Arterial stiffness in normotensive and hypertensive subjects: Frequency in community pharmacies

Med Clin (Barc). 2017 Dec 7;149(11):469-476. doi: 10.1016/j.medcli.2017.04.037. Epub 2017 Jul 12.
[Article in English, Spanish]

Abstract

Background and objective: Arterial stiffness (AS) is a well-recognized target organ lesion. This study aims to determine: 1) the frequency of AS in community pharmacies; 2) if stiffened subjects identified by brachial oscillometry have more CV risk factors than normal subjects, and 3) the dependence of stiffness on using either age-adjusted values or a fixed threshold.

Patients and method: Observational, cross-sectional study in 32 community pharmacies of the Valencia Community, between November/2015 and April/2016. Stiffness was as pulse wave velocity (PWV) measured with a semi-automatic, validated device (Mobil-O-Graph®, IEM), followed by a 10-item questionnaire.

Results: Mean age of the 1,427 consecutive recruited patients was 56.6 years. Overall proportion of patients with AS was 17.4% with age-adjusted PWV (9.4% in normotensives, 28.3% in hypertensives). Multivariate logistic regression showed independent association of stiffness in normotensives with male gender, obesity, higher pulse pressure and heart rate, in hypertensives, with higher pulse pressure and lower age. AS was globally found in 20.5% of subjects, defining stiffness by PWV>10m/s (6.2% in normotensives, 40.2% in hypertensives). It was associated with higher age and pulse pressure in both groups. Concordance in classifying stiffness was 74.6%.

Conclusions: Frequency of AS varied between 17.4-20.5%. Age-adjusted stiffness is associated in normotensives with male gender, pulse pressure, obesity and heart rate, in hypertensives with pulse pressure and inversely to age. Stiffness by 10m/s is determined by higher pulse pressure and higher age. Both definitions of PWV are not interchangeable.

Keywords: Arterial stiffness; Brachial oscillometry; Community pharmacies; Farmacias comunitarias; Lesión de órgano diana; Oscilometría braquial; Prehipertensión; Prehypertension; Pulse wave velocity; Rigidez arterial; Target organ lesion; Velocidad de onda de pulso.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Brachial Artery / physiopathology
  • Case-Control Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension / physiopathology*
  • Logistic Models
  • Male
  • Middle Aged
  • Oscillometry
  • Pharmacies
  • Pulse Wave Analysis
  • Vascular Stiffness*