Cardiovascular event risk in relation to arterial stiffness in patients with subclinical peripheral atherosclerosis

Introduction: Arterial stiffness is an independent predictor for general and cardiovascular morbidity and mortality. Peripheral atherosclerotic disease is more frequently associated with systolic hypertension, therefore wider pulse pressure is suggestive to arterial stiffness. Our study evaluates the relationship between arterial stiffness and cardiovascular event risk, estimated by the Framingham risk score, in patients with infraclinic peripheral atherosclerosis. Material and method: A total of 43 subjects with multiple cardiovascular risk factors and peripheral atheromatosis were evaluated. The Framingham risk score was calculated and the arterial stiffness was assessed by using brachial pulse pressure (PP) and digital volume pulse analysis, which determines the stiffness index (SIDVP). Results: We found that 20.93% of patients had less then 5% risk of cardiovascular events during 10 years, although atherosclerotic disease was already present at peripheral level. We also found strong correlation (p<0.05) between PP and SIDVP, although the relationship with risk factors was different. Thus, the arterial stiffness was correlated with age (p=0.012) and with the presence of hypertension (p=0.005), if appreciated by PP, respectively with smoking (p=0.003), if appreciated by SIDVP. Between subgroups composed by sex criteria, there were statistically significant differences in Framingham risk scores (p=0.001), but no differences in arterial stiffness. Both PP and the SIDVP had a progressive growth in risk levels, with a statistically significant correlation with the Framingham score (p=0.04 for PP, p=0.002 for SI). Conclusion: In subclinical stage of peripheral atherosclerotic disease, the cardiovascular event risk, estimated by the Framingham risk score, is correlated with the level of arterial stiffness.