From the Centre for Epidemiological Studies and Clinical Trials, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Hypertension. 2014 Nov;64(5):1124-30. doi: 10.1161/HYPERTENSIONAHA.114.04063. Epub 2014 Aug 4.
Pulse wave velocity (PWV) is a measure of arterial stiffness and predicts cardiovascular events and mortality in the general population and various patient populations. In the present study, we investigated the predictive value of brachial-ankle PWV for mortality in an elderly Chinese population. Our study subjects were older (≥60 years) persons living in a suburban town of Shanghai. We measured brachial-ankle PWV using an automated cuff device at baseline and collected vital information till June 30, 2013, during follow-up. The 3876 participants (1713 [44.2%] men; mean [±SD] age, 68.1±7.3 years) included 2292 (59.1%) hypertensive patients. PWV was on average 17.8 (±4.0) m/s and was significantly (P<0.0001) associated with age (r=0.48) and in unadjusted analysis with all-cause (n=316), cardiovascular (n=148), stroke (n=46), and noncardiovascular mortality (n=168) during a median follow-up of 5.9 years. In further adjusted analysis, we studied the risk of mortality according to the decile distributions of PWV. Only the subjects in the top decile (23.3-39.3 m/s) had a significantly (P≤0.003) higher risk of all-cause mortality (hazard ratio relative to the whole study population, 1.56; 95% confidence interval, 1.16-2.08), especially in hypertensive patients (hazard ratio, 1.86; 95% confidence interval, 1.31-2.64; P=0.02 for the interaction between PWV and hypertension). Similar trends were observed for cardiovascular, stroke, and noncardiovascular mortality, although statistical significance was not reached (P≥0.08). In conclusion, brachial-ankle PWV predicts mortality in elderly Chinese on the conditions of markedly increased PWV and hypertension.
脉搏波速度（PWV）是动脉僵硬度的一种衡量标准，可预测普通人群和各种患者人群的心血管事件和死亡率。在本研究中，我们调查了肱踝 PWV 对老年中国人群死亡率的预测价值。我们的研究对象是居住在上海郊区城镇的老年人（年龄≥60 岁）。我们在基线时使用自动袖口设备测量肱踝 PWV，并在随访期间收集截止到 2013 年 6 月 30 日的重要信息。3876 名参与者（男性 1713 人[44.2%]；平均[±SD]年龄 68.1±7.3 岁）中包括 2292 名（59.1%）高血压患者。PWV 的平均值为 17.8（±4.0）m/s，与年龄显著相关（r=0.48），未经调整的分析显示，与全因（n=316）、心血管（n=148）、中风（n=46）和非心血管死亡率（n=168）相关，中位随访时间为 5.9 年。在进一步的调整分析中，我们根据 PWV 的十分位数分布研究了死亡率的风险。只有在最高十分位数（23.3-39.3 m/s）的受试者中，全因死亡率的风险显著增加（与整个研究人群相比，危险比为 1.56；95%置信区间，1.16-2.08），尤其是在高血压患者中（危险比，1.86；95%置信区间，1.31-2.64；P=0.02，PWV 与高血压之间的交互作用）。虽然未达到统计学意义（P≥0.08），但观察到心血管、中风和非心血管死亡率的类似趋势。总之，在 PWV 明显升高和高血压的情况下，肱踝 PWV 可预测老年中国人的死亡率。
