Baseline baPWV Research Articles

KCNJ5 Somatic Mutations in Aldosterone-Producing Adenoma Are Associated with a Greater Recovery of Arterial Stiffness.

Simple SummaryPrimary aldosteronism (PA) is the most common form of secondary hypertension and induces various cardiovascular injuries. Aldosterone-producing adenoma (APA) is one of the major forms of PA. The occurrence of APA is closely correlated with somatic mutations, including KCNJ5. We described here the impact of KCNJ5 somatic mutations on arterial stiffness excluding the influence of age, sex, and blood pressure status. We found KCNJ5 mutation carriers had similar arterial stiffness before surgery, but greater improvement of arterial stiffness after adrenalectomy compared with non-carriers. Hence, APA patients with KCNJ5 mutations had a greater improvement in arterial stiffness after adrenalectomy than those without mutations.Primary aldosteronism is the most common form of secondary hypertension and induces various cardiovascular injuries. In aldosterone-producing adenoma (APA), the impact of KCNJ5 somatic mutations on arterial stiffness excluding the influence of confounding factors is uncertain. We enrolled 213 APA patients who were scheduled to undergo adrenalectomy. KCNJ5 gene sequencing of APA was performed. After propensity score matching (PSM) for age, sex, body mass index, blood pressure, number of hypertensive medications, and hypertension duration, there were 66 patients in each group with and without KCNJ5 mutations. The mutation carriers had a higher aldosterone level and lower log transformed brachial–ankle pulse wave velocity (baPWV) than the non-carriers before PSM, but no difference in log baPWV after PSM. One year after adrenalectomy, the mutation carriers had greater decreases in log plasma aldosterone concentration, log aldosterone–renin activity ratio, and log baPWV than the non-carriers after PSM. Only the mutation carriers had a significant decrease in log baPWV after surgery both before and after PSM. KCNJ5 mutations were not correlated with baseline baPWV after PSM but were significantly correlated with ∆baPWV after surgery both before and after PSM. Conclusively, APA patients with KCNJ5 mutations had a greater regression in arterial stiffness after adrenalectomy than those without mutations.

Association between triglyceride-glucose index and risk of arterial stiffness: a cohort study

BackgroundTriglyceride–glucose (TyG) index, a simple surrogate marker of insulin resistance, has been reported to be associated with arterial stiffness. However, previous studies were limited by the cross-sectional design. The purpose of this study was to explore the longitudinal association between TyG index and progression of arterial stiffness.MethodsA total of 6028 participants were derived from the Kailuan study. TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Arterial stiffness was measured using brachial-ankle pulse wave velocity (baPWV). Arterial stiffness progression was assessed by the annual growth rate of repeatedly measured baPWV. Multivariate linear regression models were used to estimate the cross-sectional association of TyG index with baPWV, and Cox proportional hazard models were used to investigate the longitudinal association between TyG index and the risk of arterial stiffness.ResultsMultivariate linear regression analyses showed that each one unit increase in the TyG index was associated with a 39 cm/s increment (95%CI, 29–48 cm/s, P < 0.001) in baseline baPWV and a 0.29 percent/year increment (95%CI, 0.17–0.42 percent/year, P < 0.001) in the annual growth rate of baPWV. During 26,839 person-years of follow-up, there were 883 incident cases with arterial stiffness. Participants in the highest quartile of TyG index had a 58% higher risk of arterial stiffness (HR, 1.58; 95%CI, 1.25–2.01, P < 0.001), as compared with those in the lowest quartile of TyG index. Additionally, restricted cubic spline analysis showed a significant dose–response relationship between TyG index and the risk of arterial stiffness (P non-linearity = 0.005).ConclusionParticipants with a higher TyG index were more likely to have a higher risk of arterial stiffness. Subjects with a higher TyG index should be aware of the following risk of arterial stiffness progression, so as to establish lifestyle changes at an early stage.

