Skip to main content
Top
Published in: BMC Cardiovascular Disorders 1/2011

Open Access 01-12-2011 | Research article

Pulse wave velocity and carotid atherosclerosis in White and Latino patients with hypertension

Authors: Mori J Krantz, Carlin S Long, Patrick Hosokawa, Elhum Karimkhani, Miriam Dickinson, Raymond O Estacio, Frederick A Masoudi, Edward P Havranek

Published in: BMC Cardiovascular Disorders | Issue 1/2011

Login to get access

Abstract

Background

Preventive cardiology has expanded beyond coronary heart disease towards prevention of a broader spectrum of cardiovascular diseases. Ethnic minorities are at proportionately greater risk for developing extracoronary vascular disease including heart failure and cerebrovascular disease.

Methods

We performed a cross sectional study of Latino and White hypertension patients in a safety-net healthcare system. Framingham risk factors, markers of inflammation (hsCRP, LPpLA2), arterial stiffness (Pulse wave velocity, augmentation index, and central aortic pressure), and endothelial function (brachial artery flow-mediated dilatation) were measured. Univariate and multivariable associations between these parameters and an index of extracoronary atherosclerosis (carotid intima media thickness) was performed.

Results

Among 177 subjects, mean age was 62 years, 67% were female, and 67% were Latino. In univariate analysis, markers associated with carotid intima media thickness (IMT) at p < 0.25 included pulse wave velocity (PWV), augmentation index (AIx), central aortic pressure (cAP), and LpPLA2 activity rank. However, AIx, cAP, and LpPLA2 activity were not significantly associated with carotid IMT after adjusting for Framingham risk factors (all p > .10). Only PWV retained a significant association with carotid IMT independent of the Framingham general risk profile parameters (p = .016). No statistically significant interactions between Framingham and other independent variables with ethnicity (all p > .05) were observed.

