and 4-year longitudinal associat ions between brachial pulse pressure (PP) and ultrasound measurements of co mmon carotid intima-media thickness (CCA-IMT) were assessed. Methods-A population of 957 volunteers aged 59 to 71 years was recruited fr om the electoral rolls of the city of Nantes (western France) and reexamine d 4 years later. Longitudinal changes in PP and CCA-IMT were computed as th e difference between 4-year follow-up and baseline values. Results-Baseline CCA-IMT and PP were positively associated in both age- and sex-adjusted analysis (partial correlation coefficient=0.20, P<0.001) and in multivariate analysis adjusted for traditional cardiovascular risk facto rs and mean blood pressure (partial correlation coefficient=0.18, P<0.001), In longitudinal analysis, baseline PP was associated with the change in 4- year CCA-IMT (partial correlation coefficient=0.11, P<0.001), and baseline CCA-IMT was a predictor of the 4-year change in PP (partial correlation coe fficient=0.10, 0.001<P<0.01). No association between mean blood pressure an d CCA-IMT was observed once PP was taken into account, in either cross-sect ional or longitudinal analyses (partial correlation coefficients ranged fro m 0.00 to 0.03). Similar patterns of results were observed in hypertensive, nonhypertensive, and antihypertensive-treated and -nontreated subjects. Conclusions-This longitudinal study of a large population of relatively age d subjects suggests that elevated levels of PP are associated with the prog ression of CCA-IMT, and increased CCA-LMT is associated with PP widening. T he nature of these relationships and whether atherosclerosis progression ov er time is involved or not in these associations merit further investigatio ns.