Comparison of arterial stiffness indices measured by pulse wave velocity and pulse wave analysis for predicting cardiovascular and all-cause mortality in a Chinese population

Arterial stiffness measured by pulse wave velocity and pulse wave analysis has been widely studied in different populations in terms of its correlation with cardiovascular events and all-cause mortality. It remains unknown which arterial stiffness index is better for risk stratification in the general population. We included 4129 participants from Gaoyou County, Jiangsu Province, China, with a median follow-up of 11 years. The primary endpoint was cardiovascular mortality, and the secondary endpoint was all-cause mortality. Harrell's C-index, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) based on the Cox proportional hazards regression model were evaluated to assess predictive discrimination and accuracy. The associations between the 4 indices and cardiovascular mortality remained significant after adjusting for the Framingham Risk Score (FRS) and/or associated risk factors. Considering reclassification based on the newly integrated models (FRS model combined with the 4 indices), NRI for cardiovascular mortality showed that haPWV and baPWV had more significant improvement in reclassification compared with C1 and C2 [NRI with 95% CI: haPWV 0.410 (0.293, 0.523); baPWV 0.447 (0.330, 0.553); C1 0.312 (0.182, 0.454); C2 0.328 (0.159, 0.463); all P < 0.05]. This study showed that pulse wave velocity (haPWV and baPWV) provides better discrimination of long-term risk than arterial elasticity indices (C1 and C2) in the general population.

Brachial-ankle pulse wave velocity is associated with the risk of osteoporosis: a cross-sectional evidence from a Chinese community-based cohort

Background

Association of arterial stiffness and osteoporosis has been well documented in elderly population. However, it is not clear whether they co-progress from the early stages through common mechanisms. The object of this study was to evaluate possible associations between arterial stiffness and osteoporosis by measuring brachial-ankle pulse wave velocity (baPWV) and the Osteoporosis Self-Assessment Tool for Asia (OSTA) index among a healthy population of Chinese aged 40 years and older. Whether baPWV can be used as a predictor of osteoporosis on OSTA was further assessed.

Methods

This study was cross-sectional in design. Of 3984 adults aged 40 years and older in the Yunyan district of Guiyang (Guizhou, China) who underwent both OSTA and baPWV measurements within 1 month, 1407 were deemed eligible for inclusion (women, 1088; men, 319).

Results

The mean baPWV was 1475 ± 302 cm/s (range,766–3459 cm/s). baPWV in 110 individuals with high risk of osteoporosis (OSTA index < − 4) was higher than that of individuals with non-high risk (1733 ± 461 cm/s vs. 1447 ± 304 cm/s, P < 0.001). OSTA index was negatively correlated with baPWV(ρ = − 0.296, P < 0.001) after adjusting for age, sex, body mass index, waist circumference, diastolic blood pressure, and creatinine clearance rate. baPWV was an independent predictor for the presence of high risk of osteoporosis (β = − 0.001, P < 0.001) and was consistent across age and sex subgroups, and the optimal baPWV cutoff value for predicting the presence of high risk of osteoporosis and fracture was 1693 cm/s. The AUC was 0.722 (95% confidence interval [CI], 0.667–0.777; P < 0.001, sensitivity of 52.8% and specificity of 83.6%).

Conclusions

We conclude that arterial stiffness measured by baPWV is well correlated with the severity of osteoporosis evaluated by OSTA. baPWV index may be a valuable tool for identifying individuals with risk of developing osteoporosis.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13018-020-02125-3.

Association of Serum Uric Acid with Arterial Stiffness in Peritoneal Dialysis Patients

BACKGROUND/AIMS

Serum uric acid (SUA) has been proposed as a mediator associated with increased cardiovascular risk and arterial stiffness. However, evidence on the association between SUA and arterial stiffness in peritoneal dialysis (PD) patients is lacking. The aim of this study was to examine the relationship between SUA and arterial stiffness in PD patients.

METHODS

The patients who performed vascular profiler test from January 1, 2014 to October 31, 2016, and with SUA values were enrolled. Arterial stiffness was evaluated by brachial-ankle pulse wave velocity (baPWV). The relationship between SUA and baPWV was tested by multiple linear regression models.