Conclusion

In this safety net cohort, PWV is a potentially useful adjunctive atherosclerotic risk marker independent of traditional risk factors and irrespective of ethnicity.
Appendix
Available only for authorised users
Literature
1.
go back to reference D'Agostino RB, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB: General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. 2008, 117: 743-753. 10.1161/CIRCULATIONAHA.107.699579.CrossRefPubMed D'Agostino RB, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB: General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. 2008, 117: 743-753. 10.1161/CIRCULATIONAHA.107.699579.CrossRefPubMed
2.
go back to reference Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB: Prediction of coronary heart disease using risk factor categories. Circulation. 1998, 97: 1837-1847.CrossRefPubMed Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB: Prediction of coronary heart disease using risk factor categories. Circulation. 1998, 97: 1837-1847.CrossRefPubMed
3.
go back to reference Marma AK, Ning H, Lloyd-Jones DM: Impact of a change to global cardiovascular risk estimation in lipid-lowering guidelines: Finding from the National Health and Nutrition Examination Survey (NHANES) 2001-2006. Circulation. 2009, 120: S424-10.1161/CIRCULATIONAHA.108.835470.CrossRef Marma AK, Ning H, Lloyd-Jones DM: Impact of a change to global cardiovascular risk estimation in lipid-lowering guidelines: Finding from the National Health and Nutrition Examination Survey (NHANES) 2001-2006. Circulation. 2009, 120: S424-10.1161/CIRCULATIONAHA.108.835470.CrossRef
4.
go back to reference Lloyd-Jones D, Adams RJ, Brown TM, on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee, et al: Heart disease and stroke statistics--2010 update: a report from the American Heart Association. Circulation. 2010, 121: e1-e170. 10.1161/CIRCULATIONAHA.109.878314.CrossRef Lloyd-Jones D, Adams RJ, Brown TM, on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee, et al: Heart disease and stroke statistics--2010 update: a report from the American Heart Association. Circulation. 2010, 121: e1-e170. 10.1161/CIRCULATIONAHA.109.878314.CrossRef
5.
go back to reference Ridker PM, Buring JE, Rifai N, Cook NR: Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: the Reynolds Risk Score. JAMA. 2007, 297: 611-619. 10.1001/jama.297.6.611.CrossRefPubMed Ridker PM, Buring JE, Rifai N, Cook NR: Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: the Reynolds Risk Score. JAMA. 2007, 297: 611-619. 10.1001/jama.297.6.611.CrossRefPubMed
6.
go back to reference Heffernan KS, Fahs CA, Iwamoto GA, Jae SY, Wilund KR, Woods JA, Fernhall B: Resistance exercise training reduces central blood pressure and improves microvascular function in Afrincan American and white men. Atherosclerosis. 2009, 207: 220-226. 10.1016/j.atherosclerosis.2009.03.043.CrossRefPubMed Heffernan KS, Fahs CA, Iwamoto GA, Jae SY, Wilund KR, Woods JA, Fernhall B: Resistance exercise training reduces central blood pressure and improves microvascular function in Afrincan American and white men. Atherosclerosis. 2009, 207: 220-226. 10.1016/j.atherosclerosis.2009.03.043.CrossRefPubMed
8.
go back to reference Hanratty R, Estacio RO, Dickinson LM, Chandramouli V, Steiner JF, Havranek EP, Latino Using Cardio Health Actions to Reduce Risk study investigators: Testing electronic algorithms to create disease registries in a safety net system. J Health Care Poor Underserved. 2008, 19: 452-465. 10.1353/hpu.0.0027.CrossRefPubMedPubMedCentral Hanratty R, Estacio RO, Dickinson LM, Chandramouli V, Steiner JF, Havranek EP, Latino Using Cardio Health Actions to Reduce Risk study investigators: Testing electronic algorithms to create disease registries in a safety net system. J Health Care Poor Underserved. 2008, 19: 452-465. 10.1353/hpu.0.0027.CrossRefPubMedPubMedCentral
9.
go back to reference Gabow P, Eisert S, Wright R: Denver Health: a model for the integration of a public hospital and community health centers. Ann Int Med. 2003, 138: 143-149.CrossRefPubMed Gabow P, Eisert S, Wright R: Denver Health: a model for the integration of a public hospital and community health centers. Ann Int Med. 2003, 138: 143-149.CrossRefPubMed
10.
go back to reference Lavi S, McConnell JP, Rihal CS, Prasad A, Mathew V, Lerman LO, Lerman A: Local production of lipoprotein-associated phospholipase A2 and lysophosphatidylcholine in the coronary circulation: association with early coronary atherosclerosis and endothelial dysfunction in humans. Circulation. 2007, 115: 2715-2721. 10.1161/CIRCULATIONAHA.106.671420.CrossRefPubMed Lavi S, McConnell JP, Rihal CS, Prasad A, Mathew V, Lerman LO, Lerman A: Local production of lipoprotein-associated phospholipase A2 and lysophosphatidylcholine in the coronary circulation: association with early coronary atherosclerosis and endothelial dysfunction in humans. Circulation. 2007, 115: 2715-2721. 10.1161/CIRCULATIONAHA.106.671420.CrossRefPubMed
11.
