To validate the potential predictor role of noninvasive large arterial stiffness as cardiovascular risk markers in a Chinese population.Design and Method:
850 patients with essential hypertension (EH) were recruited in the baseline (ChiCTR-TRC-10000888), which 675 (79.4%) patients were enrolled in the second follow-up. mean age was 61 years, 64% men. Arterial stiffness indices were measured in essential hypertension, including the carotid –femoral pulse wave velocity (c-f PWV), pulse wave analysis (PWA) and large and small artery elasticity (C1, C2), inter-media thickness (IMT) obtained by the carotid arterial ultrasonography. To explore the relationship between arterial stiffness and cardiovascular events in 675 with EH by using the multivariable Cox models.Results:
During median follow-up of 24 months, 90 of 675 subjects (13.3%) had a total event; moreover, 32 of 675 subjects (4.7%) had a major cardiovascular event, including non-fatal myocardial infarctions, non-fatal stroke and cardiovascular death. In multivariate Cox proportional hazard regression analysis, after adjusting for confounding factors, brachial pulse pressure was more strongly predictive of cardiovascular events than was central pulse pressure (RR = 1.409 per 10 mmHg, P < 0.001 versus RR = 1.365, P = 0.002). Additional adjustment for the MAP and all of arterial stiffness indices, each SD increased in c-f PWV (3 m/s) and IMT (0.16 mm) was associated with 47.7% and 48.7% increase in major cardiovascular events. Each SD increased in IMT (0.16 mm) was associated with 32.6% increase in the total events. For male, each SD (10.9%) increased in CAIX@75 was associated with 26.0% and 41.1% increase in total events and major cardiovascular events. For age ≥ 60 years, each SD (7.6 mmHg) increased in CAP was associated with 49.6% increase in major cardiovascular events.Conclusions:
c-f PWV and carotid IMT is independent predictor for major cardiovascular events and could be surrogate endpoints for cardiovascular events. But for the prospective values of CAP and CAIX@75 are limited by age or gender.