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. 2025 Mar;27(3):e70038.
doi: 10.1111/jch.70038.

Usefulness of Arterial Stiffness as an Integrated Marker of Cardiovascular Risk

Grethzel Prado  1 , María J Forner  2   3   4 , Oscar Calaforra  5 , Sara Vela  2   3   4 , Carlos Bea  2   3 , Gernot Pichler  6   7 , Ana de Gracia  2   3 , Lucas Serna  2 , Enrique Rodilla  8   9 , Josep Redon  3 , Fernando Martínez-García  2   3   4
Affiliations

Usefulness of Arterial Stiffness as an Integrated Marker of Cardiovascular Risk

Grethzel Prado et al. J Clin Hypertens (Greenwich). 2025 Mar.

Abstract

We analyzed the usefulness of the carotid-femoral pulse wave velocity (cfPWV) as an integrated marker for hypertension (HTN)-mediated organ damage (HMOD) and cardiovascular (CV) risk in a cohort with repeated measurements. A total of 1031 patients, 80% of whom had HTN, underwent cfPWV determinations by SphygmoCor. An HMOD score was developed, including microalbuminuria, left ventricular hypertrophy (LVH), intima-media thickness (IMT), and carotid plaques. CV complications included atrial fibrillation (AF), heart failure (HF), stroke, ischemic heart disease (IHD), peripheral artery disease (PAD), or CV death. Survival curves based on Cox regression adjusted for age and systolic blood pressure (SBP), along with Harrell's C statistic, were assessed. There was a trend toward higher cfPWV across categories of the HMOD score. Significant correlations were found among different AS parameters and blood pressure (BP) levels. Age and SBP were highly correlated with cfPWV. Among the 174 patients with at least two cfPWV measurements, there were 12 CV complications over a follow-up period of 2.4 years. The first and second cfPWV measurements, as well as the delta values, were significantly higher in those with CV complications, with most patients experiencing an increase in PWV during follow-up of ≥ 1 m/s. Survival curves significantly differed among tertiles of PWV and the delta, particularly for the second PWV determination, which also showed the highest predictive value (Harrell's C = 0.86). The optimal threshold to predict complications was 9.10 m/s. Our findings suggest that cfPWV represents a promising integrated marker of HMOD, potentially serving as a surrogate endpoint for CV risk.

Keywords: complications; hypertension (HTN); longitudinal studies; pulse wave analysis; vascular stiffness (AS).

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Average values of the cfPWV for each category of the hypertension mediated organ damage (HMOD) score with the estimated linear regression line between the PWV and SCORE. The figure also shows the histogram with the absolute number of individuals in each category of the score.
FIGURE 2
FIGURE 2
Changes in cfPWV during the follow‐up for patients with and without cardiovascular complications. Estimated regression line between changes in cfPWV and changes in central and peripheral SBP.
FIGURE 3
FIGURE 3
Bar graph for the comparison of the baseline, the follow‐up cfPWV, and the delta of increase in patients with or without cardiovascular events.
See this image and copyright information in PMC

References

    1. Roth G. A., Johnson C., Abajobir A., et al., “Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015,” Journal of the American College of Cardiology 70 (2017): 1–25. - PMC - PubMed
    1. Chow C. K., Teo K. K., Rangarajan S., et al., “Prevalence, Awareness, Treatment, and Control of Hypertension in Rural and Urban Communities in High‐, Middle‐, and Low‐Income Countries,” Journal of the American Medical Association 310 (2013): 959–968. - PubMed
    1. Elosua R., “Cardiovascular Risk Functions: Usefulness and Limitations,” Revista Española de Cardiología English Edition 67 (2014): 77–79. - PubMed
    1. Sehestedt T., Jeppesen J., Hansen T. W., et al., “Risk Prediction Is Improved by Adding Markers of Subclinical Organ Damage to SCORE,” European Heart Journal 31 (2010): 883–891. - PubMed
    1. Sequí‐Domínguez I., Cavero‐Redondo I., Álvarez‐Bueno C., Pozuelo‐Carrascosa D. P., Nuñez De Arenas‐Arroyo S., and Martínez‐Vizcaíno V., “Accuracy of Pulse Wave Velocity Predicting Cardiovascular and All‐Cause Mortality. A Systematic Review and Meta‐Analysis,” Journal of Clinical Medicine 9 (2020): 2080. - PMC - PubMed

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