Key result
Higher brachial-ankle pulse wave velocity was an independent predictor of all-cause mortality, with the highest tertile having a 1.647-fold higher risk compared to the lowest tertile.
Why the study?
Most studies linking ABI and baPWV to all-cause mortality analyze either metric alone and focus on specific disease cohorts rather than general community-dwelling elderly populations.
Does elevated brachial-ankle pulse wave velocity or abnormal ankle-brachial index predict all-cause mortality in a community-based elderly population?
Cohort (n=1,826)
No
Does elevated brachial-ankle pulse wave velocity or abnormal ankle-brachial index predict all-cause mortality in a community-based elderly population?
In a community-based elderly population, brachial-ankle pulse wave velocity is an independent predictor of all-cause mortality, whereas ankle-brachial index is not after full adjustment.
ABI and baPWV may flag mortality risk in community elderly; hypothesis-generating for combined vascular screening before practice change.
Background Ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) are both important indicators of arterial stiffness and vascular injury. At present, most studies on the relationship between ABI and baPWV and all-cause mortality in community-based elderly are analyzing ABI or baPWV alone, and will focus on a single special population such as diabetes and stroke. The purpose of this study was to evaluate the relationship between ABI and baPWV in a Chinese community-based elderly population, and to analyze their impact on all-cause mortality in a community-based population through a follow-up of nearly 10 years. Methods Participants were residents of the Wanshou Road community in Beijing, China. A total of 2,162 people in the community were included, with an average age of 71.48 years. During a mean follow-up period of 9.87 years, 1,826 subjects completed follow-up. Kaplan-Meier survival analysis and different Cox regression models were used to verify the association of ABI and baPWV with all-cause mortality. The selected subjects were divided into two groups according to ABI and baPWV, and ABI was divided into two groups with 0.90 as the cut-off point (group 1: 0.9 < ABI ≤ 1.3; group 2: ABI ≤ 0.9); according to the level of baPWV, they were divided into three groups (Tertile 1: baPWV <1761.5 cm/s; Tertile 2: 1761.5 ≤ baPWV <2121.5 cm/s; Tertile 3: baPWV ≥2121.5 cm/s). Results 1,826 people were included in the statistical analysis, and the total mortality rate was 181.3/1000. The 10-year all-cause mortality rate of the abnormal ABI group (group 2) was 44.7%, and that of the normal ABI group (group 1) was 17.0%; The 10-year all-cause mortality rates from low to high in the baPWV tertile were 10.0%, 18.7%, and 26.4%. In the Cox proportional hazards model, after adjusting for possible confounders, the effect of baPWV on all-cause mortality was significant, with the 3rd tertile having a 1.647-fold higher risk of all-cause mortality than the 1st tertile ( P = 0.014 ). Conclusions ABI and baPWV are risk factors affecting all-cause mortality in the elderly community population, and baPWV is an independent predictor of all-cause mortality in the elderly community population.
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Zhang et al. (2022) conducted a cohort in Community-dwelling elderly (n=1,826). Brachial-ankle pulse wave velocity (baPWV) vs. Lowest tertile of baPWV (<1761.5 cm/s) was evaluated on All-cause mortality (HR 1.647, 95% CI 1.106-2.452, p=0.014). Higher brachial-ankle pulse wave velocity was an independent predictor of all-cause mortality, with the highest tertile having a 1.647-fold higher risk compared to the lowest tertile.
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