Trajectories of arterial stiffness and all-cause mortality among community-dwelling older Japanese.

AIM

Aortic pulse wave velocity (PWV) is a strong predictor of all-cause mortality in later life. The present prospective study used repeated measures analysis to examine sex-specific age trends in brachial-ankle PWV (baPWV), identify baPWV trajectories and determine whether potential baPWV trajectories were associated with all-cause mortality among community-dwelling older Japanese.

METHODS

A total of 1744 adults (mean age 71.0 years [SD 5.8 years]; 57.0% women) aged 65-90 years participated in annual geriatric health assessments during the period from April 2003 through July 2015. The average number of follow-up assessments was 4.3, and the total number of observations was 7419. We checked local registries to identify deaths from any cause; 289 (16.6%) participants died during the period through December 2015.

RESULTS

baPWV similarly and significantly increased with advancing age in men and women. We identified four distinct trajectory patterns (very high, high, moderate, and low) in adults aged 65-90 years, and these trajectories showed parallel increases. After adjusting for important confounders, participants in the moderate, high and very high baPWV trajectory groups had hazard ratios of 1.12 (95% CI 0.84-1.44), 1.04 (95% CI 0.74-1.45) and 1.98 (95% CI 1.20-3.29), respectively, for all-cause mortality, as compared with those in the low trajectory group.

CONCLUSIONS

baPWV increased with age in men and women, and there was no significance between sexes in later life. This prospective study identified four major baPWV trajectory patterns in community-dwelling older adults. Individuals in the very high baPWV trajectory group, especially younger seniors, had a higher mortality risk. Geriatr Gerontol Int 2018; 18: 1108-1113.