TY - JOUR
T1 - Arterial Stiffness and Long-Term Risk of Health Outcomes
T2 - The Framingham Heart Study
AU - Vasan, Ramachandran S.
AU - Pan, Stephanie
AU - Xanthakis, Vanessa
AU - Beiser, Alexa
AU - Larson, Martin G.
AU - Seshadri, Sudha
AU - Mitchell, Gary F.
N1 - Funding Information:
G.F. Mitchell is the owner of Cardiovascular Engineering, Inc, a company that designs and manufactures devices that measure vascular stiffness. The company uses these devices in clinical trials that evaluate the effects of diseases and interventions on vascular stiffness. He also reports receiving grants from the National Institutes of Health and Novartis and consulting fees from Novartis, Bayer, Merck, and Servier. The other authors report no conflicts.
Funding Information:
This work was supported by contracts N01-HC-25195, HHSN268201500001I and 75N92019D00031 from the National Heart, Lung and Blood Institute (NHLBI); NHLBI grants HL080124, HL071039, HL077447, HL107385, HL126136, HL107385, HL60040, HL70100, HL131532, and R01HL134168; grants from the National Institute on Aging (R01 AG054076, R01 AG049607, R01 AG033040, R01 AG063507, RF1 AG052409, RF1 AG061872, U01 AG049505, AG058589); grant from the National Institute of Neurological Disorders and Stroke (NS017950). R.S. Vasan is supported by the Evans Medical Foundation and the Jay and Louis Coffman Endowment from the Department of Medicine, Boston University School of Medicine.
Publisher Copyright:
© 2022 American Heart Association, Inc.
PY - 2022/5/1
Y1 - 2022/5/1
N2 - BACKGROUND: Arterial stiffness increases with age and is associated with an increased risk of adverse outcomes on short-term follow-up (typically <10 years). Data regarding associations of arterial stiffness with health outcomes on longer-term follow-up are lacking. 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.
AB - BACKGROUND: Arterial stiffness increases with age and is associated with an increased risk of adverse outcomes on short-term follow-up (typically <10 years). Data regarding associations of arterial stiffness with health outcomes on longer-term follow-up are lacking. 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.
KW - cardiovascular diseases
KW - dementia
KW - heart diseases
KW - mortality
KW - risk
KW - vascular stiffness
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UR - http://www.scopus.com/inward/citedby.url?scp=85128488799&partnerID=8YFLogxK
U2 - 10.1161/HYPERTENSIONAHA.121.18776
DO - 10.1161/HYPERTENSIONAHA.121.18776
M3 - Article
C2 - 35168368
AN - SCOPUS:85128488799
SN - 0194-911X
VL - 79
SP - 1045
EP - 1056
JO - Hypertension
JF - Hypertension
IS - 5
ER -