Brachial-ankle pulse wave velocity as a predictor of mortality in elderly Chinese

Hypertension. 2014 Nov;64(5):1124-30. doi: 10.1161/HYPERTENSIONAHA.114.04063. Epub 2014 Aug 4.

Abstract

Pulse wave velocity (PWV) is a measure of arterial stiffness and predicts cardiovascular events and mortality in the general population and various patient populations. In the present study, we investigated the predictive value of brachial-ankle PWV for mortality in an elderly Chinese population. Our study subjects were older (≥60 years) persons living in a suburban town of Shanghai. We measured brachial-ankle PWV using an automated cuff device at baseline and collected vital information till June 30, 2013, during follow-up. The 3876 participants (1713 [44.2%] men; mean [±SD] age, 68.1±7.3 years) included 2292 (59.1%) hypertensive patients. PWV was on average 17.8 (±4.0) m/s and was significantly (P<0.0001) associated with age (r=0.48) and in unadjusted analysis with all-cause (n=316), cardiovascular (n=148), stroke (n=46), and noncardiovascular mortality (n=168) during a median follow-up of 5.9 years. In further adjusted analysis, we studied the risk of mortality according to the decile distributions of PWV. Only the subjects in the top decile (23.3-39.3 m/s) had a significantly (P≤0.003) higher risk of all-cause mortality (hazard ratio relative to the whole study population, 1.56; 95% confidence interval, 1.16-2.08), especially in hypertensive patients (hazard ratio, 1.86; 95% confidence interval, 1.31-2.64; P=0.02 for the interaction between PWV and hypertension). Similar trends were observed for cardiovascular, stroke, and noncardiovascular mortality, although statistical significance was not reached (P≥0.08). In conclusion, brachial-ankle PWV predicts mortality in elderly Chinese on the conditions of markedly increased PWV and hypertension.

Keywords: Asian continental ancestry group; aged; mortality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Ankle Brachial Index
  • Asian People*
  • Brachial Artery / physiopathology*
  • Cardiovascular Diseases / mortality*
  • Cardiovascular Diseases / physiopathology
  • China
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension / mortality
  • Hypertension / physiopathology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Pulse Wave Analysis*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Stroke / mortality
  • Stroke / physiopathology
  • Tibial Arteries / physiopathology*
  • Vascular Stiffness / physiology*