scholarly journals Correlates of Segmental Pulse Wave Velocity in Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study

2015 ◽  
Vol 29 (1) ◽  
pp. 114-122 ◽  
Author(s):  
Michelle L. Meyer ◽  
Hirofumi Tanaka ◽  
Priya Palta ◽  
Susan Cheng ◽  
Natalia Gouskova ◽  
...  
Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Patricia Pagan Lassalle ◽  
Michelle L Meyer ◽  
Kevin S Heffernan ◽  
Adam W Kiefer ◽  
Lauren C Bates ◽  
...  

Background: Carotid to femoral pulse wave velocity (cfPWV), the gold-standard measure of aortic stiffness, is associated with the incidence of cardiovascular disease (CVD) events. Most cfPWV measurements depend on technical proficiency, which limit broader implementation in clinical settings. Recently, an estimated pulse wave velocity (ePWV) measure derived from age and mean arterial pressure (MAP) has been shown to be associated with the risk of CVD events and all-cause mortality and may be a simple alternative to cfPWV. However, ePWV is poorly predictive in non-White individuals, possibly because it was originally developed from European Cohorts. Consequently, our purpose was to: estimate the strength of association between cfPWV and ePWV, and determine whether agreement is consistent across race. Hypothesis: cfPWV and ePWV are in good agreement and association would be consistent across race. Methods: We included Black and White older adults (n= 4,478; 75.2 [5.0] years) from visit 5 (2011-13) of the community-based Atherosclerosis Risk in Communities Study (ARIC). cfPWV was measured using an automated cardiovascular screening device. ePWV was calculated as presented in Fig 1. Association between cfPWV and ePWV was determined using Pearson’s correlation coefficient (r) and Bland-Altman plots. Results: As reported in Fig 1, there was a weak (r=0.35) correlation between cfPWV and ePWV for the total population, with similar correlations when stratified by Blacks (r=0.31) and Whites (r=0.36). Bland-Altman plots indicated significant systematic differences between cfPWV and ePWV (-0.17 m/s, 95% confidence interval: -0.25 to -0.09 m/s, P <.001), which was consistent by race. Conclusion: In older adults, there was weak correlation between cfPWV and ePWV and systematic differences in agreement. Our results do not support ePWV as a surrogate measure of cfPWV in a sample of older White and Black adults.


2015 ◽  
Vol 29 (11) ◽  
pp. 1268-1275 ◽  
Author(s):  
Ricky Camplain ◽  
Michelle L. Meyer ◽  
Hirofumi Tanaka ◽  
Priya Palta ◽  
Sunil K. Agarwal ◽  
...  

2020 ◽  
Vol 38 (9) ◽  
pp. 1786-1793
Author(s):  
Lee Stoner ◽  
Michelle L. Meyer ◽  
Anna Kucharska-Newton ◽  
Keeron Stone ◽  
Gabriel Zieff ◽  
...  

2015 ◽  
Vol 29 (4) ◽  
pp. 470-475 ◽  
Author(s):  
Michelle L. Meyer ◽  
Hirofumi Tanaka ◽  
Priya Palta ◽  
Mehul D. Patel ◽  
Ricky Camplain ◽  
...  

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Laura R Loehr ◽  
Michelle Snyder ◽  
Elizabeth Selvin ◽  
Priya Palta ◽  
James Pankow ◽  
...  

Introduction: Arterial stiffness measured by pulse wave velocity (PWV) predicts cardiovascular disease and mortality. Diabetes and impaired fasting glucose (IFG) have been related to arterial stiffness in smaller studies. We assessed whether diabetes and impaired fasting glucose are associated with greater arterial stiffness measured by PWV in older adults, and to evaluate gender as a modifier. Methods: PWV data on 5,147 men and women with mean age of 75.5 years (range 66-90) examined in 2011-2013 by the Atherosclerosis Risk in Communities (ARIC) study were analyzed. Diabetes was defined as fasting glucose >126 mg/dl or on hypoglycemic agents and IFG as non-diabetics with fasting glucose 100-125 mg/dl. Technicians measured carotid-femoral (cfPWV) and brachial-ankle (baPWV) velocities at least twice using the Omron VP-1000 plus system (Colin Co., Ltd., Komaki, Japan). The mean of the last two available measurements was used. The path length for cfPWV was calculated by: path length (cm) = carotid to femoral distance (cm) - (suprasternal notch - carotid distance (cm)). Path length for baPWV was automatically calculated using height-based formulas. Multivariable linear regression was used to model the cross-sectional association between diabetes status and PWV. The multivariable association of age categories with PWV was evaluated for comparison to the effect size of diabetes. Results: Participants were 57% female, 20% African-American, and 73% hypertensive. Among them 1,354 had diabetes (26%) and 2,295 (45%) had impaired fasting glucose. After adjustment for age, race-center, gender, heart rate, hypertension, BMI, and smoking status (current, former and never), cfPWV was 87 cm/s higher on average for those with diabetes, and 21 cm/s higher for those with IFG, as compared to those free of diabetes or IFG. In comparison, a 4 year increase in age (after multivariable adjustment) was associated with 64 cm/s higher cfPWV among non-smokers without diabetes. Estimates for baPWV were smaller than those for cfPWV but showed a similar pattern. There was no significant interaction by gender (P >0.1). Conclusion: Diabetes and impaired fasting glucose are both associated with arterial stiffness in older adults. We estimate that the magnitude of the cross-sectional effect of diabetes on arterial stiffness is equivalent to 4 years of arterial aging.


Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Ricky L Camplain ◽  
Michelle L Snyder ◽  
Priya Palta ◽  
Hanyu Ni ◽  
Kenneth R Butler ◽  
...  

Cigarette smoking is a preventable cause of cardiovascular disease and is associated with arterial stiffening among young adults. While smoking cessation lowers the risk of cardiovascular morbidity and mortality, evidence for a relationship between time since smoking cessation and arterial stiffness is limited in older adults. We assessed the association of smoking status and time since smoking cessation with arterial stiffness, measured by carotid-femoral (cfPWV) and brachial-ankle (baPWV) pulse wave velocity, conditional on intensity and duration of exposure to smoking (pack-years). Analyses included 1,996 men and 2,767 women aged 67 to 90 years examined in the ARIC study in 2011-2013. Smoking status was ascertained at all five ARIC examinations and during annual telephone interviews. Information on age at initiation of smoking, smoking intensity and duration were also collected. Pack-years were calculated as the product of the average number of cigarettes smoked per day and years smoked divided by 20. Two measures of baPWV and cfPWV were obtained then averaged. Multivariable linear regression was used to estimate the association between smoking status and time since smoking cessation with PWV by gender, adjusted for age, hypertension, body mass index (BMI), and heart rate. Estimates of the association between smoking cessation and PWV were further adjusted for pack-years. Among women, former smokers and current smokers had a lower baPWV when compared to never smokers [β = -40.9 (95% confidence interval (CI): -64.2, -17.6) and β = -119.7 (95%CI: -168.7, -70.7), respectively]. Similar patterns were observed for cfPWV; however, the relationship was only significant among former smokers [β = -25.3 (95%CI: -48.0, -2.5)]. Association of smoking status and PWV was not significant in men. Among men who were former smokers there was a negative and significant association between smoking cessation and cfPWV [β = -1.4 (-2.7, -0.4)]; however, this same relationship was not observed for baPWV. BMI modified the association between smoking cessation and PWV in women. Time since smoking cessation was positively associated with PWV in women with a BMI <25 kg/m 2 [baPWV: β = 3.8 (95%CI: 1.2, 6.5); cfPWV: β = 2.5 (0.3, 4.7)], but not in women with a BMI ≥25 kg/m 2 . In these cross-sectional analyses, ever smokers had lower PWV compared to never smokers among older women, but not among older men. Greater time since smoking cessation was positively associated with arterial stiffness among normal or underweight women, but not among women who were overweight or obese, or among men. Accounting for cumulative exposure to smoking over the life course, gender-specific and arterial segment-specific patterns were observed in the association between time since smoking cessation and arterial stiffness measured in community-dwelling older adults, as well as a modification of these associations by excess weight among women.


Author(s):  
Kevin Heffernan ◽  
Lee Stoner ◽  
Michelle L. Meyer ◽  
Adam Keifer ◽  
Lauren Bates ◽  
...  

