Evidence map›Paper›PMID 30661478›Full record

ArticleHypertension (Dallas, Tex. : 1979)2019

Relative Contributions of Pulse Pressure and Arterial Stiffness to Cardiovascular Disease.

Teemu J Niiranen, Bindu Kalesan, Gary F Mitchell, Ramachandran S Vasan

Open access · bronzeAbstract readMulticenter Study
In one paragraph

Article in Hypertension (Dallas, Tex. : 1979), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 1 pooled it
6.0field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

60 citing papers in PubMed, 1 synthesis or guideline pooled it, 98 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Observational
  4. Pathophysiology and Clinical Relevance of Microvascular Remodeling in Arterial Hypertension.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026
    Review
  5. Article
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  11. Review
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  13. Combined effects of hypertension and arterial stiffness on target organ damage among community-based screening participants.Hypertension research : official journal of the Japanese Society of Hypertension · 2025
    Observational
  14. Article
  15. Review
  16. Article
  17. Article
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  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 4 institutions in 2 countries.

Teemu J NiiranenFrom the Framingham Heart Study, MA (T.J.N., R.S.V.).
Bindu KalesanCenter for Clinical Translational Epidemiology and Comparative Effectiveness Research (B.K., R.S.V.), Boston University School of Medicine, MA.
Gary F MitchellCardiovascular Engineering, Inc, Norwood, MA (G.F.M.).
Ramachandran S VasanFrom the Framingham Heart Study, MA (T.J.N., R.S.V.).
Boston University · USFramingham Heart Study · USNorwood Hospital · USTurku University Hospital · FI

Funding

IDENTIFICATION OF COMMON GENETIC VARIANTS FOR ATRIAL FIBRILLATION AND PR INTERVALR01HL092577 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI BENJAMIN, EMELIA J., ELLINOR, PATRICK THOMAS · 2009 to 2025
$20.6M
Ventricular Vascular Coupling: Correlates and PrognosisR01HL080124 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI RAMACHANDRAN, VASAN S · 2005 to 2009
$3.4M
Vascular Stiffness as a Precursor of Hypertension in a Middle-aged CohortR01HL126136 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI MITCHELL, GARY FRANK, RAMACHANDRAN, VASAN S · 2015 to 2018
$2.6M
Biomarkers of Ventricular and Vascular RemodelingR01HL077447 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI RAMACHANDRAN, VASAN S · 2005 to 2009
$2.6M
Aortic Dysfunction, Pulsatile Stress and Target Organ Damage in FraminghamR01HL107385 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI MITCHELL, GARY FRANK, RAMACHANDRAN, VASAN S · 2011 to 2014
$2.6M
Vascular Function in the Framingham Third GenerationR01HL070100 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI BENJAMIN, EMELIA J. · 2002 to 2005
$2.4M
ENDOTHELIAL VASAMOTOR FUNCTION IN THE FRAMINGHAM STUDYR01HL060040 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI BENJAMIN, EMELIA J. · 1999 to 2002
$595k
Genetics of Oxidative Stress in Ventricular RemodelingR01HL071039 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI RAMACHANDRAN, VASAN S. · 2002 to 2003
$252k
THE FRAMINGHAM HEART STUDY-N01HC25195-268025195-268025195N01HC025195 · HC · TRUSTEES OF BOSTON UNIVERSITY · PI WOLF, PHILIP A · 2002 to 2006
–
NHLBI NIH HHS HHSN268201500001CNHLBI NIH HHS HHSN268201500001INHLBI NIH HHS N01 HC025195NHLBI NIH HHS R01 HL060040NHLBI NIH HHS R01 HL070100NHLBI NIH HHS R01 HL071039NHLBI NIH HHS R01 HL077447NHLBI NIH HHS R01 HL080124NHLBI NIH HHS R01 HL092577NHLBI NIH HHS R01 HL107385NHLBI NIH HHS R01 HL126136
6 · The paper itself

Abstract

Pulse pressure has been frequently used as a surrogate marker of arterial compliance. However, the prevalence and prognostic significance of mismatch between pulse pressure and arterial stiffness remains unclear. We measured carotid-femoral pulse wave velocity (CFPWV) and central pulse pressure (CPP) in 2119 Framingham Offspring Cohort participants (mean age, 60 years; 57% women). The participants were divided into 4 groups according to CPP and CFPWV status (categorized as high/low based on ≥age- and sex-specific median values) and followed up for cardiovascular disease (CVD) events. At baseline, 832 of 2119 (39%) participants had discordant CPP and CFPWV status, 417 with low CPP and high CFPWV, and 415 with high CPP and low CFPWV. The multivariable-adjusted risk for CVD events (n=246; median follow-up, 12.6 years) in individuals with a CPP-CFPWV mismatch (hazard ratio for low CPP with high CFPWV, 1.21; 95% CI, 0.83-1.76; hazard ratio for high CPP with low CFPWV, 0.76; 95% CI, 0.49-1.19) was comparable with the CVD risk observed in the low CPP with low CFPWV (referent group). In contrast, participants with a high CPP with high CFPWV (hazard ratio, 1.52; 95% CI, 1.10-2.11) experienced significantly increased CVD risk. The interaction term between CPP and CFPWV status on CVD risk was borderline significant in the multivariable model ( P=0.08). Our results demonstrate that pulse pressure-arterial stiffness mismatch is common in the community. CFPWV may modify the association of CPP with CVD risk, with the greatest risk being observed in those with elevated CPP and CFPWV.

Indexed as

Blood PressureCardiovascular DiseasesCarotid ArteriesElectrocardiographyFemaleFemoral ArteryFollow-Up StudiesHumansMaleMiddle AgedPrevalencePulse Wave AnalysisRetrospective StudiesRisk AssessmentRisk FactorsUltrasonographyarteriescardiovascular diseaseshypertensionrisk factorsvascular diseases

Identifiers

PMID30661478
PMCPMC6374179
OpenAlexW2910456986

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.