go back to reference Kolodgie FD, Burke AP, Skorija KS, Ladich E, Kutys R, Makuria AT, Virmani R: Lipoprotein-associated phospholipase A2 protein expression in the natural progression of human coronary atherosclerosis. Arterioscler Thromb Vasc Biol. 2006, 26: 2523-2529. 10.1161/01.ATV.0000244681.72738.bc.CrossRefPubMed Kolodgie FD, Burke AP, Skorija KS, Ladich E, Kutys R, Makuria AT, Virmani R: Lipoprotein-associated phospholipase A2 protein expression in the natural progression of human coronary atherosclerosis. Arterioscler Thromb Vasc Biol. 2006, 26: 2523-2529. 10.1161/01.ATV.0000244681.72738.bc.CrossRefPubMed
12.
go back to reference Mannheim D, Herrmann J, Versari D, Gossl M, Meyer FB, McConnell JP, et al: Enhanced expression of Lp-PLA2 and lysophosphatidylcholine in symptomatic carotid atherosclerotic plaque. Stroke. 2008, 39: 1448-1455. 10.1161/STROKEAHA.107.503193.CrossRefPubMedPubMedCentral Mannheim D, Herrmann J, Versari D, Gossl M, Meyer FB, McConnell JP, et al: Enhanced expression of Lp-PLA2 and lysophosphatidylcholine in symptomatic carotid atherosclerotic plaque. Stroke. 2008, 39: 1448-1455. 10.1161/STROKEAHA.107.503193.CrossRefPubMedPubMedCentral
13.
go back to reference Davidson MH, Corson MA, Alberts MJ, Anderson JL, Gorelick PB, Jones PH: Consensus panel recommendation for incorporating lipoprotein-associated phospholipase A2 testing into cardiovascular disease risk assessment guidelines. Am J Cardiol. 2008, 101: 51F-57F. 10.1016/j.amjcard.2008.04.019.CrossRefPubMed Davidson MH, Corson MA, Alberts MJ, Anderson JL, Gorelick PB, Jones PH: Consensus panel recommendation for incorporating lipoprotein-associated phospholipase A2 testing into cardiovascular disease risk assessment guidelines. Am J Cardiol. 2008, 101: 51F-57F. 10.1016/j.amjcard.2008.04.019.CrossRefPubMed
14.
go back to reference Clinical and Laboratory Standards Institute (CLSI): Methods comparison and bias estimation using patient samples; approved guideline-second edition. CLSI document EP9-A2 (ISBN 1-56238-472-4). 2002, CLSI, 940 West Valley Road, Suite 1400, Wayne PA 19087-1898 USA Clinical and Laboratory Standards Institute (CLSI): Methods comparison and bias estimation using patient samples; approved guideline-second edition. CLSI document EP9-A2 (ISBN 1-56238-472-4). 2002, CLSI, 940 West Valley Road, Suite 1400, Wayne PA 19087-1898 USA
15.
go back to reference O'Leary DH, Polak JF, Wolfson SK, et al: Use of sonography to evaluate carotid atherosclerosis in the elderly. The Cardiovascular Health Study. CHS Collaborative research Group. Stroke. 1991, 22: 1155-63. 10.1161/01.STR.22.9.1155.CrossRefPubMed O'Leary DH, Polak JF, Wolfson SK, et al: Use of sonography to evaluate carotid atherosclerosis in the elderly. The Cardiovascular Health Study. CHS Collaborative research Group. Stroke. 1991, 22: 1155-63. 10.1161/01.STR.22.9.1155.CrossRefPubMed
16.
go back to reference Mitchell GF, Hwang SJ, Vasan RS, Larson MG, Pencina MJ, Hamburg NM, et al: Arterial stiffness and cardiovascular events: the Framingham Heart Study. Circulation. 2010, 121: 505-511. 10.1161/CIRCULATIONAHA.109.886655.CrossRefPubMedPubMedCentral Mitchell GF, Hwang SJ, Vasan RS, Larson MG, Pencina MJ, Hamburg NM, et al: Arterial stiffness and cardiovascular events: the Framingham Heart Study. Circulation. 2010, 121: 505-511. 10.1161/CIRCULATIONAHA.109.886655.CrossRefPubMedPubMedCentral
17.
go back to reference Kardys I, Oei HHS, van der Meer IM, Horman A, Breteler MMB, Witteman JCM: Lipoprotein-associated phospholipase A2 and measures of extracoronary atherosclerosis: the Rotterdam study. Aterioscler Thromb Vasc Biol. 2006, 26: 631-636. 10.1161/01.ATV.0000201289.83256.cf.CrossRef Kardys I, Oei HHS, van der Meer IM, Horman A, Breteler MMB, Witteman JCM: Lipoprotein-associated phospholipase A2 and measures of extracoronary atherosclerosis: the Rotterdam study. Aterioscler Thromb Vasc Biol. 2006, 26: 631-636. 10.1161/01.ATV.0000201289.83256.cf.CrossRef
18.
go back to reference Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM, Kastelein JJ, JUPITER Study Group, et al: Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008, 359: 2195-2207. 10.1056/NEJMoa0807646.CrossRefPubMed Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM, Kastelein JJ, JUPITER Study Group, et al: Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008, 359: 2195-2207. 10.1056/NEJMoa0807646.CrossRefPubMed
19.
go back to reference Rodondi N, Marques-Vidal P, Butler J, Sutton-Tyrrel K, Comuz J, Satterfield S, Harris T, Bauer DC, Ferrucci L, Vittinghoff E, Newman AB: Markers of atherosclerosis and inflammation for prediction of coronary heart disease in older adults. Am J Epidemiol. 2010, 171: 540-549. 10.1093/aje/kwp428.CrossRefPubMedPubMedCentral Rodondi N, Marques-Vidal P, Butler J, Sutton-Tyrrel K, Comuz J, Satterfield S, Harris T, Bauer DC, Ferrucci L, Vittinghoff E, Newman AB: Markers of atherosclerosis and inflammation for prediction of coronary heart disease in older adults. Am J Epidemiol. 2010, 171: 540-549. 10.1093/aje/kwp428.CrossRefPubMedPubMedCentral
20.