Introduction: Aortic stiffness offers important insight into vascular aging and cardiovascular disease (CVD) risk. The referent measure of aortic stiffness is carotid-femoral pulse wave velocity (cfPWV). cfPWV can be estimated (ePWV) from age and mean arterial pressure. Few studies have directly compared the association of ePWV to measured cfPWV, particularly in non-White adults. Moreover, whether ePWV and cfPWV correlate similarly with CVD risk remains unexplored. Aim: (1) To estimate the strength of the agreement between ePWV and cfPWV in both Black and White older adults; and (2) to compare the associations of ePWV and cfPWV with CVD risk factors and determine whether these associations were consistent across races. Methods and Results: We evaluated 4478 [75.2 (SD 5.0) years] Black and White older adults in the Atherosclerosis Risk in Communities (ARIC) Study. cfPWV was measured using an automated pulse waveform analyzer. ePWV was derived from an equation based on age and mean arterial pressure. Association and agreement between the two measurements were determined using Pearson’s correlation coefficient (r), standard error of estimate (SEE), and Bland-Altman analysis. Associations between traditional risk factors with ePWV and cfPWV were evaluated using linear mixed regression models. We observed weak correlations between ePWV and cfPWV within White adults (r = 0.36) and Black adults (r = 0.31). The mean bias for Bland-Altman analysis was low at -0.17 m/s (95%CI: -0.25 to -0.09). However, the inspection of the Bland-Altman plots indicated systematic bias (P < 0.001), which was consistent across race strata. The SEE, or typical absolute error, was 2.8 m/s suggesting high variability across measures. In models adjusted for sex, prevalent diabetes, the number of prevalent cardiovascular diseases, and medication count, both cfPWV and ePWV were positively associated with heart rate, triglycerides, and fasting glucose, and negatively associated with body mass index (BMI) and smoking status in White adults (P < 0.05). cfPWV and ePWV were not associated with heart rate, triglycerides, and fasting glucose in Black adults, while both measures were negatively associated with BMI in Black adults. Conclusions: Findings suggest a weak association between ePWV and cfPWV in older White and Black adults from ARIC. There were similar weak associations between CVD risk factors with ePWV and cfPWV in White adults with subtle differences in associations in Black adults. One sentence summary: Estimated pulse wave velocity is weakly associated with measured carotid-femoral pulse wave velocity in older Black and White adults in ARIC.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Lee Stoner ◽  
Michelle Meyer ◽  
Anna Kucharska-newton ◽  
Keeron Stone ◽  
Simon Fryer ◽  
...  

Introduction: Carotid-femoral pulse wave velocity (cfPWV) is widely used in clinical and epidemiological studies to assess central arterial stiffness and predict cardiovascular outcomes. However, cfPWV assessments require applanation of the carotid artery, which may be challenging in some patients, and assessments may be confounded in the presence of carotid artery plaque. Further, since cfPWV is not consistent with the path of blood flow, the measure is adjusted according to an assumed timing of the pressure wave traveling in the opposite direction. Therefore, we hypothesize that heart-femoral PWV (hfPWV) could be a simpler measure of central arterial stiffness that is consistent with the path of blood flow. Objective: To estimate the strength of the association between hfPWV and cfPWV. Methods: We evaluated 4,476 older-aged (75.2 y [SD: 5.0]) adults in the community-based Atherosclerosis Risk in Communities (ARIC) Study. cfPWV and hfPWV were measured using an automated cardiovascular screening device (Omron VP-1000plus) equipped with an electrocardiogram, a phonocardiogram, and 2 applanation tonometry sensors attached to carotid and femoral arteries. Agreement between the two measurements was determined by calculating the intraclass correlation coefficient (ICC) and the standard error of estimate (SEE). We considered ICC value estimates of <0.5, 0.5-0.75, 0.75-0.9, and >0.9 as, respectively, poor, moderate, good, and excellent agreement. The SEE represents the average distance that the observed values fall from the regression line. Smaller values indicate that the observations are closer to the fitted line. The uniformity of error was assessed by visual analysis of regression plot. Results: There was ‘good’ agreement between hfPWV and cfPWV (ICC = 0.83, 95%CI: 0.82, 0.84). While the mean cfPWV (11.6 m/s [SD: 3.0]) and hfPWV (11.5 m/s [SD: 2.3]) were comparable, the SEE was 1.3 (95%CI: 1.27, 1.33) m/s. Inspection of the regression plot revealed bias, with higher PWV further away from the regression line. Conclusions: The current findings suggest good agreement between cfPWV and hfPWV, indicating that hfPWV may be a suitable alternative to cfPWV. Since hfPWV does not require applanation of the carotid artery, the measurement is easier to conduct and may be particularly suited for use in individuals for whom applanation of the carotid artery is challenging.


Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1398-P
Author(s):  
MARY R. ROONEY ◽  
OLIVE TANG ◽  
B. GWEN WINDHAM ◽  
JUSTIN B. ECHOUFFO TCHEUGUI ◽  
PAMELA LUTSEY ◽  
...  

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