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Increased arterial stiffness and cardiovascular risk prediction in controlled hypertensive patients with coronary artery disease: post hoc analysis of FMD-J (Flow-mediated Dilation Japan) Study A

Hypertension Research volume 43, pages 781–790 (2020)Cite this article

Abstract

The usefulness of brachial–ankle pulse wave velocity (baPWV), an index of arterial stiffness, is not fully known for the management of treated hypertensive patients with a history of coronary artery disease (CAD) who have blood pressure less than 130/80 mmHg, a recommended blood pressure target in the updated major hypertension guidelines. We analyzed data for 447 treated hypertensive patients with CAD enrolled in FMD-J Study A for assessment of the predictive value of baPWV for future cardiovascular events. The primary outcome was a composite of coronary events, stroke, heart failure, and sudden death. During a median follow-up period of 47.6 months, the primary outcome occurred in 64 patients. Blood pressure less than 130/80 mmHg was significantly associated with a lower risk of the composite outcome independent of other cardiovascular risk factors in treated hypertensive patients with CAD (hazard ratio, 0.59; 95% confidence interval (CI), 0.35–0.99; P = 0.04). In treated hypertensive patients with CAD who had blood pressure less than 130/80 mmHg, baPWV above the cutoff value of 1731 cm/s, derived from receiver–operator characteristic curve analysis for the composite outcome was significantly associated with a higher risk of the composite outcome independent of conventional risk factors (hazard ratio, 2.83; 95% CI, 1.02–7.91; P = 0.04). baPWV was an independent predictor of cardiovascular events in treated hypertensive patients with CAD who had blood pressure less than 130/80 mmHg, for whom measurement of baPWV is recommended for cardiovascular risk assessment.

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Acknowledgements

We thank Megumi Wakisaka, Miki Kumiji, Ki-ichiro Kawano, and Satoko Michiyama for their excellent secretarial assistance.

Funding

Grant-in-aid for Scientific Research from the Ministry of Education, Science, and Culture of Japan (18590815 and 21590898 to YH) and a grant-in-aid of Japanese Arteriosclerosis Prevention Fund (to YH).

Author information

Authors and Affiliations

  1. Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

    Tatsuya Maruhashi, Junko Soga, Noritaka Fujimura, Naomi Idei, Shinsuke Mikami, Yumiko Iwamoto, Akimichi Iwamoto, Takeshi Matsumoto, Nozomu Oda, Shogo Matsui, Haruki Hashimoto, Yuji Takaeko, Takayuki Yamaji, Takahiro Harada, Takayuki Hidaka & Yasuki Kihara

  2. Division of Regeneration and Medicine, Hiroshima University Hospital, Hiroshima, Japan

    Masato Kajikawa, Kensuke Noma & Yukihito Higashi

  3. Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    Shinji Kishimoto, Yiming Han, Yoshiki Aibara, Farina Mohamad Yusoff, Kensuke Noma & Yukihito Higashi

  4. Department of Gastroenterology and Metabolism, Biomedical Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

    Kazuaki Chayama

  5. Department of Stem Cell Biology and Medicine, Graduate School of Biomedical and Sciences, Hiroshima University, Hiroshima, Japan

    Ayumu Nakashima

  6. Department of Rehabilitation, Faculty of General Rehabilitation, Hiroshima International University, Hiroshima, Japan

    Chikara Goto & Akira Yamashina

  7. Department of Cardiology, Tokyo Medical University, Tokyo, Japan

    Hirofumi Tomiyama

  8. Division of Biomedical Engineering, National Defense Medical College Research Institute, Tokorozawa, Japan

    Bonpei Takase

  9. Division of Cardiovascular Medicine, School of Medicine, Jichi Medical University, Tochigi, Japan

    Takahide Kohro & Kazuomi Kario

  10. Division of Cardiovascular Medicine, University of Leicester, Leicester, UK

    Toru Suzuki

  11. Cardiovascular Division, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan

    Tomoko Ishizu

  12. Department of Clinical Pharmacology and Therapeutics, School of Medicine, University of the Ryukyu, Okinawa, Japan

    Shinichiro Ueda

  13. Clinical Research Support Center, Faculty of Medicine, University of Tokyo, Tokyo, Japan

    Tsutomu Yamazaki

  14. Department of Cardiovascular Medicine, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan

    Tomoo Furumoto

  15. Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan

    Teruo Inoue

  16. Department of Medicine, Division of Cardiology, School of Medicine, Showa University, Tokyo, Japan

    Shinji Koba

  17. Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology (DNHMED), School of Medicine, Yamagata University, Yamagata, Japan

    Kentaro Watanabe

  18. Department of Internal Medicine and Cardiology, Graduate School of Medicine, Osaka City University, Osaka, Japan

    Yasuhiko Takemoto

  19. Department of Medical Education and Population-based Medicine, Postgraduate School of Medicine, Wakayama Medical University, Wakayama, Japan

    Takuzo Hano

  20. Department of Cardiovascular Medicine, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan

    Masataka Sata

  21. Department of General Medicine, Faculty of Medicine, Shimane University, Izumo, Japan

    Yutaka Ishibashi

  22. Department of Cardiovascular and Renal Medicine, Saga University, Saga, Japan

    Koichi Node

  23. Department of Cardiovascular Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan

    Koji Maemura

  24. The Third Department of Internal Medicine, University of the Ryukyus, Okinawa, Japan

    Yusuke Ohya

  25. Department of Internal Medicine, School of Medicine, Teikyo University, Tokyo, Japan

    Taiji Furukawa

  26. Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan

    Hiroshi Ito

  27. Faculty of Fukuoka Medical Technology, Teikyo University, Omuta, Japan

    Hisao Ikeda

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  1. Tatsuya Maruhashi
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  49. Yukihito Higashi
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Correspondence to Yukihito Higashi.

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Maruhashi, T., Soga, J., Fujimura, N. et al. Increased arterial stiffness and cardiovascular risk prediction in controlled hypertensive patients with coronary artery disease: post hoc analysis of FMD-J (Flow-mediated Dilation Japan) Study A. Hypertens Res 43, 781–790 (2020). https://doi.org/10.1038/s41440-020-0420-6

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