Skip to main content
Download PDF
  • Research Article
  • Open access
  • Published:

Differential Sensitivity of Brachial-Ankle Pulse Wave Velocity and Ankle-Brachial Index for Cardiovascular Risk Assessment in Elderly Chinese: A Cross-Sectional Study

Artery Research volume 27, pages 82–86 (2021)Cite this article

Abstract

Background

Brachial-Ankle Pulse Wave Velocity (baPWV) and Ankle-Brachial Index (ABI) are widely used in clinic for evaluating arterial stiffness and atherosclerosis separately. This study aimed to compare the sensitivity of baPWV and ABI for cardiovascular risk assessment in elderly Chinese.

Methods

BaPWV, ABI and Carotid Intima-Media Thickness (cIMT) were assessed in 169 elderly Chinese with the mean age of 85.7 years.

Results

Compared with normotensive participants, baPWV levels elevated in both limbs of hypertensive patients (2219 ± 90 cm/s vs. 1970 ± 66 cm/s, p = 0.090; 2141 ± 52 cm/s vs. 1932 ± 67 cm/s, p = 0.023, separately). Compared with non-diabetes Mellitus (DM) participants, ABI levels declined in both limbs of DM patients (0.96 ± 0.02 vs. 1.05 ± 0.02, p = 0.002 and 0.99 ± 0.03 vs. 1.03 ± 0.02, p = 0.071, separately). ABI of left limbs and ABI of right limbs were negatively correlated to cIMT (R = −0.136, p = 0.090; R = −0.196, p = 0.026, separately) after adjusted by age, systolic pressure, diastolic pressure, body mass index, triglycerides, total cholesterol and low-density lipoprotein. The regression model for predicting Cardiovascular Disease (CVD) included the factors of gender, age, hypertension, baPWV of left limbs and baPWV of right limbs (OR = 6.701, 95% CI 0.911–49.310, p = 0.062; OR = 1.181, 95% CI 1.051–1.327, p = 0.005; OR = 0.214, 95% CI 0.066–0.688, p = 0.010; OR = 1.002, 95% CI 1.000–1.003, p = 0.065; OR = 0.998, 95% CI 0.996–0.999, p = 0.006, separately).

Conclusion

In elderly Chinese, baPWV was elevated in hypertensive patients while ABI was lower in DM patients compared with healthy people. Compared with baPWV, ABI is better equivalent to cIMT. But for predicting the risk of CVD, baPWV is a better biomarker.

References

  1. Naghavi M, Abajobir AA, Abbafati C, Abbas KM, Abd-Allah F, Abera SF, et al. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017;390:1151–210.

    Google Scholar 

  2. Saji N, Toba K, Sakurai T. Cerebral small vessel disease and arterial stiffness: tsunami effect in the brain? Pulse 2015;3:182–9.

  3. Tuttolomondo A, Pecoraro R, Di Raimondo D, Di Sciacca R, Canino B, Arnao V, et al. Immune-inflammatory markers and arterial stiffness indexes in subjects with acute ischemic stroke with and without metabolic syndrome. Diabetol Metab Syndr 2014;6:28.

    Google Scholar 

  4. Boutouyrie P, Tropeano AI, Asmar R, Gautier I, Benetos A, Lacolley P, et al. Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients: a longitudinal study. Hypertension 2002;39:10–15.

    Google Scholar 

  5. Arnett DK, Boland LL, Evans GW, Riley W, Barnes R, Tyroler HA, et al. Hypertension and arterial stiffness: the Atherosclerosis Risk in Communities Study. ARIC Investigators. Am J Hypertens 2000;13:317–23.

    Google Scholar 

  6. Nilsson PM, Boutouyrie P, Cunha P, Kotsis V, Narkiewicz K, Parati G, et al. Early vascular ageing in translation: from laboratory investigations to clinical applications in cardiovascular prevention. J Hypertens 2013;31:1517–26.

    Google Scholar 

  7. Ohkuma T, Tomiyama H, Ninomiya T, Kario K, Hoshide S, Kita Y, et al. Proposed cutoff value of brachial-ankle pulse wave velocity for the management of hypertension. Circ J 2017;81:1540–2.

    Google Scholar 

  8. Guirguis-Blake JM, Evans CV, Redmond N, Lin JS. Screening for peripheral artery disease using the ankle-brachial index updated evidence report and systematic review for the US preventive services task force. JAMA 2018;320:184–96.

