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Association between baseline brachial–ankle pulse wave velocity and short-term risk of first stroke among Chinese hypertensive adults

Abstract

Little information is available on the association between brachial–ankle pulse wave velocity (baPWV) and the risk of stroke in Chinese H-type hypertension patients. Therefore, our study aimed to assess this association between baseline baPWV and short-term risk of first stroke and to propose a cutoff value of baPWV that could predict near cerebrovascular events. A total of 9787 hypertension patients without preexisting stroke who underwent baPWV measurement were included. The primary end points were first symptomatic stroke. Secondary end points were first ischemic stroke and first hemorrhagic stroke. During a median follow-up of 20.8 months, there was a total of 138 first strokes including 123 first ischemic strokes and 15 first hemorrhagic strokes. When baPWV was categorized in quartiles, the higher risks of first stroke (HR = 1.52; 95% CI: 1.05–2.21) and first ischemic stroke (HR = 1.53; 95% CI: 1.03–2.26) were found in participants in quartile 4 (≥21.31 m/s), compared with those in quartile 1–3 (<21.31 m/s). In receiver operating characteristic curve analysis, the best cutoff value of baPWV that could predict first stroke was 21.43 m/s. Higher baPWV (≥21.43 m/s) was significantly associated with increased risk of first stroke (HR = 1.60; 95% CI: 1.10–2.32) and first ischemic stroke (HR = 1.60; 95% CI: 1.08–2.37). In conclusion, higher baPWV levels were associated with an increased risk of first stroke among Chinese H-type hypertensive patients. In addition, a cutoff value of 21.43 m/s of baPWV was proposed that could predict the next two years’ cerebrovascular events.

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Fig. 1: Flow chart of study populations.
Fig. 2: Kaplan–Meier survival curves for unadjusted first stroke and first ischemic stroke according to quartiles of baseline baPWV.
Fig. 3: The association between baseline baPWV and incident risk of first stroke and first ischemic stroke.

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We acknowledge the contribution of all staff who participated in this study as well as the study participants who shared their time with us.

Funding

The study was supported by funding from the following: Peking University Medicine Fund of Fostering Young Scholars’ Scientific & Technological Innovation [grant 34254]; the National Key Research and Development Program of China [2016YFE0205400, 2018ZX09739010, 2018ZX09301034003]; the Science and Technology Program of Guangdong, China [2020B121202010]; the Science and Technology Planning Project of Guangzhou, China [201707020010]; the Science, Technology, and Innovation Committee of Shenzhen, China [GJHS20170314114526143, JSGG20180703155802047]; the Economic, Trade, and Information Commission of Shenzhen Municipality, China [20170505161556110, 20170505160926390, 201705051617070]; Peking University Medicine Fund of Fostering Young Scholars’ Scientific & Technological Innovation (grant 34254) Peking University Medicine Fund of Fostering Young Scholars’ Scientific & Technological Innovation (grant 34254).

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Contributions

Conceptualization and methodology: XPX, YH, JPL. Software: LHH, LSL. Validation: YS, YZ. Formal analysis: LHH, YZ. Investigation: LHH, CLB, LSL, BYW, CQF, HM, XH, YZ. Data curation: LSL, YS, YZ. Writing (original draft preparation): LHH. Writing (review and editing): CLB, LSL, YS, BYW, CQF, HM, XH, YZ, XPX, XBW, YH, JPL. Supervision: XPX, YH, JPL. Project administration: CLB, LSL, YS, BYW, HM, JPL. Funding acquisition: XPX, XH, LHH. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jianping Li.

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The study was approved by the Ethics Committee of the Institute of Biomedicine, Anhui Medical University, Hefei, China.

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Hu, L., Bi, C., Liu, L. et al. Association between baseline brachial–ankle pulse wave velocity and short-term risk of first stroke among Chinese hypertensive adults. J Hum Hypertens (2021). https://doi.org/10.1038/s41371-021-00611-7

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