ABSTRACT
In hypertension, large arteries stiffen, and pulse pressure increases due to wave reflections. A major reason for measuring arterial stiffness ‘routinely’ in clinical practice in hypertensive patients comes from the recent demonstration that arterial stiffness and wave reflections have a predictive value for cardiovascular events. Measurement of local carotid stiffness may provide important prognostic information, since the carotid artery is a frequent site of atheroma formation. The independent predictive value of aortic stiffness has been demonstrated after adjustment to classical cardiovascular risk factors, including brachial pulse pressure. In order to be considered as a surrogate endpoint of cardiovascular events, a biomarker should satisfy several criteria, such as proof of concept, prospective validation, incremental value, clinical utility, clinical outcomes, cost-effectiveness, ease of use, methodological consensus and reference values. The predictive value of carotid stiffness, locally measured with high-resolution echotracking at the carotid site, has been reported in various populations.