go back to reference Terai M, Ohishi M, Ito N, Takagi T, Tatara Y, Kaibe M, et al: Comparison of arterial functional evaluations a a predictor cardiovascular events in hypertensive patients: the Non-invasive Atherosclerotic Evaluation in Hypertension (NOAH) study. Hypertens Res. 2008, 31: 1135-1145. 10.1291/hypres.31.1135.CrossRefPubMed Terai M, Ohishi M, Ito N, Takagi T, Tatara Y, Kaibe M, et al: Comparison of arterial functional evaluations a a predictor cardiovascular events in hypertensive patients: the Non-invasive Atherosclerotic Evaluation in Hypertension (NOAH) study. Hypertens Res. 2008, 31: 1135-1145. 10.1291/hypres.31.1135.CrossRefPubMed
21.
go back to reference Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Havoz D, et al: Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006, 27: 2588-2605. 10.1093/eurheartj/ehl254.CrossRefPubMed Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Havoz D, et al: Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006, 27: 2588-2605. 10.1093/eurheartj/ehl254.CrossRefPubMed
22.
go back to reference Vlachopoulos C, Aznaouridis K, Stefanidis C: Prediction of cardiovascular events and all-cause mortality with arterial stiffness: A systematic review and meta-analysis. J Am Coll Cardiol. 2010, 55: 1318-1327. 10.1016/j.jacc.2009.10.061.CrossRefPubMed Vlachopoulos C, Aznaouridis K, Stefanidis C: Prediction of cardiovascular events and all-cause mortality with arterial stiffness: A systematic review and meta-analysis. J Am Coll Cardiol. 2010, 55: 1318-1327. 10.1016/j.jacc.2009.10.061.CrossRefPubMed
23.
go back to reference Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, Fayad ZA, Foster E, Hlatky MA, Hodgson JMcB, Kushner FG, Lauer MS, Shaw LJ, Smith SC, Taylor AJ, Weintraub WS, Wenger NK: 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2010, 56: 2182-99. 10.1016/j.jacc.2010.09.002.CrossRef Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, Fayad ZA, Foster E, Hlatky MA, Hodgson JMcB, Kushner FG, Lauer MS, Shaw LJ, Smith SC, Taylor AJ, Weintraub WS, Wenger NK: 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2010, 56: 2182-99. 10.1016/j.jacc.2010.09.002.CrossRef
24.
go back to reference Munakata M, Ito N, Nunokawa T, Yoshinaga K: Utility of automated brachial ankle pulse wave velocity measurements in hypertensive patients. Am J Hypertens. 2003, 16: 653-657. 10.1016/S0895-7061(03)00918-X.CrossRefPubMed Munakata M, Ito N, Nunokawa T, Yoshinaga K: Utility of automated brachial ankle pulse wave velocity measurements in hypertensive patients. Am J Hypertens. 2003, 16: 653-657. 10.1016/S0895-7061(03)00918-X.CrossRefPubMed
25.
go back to reference Sugawara J, Hayashi K, Yokio T, Cortez-Cooper MY, DeVan AE, Anton MA, Tanaka H: Brachial-ankle pulse wave velocity: an index of central arterial stiffness?. J Hum Hypertens. 2005, 19: 401-406. 10.1038/sj.jhh.1001838.CrossRefPubMed Sugawara J, Hayashi K, Yokio T, Cortez-Cooper MY, DeVan AE, Anton MA, Tanaka H: Brachial-ankle pulse wave velocity: an index of central arterial stiffness?. J Hum Hypertens. 2005, 19: 401-406. 10.1038/sj.jhh.1001838.CrossRefPubMed
26.
go back to reference Hoel AW, Kayssi A, Brahmanandam S, Belkin M, Conte MS, Nguyen LL: Under-representation of women and ethnic minorities in vascular surgery randomized controlled trials. J Vasc Surg. 2009, 50: 349-54. 10.1016/j.jvs.2009.01.012.CrossRefPubMedPubMedCentral Hoel AW, Kayssi A, Brahmanandam S, Belkin M, Conte MS, Nguyen LL: Under-representation of women and ethnic minorities in vascular surgery randomized controlled trials. J Vasc Surg. 2009, 50: 349-54. 10.1016/j.jvs.2009.01.012.CrossRefPubMedPubMedCentral
27.
go back to reference Laurent S, Boutouyre P, Asmar R, Gautier I, Laloux B, Guize L, et al: Aortic stiffness is an independent predictor of all-cause and cardiovascular disease mortality in hypertensive patients. Hypertension. 2001, 37: 1236-1241.CrossRefPubMed Laurent S, Boutouyre P, Asmar R, Gautier I, Laloux B, Guize L, et al: Aortic stiffness is an independent predictor of all-cause and cardiovascular disease mortality in hypertensive patients. Hypertension. 2001, 37: 1236-1241.CrossRefPubMed
28.
go back to reference D'Agostion RB, Grundy S, Sullivan LM, Wilson P, CHD Risk Prediction Group: Validation of the Framingham coronary heart disease risk prediction scores. Results of a multiple ethnic groups investigation. JAMA. 2001, 286: 180-187. 10.1001/jama.286.2.180.CrossRef D'Agostion RB, Grundy S, Sullivan LM, Wilson P, CHD Risk Prediction Group: Validation of the Framingham coronary heart disease risk prediction scores. Results of a multiple ethnic groups investigation. JAMA. 2001, 286: 180-187. 10.1001/jama.286.2.180.CrossRef
Metadata
Title
Pulse wave velocity and carotid atherosclerosis in White and Latino patients with hypertension
Authors
Mori J Krantz
Carlin S Long
Patrick Hosokawa
Elhum Karimkhani
Miriam Dickinson
Raymond O Estacio
Frederick A Masoudi
Edward P Havranek
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2011
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/1471-2261-11-15

Other articles of this Issue 1/2011

BMC Cardiovascular Disorders 1/2011 Go to the issue