Key result
Higher calculated 10-year CV risk is independently associated with increased arterial stiffness in premenopausal women.
Why the study?
Aortic pulse wave velocity may serve as a more efficient, integrated cardiovascular index and treatment target than predictive risk factor scoring systems alone in younger women, motivating an examination of the relationship between cardiovascular risk scores and aPWV.
Does the evaluation of different forms of target organ damage (TOD) including pulse wave velocity improve cardiovascular risk stratification compared to routine work-up in a general population?
Cross-Sectional (n=193)
Does the evaluation of different forms of target organ damage (TOD) including pulse wave velocity improve cardiovascular risk stratification compared to routine work-up in a general population?
Measurement of pulse wave velocity and other forms of target organ damage significantly changes cardiovascular risk stratification compared to routine work-up alone.
Answers are grounded in this paper and cite their sources.
Associations of CV risk and fat mass index with PWV are hypothesis-generating in pre-menopausal women; does not support incorporating PWV into routine risk stratification.
Younger women are considered to have low cardiovascular (CV) risk. Predictive scoring systems aim to assess overall CV risk from multiple risk factors to guide treatment decisions. Aortic pulse wave velocity (aPWV) may be a more efficient, ‘integrated’ CV index providing a more effective treatment target than risk factors alone. We examined the relationship of CV risk scores to aPWV in younger women. 193 pre-menopausal women (age 36.2 years, 95% CI 35.1–37.2) underwent anthropometric, biochemical and aPWV measures. 10 year CV risk score was estimated using the Joint British Guidelines, similar to the Europe-wide ‘Heartscore’ initiative. BMI, waist & bio-impedance estimates of adiposity (fat mass index) were tested. CV risk scores were significantly higher in women who had had gestational diabetes (2.35%) than in those without (1.34%), p = 0.004, but surprisingly were not for previous gestational hypertension (1.21 vs. 1.27 %). After adjusting for other CV risk modulators not included in risk scores, (social deprivation (Townsend’s index), hsCRP, heart rate), residual independent influences on aPWV were: In young women, even without overt diabetes or hypertension, adjusting for other factors, current adiposity and calculated CV risk were independently related to aPVW. This suggests aPWV reflects the ‘load’ of CV risk at this age better than CV scores alone (which omit obesity indices).
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Banerjee et al. (2008) conducted a cross-sectional in Cardiovascular risk in pre-menopausal women (n=193). Calculated 10-year absolute cardiovascular risk score and fat mass index was evaluated on Aortic pulse wave velocity (aPWV) (Beta 0.122, 95% CI 0.023 to 0.221, p=0.016). Calculated 10-year cardiovascular risk (Beta 0.122, p=0.016) and fat mass index (Beta -0.09, p=0.031) were independently associated with aortic pulse wave velocity in pre-menopausal women.
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