3rd Department of Internal Medicine, Aristotle University, Hypertension-24h ambulatory blood pressure monitoring center, Papageorgiou Hospital, Thessaloniki, Greece.
Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, Medical School, Aristotle University of Thessaloniki, and 2nd Department of Internal Medicine, 424 General Military Hospital, Thessaloniki, Greece.
Curr Vasc Pharmacol. 2024;22(6):417-425. doi: 10.2174/0115701611299635240708045352.
Pulse Wave Velocity (PWV) remains the gold-standard method to assess Early Vascular Aging (EVA) defined by arterial stiffness. However, its high cost, time-consuming process, and need for qualified medical staff shows the importance of identifying alternative methods for the EVA evaluation.
In order to simplify the process of assessing patient's EVA, we recently developed the Early Vascular Aging Ambulatory score (EVAAs), a simple tool to predict the risk of EVA. The aim of the present study was the external validation of EVAAs in an independent population.
Eight hundred seventy-nine (46.3% men) patients who were referred to our Hypertension ESH Excellence Center were included in this study. The mean age was 46.43 ± 22.87 years. EVA was evaluated in two different ways. The first assessment included c-f PWV values, whereas the second one included EVAAs without the direct measurement of carotid-femoral PWV.
The null hypothesis was that the prediction of EVA based on EVAAs does not present any statistically significant difference compared to the prediction based on the calculation from c-f PWV. Mean squared error (MSE) was used for the assessment of the null hypothesis, which was found to be 0.40. The results revealed that the EVAAs shows the probability of EVA with 0.98 sensitivity and 0.75 specificity. The EVAAs present 95% positive predictive value and 92% negative predictive value.
Our study revealed that EVAAs could be as reliable as the carotid-femoral PWV to identify patients with EVA. Hence, we hope that EVAAs will be a useful tool in clinical practice.
脉搏波速度（PWV）仍然是评估动脉僵硬定义的早期血管老化（EVA）的金标准方法。然而，其成本高、耗时且需要合格的医务人员，这表明需要寻找替代方法来评估 EVA。
为了简化评估患者 EVA 的过程，我们最近开发了一种简单的工具，即早期血管老化门诊评分（EVAAs），用于预测 EVA 的风险。本研究的目的是在独立人群中对 EVAAs 进行外部验证。
本研究纳入了 879 名（46.3%为男性）被转诊至我们高血压 ESH 卓越中心的患者。平均年龄为 46.43 ± 22.87 岁。EVA 通过两种不同的方法进行评估。第一种评估方法包括 c-f PWV 值，而第二种评估方法则包括 EVAAs，无需直接测量颈股 PWV。
零假设是基于 EVAAs 的 EVA 预测与基于 c-f PWV 的计算的预测没有统计学上的显著差异。均方误差（MSE）用于评估零假设，发现 MSE 为 0.40。结果表明，EVAAs 可准确预测 EVA，其敏感性为 0.98，特异性为 0.75。EVAAs 的阳性预测值为 95%，阴性预测值为 92%。
本研究表明，EVAAs 与颈股 PWV 一样可用于识别 EVA 患者。因此，我们希望 EVAAs 将成为临床实践中的有用工具。
