The aortic-femoral stiffness gradient and cardiovascular risk in older adults.

Stone, Keeron J ORCID: 0000-0001-6572-7874, Fryer, Simon M ORCID: 0000-0003-0376-0104, McDonnell, Barry J., Meyer, Michelle L., Faulkner, James, Agharazii, Mohsen, Fortier, Catherine, Pugh, Christopher J. A., Paterson, Craig ORCID: 0000-0003-3125-9712, Zieff, Gabriel H, Chauntry, Aiden, Kucharska-Newton, Anna, Bahls, Martin and Stoner, Lee (2024) The aortic-femoral stiffness gradient and cardiovascular risk in older adults. Hypertension. doi:10.1161/HYPERTENSIONAHA.124.23392 (In Press)

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Abstract

Background: The aortic-femoral arterial stiffness gradient (afSG), 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 afSG measures carotid-femoral stiffness gradient (cfSG, femoral-ankle PWV divided by carotid-femoral PWV) and the heart-femoral stiffness gradient (hfSG, 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 3,109 participants of the Atherosclerosis Risk in Communities Study cohort (Age: 75±5 years; cfPWV:11.5±3.0 m/s), free of CVD. Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI). 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 cfSG (quartile 4: HR 1.43,95%CI 1.03-1.97 and quartile 3: HR 1.49,95%CI 1.08-2.05) and hfSG (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 to 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 afSG may enhance CVD risk assessment in older adults in whom the predictive capacity of traditional risk factors and PWV are attenuated.

Item Type:	Article
Article Type:	Article
Uncontrolled Keywords:	Arterial stiffness; Pulse wave velocity; Pulse wave velocity ratio; Cardiovascular disease; Mortality; Risk factors; Epidemiology
Subjects:	R Medicine > RA Public aspects of medicine > RA645.A-Z Individual diseases or groups of diseases, A-Z R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine > RA645.A-Z Individual diseases or groups of diseases, A-Z > RA645.C68 Coronary heart disease
Divisions:	Schools and Research Institutes > School of Education and Science
Depositing User:	Charlotte Crutchlow
Date Deposited:	02 Oct 2024 10:22
Last Modified:	22 Oct 2024 11:45
URI:	https://eprints.glos.ac.uk/id/eprint/14398

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