Dataset Information

Estimated pulse wave velocity as a measure of vascular aging.

ABSTRACT:

Background

Carotid-femoral pulse wave velocity (cfPWV), the referent measure of aortic stiffness, is an established measure of vascular aging. In studies where cfPWV cannot be measured, alternative methods are needed to help promote research on vascular aging. This study examines the construct validity of a measure of PWV estimated from age and blood pressure (ePWV). The specific aims of the study are to: 1) explore the strength of association between ePWV, cfPWV, and other established measures of vascular aging; 2) examine the sensitivity and specificity of elevated ePWV (≥10m/s) in relation to elevated cfPWV (≥10m/s).

Methods

We measured cfPWV in two-hundred and fifty-two adults (mean age 57±12 years, 48% female) and calculated each participant's ePWV from their age and brachial blood pressure. Additional measures of vascular aging included: carotid intima-media thickness (cIMT); carotid stiffness measured as elastic modulus (cEp); and carotid augmentation index (cAIx).

Results

The correlations between cfPWV and measures of vascular aging were: cEp (r = 0.36), cIMT (r = 0.49), and cAIx (r = 0.04). The correlations between ePWV and measures of vascular aging were: cEp (r = 0.45), cIMT (r = 0.60), and cAIx (r = 0.24). The correlation between ePWV and cfPWV was (r = 0.67). The sensitivity and specificity of elevated ePWV (≥ 10 m/s) for concomitantly identifying high cfPWV (≥ 10 m/s) were 85.4% and 73.0% respectively.

Conclusion

ePWV is associated with established measures of vascular aging, such as carotid thickness, carotid stiffness and carotid augmentation index. ePWV may be a useful tool to help promote research on vascular aging.

SUBMITTER: Heffernan KS

PROVIDER: S-EPMC9879446 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Estimated pulse wave velocity as a measure of vascular aging.

Heffernan Kevin S KS Stoner Lee L London Andrew S AS Augustine Jacqueline A JA Lefferts Wesley K WK

PloS one 20230126 1

<h4>Background</h4>Carotid-femoral pulse wave velocity (cfPWV), the referent measure of aortic stiffness, is an established measure of vascular aging. In studies where cfPWV cannot be measured, alternative methods are needed to help promote research on vascular aging. This study examines the construct validity of a measure of PWV estimated from age and blood pressure (ePWV). The specific aims of the study are to: 1) explore the strength of association between ePWV, cfPWV, and other established m ...[more]

PMID: 36701358

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Project description:ImportanceAortic stiffness, as assessed by carotid-femoral pulse wave velocity, is an independent predictor of future events in individuals with hypertension. Recent data suggest a predictive role of estimated pulse wave velocity (ePWV) calculated by previously published equations using age and blood pressure in future events in individuals with hypertension.ObjectiveTo investigate whether ePWV and its response to treatment predict survival in the Systolic Blood Pressure Intervention Trial (SPRINT).Design, setting, and participantsThis exploratory, hypothesis-generating, post hoc secondary analysis conducted from October 1, 2018, to August 31, 2019, examined data from 9361 participants in SPRINT and calculated ePWV at baseline and at 12 months. Adjusted hazard ratios (HRs) with 95% CIs of ePWV per 1 SD were estimated using Cox proportional hazards regression models. A total of 8450 patients were assigned to 4 groups according to their treatment allocation and their response in ePWV after 12 months.InterventionsParticipants were assigned a systolic blood pressure target of less than 120 mm Hg (intensive treatment) or less than 140 mm Hg (standard treatment).Main outcomes and measuresThe primary composite cardiovascular outcome was myocardial infarction, other acute coronary syndromes, stroke, heart failure, or death from cardiovascular causes.ResultsIn the SPRINT population (3332 women and 6029 men; mean [SD] age, 67.9 [9.4] years), ePWV predicted the primary outcome (HR, 1.30 [95% CI, 1.17-1.43]; P < .001) and all-cause death (HR, 1.65 [95% CI, 1.46-1.86]; P < .001) independent of the Framingham Risk Score. Estimated pulse wave velocity improved the C statistic model for the primary outcome from 0.676 (95% CI, 0.65-0.70) to 0.683 (95% CI, 0.66-0.71; P = .049) and improved the C statistic model for all-cause death from 0.67 (95% CI, 0.64-0.69) to 0.69 (95% CI, 0.66-0.72; P = .03). Net reclassification index indicated improvement in risk discrimination for survival compared with the Framingham Risk Score (categorical net reclassification index = 0.111; P < .001). Regarding response to treatment, intensive treatment was superior to standard treatment only when it was accompanied with a response in ePWV at the first year, while, within the standard treatment group, individuals whose ePWV responded to antihypertensive treatment had improved all-cause mortality, with a 42% lower risk of death compared with nonresponders (HR, 0.58 [95% CI, 0.36-0.94]; P = .03); effects were independent of changes in systolic blood pressure.Conclusions and relevanceThese results suggest that, in the SPRINT trial, ePWV predicted outcomes independent of the Framingham Risk Score, indicating an incremental role of markers of aortic stiffness on cardiovascular risk. Better survival of individuals whose ePWV responded to antihypertensive treatment independently of systolic blood pressure reduction suggests a role of markers of aortic stiffness as effective treatment targets in individuals with hypertension.

Project description:ObjectivesOlder individuals usually have greater arterial stiffness, lower serum Klotho levels and a greater incidence of chronic kidney disease (CKD). The current study aimed to evaluate the interaction effect of estimated pulse wave velocity (ePWV) and serum Klotho levels on CKD in Americans.MethodsData from the National Health and Nutrition Examination Survey database from 2007 to 2016 were used. Participants with data for the assessment of ePWV and serum Klotho and for the assessment of CKD were enrolled. The associations between ePWV and serum Klotho levels were analyzed via restricted cubic spline analysis and a linear regression model. The associations between exposure factors and CKD prevalence were assessed via a logistic regression model. Subgroup analysis was performed for each confounding factor to assess the robustness of the results.ResultsThis study enrolled 13,273 participants, 3859 of whom were CKD patients. CKD patients had higher ePWV (9.66 ± 1.75 m/s vs. 8.48 ± 1.64 m/s, p < 0.001) and lower levels of serum Klotho (816.35 ± 290.47 pg/mL vs. 869.87 ± 315.87 pg/mL, p < 0.001). A significant negative linear association was found between ePWV and serum Klotho. According to the fully adjusted model, a significant interaction effect between ePWV and serum Klotho was observed on the risk of CKD (p < 0.001). Compared with individuals with a lower ePWV and higher serum Klotho, individuals with an increased ePWV and lower serum Klotho had a significantly elevated risk of CKD (OR: 1.847, 95% confidence interval: 1.467-2.325; p < 0.001). The subgroup analysis revealed that the results were robust.ConclusionsThe study demonstrated significant interaction effect of ePWV and serum Klotho on the prevalence of CKD. Individuals with increased ePWV and decreased serum Klotho levels had the highest risk of CKD. The assessment of the combination of ePWV and serum Klotho for CKD management should be considered routine in clinical practice.

Dataset Information

Estimated pulse wave velocity as a measure of vascular aging.

Background

Methods

Results

Conclusion

Publications

Estimated pulse wave velocity as a measure of vascular aging.

Similar Datasets

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