1. Arterial Stiffness and Long-Term Risk of Health Outcomes: The Framingham Heart Study
- Author
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Ramachandran S. Vasan, Stephanie Pan, Vanessa Xanthakis, Alexa Beiser, Martin G. Larson, Sudha Seshadri, and Gary F. Mitchell
- Subjects
Heart Failure ,Male ,Middle Aged ,Pulse Wave Analysis ,Article ,Stroke ,Vascular Stiffness ,Cardiovascular Diseases ,Risk Factors ,Hypertension ,Internal Medicine ,Diabetes Mellitus ,Humans ,Dementia ,Female ,Longitudinal Studies ,Prospective Studies ,Renal Insufficiency, Chronic - Abstract
Background: Arterial stiffness increases with age and is associated with an increased risk of adverse outcomes on short-term follow-up (typically Methods: We evaluated 7283 Framingham Study participants (mean age 50 years, 53% women) who underwent assessment of carotid-femoral pulse wave velocity (a marker of arterial stiffness) via applanation tonometry at one or more routine examinations. We used time-dependent Cox proportional hazards regression models to relate carotid-femoral pulse wave velocity to the incidence of health outcomes (updating carotid-femoral pulse wave velocity and all covariates at serial examinations). Results: On long-term follow-up (median 15 years; minimum-maximum, 0–20), participants developed cardiometabolic disease (hypertension [1255 events]; diabetes [381 events]), chronic kidney disease (529 events), dementia (235 events), cardiovascular disease (684 events) and its components (coronary heart disease [314 events], heart failure [191 events], transient ischemic attacks or stroke [250 events]), and death (1086 events). In multivariable-adjusted models, each SD increment in carotid-femoral pulse wave velocity was associated with increased risk of hypertension (hazard ratio [HR], 1.32 [95% CI, 1.21–1.44]), diabetes (HR, 1.32 [95% CI, 1.11–1.58]), chronic kidney disease (1.19 [95% CI, 1.05–1.34]), dementia (HR 1.27 [95% CI, 1.06–1.53]), cardiovascular disease (HR, 1.20 [95% CI, 1.06–1.36]) and its components (coronary heart disease, HR 1.37 [95% CI, 1.13–1.65]; transient ischemic attack/stroke, HR, 1.24 [95% CI, 1.00–1.53]), and death (HR, 1.29 [95% CI, 1.17–1.43]). The association with heart failure was borderline nonsignificant (HR, 1.21 [95% CI, 0.98–1.51], P =0.08). Conclusions: Our prospective observations of a large community-based sample establish the long-term prognostic importance of arterial stiffness for multiple health outcomes.
- Published
- 2023