Ps-bpc01-6: brachial-ankle pulse wave velocity is useful for cardiovascular risk assessment in well-treated hypertensive patients with coronary heart disease

Objective: Measurement of brachial-ankle pulse wave velocity (baPWV) has been performed for the assessment of arterial stiffness. The purpose of this study was to determine whether baPWV is useful for cardiovascular risk assessment in treated hypertensive patients with a history of coronary heart disease (CHD). Design and method: This study was a post hoc analysis of Flow-mediated Dilation Japan Study A, which is a prospective multicenter observational cohort study. A total of 447 treated hypertensive patients with a history of CHD were enrolled to assess predictive value of baPWV for future cardiovascular events. The primary outcome was a composite of coronary events, stroke, heart failure, and sudden death. Results: The primary outcome occurred in 64 patients during a median follow-up period of 47.6 months. When using a blood pressure ≧ 130/80 mmHg as a reference, blood pressure < 130/80 mmHg was significantly associated with a lower risk of the primary outcome after adjustments for other cardiovascular risk factors in treated hypertensive patients with CHD (hazard ratio, 0.59; 95% confidence interval [CI], 0.35–0.99; P = 0.04). In well-treated patients with CHD who had a blood pressure < 130/80 mmHg, baPWV ≧ 1736 cm/s, that was derived from receiver-operator characteristic curve analysis, was significantly associated with a higher risk of the primary outcome after adjustments for traditional cardiovascular risk factors (hazard ratio, 2.83; 95% CI, 1.02–7.91; P = 0.04). Conclusions: The achievement of the target blood pressure is important to reduce the risk of cardiovascular events in treated hypertensive patients with a history of CHD. In well-treated hypertensive patients with CHD, baPWV is useful for cardiovascular risk assessment.