Abstract
Background Brachial pulse pressure (PP) has been found to be associated with markers of subclinical cardiovascular disease, including carotid intima-media thickness and left-ventricular mass index (LVMI), but it is unclear whether these associations are independent of traditional cardiovascular risk factors and of the steady, nonpulsatile component of blood pressure (BP). Moreover, it is unknown whether these associations are modified by gender, age, or race/ethnicity. Methods We used multivariate linear regression models to assess the relationship between brachial PP and three markers of subclinical cardiovascular disease (CVD) (common carotid intima-media thickness (CC-IMT), internal carotid intima-media thickness (IC-IMT), and LVMI) in four race/ethnic groups in the Multi-Ethnic Study of Atherosclerosis. The models were adjusted for traditional Framingham risk factors (age, low-density lipoprotein- cholesterol, high-density lipoprotein-cholesterol, diabetes, smoking status), use of lipid-lowering medication, use of antihypertensive medication, study site, and mean arterial pressure (MAP).RESULTSThe assessment was done on 6,776 participants (2,612 non-Hispanic white, 1,870 African-American, 1,494 Hispanic, and 800 Chinese persons). The associations between brachial PP and CC-IMT, IC-IMT, and LVMI were significant in fully adjusted models. The three subclinical markers also showed significant interactions with gender (P <0.0001), with stronger interactions in men. There was an interaction with age for LVMI (P = 0.004) and IC-IMT (P = 0.008). Race/ethnicity modified the association of PP with CC-IMT. Conclusions Brachial PP was independently associated with subclinical CVD after adjustment for cardiovascular risk factors and mean arterial pressure (MAP). The strength of the association differed significantly for strata of gender, age, and race/ethnicity.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 636-642 |
| Number of pages | 7 |
| Journal | American Journal of Hypertension |
| Volume | 26 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 2013 |
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Keywords
- aging
- arterial stiffness
- blood pressure
- carotid intima-media thickness
- hypertension
- left ventricular mass index
- pulse pressare
- subclinical cardiovascular disease
ASJC Scopus subject areas
- Internal Medicine
Cite this
Pulse pressure and subclinical cardiovascular disease in the multi-ethnic study of atherosclerosis. / Winston, Ginger J.; Palmas, Walter; Lima, Joao; Polak, Joseph F.; Bertoni, Alain G.; Burke, Gregory; Eng, John; Gottesman, Rebecca F; Shea, Steven.
In: American Journal of Hypertension, Vol. 26, No. 5, 05.2013, p. 636-642.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Pulse pressure and subclinical cardiovascular disease in the multi-ethnic study of atherosclerosis
AU - Winston, Ginger J.
AU - Palmas, Walter
AU - Lima, Joao
AU - Polak, Joseph F.
AU - Bertoni, Alain G.
AU - Burke, Gregory
AU - Eng, John
AU - Gottesman, Rebecca F
AU - Shea, Steven
PY - 2013/5
Y1 - 2013/5
N2 - Background Brachial pulse pressure (PP) has been found to be associated with markers of subclinical cardiovascular disease, including carotid intima-media thickness and left-ventricular mass index (LVMI), but it is unclear whether these associations are independent of traditional cardiovascular risk factors and of the steady, nonpulsatile component of blood pressure (BP). Moreover, it is unknown whether these associations are modified by gender, age, or race/ethnicity. Methods We used multivariate linear regression models to assess the relationship between brachial PP and three markers of subclinical cardiovascular disease (CVD) (common carotid intima-media thickness (CC-IMT), internal carotid intima-media thickness (IC-IMT), and LVMI) in four race/ethnic groups in the Multi-Ethnic Study of Atherosclerosis. The models were adjusted for traditional Framingham risk factors (age, low-density lipoprotein- cholesterol, high-density lipoprotein-cholesterol, diabetes, smoking status), use of lipid-lowering medication, use of antihypertensive medication, study site, and mean arterial pressure (MAP).RESULTSThe assessment was done on 6,776 participants (2,612 non-Hispanic white, 1,870 African-American, 1,494 Hispanic, and 800 Chinese persons). The associations between brachial PP and CC-IMT, IC-IMT, and LVMI were significant in fully adjusted models. The three subclinical markers also showed significant interactions with gender (P <0.0001), with stronger interactions in men. There was an interaction with age for LVMI (P = 0.004) and IC-IMT (P = 0.008). Race/ethnicity modified the association of PP with CC-IMT. Conclusions Brachial PP was independently associated with subclinical CVD after adjustment for cardiovascular risk factors and mean arterial pressure (MAP). The strength of the association differed significantly for strata of gender, age, and race/ethnicity.
AB - Background Brachial pulse pressure (PP) has been found to be associated with markers of subclinical cardiovascular disease, including carotid intima-media thickness and left-ventricular mass index (LVMI), but it is unclear whether these associations are independent of traditional cardiovascular risk factors and of the steady, nonpulsatile component of blood pressure (BP). Moreover, it is unknown whether these associations are modified by gender, age, or race/ethnicity. Methods We used multivariate linear regression models to assess the relationship between brachial PP and three markers of subclinical cardiovascular disease (CVD) (common carotid intima-media thickness (CC-IMT), internal carotid intima-media thickness (IC-IMT), and LVMI) in four race/ethnic groups in the Multi-Ethnic Study of Atherosclerosis. The models were adjusted for traditional Framingham risk factors (age, low-density lipoprotein- cholesterol, high-density lipoprotein-cholesterol, diabetes, smoking status), use of lipid-lowering medication, use of antihypertensive medication, study site, and mean arterial pressure (MAP).RESULTSThe assessment was done on 6,776 participants (2,612 non-Hispanic white, 1,870 African-American, 1,494 Hispanic, and 800 Chinese persons). The associations between brachial PP and CC-IMT, IC-IMT, and LVMI were significant in fully adjusted models. The three subclinical markers also showed significant interactions with gender (P <0.0001), with stronger interactions in men. There was an interaction with age for LVMI (P = 0.004) and IC-IMT (P = 0.008). Race/ethnicity modified the association of PP with CC-IMT. Conclusions Brachial PP was independently associated with subclinical CVD after adjustment for cardiovascular risk factors and mean arterial pressure (MAP). The strength of the association differed significantly for strata of gender, age, and race/ethnicity.
KW - aging
KW - arterial stiffness
KW - blood pressure
KW - carotid intima-media thickness
KW - hypertension
KW - left ventricular mass index
KW - pulse pressare
KW - subclinical cardiovascular disease
UR - http://www.scopus.com/inward/record.url?scp=84876566732&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84876566732&partnerID=8YFLogxK
U2 - 10.1093/ajh/hps092
DO - 10.1093/ajh/hps092
M3 - Article
C2 - 23388832
AN - SCOPUS:84876566732
VL - 26
SP - 636
EP - 642
JO - Journal of clinical hypertension
JF - Journal of clinical hypertension
SN - 0895-7061
IS - 5
ER -