Abstract
The relation between inflammation, hemostasis and arterial stiffness is of pathophysiological relevance for the development of cardiovascular disease (CVD). Data investigating this interplay using stiffness index (SI) by digital photoplethysmography are not available yet. Therefore, sex-specific relation between SI and inflammatory and hemostatic biomarkers was investigated within 13,724 subjects from the population-based Gutenberg Health Study. C-reactive protein (CRP), white blood cell count (WBCC), neopterin, interleukin-18, interleukin-1 receptor antagonist (IL-1RA), fibrinogen and hematocrit were measured. Multivariable linear regression analysis with adjustment for cardiovascular risk factors, medication, and hormonal status (in females) revealed an independent association between SI and WBCC, IL-1RA and hematocrit in both sexes, and with fibrinogen in women. There was a joint effect of increasing tertiles of SI and biomarker concentrations for future CVD risk prediction. Subjects with both SI and biomarker concentration above the median had the worst overall survival and with both below the median the best survival during a follow-up period of 6.2 ± 1.7 years, except for hematocrit. The results support the relation between inflammation, hemostasis and arterial stiffness measured by digital photoplethysmography. Markers of inflammation and hemostasis modulate the ability of SI to identify subjects at risk for future CVD or higher mortality.
Highlights
High blood pressure represents one of the potent cardiovascular risk (CV) factor and a leading cause of total and CV mortality[1, 2]
Taking into account that stiffness index (SI) was found to be markedly lower in females compared to males in our previous investigation[22], we investigated such association sex- in a large population-based Gutenberg Health Study (GHS)
To the best of our knowledge this is the first study demonstrating the relation between a panel of biomarkers reflecting these processes and SI derived from digital photoplethysmography
Summary
High blood pressure represents one of the potent cardiovascular risk (CV) factor and a leading cause of total and CV mortality[1, 2]. To date several studies investigated the relation of AS with markers of inflammation and hemostasis in apparently healthy individuals with controversial results[8,9,10,11,12,13,14,15,16,17]. Most of published data were based on the measurement of carotid-femoral pulse wave velocity (cf-PWV), a widely used method for determination of AS to date[18]. Another interesting approach for assessment of arterial function and AS in particular might represent stiffness index (SI) by digital photoplethysmography[19], which might reflect systemic AS20, 21, rather than providing similar to central PWV information. Taking into account that SI was found to be markedly lower in females compared to males in our previous investigation[22], we investigated such association sex- in a large population-based Gutenberg Health Study (GHS)
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