Aortic-Femoral Stiffness Gradient and Cardiovascular Risk in Older Adults.

Autor:	Stone K; Centre for Cardiovascular Research, Innovation and Development, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Wales, United Kingdom (K.S., B.J.M., C.J.A.P.).; National Cardiovascular Research Network, Wales, United Kingdom (K.S., B.J.M. , C.J.A.P.)., Fryer S; School of Education and Science, University of Gloucestershire, Gloucester, United Kingdom (S.F.)., McDonnell BJ; Centre for Cardiovascular Research, Innovation and Development, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Wales, United Kingdom (K.S., B.J.M., C.J.A.P.).; National Cardiovascular Research Network, Wales, United Kingdom (K.S., B.J.M. , C.J.A.P.)., Meyer ML; Department of Emergency Medicine, School of Medicine (M.L.M.), University of North Carolina at Chapel Hill., Faulkner J; Department of Sport, Exercise and Health, University of Winchester, United Kingdom (J.F.)., Agharazii M; Endocrinology and Nephrology Axis, Centre hospitalier universitaire de Québec Research Center, Faculty and Department of Medicine, Université Laval, Quebec City, Canada (M.A., C.F.)., Fortier C; Endocrinology and Nephrology Axis, Centre hospitalier universitaire de Québec Research Center, Faculty and Department of Medicine, Université Laval, Quebec City, Canada (M.A., C.F.)., Pugh CJA; Centre for Cardiovascular Research, Innovation and Development, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Wales, United Kingdom (K.S., B.J.M., C.J.A.P.).; National Cardiovascular Research Network, Wales, United Kingdom (K.S., B.J.M. , C.J.A.P.)., Paterson C; Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom (C.P.)., Zieff G; School of Kinesiology, University of British Columbia, Canada (G.Z.)., Chauntry AJ; Department of Exercise and Sport Science (A.J.C., L.S.), University of North Carolina at Chapel Hill., Kucharska-Newton A; Department of Epidemiology, The Gillings School of Global Public Health (A.K.-N., L.S.), University of North Carolina at Chapel Hill., Bahls M; Center for Health Promotion and Disease Prevention (M.B.), University of North Carolina at Chapel Hill.; Department of Internal Medicine B, University Medicine Greifswald, Germany (M.B.).; German Centre for Cardiovascular Research, partner site Greifswald, Germany (M.B.)., Stoner L; Department of Exercise and Sport Science (A.J.C., L.S.), University of North Carolina at Chapel Hill.; Department of Epidemiology, The Gillings School of Global Public Health (A.K.-N., L.S.), University of North Carolina at Chapel Hill.
Jazyk:	angličtina
Zdroj:	Hypertension (Dallas, Tex. : 1979) [Hypertension] 2024 Dec; Vol. 81 (12), pp. e185-e196. Date of Electronic Publication: 2024 Oct 07.
DOI:	10.1161/HYPERTENSIONAHA.124.23392
Abstrakt:	Background: The aortic-femoral arterial stiffness gradient, calculated as the ratio of lower-limb pulse-wave velocity (PWV) to central (aortic) PWV, is a promising tool for assessing cardiovascular disease (CVD) risk, but whether it predicts incident CVD is unknown. Methods: We examined the association of the aortic-femoral arterial stiffness gradient measures carotid-femoral stiffness gradient (femoral-ankle PWV divided by carotid-femoral PWV) and the heart-femoral stiffness gradient (femoral-ankle PWV divided by heart-femoral PWV), as well as PWV, with incident CVD (coronary disease, stroke, and heart failure) and all-cause mortality among 3109 participants of the Atherosclerosis Risk in Communities Study cohort (age, 75±5 years; carotid-femoral PWV, 11.5±3.0 m/s), free of CVD. Cox regression was used to estimate hazard ratios (HR) and 95% CIs. Results: Over a median 7.4-year follow-up, there were 322 cases of incident CVD and 410 deaths. In fully adjusted models, only top quartiles of carotid-femoral stiffness gradient (quartile 4: HR, 1.43 [95% CI, 1.03-1.97]; and quartile 3: HR, 1.49 [95% CI, 1.08-2.05]) and heart-femoral stiffness gradient (quartile 4: HR, 1.77 [95% CI, 1.27-2.48]; and quartile 3: HR, 1.41 [95% CI, 1.00-2.00]) were significantly associated with a greater risk of incident CVD. Only high aortic stiffness in combination with low lower-limb stiffness was significantly associated with incident CVD (HR, 1.46 [95% CI, 1.06-2.02]) compared with the referent low aortic stiffness and high lower-limb stiffness. No PWVs were significantly associated with incident CVD. No exposures were associated with all-cause mortality. Conclusions: The aortic-femoral arterial stiffness gradient may enhance CVD risk assessment in older adults in whom the predictive capacity of traditional risk factors and PWV are attenuated. Competing Interests: None.
Databáze:	MEDLINE
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