Thomas T van Sloten1, Miranda T Schram2, Katja van den Hurk3, Jacqueline M Dekker3, Giel Nijpels4, Ronald M A Henry2, Coen D A Stehouwer5. 1. Department of Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, the Netherlands; School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, Maastricht, the Netherlands. 2. Department of Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, the Netherlands. 3. EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, the Netherlands. 4. EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands. 5. Department of Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, the Netherlands. Electronic address: cda.stehouwer@mumc.nl.
Abstract
OBJECTIVES: This study sought to investigate the association of local and segmental arterial stiffness with incident cardiovascular events and all-cause mortality. BACKGROUND: The association of different stiffness indices, in particular of carotid, brachial, and femoral stiffness, with cardiovascular disease and mortality is currently unknown. METHODS: In a population-based cohort (n = 579, mean age 67 years, 50% women, 23% with type 2 diabetes [by design]), we assessed local stiffness of carotid, femoral, and brachial arteries (by ultrasonography), carotid-femoral pulse wave velocity (cfPWV), aortic augmentation index, and systemic arterial compliance. RESULTS: After a median follow-up of 7.6 years, 130 participants had a cardiovascular event and 96 had died. The hazard ratios (HRs) (95% confidence intervals [CIs]) per 1 SD for cardiovascular events and all-cause mortality, respectively, were HR: 1.22 (95% CI: 0.95 to 1.56) and 1.51 (95% CI: 1.11 to 2.06) for lower carotid distensibility; HR: 1.19 (95% CI: 1.00 to 1.41) and 1.28 (95% CI: 1.07 to 1.53) for higher carotid elastic modulus; HR: 1.08 (95% CI: 0.88 to 1.31) and 1.43 (95% CI: 1.10 to 1.86) for lower carotid compliance; HR: 1.39 (95% CI: 1.06 to 1.83) and 1.27 (95% CI: 0.90 to 1.79) for lower femoral distensibility; HR: 1.25 (95% CI: 0.96 to 1.63) and 1.47 (95% CI: 1.01 to 2.13) for lower femoral compliance; and HR: 1.56 (95% CI: 1.23 to 1.98) and 1.13 (95% CI: 0.83 to 1.54) for higher cfPWV. These results were adjusted for age, sex, mean arterial pressure, and cardiovascular risk factors. Mutual adjustments for each of the other stiffness indices did not materially change these results. Brachial stiffness, augmentation index, and systemic arterial compliance were not associated with cardiovascular events or mortality. CONCLUSIONS: Carotid and femoral stiffness indices are independently associated with incident cardiovascular events and all-cause mortality. The strength of these associations with events may differ per stiffness parameter.
OBJECTIVES: This study sought to investigate the association of local and segmental arterial stiffness with incident cardiovascular events and all-cause mortality. BACKGROUND: The association of different stiffness indices, in particular of carotid, brachial, and femoral stiffness, with cardiovascular disease and mortality is currently unknown. METHODS: In a population-based cohort (n = 579, mean age 67 years, 50% women, 23% with type 2 diabetes [by design]), we assessed local stiffness of carotid, femoral, and brachial arteries (by ultrasonography), carotid-femoral pulse wave velocity (cfPWV), aortic augmentation index, and systemic arterial compliance. RESULTS: After a median follow-up of 7.6 years, 130 participants had a cardiovascular event and 96 had died. The hazard ratios (HRs) (95% confidence intervals [CIs]) per 1 SD for cardiovascular events and all-cause mortality, respectively, were HR: 1.22 (95% CI: 0.95 to 1.56) and 1.51 (95% CI: 1.11 to 2.06) for lower carotid distensibility; HR: 1.19 (95% CI: 1.00 to 1.41) and 1.28 (95% CI: 1.07 to 1.53) for higher carotid elastic modulus; HR: 1.08 (95% CI: 0.88 to 1.31) and 1.43 (95% CI: 1.10 to 1.86) for lower carotid compliance; HR: 1.39 (95% CI: 1.06 to 1.83) and 1.27 (95% CI: 0.90 to 1.79) for lower femoral distensibility; HR: 1.25 (95% CI: 0.96 to 1.63) and 1.47 (95% CI: 1.01 to 2.13) for lower femoral compliance; and HR: 1.56 (95% CI: 1.23 to 1.98) and 1.13 (95% CI: 0.83 to 1.54) for higher cfPWV. These results were adjusted for age, sex, mean arterial pressure, and cardiovascular risk factors. Mutual adjustments for each of the other stiffness indices did not materially change these results. Brachial stiffness, augmentation index, and systemic arterial compliance were not associated with cardiovascular events or mortality. CONCLUSIONS: Carotid and femoral stiffness indices are independently associated with incident cardiovascular events and all-cause mortality. The strength of these associations with events may differ per stiffness parameter.
Authors: O Cseprekál; J Egresits; Á Tabák; J Nemcsik; Z Járai; L Babos; E Fodor; K Farkas; G Godina; K I Kárpáthi; L Kerkovits; A Marton; Z Nemcsik-Bencze; Z Németh; L Sallai; I Kiss; A Tislér Journal: J Hum Hypertens Date: 2015-10-01 Impact factor: 3.012
Authors: Elizabeth K Hom; Daniel A Duprez; David R Jacobs; David A Bluemke; Lyndia C Brumback; Joseph F Polak; Carmen A Peralta; Philip Greenland; Sheryl L Magzamen; João A C Lima; Alban Redheuil; David M Herrington; James H Stein; Dhananjay Vaidya; Pamela Ouyang; Joel D Kaufman Journal: Am J Epidemiol Date: 2016-12-06 Impact factor: 4.897
Authors: Huimin Yan; Sushant M Ranadive; Abbi D Lane-Cordova; Rebecca M Kappus; Michael A Behun; Marc D Cook; Jeffrey A Woods; Kenneth R Wilund; Tracy Baynard; John R Halliwill; Bo Fernhall Journal: J Appl Physiol (1985) Date: 2016-12-15