Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
BMC Geriatr. 2023 Oct 9;23(1):635. doi: 10.1186/s12877-023-04332-z.
To explore the relationship between ankle-brachial blood pressure index (ABPI) and all-cause or cardiovascular mortality in adults without arterial stiffness.
A total of 6784 participants without arterial stiffness were enrolled from National Health and Nutrition Examination Survey 1999-2004. The hazard ratio (HR) and 95% confidence interval (CI) of ABPI associating with the risk of all-cause and cardiovascular mortality was calculated by Cox proportional regression models adjusted for demographic and traditional risk factors. Dose-response relationship was explored with restricted cubic spines.
After an average follow-up of 12.1 years, 1844 all-cause deaths and 299 cardiovascular deaths occurred. Compared with the lowest ABPI quartile, the second quartile was associated with the lowest risk of all-cause mortality (HR 0.89, 95%CI 0.79-0.98; p = 0.036) and cardiovascular mortality (HR 0.75, 95%CI 0.56-0.98; p = 0.048). Besides, dose-response analysis revealed that ABPI was nonlinearly correlated to all-cause mortality (p for nonlinearity < 0.001) and linearly correlated to cardiovascular mortality (p for nonlinearity = 0.459).
The relationship between ABPI and all-cause and cardiovascular mortality followed a L-shape curve. A lower ABPI was independently associated with an increased risk of all-cause and cardiovascular mortality in adults without arterial stiffness.
探讨无动脉僵硬度的成年人踝臂血压指数（ABPI）与全因或心血管死亡率之间的关系。
本研究共纳入了 1999-2004 年国家健康与营养调查（NHANES）中无动脉僵硬度的 6784 名参与者。通过 Cox 比例风险回归模型，在调整了人口统计学和传统危险因素后，计算了 ABPI 与全因和心血管死亡率风险的比值比（HR）和 95%置信区间（CI）。采用限制性立方样条探索剂量反应关系。
在平均 12.1 年的随访后，发生了 1844 例全因死亡和 299 例心血管死亡。与 ABPI 最低四分位相比，第二四分位与全因死亡率（HR 0.89，95%CI 0.79-0.98；p=0.036）和心血管死亡率（HR 0.75，95%CI 0.56-0.98；p=0.048）的风险最低相关。此外，剂量反应分析显示 ABPI 与全因死亡率呈非线性相关（p<0.001），与心血管死亡率呈线性相关（p<0.001）。
ABPI 与全因和心血管死亡率之间的关系呈 L 型曲线。在无动脉僵硬度的成年人中，较低的 ABPI 与全因和心血管死亡率的风险增加独立相关。
