Factors associated with high brachial–ankle pulse wave velocity in non-hypertensive and appropriately treated hypertensive patients with atherosclerotic risk factors

Figures & data

Figure 1 Trend graphs of two typical blood pressure-controlled patients with or without improved baPWV.

Notes: (A) Born in May, 1942, male, hypertension. Minor old myocardial infarction was seen during first visit, April 2010;. baPWV was relatively high at 2,000 cm/s but improved with BP reduction and was kept stable at approximately 1,400 cm/s for several years. (B) Born in March 1941, male, hypertension, diabetes, smoking, minor cardiomegaly. Antihypertensive treatment was started in May 2007. Despite adequate blood pressure control, baPWV did not improve but increased 5 years after the initiation of antihypertensives and remained at approximately 2,500 cm/s with perturbation.
Abbreviations: baPWV, brachial–ankle pulse wave velocity; BP, blood pressure; H, high; ST, standard.

Figure 2 Flow chart showing the patient selection procedure.

Abbreviations: ABI, ankle–brachial index; baPWV, brachial–ankle pulse wave velocity; %MAP, percent mean arterial pressure; UT, upstroke time.

Table 1 Patient characteristics according to sex and baPWV category

	All (N=107)	Male (N=67)	Female (N=40)	p^*	ST-baPWV (N=90)	H-baPWV (N=17)	p^**
Age (years)	66±6	66±7	66±6	0.94	66±6	67±7	0.64
Height (cm)	164±8	168±5	158±6	<0.00001	164±8	164±8	0.88
BMI (Kg/m^2)	22.8±2.9	23.2±2.6	22.0±3.1	<0.05	23.1±2.8	20.8±2.5	<0.002
Systolic BP (mmHg)	124±10	122±10	126±9	<0.03	123±9	126±9	0.17
Diastolic BP (mmHg)	76±8	76±9	77±9	0.62	78±7	76±8	0.23
baPWV (cm/s)	1644±302	1624±286	1678±329	0.4	1556±206	2112±301	<0.00001
ABI	1.14±0.07	1.15±0.08	1.13±0.05	0.14	1.14±0.07	1.16±0.07	0.22
%MAP	38±3	38±3	40±2.8	<0.0001	38±3	39±3	0.56
UT (msec)	148±16	146±16	150±15	0.16	148±15	146±20	0.67
HR (bpm)	64±10	63±11	65±9	0.41	63±10	68±9	<0.04
ET (msec)	289±25	286±25	295±23	<0.05	292±23	275±28	<0.04
PEP (msec)	106±14	107±15	105±12	0.65	106±14	105±12	0.75
ET/PEP	2.78±0.45	2.74±0.48	2.82±0.41	0.23	2.80±0.44	2.65±0.46	0.25
Sex (male, %)	63%	–	–	–	62%	65%	0.91
H-baPWV (%)	16%	16%	15%	0.84	–	–	–
Diabetes (%)	16%	25%	0%	<0.002	16%	18%	0.84
Hypertension (%)	60%	63%	55%	0.62	56%	82%	0.19
Dyslipidemia (%)	45%	45%	45%	0.99	46%	41%	0.8
Smoking (%)	37%	58%	3%	<0.00001	34%	53%	0.25
CAD (%)	13%	18%	5%	0.07	13%	12%	0.87
CVD (%)	3%	3%	3%	0.88	2%	6%	0.41
OHD (%)	7%	3%	13%	0.06	6%	12%	0.36

Notes: p^*, comparison between males and females; p^**, comparison between the ST-baPWV group and the H-baPWV group. Data shown as mean ± SD, percentage, or p-value.

Abbreviations: ABI, ankle–brachial index; BMI, body mass index; BP, blood pressure; baPWV, brachial–ankle pulse wave velocity; CAD, coronary artery disease; CVD, cerebrovascular disease; ET, ejection time; H, high; HR, heart rate; %MAP, percent mean arterial pressure; OHD, other heart disease; PEP, pre-ejection period; ST, standard; UT, upstroke time.

Figure 3 The baPWV according to age and category.

Abbreviations: baPWV, brachial–ankle pulse wave velocity; H, high; ST, standard.

Table 2 Univariate and multivariate regression analysis of factors and baPWV as a continuous variable

Univariate analysis			Multivariate analysis
	R	p	B	b	t	p
Age (years)	0.49	<0.00001	19.84	0.43	6.00	<0.00001
Height (cm)	−0.18	<0.07
BMI (kg/m^2)	−0.24	<0.02	−30.12	−0.28	3.93	<0.001
Sex (male=1)	−0.09	0.38
Systolic BP (mmHg)	0.26	<0.01	8.01	0.25	3.52	<0.001
ABI	0.13	0.19
HR (bpm)	0.27	<0.01	6.83	0.23	3.34	<0.01
Diabetes (yes=1)	0.01	0.93
Hypertension (yes=1)	0.32	<0.001	184.08	0.61	4.13	<0.0001
Dyslipidemia (yes=1)	0.03	0.8
Smoking (yes=1)	0.05	0.63
CAD (yes=1)	−0.02	0.87
CVD (yes=1)	0.05	0.58
OHD (yes=1)	−0.05	0.59

Note: R-squared, 0.50; adjusted R-squared: 0.48. Multivariate model included variables as follows: age, height, BMI, sex, systolic BP, HR, diabetes, hypertension, dyslipidemia, and smoking.

Abbreviations: ABI, ankle–brachial index; B, regression coefficient; BMI, body mass index; BP, blood pressure; CAD, coronary artery disease; CVD, cerebrovascular disease; HR, heart rate; OHD, other heart disease; R, Pearson correlation coefficient; β, standardized regression coefficient.

Table 3 Multivariate logistic regression analysis of H-baPWV determinants

	OR (95% CI)	p
BMI (SD)	0.57 (0.42–0.78)	<0.001
Hypertension	6.41 (1.46–28.1)	<0.02
Smoking	4.62 (1.23–17.3)	<0.03

Note: Multivariate model included variables as follows: BMI, systolic blood pressure, HR, diabetes, hypertension, dyslipidemia, and smoking.

Abbreviations: baPWV, brachial–ankle pulse wave velocity; BMI, body mass index; CI, confidence interval; H, high HR, heart rate; OR, odds ratio; SD, standard deviation.