eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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vol. 15
Systematic review/Meta-analysis

Pulse wave velocity as a measure of arterial stiffness in patients with familial hypercholesterolemia: a systematic review and meta-analysis

Željko Reiner
Luis E. Simental-Mendía
Massimiliano Ruscica
Niki Katsiki
Maciej Banach
Khalid Al Rasadi
Tannaz Jamialahmadi
Amirhossein Sahebkar

Arch Med Sci 2019; 15 (6): 1365–1374
Online publish date: 2019/11/03
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The aim of this meta-analysis was to establish whether vascular pulse wave velocity (PWV) as a measure of arterial stiffness is changed in patients with familial hypercholesterolemia (FH).

Material and methods
Studies comparing PWV between patients with FH and controls were searched in PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases (up to November 26, 2017). A meta-analysis was conducted using Comprehensive Meta-Analysis V2 software. A random-effects model (using the DerSimonian-Laird method) and the generic inverse variance method were used to compensate for the heterogeneity of studies concerning demographic characteristics and differences in the studies’ design.

This meta-analysis of 8 studies involving 317 patients with FH and 244 non-FH individuals did not suggest a significantly altered PWV in FH patients versus controls (weighted mean difference (WMD): 0.17 m/s, 95% confidence interval (CI): –0.31, 0.65, p = 0.489; I2 = 80.15%). The result was robust in the sensitivity analysis and its significance was not influenced after omitting each of the included studies from the meta-analysis. Subanalysis of 6 of these studies which had data on intima-media thickness (IMT) indicated an increased IMT in FH patients when compared with controls (WMD = 0.03 mm, 95% CI: 0.003, 0.06, p = 0.034; I2 = 48.95%). However, the effect size was sensitive to some of the included studies.

This meta-analysis suggests that FH patients do not have significantly altered PWV when compared with normocholesterolemic individuals. However, a subanalysis of studies in which IMT was measured indicated that IMT is increased in FH patients compared with controls.


familial hypercholesterolemia, arterial stiffness, pulse wave velocity, intima-media thickness

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