Relationship of Noninvasive Assessment of Arterial Stiffness with 10-Year Atherosclerotic Cardiovascular Disease (ASCVD) Risk in a General Middle-Age and Elderly Population

Abstract

As a powerful indicator of arterial stiffening, the brachial-ankle pulse wave velocity (baPWV) has been extensively validated for predicting cardiovascular events. However, whether and how the brachial-ankle pulse wave velocity (baPWV) is correlated with the 10-year atherosclerotic cardiovascular disease (ASCVD) risk is unclear. This study aimed to investigate the association between baPWV and 10-year ASCVD risk in Chinese population. Methods: A total of 1768 subjects were enrolled from Shanghai, China. They were divided into two groups according to the Pooled Cohorts Equations model made by ACC/AHA as follows: low ASCVD risk (n = 992, 10-year ASCVD risk <7.5%) and high ASCVD risk (n = 776, 10-year ASCVD risk ≥7.5%). The baseline characteristics were obtained via the use of a questionnaire. Measurement of baPWV, laboratory tests, and echocardiography were conducted by trained physicians. The relationship between baPWV and 10-year ASCVD risk was evaluated using multiple logistic regression model and generalized additive model. Results:The mean age of the subjects was 58.89±8.60 years, 32.69% of which were male. Non-linear relationship analysis revealed threshold effects between baPWV and 10-year ASCVD risk in which a baPWV of approximately 16 m/s might be the threshold effect of 10year ASCVD risk. After multivariable adjustment, logistic-regression analysis demonstrated that ankle-brachial index (ABI) (OR 5.28,) and baPWV (OR 9.09, 95% CI 6.84-12.07) were independently correlated with 10-year ASCVD risk. The AUC for baPWV for predicting 10-year ASCVD risk was 0.80 (95% CI 0.78-0.82). Conclusion: Increased baPWV as an indicator of arterial stiffness correlates strongly with 10-year ASCVD risk in general middle-aged and elderly populations. The association between baPWV and 10-year ASCVD risk is not purely linear but non-linear. Subjects with baPWV above 16 m/s are more likely to encounter a higher 10-year ASCVD risk.

Serum Pentosidine is Associated with Cardiac Dysfunction and Atherosclerosis in T2DM

“… 31 Similarly, as a powerful indicator of arteriosclerosis, 32 baPWV has been proved to be closely related to the 10-year risk of atherosclerotic cardiovascular disease (ASCVD) in the middle-aged and elderly population. 33 Through multiple stepwise linear regression analysis, this study found that hemorrhagic pentosidine was significantly correlated with these two indicators. We speculated that the increase of serum pentosidine caused vascular inflammation and oxidative stress, affected the cross-linking of angioplasty protein and collagen, resulting in vascular sclerosis, and then caused cardiac insufficiency.…”

Association between pulse wave velocity and the 10‐year risk of atherosclerotic cardiovascular disease in the Chinese population: A community‐based study

“…In a previous study involving 3876 older people in Shanghai, baPWV was closely related to all‐cause death, cardiovascular death, and stroke events during a median follow‐up of 5.9 years 29 . Another study showed that an increase in baPWV correlates strongly with the 10‐year ASCVD risk, as calculated by the Pooled Cohort Equations model, in general middle‐aged and older Chinese populations 30 31 .…”

“…29 Another study showed that an increase in baPWV correlates strongly with the 10-year ASCVD risk, as calculated by the Pooled Cohort Equations model, in general middleaged and older Chinese populations. 30 A meta-analysis also found that, similar to cfPWV, baPWV is independently associated with an increased risk of cardiovascular events, cardiovascular mortality, and all-cause mortality in patients with ASCVD in East Asia. 31 A previous study suggested that geographic region is an important factor affecting the ASCVD risk 3 ; however, large-sample and long-term follow-up studies in the population of northern China are lacking.…”

“…A meta‐analysis also found that, similar to cfPWV, baPWV is independently associated with an increased risk of cardiovascular events, cardiovascular mortality, and all‐cause mortality in patients with ASCVD in East Asia 31 . A previous study suggested that geographic region is an important factor affecting the ASCVD risk 3 ; however, large‐sample and long‐term follow‐up studies in the population of northern China are lacking 29–31 …”

“…31 A previous study suggested that geographic region is an important factor affecting the ASCVD risk 3 ; however, large-sample and long-term follow-up studies in the population of northern China are lacking. [29][30][31] Our team has previously conducted long-term studies in the Pingguoyuan and Gucheng communities of Shijingshan District, Beijing, China. 15,32,33 BaPWV and cfPWV were measured in 2018 in this population.…”