Brachial-ankle pulse wave velocity predicts the development of cardiovascular disease in a general Japanese population

Ninomiya, Toshiharu; Kojima, Iwao; Doi, Yasufumi; Fukuhara, Mikio; Hirakawa, Yoichiro; Hata, Jun; Kitazono, Takanari; Kiyohara, Yutaka

doi:10.1097/hjh.0b013e32835c5c23

Cited by 95 publications

(80 citation statements)

References 27 publications

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“…Because baPWV is non-invasive, convenient to measure, and requires little technical expertise, it is widely available. Both cfPWV and baPWV have been shown to be strong predictors of clinically evident CVD events [12][13][14][15][16][17] . However, few populationbased observational studies have documented a link between either measurement and subclinical atherosclerosis, including CAC 18,19) .…”

Section: Blood Testmentioning

confidence: 99%

Association between Pulse Wave Velocity and Coronary Artery Calcification in Japanese men

Torii

Arima

Fujiyoshi

et al. 2015

J Atheroscler Thromb

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Aim: Pulse wave velocity (PWV) is a simple and valid clinical method for assessing arterial stiffness. Coronary artery calcification (CAC) is an intermediate stage in the process leading to overt cardiovascular disease (CVD)and an established determinant of coro nary artery disease. This study aimed to examine the association between PWV and CAC in a population-based sample of Japanese men. Methods: This is a cross-sectional study of 986 randomly selected men aged 40-79 years from Shiga, Japan. CVD-free participants were examined from 2006 to 2008. Brachial-ankle PWV (baPWV) was measured using an automatic waveform analyzer. CAC was assessed using computed tomography. Agatston scores ≥ 10 were defined as the presence of CAC. Results: Prevalence of CAC progressively increased with rising levels of baPWV: 20.6%, 41.7%, 56.3%, and 66.7% across baPWV quartiles 1378, 1378-1563, 1564-1849, and 1849 cm/s (P 0.001 for trend). Associations remained significant after adjusting for age and other factors, including body mass index, systolic blood pressure, pulse rate, total and high-density lipoprotein cholesterol, hemoglobin A1c, drinking, smoking and exercise status, and the use of medication to treat hypertension, dyslipidemia and diabetes (P 0.042 for trend). The optimal cutoff level of baPWV to detect CAC was 1612 cm/s using receiver operating characteristic curve analysis. Conclusions: Arterial stiffness as defined by an elevated baPWV is associated with an increased prevalence of CAC in a general population-based setting among Japanese men.

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Section: Blood Testmentioning

confidence: 99%

Association between Pulse Wave Velocity and Coronary Artery Calcification in Japanese men

Torii

Arima

Fujiyoshi

et al. 2015

J Atheroscler Thromb

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“…9 Particularly relevant to this report, recent longitudinal studies have demonstrated that increased baPWV levels predict cardiovascular mortality and morbidity among high-risk patients and the general population. [10][11][12][13] In their current guidelines on the management of arterial hypertension, the European Society of Hypertension mentioned PWV as a potential consideration in managing middle-aged hypertensive patients with increased aortic stiffness.…”

Section: Song Et Al Bapwv and Bp Control Predict First Incident Strokmentioning

confidence: 99%

Independent and Joint Effect of Brachial-Ankle Pulse Wave Velocity and Blood Pressure Control on Incident Stroke in Hypertensive Adults

Song

et al. 2016

Hypertension

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Stroke Association's updated guidelines on the primary prevention of stroke, treatment of hypertension is among the most effective strategies for preventing both ischemic and hemorrhagic stroke. 4 Little is known, however, about the role of pulse wave velocity (PWV), a marker of arterial stiffness, in the primary prevention of stroke. There is a growing recognition that PWV may affect blood pressure (BP) and the response to antihypertension treatment. Large arterial stiffness and wave-reflection intensity have both been associated with Abstract-Pulse wave velocity (PWV) has been shown to influence the effects of antihypertensive drugs in the prevention of cardiovascular diseases. Data are limited on whether PWV is an independent predictor of stroke above and beyond hypertension control. This longitudinal analysis examined the independent and joint effect of brachial-ankle PWV (baPWV) with hypertension control on the risk of first stroke. This report included 3310 hypertensive adults, a subset of the China Stroke Primary Prevention Trial (CSPPT) with baseline measurements for baPWV. During a median follow-up of 4.5 years, 111 participants developed first stroke. The risk of stroke was higher among participants with baPWV in the highest quartile than among those in the lower quartiles (6.3% versus 2.4%; hazard ratio, 1.66; 95% confidence interval, 1.06-2.60). Similarly, the participants with inadequate hypertension control had a higher risk of stroke than those with adequate control (5.1% versus 1.8%; hazard ratio, 2.32; 95% confidence interval, 1.49-3.61). When baPWV and hypertension control were examined jointly, participants in the highest baPWV quartile and with inadequate hypertension control had the highest risk of stroke compared with their counterparts (7.5% versus 1.3%; hazard ratio, 3.57; 95% confidence interval, 1.88-6.77). There was a significant and independent effect of high baPWV on stroke as shown among participants with adequate hypertension control (4.2% versus 1.3%; hazard ratio, 2.29, 95% confidence interval, 1.09-4.81). In summary, among hypertensive patients, baPWV and hypertension control were found to independently and jointly affect the risk of first stroke. Participants with high baPWV and inadequate hypertension control had the highest risk of stroke compared with other groups.

