Zhang Anhang, Liu Yupeng, Ma Shouyuan, Bao Qiligeer, Sun Jin, Su Yongkang, Cai Shuang, Cheng Bokai, Li Man, Zhang Yan, Tao Tianqi, Qiu Jiaojiao, Dong Jing, Song Ge, Zhu Ping, Wang Shuxia
Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China.
Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.
Front Cardiovasc Med. 2022 Sep 13;9:883651. doi: 10.3389/fcvm.2022.883651. eCollection 2022.
Ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) are both important indicators of arterial stiffness and vascular injury. At present, most studies on the relationship between ABI and baPWV and all-cause mortality in community-based elderly are analyzing ABI or baPWV alone, and will focus on a single special population such as diabetes and stroke. The purpose of this study was to evaluate the relationship between ABI and baPWV in a Chinese community-based elderly population, and to analyze their impact on all-cause mortality in a community-based population through a follow-up of nearly 10 years.
Participants were residents of the Wanshou Road community in Beijing, China. A total of 2,162 people in the community were included, with an average age of 71.48 years. During a mean follow-up period of 9.87 years, 1,826 subjects completed follow-up. Kaplan-Meier survival analysis and different Cox regression models were used to verify the association of ABI and baPWV with all-cause mortality. The selected subjects were divided into two groups according to ABI and baPWV, and ABI was divided into two groups with 0.90 as the cut-off point (group 1: 0.9 < ABI ≤ 1.3; group 2: ABI ≤ 0.9); according to the level of baPWV, they were divided into three groups (Tertile 1: baPWV <1761.5 cm/s; Tertile 2: 1761.5 ≤ baPWV <2121.5 cm/s; Tertile 3: baPWV ≥2121.5 cm/s).
1,826 people were included in the statistical analysis, and the total mortality rate was 181.3/1000. The 10-year all-cause mortality rate of the abnormal ABI group (group 2) was 44.7%, and that of the normal ABI group (group 1) was 17.0%; The 10-year all-cause mortality rates from low to high in the baPWV tertile were 10.0%, 18.7%, and 26.4%. In the Cox proportional hazards model, after adjusting for possible confounders, the effect of baPWV on all-cause mortality was significant, with the 3rd tertile having a 1.647-fold higher risk of all-cause mortality than the 1st tertile ( = 0.014 ).
ABI and baPWV are risk factors affecting all-cause mortality in the elderly community population, and baPWV is an independent predictor of all-cause mortality in the elderly community population.
踝臂指数（ABI）和臂踝脉搏波速度（baPWV）都是动脉僵硬度和血管损伤的重要指标。目前，大多数关于社区老年人中ABI和baPWV与全因死亡率关系的研究都是单独分析ABI或baPWV，且多聚焦于糖尿病和中风等单一特殊人群。本研究旨在评估中国社区老年人群中ABI与baPWV的关系，并通过近10年的随访分析它们对社区人群全因死亡率的影响。
研究对象为中国北京万寿路社区的居民。该社区共纳入2162人，平均年龄71.48岁。在平均9.87年的随访期内，1826名受试者完成了随访。采用Kaplan-Meier生存分析和不同的Cox回归模型来验证ABI和baPWV与全因死亡率的关联。根据ABI和baPWV将入选受试者分为两组，ABI以0.90为界分为两组（组1：0.9＜ABI≤1.3；组2：ABI≤0.9）；根据baPWV水平分为三组（三分位数1：baPWV＜1761.5 cm/s；三分位数2：1761.5≤baPWV＜2121.5 cm/s；三分位数3：baPWV≥2121.5 cm/s）。
1826人纳入统计分析，总死亡率为181.3/1000。ABI异常组（组2）的10年全因死亡率为44.7%，ABI正常组（组1）为17.0%；baPWV三分位数中从低到高的10年全因死亡率分别为10.0%、18.7%和26.4%。在Cox比例风险模型中，调整可能的混杂因素后，baPWV对全因死亡率的影响显著，三分位数3的全因死亡风险比三分位数1高1.647倍（P = 0.014）。
ABI和baPWV是影响社区老年人群全因死亡率的危险因素，且baPWV是社区老年人群全因死亡率的独立预测因子。
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