    Google Scholar 

  9. Lorenz MW, Polak JF, Kavousi M, Mathiesen EB, Völzke H, Tuomainen TP, et al. Carotid intima-media thickness progression to predict cardiovascular events in the general population (the PROG-IMT collaborative project): a meta-analysis of individual participant data. Lancet 2012;379:2053–62.

    Google Scholar 

  10. Lorenz MW, Price JF, Robertson C, Bots ML, Polak JF, Poppert H, et al. Carotid intima-media thickness progression and risk of vascular events in people with diabetes: results from the PROG-IMT collaboration. Diabetes Care 2015;38:1921–9.

    Google Scholar 

  11. O’Rourke MF, Safar ME, Dzau V. The cardiovascular continuum extended: aging effects on the aorta and microvasculature. Vasc Med 2010;15:461–8.

    Google Scholar 

  12. Munakata M, Konno S, Miura Y, Yoshinaga K, J-TOPP Study Group. Prognostic significance of the brachial-ankle pulse wave velocity in patients with essential hypertension: final results of the J-TOPP study. Hypertens Res 2012;35:839–42.

    Google Scholar 

  13. Nativel M, Potier L, Alexandre L, Baillet-Blanco L, Ducasse E, Velho G, et al. Lower extremity arterial disease in patients with diabetes: a contemporary narrative review. Cardiovasc Diabetol 2018;17:138.

    Google Scholar 

  14. Norman PE, Davis WA, Bruce DG, Davis TM. Peripheral arterial disease and risk of cardiac death in type 2 diabetes: the Fremantle Diabetes Study. Diabetes Care 2006;29:575–80.

    Google Scholar 

  15. Urbina EM, Williams RV, Alpert BS, Collins RT, Daniels SR, Hayman L, et al. Noninvasive assessment of subclinical atherosclerosis in children and adolescents: recommendations for standard assessment for clinical research: a scientific statement from the American Heart Association. Hypertension 2009;54:919–50.

    Google Scholar 

  16. Eikendal AL, Groenewegen KA, Bots ML, Peters SA, Uiterwaal CS, den Ruijter HM. Relation between adolescent cardiovascular risk factors and carotid intima-media echogenicity in healthy young adults: the atherosclerosis risk in young adults (ARYA) study. J Am Heart Assoc 2016;5:e002941.

  17. Sutton-Tyrrell K, Najjar SS, Boudreau RM, Venkitachalam L, Kupelian V, Simonsick EM, et al. Elevated aortic pulse wave velocity, a marker of arterial stiffness, predicts cardiovascular events in well-functioning older adults. Circulation 2005; 111:3384–90.

  18. Ohkuma T, Ninomiya T, Tomiyama H, Kario K, Hoshide S, Kita Y, et al. Brachial-ankle pulse wave velocity and the risk prediction of cardiovascular disease: an individual participant data meta-analysis. Hypertension 2017;69:1045–52.

    Google Scholar 

  19. Ninomiya T, Kojima I, Doi Y, Fukuhara M, Hirakawa Y, Hata J, et al. Brachial-ankle pulse wave velocity predicts the development of cardiovascular disease in a general Japanese population: the Hisayama Study. J Hypertens 2013;31:477–83.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Geriatrics Department, Shanghai Jiaotong University Affiliated Shanghai Sixth People’s Hospital, Shanghai, China

    Guoxiang Fu, Yuan Zhong & Fengfeng Pan

  2. Department of Internal Medicine, Shanghai Raffles Hospital, Shanghai, China

    Chanchan Xu

Authors
  1. Guoxiang Fu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuan Zhong
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fengfeng Pan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chanchan Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chanchan Xu.

Additional information

Peer review under responsibility of the Association for Research into Arterial Structure and Physiology

Data availability statement: The authors confirm that the data supporting the findings of this study are available within the article [and/or] its supplementary materials.

Rights and permissions

This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fu, G., Zhong, Y., Pan, F. et al. Differential Sensitivity of Brachial-Ankle Pulse Wave Velocity and Ankle-Brachial Index for Cardiovascular Risk Assessment in Elderly Chinese: A Cross-Sectional Study. Artery Res 27, 82–86 (2021). https://doi.org/10.2991/artres.k.201225.002

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2991/artres.k.201225.002

Keywords

Artery Research

ISSN: 1876-4401

Contact us