CAROTID-FEMORAL PULSE WAVE VELOCITY AND STIFFNESS INDEX MEASURED 5-15 YEARS EARLIER WERE SIGNIFICANTLY HIGHER IN DECEASED THAN IN STILL LIVING TREATED FINNISH HYPERTENSIVE PATIENTS

Abstract

Objective: To clarify if there is a difference in pulse wave velocity (PWV) measured in the years 2006-2014 (n = 251) comparing in the years 2015-2022 deceased (n = 40) and in the beginning of the year 2023 still living (n = 211) Finnish drug-treated hypertensive patients participating that PWV measurement. Design and method: A Doppler ultrasonography device (Micro Medical PulseTrace PWV and PCA, Micro Medical Ltd, Rochester, Kent, UK) was used to measure carotid-femoral (C-F) PWV and photoplethysmographic transducer of the same machine to measure stiffness index (SI) and resistance index (RI) in 251 Finnish drug-treated hypertensive patients (126 females and 125 males) during the years 2006-2014. At the time of measurement the mean age of the patients was 64.0 (8.3) years. Results: The age at death of the deceased patients was 79.6 (SD 8.14, median 82, range 62-91) years (n = 40). The age in 01Jan2023 living patients was 75.1 (SD 7.6, median 76, range 45-91) years (n = 211), p = 0.0001 between the two groups. The mean C-F PWV was 12.5 (3.6) in deceased and 10.4 (2.2) m/s (p = 0.0001) in living and SI respectively 11.0 (3.4) and 9.6 (2.9) m/s (p = 0.007). No significant difference between the groups was seen in RI. Mean office systolic blood pressure was 150.0 (18.8) mmHg in deceased and 137.5 (14.5) in living (p = 0.003) and respectively mean office diastolic pressure 86.4 (9.2) and 83.4 (9.2) mmHg (p = 0.058). The three most common causes of death were malignancy (n = 13), sudden death (n = 10) and high age (n = 9). Dementia was noticed before death in 13 patients. Conclusions: Carotid-femoral PWV and stiffness index measured 5-15 years earlier were significantly higher in deceased than in still living treated Finnish hypertensive patients Deceased patients were older and their systolic blood pressure was higher which may explain the difference. Malignancies were a common cause of death as also diagnosed dementia in these hypertensive patients. More studies are needed concerning the predictive value of PWV in hypertensive patients.