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Arterial stiffness and cardiovascular events: the Framingham Heart Study.

Publication ,  Journal Article
Mitchell, GF; Hwang, S-J; Vasan, RS; Larson, MG; Pencina, MJ; Hamburg, NM; Vita, JA; Levy, D; Benjamin, EJ
Published in: Circulation
February 2, 2010

BACKGROUND: Various measures of arterial stiffness and wave reflection have been proposed as cardiovascular risk markers. Prior studies have not assessed relations of a comprehensive panel of stiffness measures to prognosis in the community. METHODS AND RESULTS: We used proportional hazards models to analyze first-onset major cardiovascular disease events (myocardial infarction, unstable angina, heart failure, or stroke) in relation to arterial stiffness (pulse wave velocity [PWV]), wave reflection (augmentation index, carotid-brachial pressure amplification), and central pulse pressure in 2232 participants (mean age, 63 years; 58% women) in the Framingham Heart Study. During median follow-up of 7.8 (range, 0.2 to 8.9) years, 151 of 2232 participants (6.8%) experienced an event. In multivariable models adjusted for age, sex, systolic blood pressure, use of antihypertensive therapy, total and high-density lipoprotein cholesterol concentrations, smoking, and presence of diabetes mellitus, higher aortic PWV was associated with a 48% increase in cardiovascular disease risk (95% confidence interval, 1.16 to 1.91 per SD; P=0.002). After PWV was added to a standard risk factor model, integrated discrimination improvement was 0.7% (95% confidence interval, 0.05% to 1.3%; P<0.05). In contrast, augmentation index, central pulse pressure, and pulse pressure amplification were not related to cardiovascular disease outcomes in multivariable models. CONCLUSIONS: Higher aortic stiffness assessed by PWV is associated with increased risk for a first cardiovascular event. Aortic PWV improves risk prediction when added to standard risk factors and may represent a valuable biomarker of cardiovascular disease risk in the community.

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Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

February 2, 2010

Volume

121

Issue

4

Start / End Page

505 / 511

Location

United States

Related Subject Headings

  • Stroke
  • Risk Factors
  • Proportional Hazards Models
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Heart Failure
  • Follow-Up Studies
  • Femoral Artery
 

Citation

APA
Chicago
ICMJE
MLA
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Mitchell, G. F., Hwang, S.-J., Vasan, R. S., Larson, M. G., Pencina, M. J., Hamburg, N. M., … Benjamin, E. J. (2010). Arterial stiffness and cardiovascular events: the Framingham Heart Study. Circulation, 121(4), 505–511. https://doi.org/10.1161/CIRCULATIONAHA.109.886655
Mitchell, Gary F., Shih-Jen Hwang, Ramachandran S. Vasan, Martin G. Larson, Michael J. Pencina, Naomi M. Hamburg, Joseph A. Vita, Daniel Levy, and Emelia J. Benjamin. “Arterial stiffness and cardiovascular events: the Framingham Heart Study.Circulation 121, no. 4 (February 2, 2010): 505–11. https://doi.org/10.1161/CIRCULATIONAHA.109.886655.
Mitchell GF, Hwang S-J, Vasan RS, Larson MG, Pencina MJ, Hamburg NM, et al. Arterial stiffness and cardiovascular events: the Framingham Heart Study. Circulation. 2010 Feb 2;121(4):505–11.
Mitchell, Gary F., et al. “Arterial stiffness and cardiovascular events: the Framingham Heart Study.Circulation, vol. 121, no. 4, Feb. 2010, pp. 505–11. Pubmed, doi:10.1161/CIRCULATIONAHA.109.886655.
Mitchell GF, Hwang S-J, Vasan RS, Larson MG, Pencina MJ, Hamburg NM, Vita JA, Levy D, Benjamin EJ. Arterial stiffness and cardiovascular events: the Framingham Heart Study. Circulation. 2010 Feb 2;121(4):505–511.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

February 2, 2010

Volume

121

Issue

4

Start / End Page

505 / 511

Location

United States

Related Subject Headings

  • Stroke
  • Risk Factors
  • Proportional Hazards Models
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Heart Failure
  • Follow-Up Studies
  • Femoral Artery