Abstract P2066: The Difference of With or Without Blood Pressure Adjustment for Pulse Wave Velocity as a Risk Factor for Cardiovascular Disease

Abstract

Background: Arterial stiffness, assessed by pulse wave velocity (PWV), is an independent predictor of future cardiovascular (CV) events. While blood pressure (BP) functionally increases the value of PWV, the significance of this increase as a risk for CV disease (CVD) has not been fully clarified. The stiffness-index beta has been used as a less BP-influenced marker to assess arterial stiffness. Then, the present study examined whether BP-adjusted value of the PWV improve or attenuate the predictive value for the development of the hypertension, retinopathy, and renal dysfunction, or of future CV events as compared to brachial-ankle PWV (baPWV). Methods and Results: Study 1: In the 7-year prospective observation conducted in 3274 Japanese men without hypertension at the baseline for the development of hypertension and also in 3490 Japanese men for the development of organ damage, baPWV, BP, estimated glomerular filtration rate (eGFR), and fundus findings were measured at baseline and end of study period. During the study period, 474 subjects developed to hypertension, 29 subjects had renal dysfunction, and 91 subjects had the development of retinopathy. The area under the curve (AUC), in the receiver operator characteristic curve analysis, of baPWV was higher than that of BP-adjusted baPWV for the development of hypertension (0.73 vs. 0.59; p<0.01), for eGFR <60 mL/min/1.73m 2 and for the development of retinopathy. The baPWV rather than BP-adjusted baPWV showed a significant odds ratio for the development of hypertension (1.84 per standard deviation increase, p<0.01) and that of retinopathy (1.25 per standard deviation increase, p<0.01). Study 2: During the 3-year observation period in 511 patients with coronary artery disease, 72 CV events were confirmed. While the AUCs of both markers for the development of CV events were similar, the Cox proportional hazards model analysis revealed that baPWV rather than BP-adjusted baPWV showed a significant hazard ratio (1.38, P<0.01) for the development of CV events. Conclusions: The BP adjustment, based on the concept of stiffness-index beta, may attenuate the significance of baPWV as a risk marker for the development of CVD, especially in its development related pathophysiological abnormalities in male subjects.