Radial Pulse Wave Signals Combined with Ba-PWV for the Risk Prediction of Hypertension and the Monitoring of Its Accompanying Metabolic Risk Factors.

Zhen Qi,Yu Zhang,Zhi-Yue Zhao,Yi-Min Bao,Zhi-Feng Zhang,Jia-Tuo Xu,Li-Ping Zhu

doi:10.1155/2020/3926851

Abstract

Our aim was to study whether radial pulse wave signals can improve the risk prediction of incident hypertension and are associated with its concomitant metabolic risk factors beyond the traditional cardiovascular risk factor Ba-PWV. By enrolling 523 Chinese subjects in this study, linear and stepwise regression analysis was performed to assess the association of radial artery pulse wave signals and Ba-PWV with blood pressure and its related metabolic risk factors such as fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and uric acid (UA). The area under the receiver-operating characteristic curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were calculated by risk assessment plot to compare the discriminative ability among models with and without radial artery pulse wave signals. After adjusting related confounding factors, radial artery pulse wave variable h3/h1 was selected as the sensitive influential factor for blood pressure. Moreover, a new model with h3/h1 had a higher AUC than the reference model without it (0.86 vs 0.84; P=0.030). And the NRI and IDI for the new model was 50.0% (P=0.017) and 3.16% (P=0.044), respectively. In addition to Ba-PWV, we found that the decrease of t4, t5, and h5 might be associated with higher FPG, TC, LDL-C, and UA and lower HDL-C. This research might provide a valuable additional tool for remote wearable monitoring of radial artery pulse wave signals in hypertension risk evaluation and management.

Highlights

Hypertension, as an important risk factor responsible for 19% of global deaths [1] and more than half of the development of a variety of cardiovascular disorders [2, 3], has become a growing global health issue
The combination of arterial stiffness measured by the cardio-ankle vascular index (CAVI) and small artery retinopathy detected by retinal fundus photography could predict the development of hypertension [18]
We have shown for the first time that radial pulse wave variable h3/h1, which was significantly augmented in hypertension patients and associated with all blood pressure indicators (SBP, Diastolic blood pressure (DBP), and pulse pressure (PP)), is an independent additive predictor of incident hypertension beyond the traditional cardiovascular risk factor brachial-ankle pulse wave velocity (Ba-PWV). e radial artery pulse wave variable h3/h1, which represents the amplitude ratio of tidal wave to main wave, can reflect the intensity of reflection wave [43]

Summary

Introduction

Hypertension, as an important risk factor responsible for 19% of global deaths [1] and more than half of the development of a variety of cardiovascular disorders [2, 3], has become a growing global health issue. It is reported that arterial stiffness makes an important contribution to the increase in systolic blood pressure (SBP) and the development of hypertension in general population, independently of traditional hypertension risk factors [9,10,11,12,13,14,15]. Changes in both small and large arteries could predict future hypertension. The combination of arterial stiffness measured by the cardio-ankle vascular index (CAVI) and small artery retinopathy detected by retinal fundus photography could predict the development of hypertension [18]

Objectives

Methods

Results

Conclusion