Increased brachial-ankle pulse wave velocity is independently associated with risk of cerebral ischemic small vessel disease in elderly hypertensive patients

Objective: Increased arterial stiffness is an independent predictor of cardiovascular diseases in hypertensive patients. Hypertension and aging can cause similar damage to small vessel walls. The objective of this study was to determine relationship between arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV) and the risk of cerebral small vessel disease (SVD) in elderly people with hypertension. Methods: We studied 196 elderly subjects with hypertension (>= 50 years of age) who had neither large vessel stroke nor cardiac embolism. These patients were divided into three groups based on the results of brain MR]: (1) those with first-ever small vessel stroke; (2) those with asymptornatic subcortical ischemia; and (3) a control group with hypertension. Results: The baPWV was significantly increased in the patients with first-ever small vessel stroke or asymptornatic subcortical infarction when compared to the control group, after adjusting for systolic blood pressure (SBP), pulse pressure (PP), and hs-CRP (p = 0.005). Among subjects with SVD on MRI, the number of lacunar infarcts (Lls) >= 5 was significantly related to a higher baPWV (P = 0.02). The relationship between the severity of periventricular white matter hyperintensities (PWMH) and the degree of baPWV became insignificant after adjustment for age. Conclusion: Increased baPWV was significantly associated with the risk of SVD in elderly persons with hypertension. Therefore, the measurement of baPWV could be used to predict SVD. (c) 2008 Elsevier B.V. All rights reserved.