The usefulness of brachial–ankle pulse wave velocity (baPWV), an index of arterial stiffness, is not fully known for the management of treated hypertensive patients with a history of coronary artery disease (CAD) who have blood pressure less than 130/80 mmHg, a recommended blood pressure target in the updated major hypertension guidelines. We analyzed data for 447 treated hypertensive patients with CAD enrolled in FMD-J Study A for assessment of the predictive value of baPWV for future cardiovascular events. The primary outcome was a composite of coronary events, stroke, heart failure, and sudden death. During a median follow-up period of 47.6 months, the primary outcome occurred in 64 patients. Blood pressure less than 130/80 mmHg was significantly associated with a lower risk of the composite outcome independent of other cardiovascular risk factors in treated hypertensive patients with CAD (hazard ratio, 0.59; 95% confidence interval (CI), 0.35–0.99; P = 0.04). In treated hypertensive patients with CAD who had blood pressure less than 130/80 mmHg, baPWV above the cutoff value of 1731 cm/s, derived from receiver–operator characteristic curve analysis for the composite outcome was significantly associated with a higher risk of the composite outcome independent of conventional risk factors (hazard ratio, 2.83; 95% CI, 1.02–7.91; P = 0.04). baPWV was an independent predictor of cardiovascular events in treated hypertensive patients with CAD who had blood pressure less than 130/80 mmHg, for whom measurement of baPWV is recommended for cardiovascular risk assessment.

中文翻译：

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控制性高血压合并冠状动脉疾病患者的动脉僵硬度增加和心血管风险预测：FMD-J（日本血流介导扩张）研究 A 的事后分析

臂踝脉搏波速度 (baPWV) 是动脉僵硬度的一个指标，它在治疗血压低于 130/80 mmHg 且有冠状动脉疾病 (CAD) 病史的高血压患者中的作用尚不完全清楚，在更新的主要高血压指南中推荐的血压目标。我们分析了 447 名参加 FMD-J 研究 A 的 CAD 高血压患者的数据，以评估 baPWV 对未来心血管事件的预测价值。主要结局是冠状动脉事件、中风、心力衰竭和猝死的复合结局。在 47.6 个月的中位随访期间，64 名患者出现了主要结果。在接受治疗的 CAD 高血压患者中，血压低于 130/80 mmHg 与复合结局的较低风险显着相关，独立于其他心血管危险因素（风险比，0.59；95% 置信区间 (CI)，0.35–0.99；P = 0.04）。在血压低于 130/80 mmHg 的经治疗的 CAD 高血压患者中，baPWV 高于 1731 cm/s 的临界值，来自复合结局的接受者 - 操作者特征曲线分析，与复合结局的较高风险显着相关结果独立于常规风险因素（风险比，2.83；95% CI，1.02–7.91；P = 0.04）。baPWV 是血压低于 130/80 mmHg 的经治疗的 CAD 高血压患者心血管事件的独立预测因子，