Public Release: 

Stiffness of aorta predicts stroke deaths in hypertensive patients

American Heart Association rapid access journal report

American Heart Association

DALLAS, April 4 - For the first time, researchers have linked the stiffness of the aorta (the major artery that carries blood from the heart to the rest of the body) to fatal stroke regardless of other stroke risk factors, according to a study in today's rapid access issue of Stroke: Journal of the American Heart Association.

Aging, environmental and genetic factors decrease the elasticity of arterial walls. This increased stiffness leads to elevated blood pressure.

Researchers from Hôpital Européen Georges Pompidou in Paris followed 1,715 patients with mild hypertension, but without overt signs of cardiovascular disease, for an average of 7.9 years. Each participant had some degree of arterial stiffness. Arterial stiffness was gauged by measuring how long it took a pulse wave to move from the heart to other parts of the body (pulse wave velocity or PWV). Stiffer arteries had higher PWV numbers. There were 157 deaths, including 25 from strokes and 35 from coronary events.

Researchers calculated the relative risk for fatal stroke compared to PWV. They found a 72 percent increase in relative risk for fatal stroke for each four meters per second in PWV. That's "equivalent to seven years of aging," says lead author Stéphane Laurent, M.D.

The predictive value of PWV remained significant after adjusting for classic cardiovascular risk factors including age, elevated cholesterol, diabetes, smoking and high blood pressure.

Several mechanisms may explain the association. Aortic stiffness may increase pulse pressure (the difference between the upper and lower numbers in a blood pressure reading) thereby increasing the likelihood of heart disease and stroke; or the stiffness measurement may reflect damage in the artery wall, Laurent says.

Researchers conclude that aortic stiffness can gauge the fatal stroke risk of hypertensive patients. However, large clinical trials using antihypertensive drugs that relieve arterial stiffness should be conducted to determine if the drugs can prevent stroke deaths.

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