Association between brachial–ankle pulse wave velocity and 3-year mortality in community-dwelling older adults

Abstract

With aging, arterial stiffness increases and results in cardiovascular diseases. Recently, high brachial-ankle pulse wave velocity (baPWV), measured using a new noninvasive device to estimate arterial stiffness, was reported to be associated with the prevalence of cardiovascular diseases. The purpose of this study was to clarify the association between baPWV with 3-year mortality in community-dwelling older adults and to determine the cutoff value of baPWV in terms of mortality. A total of 530 subjects aged 65 years or older (men/women, 207:323; mean age, 76 years) participated. They were dichotomized by the median value of baPWV. Within 3 years, 30 deaths occurred, including 11 cardiovascular deaths. The high-baPWV group had a higher incidence of total deaths (high-baPWV group vs. low-baPWV group, 8.3 vs. 3.0%, respectively) and cardiovascular deaths (high-baPWV group vs. lowbaPWV group, 3.8 vs. 0.4%, respectively). A high-baPWV level was associated with an increased risk of 3-year total mortality after adjustment for age, sex and systolic blood pressure (hazard ratio for high baPWV vs. low baPWV¼2.98, 95% CI¼1.25-7.07) and with an increased risk of 3-year cardiovascular mortality (hazard ratio for high baPWV vs. low baPWV¼10.01, 95% CI¼1.21-82.49). A receiver-operating characteristic curve showed that the optimal cutoff value of baPWV for total mortality was 19.63 m s À1 , and for cardiovascular mortality it was 19.63 m s À1 . This study provides a preliminary finding that assessment of arterial stiffness by baPWV might be a useful method to predict mortality risk in community-dwelling older adults. Large longitudinal studies for extended periods of time are necessary to confirm the association.

Prognostic significance of the brachial–ankle pulse wave velocity in patients with essential hypertension: final results of the J-TOPP study

“…15 Furthermore, it has been shown in end-stage renal disease and in the general population that baPWV predicts total mortality as well as cardiovascular mortality. 16,17 Thus, taking those recent reports and our results into consideration, baPWV seems to have prognostic significance similar to that of cfPWV.…”

“…One studied baPWV in hemodialysis patients, 16 two were conducted in the general population 17,18 and the remaining two were conducted in patients with acute coronary syndrome 21 or diabetes accompanied by coronary artery disease. 22 Although the cohorts differed extensively, the suggested cut off value for poor cardiovascular prognosis ranged from 1700 to 1963 cm s -1 .…”

“…16 It has also been shown in the general populations that higher baPWV is associated with an increased risk of total death, as well as of cardiovascular death. 17,18 However, whether increased baPWV is predictive of clinical outcome or death in patients with essential hypertension has not been studied. To address this issue, we performed a prospective, multicenter cohort study titled 'Japanese Trial on the Prognostic Implication of PWV (J-TOPP)' in 2002.…”

Cut-Off Value of Brachial-Ankle Pulse Wave Velocity to Predict Cardiovascular Disease in Hypertensive Patients: A Cohort Study

“…This result seems to coincide well with the baPWV cut-off value revealed in the present study. Miyano et al reported that, in elderly people (mean age: 76 years), a baPWV of 1963 cm/sec can be the cut-off for predicting total mortality or cardiovascular mortality 20) . Because arterial stiffness is well known to increase with age 21) , older subjects have a higher baPWV.…”

Impact of a systolic parameter, defined as the ratio of right brachial pre-ejection period to ejection time, on the relationship between brachial-ankle pulse wave velocity and left ventricular diastolic function

“…Increased PWV is an independent predictor of cardiovascular morbidity and mortality in the general population and in hypertensive patients, the elderly, and patients with end-stage renal disease. 2,27,29 Despite the fact that there are several parameters used in the assessment of arterial stiffness, the gold standard of non-invasive arterial stiffness measurement is carotid-femoral PWV. 27 In this study, we used baPWV as the parameter of arterial stiffness.…”