Cao Qiuyu, Li Mian, Wang Tiange, Chen Yuhong, Dai Meng, Zhang Di, Xu Yu, Xu Min, Lu Jieli, Wang Weiqing, Ning Guang, Bi Yufang, Zhao Zhiyun
Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Cardiovasc Med. 2022 Aug 11;9:895792. doi: 10.3389/fcvm.2022.895792. eCollection 2022.
Early Vascular Aging and Supernormal Vascular Aging are two extreme phenotypes of vascular aging, and people in the two categories demonstrate distinct clinical characteristics and cardiovascular prognosis. However, the clinical implication of vascular aging categories in the Asian or Chinese population has not been investigated. We aimed to investigate the association between vascular aging categories and cardiovascular events in a Chinese cohort.
We explored the association of vascular aging categories with incident cardiovascular disease in a community cohort in Shanghai, China, which included 10,375 participants following up for 4.5 years. Vascular age was predicted by a multivariable linear regression model including classical risk factors and brachial-ankle pulse wave velocity. Early and Supernormal vascular aging groups were defined by 10% and 90% percentiles of Δ-age, which was calculated as chronological minus vascular age.
We found that cardiovascular risk significantly increased in Early [hazard ratio (HR), 1.597 (95% CI, 1.043-2.445)] and decreased in Supernormal [HR, 0.729 (95% CI, 0.539-0.986)] vascular aging individuals, comparing with normal vascular aging subjects. The associations were independent of the Framingham risk score. Early vascular aging individuals also showed an elevated risk of total mortality [HR, 2.614 (95% CI, 1.302-5.249)]. Further, the associations of vascular aging categories with cardiovascular risk were much stronger in females than in males. Vascular aging categories with different cutoff levels expressed as percentiles (10th, 20th, and 25th) of Δ-age showed similar associations with cardiovascular risk.
In conclusion, the vascular aging categories could identify people with different levels of cardiovascular risk in the Chinese population, particularly in women.
早期血管衰老和超常血管衰老为血管衰老的两种极端表型，两类人群具有不同的临床特征及心血管预后。然而，亚洲或中国人群中血管衰老类型的临床意义尚未得到研究。我们旨在研究中国队列中血管衰老类型与心血管事件之间的关联。
我们在中国上海的一个社区队列中探究了血管衰老类型与心血管疾病发病的关联，该队列包含10375名参与者，随访4.5年。通过包含经典危险因素和臂踝脉搏波速度的多变量线性回归模型预测血管年龄。早期和超常血管衰老组由Δ年龄的第10百分位数和第90百分位数定义，Δ年龄计算为实际年龄减去血管年龄。
我们发现，与正常血管衰老个体相比，早期血管衰老个体的心血管风险显著增加[风险比(HR)，1.597(95%置信区间，1.043 - 2.445)]，超常血管衰老个体的心血管风险降低[HR，0.729(95%置信区间，0.539 - 0.986)]。这些关联独立于弗雷明汉风险评分。早期血管衰老个体的全因死亡风险也升高[HR，2.614(95%置信区间，1.302 - 5.249)]。此外，血管衰老类型与心血管风险的关联在女性中比在男性中更强。以Δ年龄的百分位数(第10、20和25)表示的不同截断水平的血管衰老类型与心血管风险显示出相似的关联。
总之，血管衰老类型可识别中国人群中具有不同心血管风险水平的个体，尤其是女性。
