The relationship between carotid-femoral pulse wave velocity and pulse pressure,carotid intima-media thickness in the patients with hypertension

Objective To investigate the relationships between pulse pressure, carotid intima-media thickness（CIMT） and carotid-femoral pulse wave velocity（cfPWV） in patients with hypertension. Methods A total of 469 subjects with hypertension and 274 subjects with normal blood pressure were enrolled from the Department of General Medicine and Geriatric Medicine of the First Affiliated Hospital of Fujian Medical University from January 2016 to June 2017. Firstly, based on the 2×2 design method, all the subjects were divided into hypertension group or normal blood pressure group. Then in each of the above two groups, with cfPWV 10 m/s as the cutting point, the patients were further divided into two sub-groups: the increased cfPWV group（cfPWV≥10 m/s） and the normal cfPWV group（cfPWV＜10 m/s）. Secondly, all subjects were divided into two groups based on the CIMT using the cut-point at 1 mm. Finally, using the age at 65 years old as cutting point, all subjects were divided into middle and young age group（＜65 years old） and elderly group（≥65 years old）. Blood pressure was measured in all subjects and pulse pressure was calculated. Pearson correlation analysis and multiple linear regression analysis was used to analyze the influencing factors of cfPWV. Results cfPWV, pulse pressure, CIMT in patients with hypertension were higher than those in patients with normal blood pressure （9.56±1.93） vs（8.46±1.47）m/s,（58.6±13.5） vs（49.2±10.3）mm Hg,（0.93±0.18） vs（0.82±0.17）mm, all P＜0.05. In the patients with hypertension, pulse pressure, CIMT in the increased cfPWV group were significantly higher than those in the normal cfPWV group （66.8±14.1） vs（54.1±10.7）mm Hg,（0.98±0.16） vs（0.90±0.18）mm, all P＜0.05, and the cfPWV, pulse pressure in the elderly group were significantly higher than those in middle-aged and young people group （10.52±2.11） vs（9.00±1.55）m/s,（66.1±13.7） vs（54.1±11.1）mm Hg,（1.02±0.15） vs（0.88±0.17）mm, all P＜0.05. Multiple linear regression stepwise analysis showed that pulse pressure, age, heart rate, gender and fasting blood glucose were the influencing factors of cfPWV in all subjects（β: 0.346, 0.345, 0.241,-0.142, 0.096, all P＜0.05）, and stratified analysis showed that pulse pressure was the influencing factor of cfPWV regardless of age and gender. CIMT was the influential factor of cfPWV in the middle-aged and young people（＜65 years old）, but not in the elderly population（≥65 years old）. Conclusion Pulse pressure is an important influencing factor of cfPWV in patients with hypertension, and CIMT is associated with cfPWV only in young and middle-aged patients with hypertension.