Prognostic value of arterial stiffness in menopausal women

OBJECTIVE: Because menopausal women have an increased cardiovascular risk, risk stratification is very crucial in this population. This study aimed to verify the prognostic value of arterial stiffness in menopausal women. METHODS: We retrospectively analyzed 2,917 menopausal women (age >55y) without overt cardiovascular disease who underwent brachial-ankle pulse wave velocity measurement. The primary endpoint was a composite of clinical events, including all-cause death, nonfatal myocardial infarction, coronary revascularization, and stroke, hereafter referred to as major adverse cardiovascular events. Propensity score matching and inverse probability-treatment weighting analysis were used to balance differences in baseline participant characteristics. RESULTS: The mean participant age was 66.8 ± 7.7 years. During a median follow-up period of 4.0 (interquartile range of 1.9-6.3) years, the primary outcome was noted in 56 cases (1.9%). Pulse wave velocity was significantly higher in participants with the primary outcome than in those without (1,947 ± 388 vs 1,690 ± 348 cm/s; P < 0.001). For every 100 cm/s increase in pulse wave velocity, the hazard ratio for the primary endpoint increased by 1.15 times (95% confidence interval, 1.08-1.22; P < 0.001) in multivariable Cox regression analysis. A pulse wave velocity > 1,613 cm/s was associated with increased risk of the primary endpoint in the same multivariable analysis (hazard ratio, 3.06; 95% confidence interval, 1.40-6.68; P = 0.005). The results were consistent after propensity score matching and inverse probability-treatment weighting analysis. CONCLUSIONS: Elevated brachial-ankle pulse wave velocity was associated with the occurrence of major adverse cardiovascular events in menopausal women without cardiovascular disease and may represent a useful screening tool.