FOR RELEASE:1:30 p.m. ET, WednesdayOctober 25, 2000
CONTACT:Maggie Francis (214) 706-1397
Carole Bullock (214) 706-1279[email protected]
Abstract P113
American Heart Association meeting report: Stiff aorta increases risk of first heart attack
WASHINGTON, Oct. 25 -- Doctors may be able to determine which of their patients with high blood pressure are at greatest risk for heart attack by measuring the flexibility of the heart's largest vessel, the aorta, researchers report at the 54th Annual Fall Conference of the American Heart Association's Council for High Blood Pressure Research.
The study is the first to establish a direct link between aortic stiffness and heart disease events -- such as heart attacks and procedures to open clogged blood vessels -- in people with high blood pressure. Aortic stiffness is associated with high blood pressure, high cholesterol, diabetes, aging and other conditions in which the vessel that carries blood from the heart to the rest of the body becomes less flexible.
"Our results suggest that measuring aortic stiffness may help identify patients at high risk of coronary heart disease (CHD) who require more aggressive treatment," says Stephane Laurent, M.D., Ph.D., a professor of pharmacology at the University of Paris, UFR Broussais-Hotel Dieu and a cardiologist at Hopital Europeen Georges Pompidou, Paris. The research was presented at the meeting by his co-author Anne-Isabelle Tropeano, M.D.
While a measure of aortic stiffness is not used routinely, Laurent says it adds valuable information when used either alone or with the Framingham Algorithm (FA), a mathematical formula that scores patients on the basis of known cardiovascular disease risk factors including gender, age, blood pressure, cholesterol, diabetes and smoking. The algorithm was developed for the famous Framingham Heart Study, he explains. The Framingham, Mass., research is the world's longest-running study of how heart disease develops.
The researchers studied 1,212 patients who were treated for high blood pressure at Broussais Hospital between 1980 and 1996.
Researchers found that the FA was a good predictor of heart attacks in study participants who already had heart disease. However, aortic stiffness was a better, and independent, predictor of first heart attacks in people who had not yet developed heart disease.
Their aortic stiffness was measured with carotid-femoral pulse wave velocity (PWV). PWV is a velocity measurement, calculated by determining the distance between the carotid artery in the neck and the femoral artery in the leg and dividing that by the time it takes a pressure wave to travel between the two locations, Laurent explains.
There are several ways to measure PWV, he says. Researchers who gathered in Paris in June agreed on international standards for PWV, a non-invasive test that takes 15 minutes to perform and can be done by a doctor, nurse or technician with a small amount of training.
The patients were also evaluated using the Framingham score. During a follow-up time of nearly six years, the patients had 73 fatal and non-fatal coronary heart disease events such as heart attacks, revascularization procedures to open or bypass clogged arteries, or the chest pain known as angina.
"This study indicates that classic cardiovascular disease risk factors may increase the risk of CHD events through an increase in aortic stiffness," Laurent says. "It also implies that aortic stiffness is a better predictor than the Framingham score in determining the risk of CHD events in this French population who had no other heart disease risk factors except high blood pressure. It remains to be seen whether these findings may apply to American patients.
"Finally, this study suggests that consideration of classic cardiovascular risk factors may be insufficient to accurately predict the risk of a first heart attack in people with high blood pressure," he says, "and that the measurement of aortic stiffness may improve the predictive power."
Co-authors include Bruno Pannier, M.D.; Roland Asmar, M.D.; Isabelle Gautier; Brigitte LaLoux; Pierre Boutouyrie, M.D., Ph.D.; and Athanase Benetos.
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(NR00-1200/Laurent)
Media advisory: Dr. Laurent can be reached by phone at: 33-1-43-95-94-09; by fax at: 33-1-43-95-81-00; or by e-mail at: [email protected]. Anne-Isabelle Tropeano can be reached by e-mail at: [email protected] (Please do not publish telephone numbers or e-mail addresses.)
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