Table 1.

Studies linking vascular stiffness with adverse perioperative outcomes including stroke.

Publication	Hypothesis	Methods	Results
Aronson et al.[4*]	Preoperative elevated pulse pressure increases risk of perioperative renal dysfunction or failure	Prospective data including baseline pulse pressure, collected on a group of patients undergoing CABG surgery. Variables predictive of renal dysfunction or failure determined in one cohort then validated in a second cohort.	Elevated preoperative pulse pressure was identified as one of the risk factors associated with postoperative renal dysfunction or failure.
Benjo et al.[5*]	Pulse pressure is a predictive factor in risk for stroke after cardiac surgery	Retrospective review of data from patients underwent CABG surgery. Brachial artery pulse pressure was measured. The incidence of stroke for an average follow- up of 348 ±215 days after surgery was determined.	Pulse pressure was identified as an age independent predictor of stroke occurrence.
Fontes et al.[6*]	Increased pulse pressure is associated with risk for adverse vascular outcomes in patients undergoing CABG surgery.	Prospective cohort study. Data from over 4000 patients undergoing CABG surgery were collected and the relationship between these factors and adverse vascular events were determined.	Elevated pulse pressure was independently associated with cardiac and neurologic adverse outcomes. PP increment of 10mmHg associated with increased risk of cerebral events; a PP value over 80 mmHg was associated with almost double the incidence of cerebral event or death from neurologic complications.
Nikolov et al.[7]	Elevated pulse pressure is associated with decreased long term survival after CABG surgery.	Prospective cohort study. Baseline preoperative pulse pressure and other variables collected from 973 patients prior to CABG.	Elevated preoperative pulse pressure measurements as well as duration of cardiopulmonary bypass, diabetes, and Hannan risk index were predictive of decreased survival after a median follow-up of 7.3 years.
Oprea et al.[31]	To determine if baseline pulse pressure is associated with acute kidney injury and 30-day mortality after non-cardiac surgery.	Retrospective review of data from 9125 patients undergoing non-cardiac surgery at a single center.	Elevated pulse pressure was associated with the adjusted risk for acute kidney injury but not 30- day mortality.
Mazzeffi et al[20]	Increased baseline pulse pressure is associated with 30-day and 1-year mortality after lower extremity artery bypass surgery.	Retrospective review of data from 556 patients undergoing infra-inguinal arterial bypass surgery.	A large percentage (44.6%) of patients had elevated pulse pressure. There was no relationship between pulse pressure and 30-day (p=0.35) or 1- year (p-0.14) mortality.