Diagnostic and Predictive Value of Brachial-Ankle Pulse Wave Velocity and Pulse Pressure Index for Coronary Heart Disease in Elderly Patients With Hypertension

Abstract OBJECTIVE To explore the diagnostic and predictive value of pulse pressure index (PPI) and brachial–ankle pulse wave velocity (baPWV) for coronary heart disease (CHD) in elderly patients with hypertension. METHODS A total of 307 elderly patients who had chest pain or chest distress and coronary angiography were enrolled. According to the Gensini score, patients with CHD (n = 260) were divided into low-risk group (<20 points, n = 96), moderate-risk group (20–40 points, n = 80), and high-risk group (>40 points, n = 84). baPWV was measured using an ankle–brachial index and pulse wave measuring device. Multivariate logistic regression analysis was used to analyze the risk factors of CHD. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of baPWV and PPI for CHD. RESULTS PPI and baPWV of elderly hypertensive patients with CHD at low, moderate, and high risk were higher than those without CHD [PPI: 0.43 ± 0.04, 0.45 ± 0.04, 0.45 ± 0.05 vs. 0.41 ± 0.05, F = 31.768, P < 0.001; baWV: 1,671 (1,587–1,755), 1,717 (1,597–1,843), 1,780 (1,661–1,960) vs. 1,570 (1,477–1,699) cm/s, X2 = 60.918, P < 0.001]. With the increase in CHD severity, the PPI and baPWV were significantly increased (P < 0.05). Spearman/Pearson correlation analysis showed that the Gensini score was positively correlated with baPWV and PPI, respectively (both P < 0.001). Multivariate logistic regression analysis showed that baPWV, PPI, and systolic blood pressure were the influencing factors of CHD in hypertensive patients. The areas under the ROC curve (95% CI) of baPWV, PPI, and their combination for diagnosing CHD were 0.792 (0.723–0.861), 0.708 (0.625–0.792), and 0.837 (0.779–0.895), respectively, and was significantly different between baPWV or PPI alone and the combination of the 2 (Z = −2.178, P = 0.029; Z = −3.330, P = 0.001). CONCLUSIONS Elevations of baPWV and PPI are positively correlated with the severity of CHD. Both baPWV and PPI have a diagnostic and predictive value for CHD in elderly hypertensive patients, and the combination of baPWV and PPI is more accurate.