Cardoso CRL, et al. - In a prospective cohort of 891 resistant hypertensive patients who were followed-up for a median of 7.8 years, researchers assessed prognostic value of aortic stiffness for the occurrence of adverse cardiovascular outcomes and mortality in this patient population by using multivariate Cox analysis. Baseline assessment of aortic stiffness by carotid-femoral pulse wave velocity (cf-PWV) was carried out and C statistics and the integrated discrimination improvement index were used to evaluate the improvement in risk stratification. A cardiovascular event (CVE) was reported in 138 patients during follow-up (123 major adverse CVE). At the same time, death was reported for 142 patients (91 from cardiovascular causes) was reported. A significant 2.2- to 2.6-fold increase in the risk of CVEs and mortality was observed in patients with increased aortic stiffness (cf-PWV ≥10 m/s after correction for the white-coat effect, or uncorrected directly measured ≥11 m/s) after adjustments for other risk factors, like 24-hour ambulatory blood pressures and dipping patterns. Overall, adverse cardiovascular outcomes and mortality were predicted by increased aortic stiffness, which improved cardiovascular risk stratification. Inclusion of cf-PWV measurement into the routine clinical management of resistant hypertension was recommended.