Association between egg consumption and arterial stiffness: a longitudinal study

BackgroundInconsistent associations between egg consumption and cardiovascular disease (CVD) risk have been observed in previous studies. This study aims to longitudinally investigate the association between egg consumption and altered risk of arterial stiffness, a major pre-clinical pathogenic change of CVD, which was assessed by brachial-ankle pulse wave velocity (baPWV).MethodsA total of 7315 Chinese participants from the Kailuan Study, free of CVD and cancer were included in this study. Egg consumption was assessed by a semi-quantitative validated food frequency questionnaire in 2014. baPWV was repeatedly measured at baseline and during follow-up (mean follow-up: 3.41 years). General linear regression was used to calculate means of baPWV change rate across different egg consumption groups, adjusting for age, sex, baseline baPWV, healthy eating index, total energy, social-economic status, blood pressure, obesity, smoking, lipid profiles, and fasting glucose concentrations.ResultsCompared to the annual baPWV change rate in participants with 0–1.9 eggs/wk. (adjusted mean: 35.9 ± 11.2 cm/s/y), those consuming 3–3.9 eggs/wk. (adjusted mean: 0.2 ± 11.4 cm/s/y) had the lowest increase in baPWV during follow-up (P-difference = 0.002). Individuals with low (0–1.9 eggs/wk) vs. high (5+ eggs /wk) egg intake showed similar changes in baPWV.ConclusionsIn this large-scale longitudinal analysis, we did not find a significant difference in arterial stiffness, as assessed by baPWV level, between low and high egg consumption groups. However, moderate egg consumption (3–3.9 eggs/wk) appeared to have beneficial effects on arterial stiffness.

Blood pressure control and progression of arteriosclerosis in hypertension.

Using the brachial--ankle pulse wave velocity (baPWV) as a biomarker for arteriosclerosis, we studied the effect of blood pressure (BP) and BP control on arteriosclerosis progression. The community-based longitudinal Kailuan study included 6552 participants [4938 (75.37%) men] with a mean follow-up of 4.62 ± 2.21 years. Hypertension was defined based on the Joint National Committee (JNC7) criteria and the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines. All study participants had hypertension and were stratified as follows according to BP at baseline and follow-up: the normal--normal [normal BP (under therapy) at baseline and final follow-up], normal--hypertensive, hypertensive--normal, and hypertensive--hypertensive groups. Using the JNC7-based hypertension definition, the annual baPWV increase was the highest (P < 0.001) in the hypertensive--hypertensive group [17.32 cm/s; 95% confidence interval [CI]:9.7--24.9], followed by the normal--hypertensive group (14.44 cm/s; 95% CI:5.5--23.4), and the hypertensive--normal group (0.88 cm/s; 95% CI: -7.84 to 9.60), with the normal--normal group as the reference group in a multivariable model. The model additionally included parameters, such as age, baseline baPWV, heart rate, BMI, serum glucose concentration, prevalence of antihypertensive treatment and alcohol consumption, heart rate, and estimated glomerular filtration rate. Applying the ACC/AHA guidelines and the same multivariable model, the annual baPWV increase was the highest (P < 0.001) in the hypertensive--hypertensive group (43.54 cm/s; 95% CI: 22.54--64.55), followed by the normal--hypertensive group (34.01 cm/s; 95% CI: 10.39--57.62) and the hypertensive--normal group (24.12 cm/s; 95% CI: 1.24--47.00). Lower BP and medical reduction in increased BP were associated with a reduction in the baPWV increase and may delay the progression of arteriosclerosis in hypertensive patients.

