Effects of ankle-brachial index and brachial-ankle pulse wave velocity on all-cause mortality in a community-based elderly population

Abstract

BackgroundAnkle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) are both important indicators of arterial stiffness and vascular injury. At present, most studies on the relationship between ABI and baPWV and all-cause mortality in community-based elderly are analyzing ABI or baPWV alone, and will focus on a single special population such as diabetes and stroke. The purpose of this study was to evaluate the relationship between ABI and baPWV in a Chinese community-based elderly population, and to analyze their impact on all-cause mortality in a community-based population through a follow-up of nearly 10 years.MethodsParticipants were residents of the Wanshou Road community in Beijing, China. A total of 2,162 people in the community were included, with an average age of 71.48 years. During a mean follow-up period of 9.87 years, 1,826 subjects completed follow-up. Kaplan-Meier survival analysis and different Cox regression models were used to verify the association of ABI and baPWV with all-cause mortality. The selected subjects were divided into two groups according to ABI and baPWV, and ABI was divided into two groups with 0.90 as the cut-off point (group 1: 0.9 < ABI ≤ 1.3; group 2: ABI ≤ 0.9); according to the level of baPWV, they were divided into three groups (Tertile 1: baPWV <1761.5 cm/s; Tertile 2: 1761.5 ≤ baPWV <2121.5 cm/s; Tertile 3: baPWV ≥2121.5 cm/s).Results1,826 people were included in the statistical analysis, and the total mortality rate was 181.3/1000. The 10-year all-cause mortality rate of the abnormal ABI group (group 2) was 44.7%, and that of the normal ABI group (group 1) was 17.0%; The 10-year all-cause mortality rates from low to high in the baPWV tertile were 10.0%, 18.7%, and 26.4%. In the Cox proportional hazards model, after adjusting for possible confounders, the effect of baPWV on all-cause mortality was significant, with the 3rd tertile having a 1.647-fold higher risk of all-cause mortality than the 1st tertile (P = 0.014 ).ConclusionsABI and baPWV are risk factors affecting all-cause mortality in the elderly community population, and baPWV is an independent predictor of all-cause mortality in the elderly community population.

Combined Evaluation of Arterial Stiffness and Blood Pressure Promotes Risk Stratification of Peripheral Arterial Disease

“… 27 ABI is an independent risk factor for the development of cardiovascular diseases and all-cause mortality. 28 , 29 AS is an indicator of structural and functional changes in vessel walls, causing thickening of artery walls, reduced complacency, and increased rigidity. 30 Previous studies have shown that elevated AS is associated with an increased risk for cardiovascular events such as coronary artery disease, stroke, and end-stage renal disease.…”

The predictive value of arterial stiffness combined with hypertension in the index of atherosclerotic cardiovascular disease

“…On the other hand, elevated baPWV and increased blood pressure were deemed to be related to aging, rather than pathological element. Recently, a study of elderly cohort, with an average age of 71.48 years, presented that elevated baPWV is an independent predictor of all-cause mortality in a community-based elderly population over 10 years of follow-up 18 . However, the exact mechanism of ASCVD caused by AS remains to be elucidated.…”

“…Numerous studies, especially the Framingham study 15 , had affirmed that hypertension was a risk factor for ASCVD 4,5 . In addition, some studies had gradually found that baPWV, as an assessment indicator of AS, can predict all-cause mortality and ASCVD events [16][17][18][19] . As early as 2010, a cohort study with 2,642 participants clearly put forward baPWV as an independent predictor of all-cause mortality after 6.5 years of follow-up 17 .…”