Dataset Information

Association of Estimated Pulse Wave Velocity With Survival: A Secondary Analysis of SPRINT.

ABSTRACT:

Importance

Aortic 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.

Objective

To investigate whether ePWV and its response to treatment predict survival in the Systolic Blood Pressure Intervention Trial (SPRINT).

Design, setting, and participants

This 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.

Interventions

Participants 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 measures

The primary composite cardiovascular outcome was myocardial infarction, other acute coronary syndromes, stroke, heart failure, or death from cardiovascular causes.

Results

In 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?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.

SUBMITTER: Vlachopoulos C

PROVIDER: S-EPMC6802234 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Association of Estimated Pulse Wave Velocity With Survival: A Secondary Analysis of SPRINT.

Vlachopoulos Charalambos C Terentes-Printzios Dimitrios D Laurent Stephane S Nilsson Peter M PM Protogerou Athanase D AD Aznaouridis Konstatinos K Xaplanteris Panagiotis P Koutagiar Iosif I Tomiyama Hirofumi H Yamashina Akira A Sfikakis Petros P PP Tousoulis Dimitrios D

JAMA network open 20191002 10

<h4>Importance</h4>Aortic 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.<h4>Objective</h4>To investigate whether ePWV and its response to treatment predict survival in the Systolic Blood Pressure Interv ...[more]

PMID: 31596491

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Project description:Background:Obesity is an important risk factor of cardiovascular disease (CVD). Atherosclerosis can be considered an important signal of CVD. Primary physicians can reduce the risk of CVD by preventing and treating obesity. Therefore, finding a tool to diagnose the association of obesity with arteriosclerosis is important. The association between obesity parameters and arterial stiffness remains controversial. To our knowledge, no previous studies reported the relationships between multiple new anthropometric parameters (a body shape index [ABSI], body round index [BRI], and visceral adiposity index [VAI]) and brachial-ankle wave velocity (ba-PWV) as an indicator of CVD risk, especially in the Korean population. Objective:To investigate the relationships between arterial stiffness (assessed using ba-PWV) and anthropometric parameters estimated on the basis of body mass index (BMI), waist circumference (WC), ABSI, BRI, and VAI, and to identify the indicators of obesity that best represents CVD risk. Methods:A total of 2,647 adults (1,474 men and 1,173 women) were recruited for this cross-sectional study. The correlations between the anthropometric indexes (BMI, WC, ABSI, BRI, and VAI) and mean ba-PWV were analyzed. A multivariate linear regression analysis was performed to evaluate the association between each anthropometric and the presence of arterial stiffness. Results:We investigated the relationships between the obesity parameters and ba-PWV by adjusting the covariates (age, diabetes mellitus [DM], hypertension [HTN], and smoking status) related to the mean ba-PWV. In the multivariate regression analysis, ABSI (men: ? =0.066, p<0.01; women: ? =0.087, p<0.001) and VAI (men: ? =0.067, p<0.01; women: ? =0.136, p<0.001) were found to be significantly correlated with the mean ba-PWV in both men and women in Korea. Conclusion:Among the new obesity indices, ABSI and VAI were found to be significantly associated with arterial stiffness, represented by the mean ba-PWV, in both men and women in Korea. These results suggest that ABSI and VAI may be convenient, highly cost-effective, and simple assessment tools for obesity and CVD risk in clinical practice.

Dataset Information

Association of Estimated Pulse Wave Velocity With Survival: A Secondary Analysis of SPRINT.

Importance

Objective

Design, setting, and participants

Interventions

Main outcomes and measures

Results

Publications

Association of Estimated Pulse Wave Velocity With Survival: A Secondary Analysis of SPRINT.

Similar Datasets

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