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Changes in baPWV and the risk of clinical outcomes: a cohort study of Chinese community-based population

Journal of Human Hypertension (2024)Cite this article

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Abstract

It has not been fully investigated whether improved arterial stiffness (AS) can reduce the clinical outcomes risk in community population-based study. In this prospective study, a total of 5247 individuals with abnormal AS (at baseline) and repeated brachial-ankle pulse wave velocity (baPWV) measurement before 2018 years were enrolled from the Kailuan Study. According the second baPWV measurement, we divided the participants into two groups, improved AS (defined as transfer elevated AS status to normal) and persistent AS (defined as maintaining elevated AS status). The outcome was a composite event of stroke, myocardial infraction, and all-cause mortality. We used Cox proportional hazards regression to examine the association between AS status at the follow-up and the subsequent outcome. During a median of 5.2 years follow-up, we observed 413 end point events. After adjusted for potential confounders, comparing with the persistent AS group, individuals in the improved AS group had a 43% (hazard ratio [HR], 0.57; 95% confidence interval [CI] 0.35–0.94) decreased the risk of the primary composite events. We also found a baPWV decrease of 1 m/s was associated with a 3% decreased risk (HR, 0.97; 95% CI 0.94–0.99) for primary composite events. We further demonstrated that younger than 60 years, non-smoker, non-hypertension, and non-diabetes were associated with improved the AS status. In conclusion, improving AS status may reduce the risk of clinical events. In the future, more research should be performed to explore the target for improving the AS status.

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Fig. 1: Cumulative incidence of clinical events in participants with improved AS or persistent AS.
Fig. 2
Fig. 3: Factors associated with improved arterial stiffness.

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Data are available to researchers on request for purposes of reproducing the results or replicating the procedure by directly contacting the corresponding author.

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Acknowledgements

We thank all the survey teams of the Kailuan Study group for their contribution and the study participants who contributed their information.

Funding

This study was supported by National Key Research and Development Program of China (2022YFC3600600), Beijing Natural Science Foundation Haidian original innovation joint fund (L222123), Fund for Young Talents of Beijing Medical Management Center (QML20230505), and the high-level public health talents (xuekegugan-02-47). Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China

    Yingting Zuo

  2. Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China

    Shuohua Chen & Shouling Wu

  3. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Xue Tian & Anxin Wang

  4. China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Xue Tian & Anxin Wang

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Contributions

YZ wrote the manuscript, and are equal contributors in this study, thus share first authorships. XT participated in the data analysis. SC participated in the data collection, study management and study coordination. AW and SW contributed to the discussion, reviewed, and edited the manuscript. All authors read and approved the final manuscript.

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Correspondence to Shouling Wu or Anxin Wang.

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Zuo, Y., Chen, S., Tian, X. et al. Changes in baPWV and the risk of clinical outcomes: a cohort study of Chinese community-based population. J Hum Hypertens (2024). https://doi.org/10.1038/s41371-024-00902-9

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