Use of lipid parameters to identify apparently healthy men at high risk of arterial stiffness progression

BackgroundDyslipidemia contributes to the development and progression of arterial stiffness. We aimed to identify the most informative measures of serum lipids and their calculated ratios in terms of arterial stiffness progression risk.MethodsTotal cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and brachial-ankle pulse wave velocity (baPWV) of 659 healthy males (47.4 ± 10.7 years) were measured at baseline. Values for non-HDL-C, TC/HDL-C, TG/HDL-C, LDL-C/HDL-C, and non-HDL-C/HDL-C were calculated. BaPWV was re-performed after 4.1 years follow-up. Elevated baPWV was defined as baPWV ≥ 1400 cm/s.ResultsOver the follow-up period, the mean baPWV value increased from 1340 cm/s to 1410 cm/s, and 331 individuals increased/persisted with high baPWV (outcome 1). Among the 448 subjects who had normal baseline baPWV, 100 incident elevated baPWV occurred (outcome 2). Only baseline logTG (OR 1.64 [95% CI: 1.14–2.37] for outcome 1; 1.89 [1.14–3.17] for outcome 2) and logTG/HDL-C (1.54 [1.15–2.10] for outcome 1; 1.60 [1.05–2.45] for outcome 2) were significantly associated with arterial stiffness progression after adjusting for confounding factors. Adding logTG or logTG/HDL-C to age and blood pressure improved the accuracy of risk predictions for arterial stiffness progression. These associations remained significant when lipids were analyzed as categorical variables.ConclusionsBaseline serum TG and TG/HDL-C were independently associated with increases in/persistently high baPWV and incident elevated baPWV, and they performed more effectively than other lipid variables in identifying healthy men at high risk of arterial stiffness progression.

Effect of tofogliflozin on arterial stiffness in patients with type 2 diabetes: prespecified sub-analysis of the prospective, randomized, open-label, parallel-group comparative UTOPIA trial

BackgroundTofogliflozin, an SGLT2 inhibitor, is associated with favorable metabolic effects, including improved glycemic control and serum lipid profile and decreased body weight, visceral adipose tissue, and blood pressure (BP). This study evaluated the effects of tofogliflozin on the brachial-ankle pulse wave velocity (baPWV) in patients with type 2 diabetes (T2DM) without a history of apparent cardiovascular disease.MethodsThe using tofogliflozin for possible better intervention against atherosclerosis for type 2 diabetes patients (UTOPIA) trial is a prospective, randomized, open-label, multicenter, parallel-group, comparative study. As one of the prespecified secondary outcomes, changes in baPWV over 104 weeks were evaluated in 154 individuals (80 in the tofogliflozin group and 74 in the conventional treatment group) who completed baPWV measurement at baseline.ResultsIn a mixed-effects model, the progression in the right, left, and mean baPWV over 104 weeks was significantly attenuated with tofogliflozin compared to that with conventional treatment (– 109.3 [– 184.3, – 34.3] (mean change [95% CI] cm/s, p = 0.005; – 98.3 [– 172.6, – 24.1] cm/s, p = 0.010; – 104.7 [– 177.0, – 32.4] cm/s, p = 0.005, respectively). Similar findings were obtained even after adjusting the mixed-effects models for traditional cardiovascular risk factors, including body mass index (BMI), glycated hemoglobin (HbA1c), total cholesterol, high-density lipoprotein (HDL)-cholesterol, triglyceride, systolic blood pressure (SBP), hypertension, smoking, and/or administration of drugs, including hypoglycemic agents, antihypertensive agents, statins, and anti-platelets, at baseline. The findings of the analysis of covariance (ANCOVA) models, which included the treatment group, baseline baPWV, and traditional cardiovascular risk factors, resembled those generated by the mixed-effects models.ConclusionsTofogliflozin significantly inhibited the increased baPWV in patients with T2DM without a history of apparent cardiovascular disease, suggesting that tofogliflozin suppressed the progression of arterial stiffness.Trial Registration UMIN000017607. Registered 18 May 2015. (https://www.umin.ac.jp/icdr/index.html)

Longitudinal Study of Brachial-Ankle Pulse Wave Velocity and Change in Estimated Glomerular Filtration Rate among Chinese Adults

