Estimated Pulse Wave Velocity (Epwv) and Mortality in Subjects With Healthy Vascular Ageing (Hva) and Early Vascular Ageing (Eva) in General Population. Eh-Uh Study

Objective: Arterial stiffness (cfPWV) is acknowledged biomarker of ageing having significant predictive value for cardiovascular (CV) events in hypertensive patients. It was observed that ePWV calculated by equation using age and mean blood pressure (MBP) improved risk prediction compared with traditional risk scores in healthy subjects, untreated hypertensives and very high risk patients. Our aim was to analyze association of ePWV with mortality in subjects with EVA and HVA in general Croatian population. Design and method: In a stratified random sample of 1087 subjects from the general Croatian adult population which was enrolled in a nationwide survey (EH-UH 1) from 2000–2005 analyses on ePWV were done and subjects were followed-up for 17years. ePWV was calculated using formula: ePWV = 9.587–0.402 × age+4.560 × 10-3 × age2–2.621 × 10-5 × age2 × MBP+3.176 × 10-3 × age × MBP-1.832 × 10-2 × MBP. MBP = (DBP)+0.4(SBP-DBP). HVA was defined as the lowest 10%, EVA as the highest10% of the standardized PWV distribution, adjusted for age quintiles. Subjects with MI, stroke/TIA, DM were excluded. Mortality data were collected from National Public Health Institute records. Results: At the end of follow up period 228 deaths (20.9%) were recorded in the whole group (CV43.4%, stroke10.5%, cancer28.5%, dementia and degenerative diseases5.2%, COPD3.1%). There were 16.5% and 14.2% deaths in EVA and HVA groups, respectively (p > 0.05). Significantly more CV/stroke deaths were observed in EVAvs.HVA (X2 = 5.488;p = 0.0019). In a subgroup of subjects who died, at basal EVA subjects were older, obese, more frequently hypertensives, had higher BMI, BP, heart rate and ePWV compared to HVA (13.8 ± 1.1vs.10.5 ± 2.5;p < 0.0001). Both died HVA and EVA were at basal less physically active than survivors. In a subgroup of EVA subjects, those who died, at basal were older, had higher systolic BP, lower eGFR and higher ePWV (13.8 ± 1.1vs.9.9 ± 2.3;p < 0.0001) and were less physically active (X2 = 1.54;p = 0.01) compared to survivors. We failed to find differences between dead and alive EVA in basal diastolic BP, BMI, heart rate, prevalence of hypertension. Conclusions: Age, systolic BP, eGFR and ePWV were associated with mortality risk in EVA subjects. Physical inactivity was associated with higher mortality both in EVA and HVA participants. Comparing to HVA, in addition to aforementioned parameters, EVA subjects had higher BMI, diastolic BP and heart rate.