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“…We excluded 5506 subjects from the analyses (the details of the exclusions and inaccurate baPWV measurement 25 are described in Appendix S1 in the online-only Data Supplement). A final total of 13 381 subjects from 7 cohorts were included in the analysis for all-cause mortality (5 published studies 12,13,15,17,18 and 2 unpublished studies 14,16 ), and 14 673 participants from 8 studies (5 published studies 12,13,15,17,18 and 3 unpublished studies 11,14,16 ) were included in the analysis for CVD risk.…”

Section: Study Populationmentioning

confidence: 99%

“…This collaborative study included the data from 14 cohort studies conducted in Japan (9 published and 5 unpublished studies). [11][12][13][14][15][16][17][18][19][20][21][22][23][24] The study was conducted with the approval of the Ethical Guidelines Committee of Tokyo Medical University (No 2655. Figure 1 depicts the process used to select the study population.…”

Section: Study Populationmentioning

confidence: 99%

Brachial-Ankle Pulse Wave Velocity and the Risk Prediction of Cardiovascular Disease

Ohkuma¹,

Ninomiya²,

et al. 2017

Self Cite

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A rterial stiffness is well-recognized as an important predictor of development of cardiovascular disease (CVD), 1,2 and meta-analyses of prospective cohort studies have revealed that increase in the carotid-femoral pulse wave velocity (cfPWV) is associated with an increase in the risk of development of CVD. 3,4 However, the cfPWV is measured by tonometry or Doppler, which requires specialized training and exposure of the inguinal region. 5,6Abstract-An individual participant data meta-analysis was conducted in the data of 14 673 Japanese participants without a history of cardiovascular disease (CVD) to examine the association of the brachial-ankle pulse wave velocity (baPWV) with the risk of development of CVD. During the average 6.4-year follow-up period, 687 participants died and 735 developed cardiovascular events. A higher baPWV was significantly associated with a higher risk of CVD, even after adjustments for conventional risk factors (P for trend <0.001). When the baPWV values were classified into quintiles, the multivariableadjusted hazard ratio for CVD increased significantly as the baPWV quintile increased. The hazard ratio in the subjects with baPWV values in quintile 5 versus that in those with the values in quintile 1 was 3.50 (2.14-5.74; P<0.001). Correspondence to Hirofumi Tomiyama, Department of Cardiology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Tokyo, Japan. E-mail tomiyama@ tokyo-med.ac.jp In the early 2000s, a simple device for measurement of the brachial-ankle pulse wave velocity (baPWV) was launched for clinical use. Brachial-Ankle Pulse Wave Velocity and the Risk Prediction of Cardiovascular Disease An Individual Participant Data Meta-Analysis7 baPWV is automatically measured using a separate cuff for each of the 4 limbs by an oscillometric method. baPWV may be more easily applied in clinical practice than the cfPWV because of the simplicity and ease of its measurement.7,8 baPWV has been reported to be closely correlated with the directly measured aortic PWV and cfPWV. 9 A recent meta-analysis using summary data from the literature has demonstrated that higher levels of baPWV were associated with an increased risk of development of CVD.10 However, most of the studies included in the meta-analyses were conducted in patients with a high CVD risk (patients with CVD or end-stage renal disease), and thus, the usefulness of baPWV to assess the risk of development of CVD in subjects with a low to intermediate CVD risk as assessed using the Framingham risk score (FRS) had not been clearly elucidated. Furthermore, these studies did not determine the predictive ability for CVD over that of the traditional risk factors. Therefore, we conducted a meta-analysis using individual participant data (IPD) from prospective cohort studies to clarify whether baPWV could be used as an independent marker to predict the risk of development of CVD in subjects without preexisting CVD. Methods Study PopulationJ-BAVEL (Japan Brachial-Ankle Pulse Wave Velocity Individual Participant Data Meta-Analysis of Pros...

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Brachial-ankle pulse wave velocity predicts the development of cardiovascular disease in a general Japanese population

Cited by 95 publications

References 27 publications

Association between Pulse Wave Velocity and Coronary Artery Calcification in Japanese men

Association between Pulse Wave Velocity and Coronary Artery Calcification in Japanese men

Independent and Joint Effect of Brachial-Ankle Pulse Wave Velocity and Blood Pressure Control on Incident Stroke in Hypertensive Adults

Brachial-Ankle Pulse Wave Velocity and the Risk Prediction of Cardiovascular Disease

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