Background and Objectives: Studies on the association between arterial stiffness and kidney function have generated inconsistent results. Whether arterial stiffness is linked to decline in renal function warrants further study. This study aimed to investigate the association between brachial-ankle pulse wave velocity (baPWV) and longitudinal change in estimated glomerular filtration rate (eGFR) among Chinese adults. Methods: In this longitudinal study, 8,264 participants in a community-based cohort had baPWV measured in 2010–2011 and were followed in subsequent surveys through to 2016. During each survey visit, fasting blood samples were collected for serum creatinine and eGFR was calculated. Participants were divided into 5 groups (Q1-Q5) by baPWV quintile. The association between baPWV and longitudinal changes in eGFR was assessed using generalized estimating equation models. Results: A total of 8,045 participants were included in the final analysis. The average age was 54 ± 12 years (age range 24–97 years), and mean eGFR was 93.0 ± 18.6 mL/min/1.73 m². There was an inverse linear association between baseline baPWV and eGFR change rate (p < 0.001). Compared with Q1 (lowest) group, the mean differences and 95% CI in eGFR decrease rate among Q2–Q5 groups were −0.23 (−0.62, 0.16), −0.67 (−1.06, −0.28), −1.11 (−1.50, −0.72), and −1.30 (−1.69, −0.92) mL/min/1.73 m² per year, respectively, after adjustment for age, gender, and other potential confounders (p trend < 0.0001). For each 100 cm/s increase in baPWV at baseline, the fully adjusted mean difference in eGFR decrease rate was −0.14 mL/min/1.73 m² per year (95% CI −0.18, −0.10; p < 0.0001). Compared with participants with baPWV < 1,400 cm/s, the fully adjusted mean difference in eGFR decrease rate was −0.92 mL/min/1.73 m² per year (95% CI −1.18, −0.66) for those with baPWV ≥ 1,400 cm/s (p < 0.0001). Conclusions: Participants with a higher baPWV at baseline had a greater decrease in eGFR over time. Future studies could examine the relationship between baPWV and decline in renal function in higher risk cohorts, and its potential role in targeting reno-protective interventions to those who may benefit from them most.

Arterial Stiffness Preceding Diabetes: A Longitudinal Study.

Previous studies on the relationship between diabetes and arterial stiffness were mostly cross-sectional. A few longitudinal studies focused on one single direction. Whether the association between arterial stiffness and diabetes is bidirectional remains unclear to date. To explore the temporal relationship between arterial stiffness and fasting blood glucose (FBG) status. Included were 14 159 participants of the Kailuan study with assessment of brachial-ankle pulse wave velocity (baPWV) from 2010 to 2015, and free of diabetes, cardiovascular and cerebrovascular diseases, and chronic kidney disease at baseline. FBG and baPWV were repeatedly measured at baseline and follow-ups. Cox proportional hazard regression model was used to estimate hazard ratios and 95% confidence intervals (CIs) of incident diabetes across baseline baPWV groups: <1400 cm/s (ref), 1400≤ baPWV <1800 cm/s, and ≥1800 cm/s. Path analysis was used to analyze the possible temporal causal relationship between baPWV and FBG, among 8956 participants with repeated assessment of baPWV and FBG twice in 2010 to 2017. The mean baseline age of the observed population was 48.3±12.0 years. During mean 3.72 years of follow-up, 979 incident diabetes cases were identified. After adjusting for potential confounders, the hazard ratio (95% CI) for risk of diabetes was 1.59 (1.34-1.88) for the borderline arterial stiffness group and 2.11 (1.71-2.61) for the elevated arterial stiffness group, compared with the normal ideal arterial stiffness group. In the path analysis, baseline baPWV was associated with follow-up FBG (the standard regression coefficient was 0.09 [95% CI, 0.05-0.10]). In contrast, the standard regression coefficient of baseline FBG for follow-up baPWV (β=0.00 [95% CI, -0.02 to 0.02]) was not significant. Arterial stiffness, as measured by baPWV, was associated with risk of developing diabetes. Arterial stiffness appeared to precede the increase in FBG.

Association between brachial-ankle pulse wave velocity and risk of type 2 diabetes mellitus: results from a cohort study

IntroductionBrachial-ankle pulse wave velocity (ba-PWV), as a simple and easily measured marker of arterial stiffness, has not been prospectively explored for its role in type 2 diabetes mellitus (T2DM) risk...

