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

DOI: 10.1186/1471-2261-11-15

Keywords: Pulse wave velocity, hypertension, atherosclerosis, carotid intima media thickness, Latino, inflammatory markers, augmentation index, central aortic pressure, C-reactive protein

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Abstract:

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.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.In this safety net cohort, PWV is a potentially useful adjunctive atherosclerotic risk marker independent of traditional risk factors and irrespective of ethnicity.An emerging concept in cardiovascular disease (CVD) prevention is a shift in focus from predicting isolated coronary events to broader prediction of any CVD event. This has led to derivation of a new Framingham CVD risk profile [1] beyond the traditional score for predicting 10-year coronary disease events [2]. To illustrate this, data from the National Health and Nutrition Examination Surveys compared the two instruments among US men and women and found that just 3% of individuals were at a high (>20%) predicted coronary disease risk, whereas 18% were at high CVD risk when CVD death, myocardial in

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