Elevated Brachial-Ankle Pulse Wave Velocity Is Associated with Left Ventricular Hypertrophy in Hypertensive Patients after Stroke

Elevated Brachial-Ankle Pulse Wave Velocity Is Associated with Left Ventricular Hypertrophy in Hypertensive Patients after Stroke

HISASHI MASUGATA,¹ SHOICHI SENDA,¹ JUN HOSHIKAWA,² KOJI MURAO,³ NAOHISA HOSOMI,⁴ HIROYUKI OKUYAMA,¹ MICHIO INUKAI,¹ TAKASHI HIMOTO,¹ YOICHI NAKATSUKA,² MASANOBU IMAI,² TAKAHISA NOMA,⁵ MASAKAZU KOHNO⁵ and FUMINORI GODA¹

¹Department of Integrated Medicine, Kagawa University, Kagawa, Japan
²Kagawa General Rehabilitation Center, Takamatsu, Japan
³Division of Endocrinology and Metabolism, Department of Internal Medicine, Kagawa University
⁴Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, Japan
⁵Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University, Kagawa, Japan

Brachial-ankle pulse wave velocity (baPWV) is widely used as a marker of arterial stiffness, but there are no data regarding the usefulness of measuring baPWV in hypertensive patients after stroke. The purpose of this study was to examine the clinical significance of baPWV by assessing its correlation with echocardiographic parameters in hypertensive patients after stroke. The study enrolled 61 hypertensives after stroke (24 patients with cerebral infarction and 37 with cerebral hemorrhage) and 61 age-matched hypertensives without stroke. Left ventricular (LV) hypertrophy was evaluated by measuring LV mass index (LVMI) and relative wall thickness (RWT), and LV diastolic function was evaluated by measuring peak early mitral annular velocities (E') using echocardiography. Concentric LV hypertrophy showing increased RWT (0.50 ± 0.12) was observed in hypertensives after stroke, but not in hypertensives without stroke. In hypertensives after stroke, elevated baPWV correlated with age (r = 0.60, p < 0.001), systolic blood pressure (r = 0.56, p < 0.001), increased LVMI (r = 0.47, p < 0.001), and decreased E' (r = −0.40, p = 0.002). Multiple regression analysis showed that age (β coefficient = 0.43, p < 0.001), systolic blood pressure (β coefficient = 0.40, p < 0.001), and LVMI (β coefficient = 0.25, p = 0.008) were independent determinants of elevated baPWV. In conclusion, elevated baPWV is more closely associated with LV hypertrophy than with LV diastolic dysfunction. Elevated baPWV is independently associated with the severity of LV hypertrophy adjusted with systolic blood pressure and age in hypertensive patients after stroke.

keywords —— hypertension; stroke; brachial-ankle pulse wave velocity; echocardiography; left ventricular hypertrophy

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Tohoku J. Exp. Med., 2010, 220, 177-182

Correspondence: Hisashi Masugata, M.D., Ph.D., Department of Integrated Medicine, Kagawa University, 1750-1, Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan.

e-mail: masugata@med.kagawa-u.ac.jp