RESULTS

Of 645 PD patients, mean SUA was 6.80 (±1.29) mg/dL, mean baPWV was 1713 (±505) cm/s. In fully adjusted linear regression models, higher SUA was significantly associated with higher baPWV in young [standardized coefficients (β), 0.085; 95% confidence interval (95% CI), 0.013 to 0.130; P=0.02] but not in elderly (β, -0.194; 95% CI, -0.774 to 0.093; P=0.1) PD patients. In gender-stratified models of young patients, there was a significant association between SUA and baPWV in male (β, 0.115; 95% CI, 0.015 to 0.182; P=0.02) but not in female. Male in the highest gender-specific SUA quartile had a higher baPWV than those in the lowest quartile (β, 0.132; 95% CI, 0.011 to 0.209; P=0.03). This gender difference was reversed when selecting male patients with lower SUA levels (quartile 1 and 2) and female patients with higher SUA levels (quartile 3 and 4).

CONCLUSION

SUA was positively associated with baPWV in young PD patients, and this association was significant in males but not in females, which is possibly explained by the higher SUA level in males than in females.

Arteriosclerosis can predict hypotension during anesthesia induction in patients 40 years and older

STUDY OBJECTIVES

To identify the factors that predict blood pressure (BP) changes during induction of general anesthesia, and the relationship between the level of arteriosclerosis and BP changes during anesthesia induction.

DESIGN

Prospective, case-control observational study.

SETTINGS

Operating room of a university hospital.

PATIENTS

Seventy-two patients who received general anesthesia for oral and maxillofacial surgery.

MEASUREMENTS

Brachial-ankle pulse wave velocity (baPWV) and central BP were measured. The primary variable was the parameters affecting BP changes during the induction of general anesthesia. For additional analyses, the parameters were compared between high and low PWV groups (1606 cm/s was the cutoff value of baPWV). To measure the relationships between the parameters and BP changes, bivariate and multiple linear regression analyses were performed.

RESULTS

Seventy-two patients (including 41 men) with a mean age of 61.7 years and a median baPWV value of 1606 cm/s were evaluated. Significantly higher values for age, central BP, preoperative systolic BP (SBP), amount of decrease in SBP and diastolic BP, and number of patients with diabetes mellitus (DM) and hypertension were observed in the high PWV group. Multiple linear regression analysis demonstrated that age, baPWV, and DM were factors independently associated with the amount of decrease in SBP.

CONCLUSION

In patients 40 years and older, age, baPWV, and DM are thought to be effective predictors of the amount of decrease in SBP during induction of general anesthesia.

Serum high-density lipoprotein cholesterol and progression to arterial stiffness in middle-aged and elderly Chinese

BACKGROUND AND AIMS

Low high-density lipoprotein cholesterol (HDL-c) is a risk factor for cardiovascular disease. Brachial-ankle pulse wave velocity (baPWV) is an indicator of arterial stiffness, which is recognized as a predictor of cardiovascular disease. The aim of this study was to investigate the association between HDL-c and baPWV among middle-aged and elderly Chinese.

METHODS

A total number of 1133 Chinese (430 men, 703 women) aged from 50 to 90 years old were recruited from Shanghai downtown district. The baPWV and major cardiovascular risk factors of the participants were measured.

RESULTS

Serum HDL-c was negatively correlated with baPWV (r = -0.143, P < 0.001) after adjustment for age and gender. Multivariate linear regression analysis demonstrated that age (P < 0.001), systolic blood pressure (P < 0.001), HDL-c (P < 0.001), smoking (P = 0.001), BMI (P = 0.002), fasting plasma glucose (P = 0.004), and white blood cell (P = 0.005) were independently associated with baPWV. After multiple adjustments, participants in the highest quartile of HDL-c had an odds ratio of 0.442 (95% CI 0.268-0.729) for developing high arterial stiffness compared with participants in the lowest quartile. The association remained significant after further adjustment for major cardiovascular risk factors.

CONCLUSION

HDL-c has an independent protective effect on arterial stiffness in middle-aged and elderly Chinese. Early detection of HDL-c level is important in high risk populations with arterial stiffness. Increasing HDL-c level may be an attractive therapeutic target for the prevention of arterial function and subsequent disease.