Pulse pressure and aortic pulse wave are markers of cardiovascular risk inhypertensive populations

Background: Pulse pressure (PP) and aortic pulse wave velocity (PWV) are si gnificant markers of cardiovascular risk, but a similar role for central wa ve reflections has never been investigated. Procedures: To determine the factors influencing PP, PWV, and carotid wave reflections, a cohort of 1087 patients with essential hypertension either t reated or untreated was studied cross-sectionally. Atherosclerotic alterati ons (AA) were defined on the basis of clinical events and PWV evaluated fro m an automatic device. The carotid amplification index (CAI), a quantitativ e estimation of the magnitude of central wave reflections, was measured non invasively from pulse wave analysis using radial and carotid aplanation ton ometry. Results: In the overall population, age and mean arterial pressure represen ted 30.4%, 32.3%, and 5.6% of the variance of, respectively PP, PWV, and CA I. For the latter, body weight and heart rate represented 22.9% of variabil ity. On the basis of logistic regression, AA were associated, in addition t o age, plasma creatinine and HDL cholesterol levels, and tobacco consumptio n to three mechanical factors, increased PP, increased PWV, and low diastol ic blood pressure, but not by CAI (adjusted odds ratio: 1.00; 95% confidenc e intervals: 0.99-1.01). Conclusion: In cross-sectional hypertensive populations, PP and PWV, but no t CAI, are significantly and independently associated with cardiovascular a mplications. Am J Hypertens 2001;14:91-97 (C) 2001 American Journal of Hype rtension, Ltd.