Effect of brachial-ankle pulse wave velocity combined with blood pressure on cardio-cerebrovascular events

Yuntao Wu; Yajing Zhang; Jingsheng Gao; Shuli Man; Jianong Xing; Zhiwei Cao; Shaomin Song; Shouling Wu; Wenyuan Gao

doi:10.3892/etm.2019.8149

Effect of brachial-ankle pulse wave velocity combined with blood pressure on cardio-cerebrovascular events

Exp Ther Med. 2019 Dec;18(6):4555-4566. doi: 10.3892/etm.2019.8149. Epub 2019 Oct 30.

Authors

Yuntao Wu^{1

2}, Yajing Zhang^{2

3}, Jingsheng Gao², Shuli Man¹, Jianong Xing⁴, Zhiwei Cao⁵, Shaomin Song⁶, Shouling Wu², Wenyuan Gao¹

Affiliations

¹ School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, P.R. China.
² Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China.
³ Graduate School, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China.
⁴ Department of Cardiology, The Third People's Hospital, Tangshan, Hebei 063000, P.R. China.
⁵ Department of Cardiology, The People's Hospital of Luanxian, Tangshan, Hebei 063000, P.R. China.
⁶ Department of Cardiology, Linxi Hospital of Kailuan, Tangshan, Hebei 063000, P.R. China.

Abstract

The aim of the present study was to evaluate the effect of brachial-ankle pulse wave velocity (baPWV) combined with blood pressure (BP) on cardio-cerebrovascular events. Participants who received health examinations during the periods 2010-2011, 2012-2013 and 2014-2015 were recruited. The participants were divided into four groups according to their BP and baPWV levels as follows: Normotension + low baPWV, normotension + high baPWV, hypertension + low baPWV, and hypertension + high baPWV. The cumulative incidence of cardio-cerebrovascular events was calculated using life-table analysis, and the associations of BP and baPWV with cardio-cerebrovascular events were analyzed using a multivariate Cox proportional hazards regression model. Receiver operating characteristic curves were used to calculate the predictive values of baPWV combined with BP, baPWV alone or BP alone for cardio-cerebrovascular events by comparing their area under the curve (AUC) using the normal approximation method. There were 20,310 participants with a mean age of 50.13±0.09 years in the present study, including 13,240 males. A total of 278 participants developed a cardio-cerebrovascular event after a mean follow-up period of 3.34±1.82 years. The cumulative incidence of cardio-cerebrovascular events in the normotension + low baPWV, normotension + high baPWV, hypertension + low baPWV and hypertension + high baPWV groups was 0.2, 0.9, 0.8 and 3.1%. Multivariate Cox proportional hazards regression analysis showed that compared with the normotension + low baPWV group, the risks of cardio-cerebrovascular events in the normotension + high baPWV, hypertension + low baPWV and hypertension + high baPWV groups were increased after adjusting for confounding factors, and their hazard ratios (95% CI) were 4.18 (2.23-7.83), 3.00 (1.39-6.47) and 9.34 (5.14-16.96), respectively. The AUC values for the predictive values of baPWV combined with BP, baPWV alone and BP alone on cardio-cerebrovascular events were calculated to be 0.744, 0.677 and 0.698, respectively. In conclusion, high baPWV accompanied by hypertension could increase the risk of cardio-cerebrovascular events. The predictive value of baPWV combined with BP on cardio-cerebrovascular events is superior compared with that of either baPWV or BP alone.

Keywords: Kailuan study; blood pressure; brachial-ankle pulse wave velocity; cardio-cerebrovascular events; predictive value.