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Vol. 149. Issue 11.
Pages 469-476 (December 2017)
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Vol. 149. Issue 11.
Pages 469-476 (December 2017)
Original article
DOI: 10.1016/j.medcle.2017.10.024
Arterial stiffness in normotensive and hypertensive subjects: Frequency in community pharmacies
Rigidez arterial en sujetos normotensos e hipertensos: frecuencia en farmacias comunitarias
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Enrique Rodilla Salaa,b,
Corresponding author
rodilla_enr@gva.es

Corresponding author.
, Manuel Adell Alegrec, Vicente Giner Galvañd, Zeneida Perseguer Torregrosac, Jose Maria Pascual Izuela, María Teresa Climent Catalác, on behalf of the RIVALFAR Study Group
a Unidad de HTA y Riesgo Vascular, Servicio de Medicina Interna, Hospital de Sagunto, Sagunto, Valencia, Spain
b Universidad CEU Cardenal Herrera, Área de Ciencias de la Salud de Moncada, Moncada, Valencia, Spain
c Sociedad Española de Farmacia Familiar y Comunitaria de la Comunitat Valenciana, Valencia, Spain
d Unidad de HTA y Riesgo Cardiometabólico, Servicio de Medicina Interna, Hospital Verge dels Lliris, Alcoi, Alicante, Spain
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Tables (5)
Table 1. Characteristics of patients in the total cohort (n=1427).
Table 2. Characteristics of the normotensive and hypertensive patients according to the pulse wave velocity adjusted to 7 age-groups or to a fixed value (n=1427).
Table 3. Variables associated to arterial stiffness according to the pulse wave velocity adjusted for 7 age-groups in untreated normotensive patients and hypertensive patients in multivariate logistic regression analysis.
Table 4. Variables associated with arterial stiffness according to a fixed value of 10m/s in normotensive patients and hypertensive patients in multivariate logistic regression analysis.
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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 1427 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% and 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
Target organ lesion
Pulse wave velocity
Brachial oscillometry
Prehypertension
Community pharmacies
Resumen
Antecedentes y objetivo

La rigidez arterial (RA) es una lesión de órgano diana reconocida. El objetivo es determinar: 1) su frecuencia en farmacias comunitarias; 2) si sujetos con RA presentan más factores de riesgo CV, y 3) su dependencia de una definición ajustada por grupos de edad o valores fijos.

Pacientes y método

Estudio observacional transversal en 32 farmacias comunitarias de la Comunidad Valenciana entre noviembre de 2015 y abril de 2016. La RA como velocidad de onda de pulso (VOP) se midió mediante un dispositivo validado semiautomático (Mobil-O-Graph®, IEM), seguido de un cuestionario de 10 preguntas.

Resultados

La edad media de los 1.427 participantes consecutivos fue 56,6 años. La proporción de pacientes con RA fue 17,4% (9,4% en normotensos, 28,3% en hipertensos) con ajuste por grupos de edad. La regresión logística multivariante mostró en normotensos una asociación de la RA con el sexo masculino, la obesidad, una mayor presión de pulso y la frecuencia cardiaca, y en hipertensos, con una mayor presión de pulso y una menor edad. Definiendo RA por VOP>10m/s, el 20,5% global (6,2% en normotensos, 40,2% en hipertensos) presentó RA. Se asoció a mayor edad y presión de pulso en normotensos e hipertensos. La concordancia de RA entre ambas definiciones fue del 74,6%.

Conclusiones

La RA varió entre el 17,4 y el 20,5%. La RA ajustada por edad se asocia en normotensos a sexo masculino, presión de pulso, obesidad y frecuencia cardiaca, y en hipertensos, a mayor presión de pulso y menor edad. Los determinantes de RA medida como VOP>10m/s son mayor presión de pulso y mayor edad. Ambas definiciones de RA no son superponibles.

Palabras clave:
Rigidez arterial
Lesión de órgano diana
Velocidad de onda de pulso
Oscilometría braquial
Prehipertensión
Farmacias comunitarias

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