The Association Between Insomnia and Night Eating Behavior in Chinese Adults

Abstract Objectives Few studies have examined whether a certain sleep disorder could have an impact on eating behavior. We, thus, examined whether insomnia, one of the most common sleep disorders, was associated with the frequency of night eating. Methods Included were 74,147 adult participants (52.2 ±14.2 years, 82.3% men) of the Kailuan Study, an ongoing Chinese cohort, who completed survey questions on sleep and diet quality in 2014–2015. Insomnia status (yes/no) was assessed using a Chinese version of the Athens Insomnia Scale. Night eating was assessed via a questionnaire and participants who reported eating at night were further asked for night eating frequency (times per week). Logistic regression models were used to calculate the odd ratios (ORs) and 95% confidence intervals (CIs) of having night eating (yes/no) across insomnia status. General linear models were used to compare the mean and 95%CI of night eating frequency between participants with vs without insomnia. We adjusted for age, sex, baseline baPWV, total energy intake, Dietary Approaches to Stop Hypertension (DASH) score, physical activity, marriage status, occupation, education level, alcohol consumption, smoking status, body mass index, use of antihypertensive or antidiabetic drugs, systolic blood pressure, fasting blood glucose, lipid profiles, sleep duration, and snoring in the multivariate model. Results Of the 74,147 participants, 2267 were categorized as having insomnia. The adjusted OR of having night eating behavior for participants with insomnia, compared to those without insomnia, was 1.75 (95% Cl: 1.56–1.96) in the multivariate-adjusted model. Insomnia was also positively associated with more frequent night eating behavior (adjusted difference = 0.29/wk, P &amp;lt; 0.001). Conclusions People with insomnia were more likely to have night eating. Funding Sources The Penn State University and the start-up grant from the college of health and human development and the department of nutritional sciences, Penn State University.

Brachial-Ankle Pulse Wave Velocity Predicts New-Onset Hypertension and the Modifying Effect of Blood Pressure in a Chinese Community-Based Population.

Brachial-ankle pulse wave velocity (baPWV) was proven to be a prognostic indicator of cardiovascular events. However, the modifying effect of blood pressure (BP) on the longitudinal association between baPWV and new-onset hypertension is not well established. This study included 1849 non-hypertensive Chinese subjects from Shougang cohort study during December 2011 to July 2014. BaPWV was obtained using an Omron Colin BP-203RPE III device. Multivariate logistic regression models were used to evaluate associations of baPWV and outcomes. During a mean follow-up time of 2.36 years, 248 (13.41%) developed hypertension. BaPWV independently and gradably predicted the risk of incident hypertension and the SBP level at revisit (odds ratio or β (95% confidence interval) for participants with baPWV in quartile 4 vs. quartile 1: 2.72 (1.54, 4.78) for incident hypertension and 5.92 (4.26, 7.58) for SBP, P for trend: <0.001) after adjusting demonstrated risk factors. Besides, the effects of baseline baPWV on either incident hypertension or SBP at revisit were interactively modified by the level of baseline SBP; the effect size increased as the SBP level decreased. baPWV independently predicted the risk of hypertension and BP progression, modified by the level of SBP at baseline in this Chinese community-based population. The combination of baPWV and SBP can help differentiate the potential high-risk candidates who will develop hypertension quickly and benefit from early diagnosis and treatment.

Effect of the baseline pulse wave velocity on short term and long term blood pressure control in primary hypertension

ObjectivesArterial stiffness may affect antihypertensive response to antihypertensive treatment. However, sufficient clinical evidence is lacking. This longitudinal study aimed to evaluate the effect of baseline arterial stiffness measured by the brachial-ankle pulse wave velocity (baPWV) on response to short-term and long-term enalapril-based treatment in 3310 hypertensive adults from the China Stroke Primary Prevention Trial (CSPPT). Methods and resultsBlood pressure (BP) measured at three months (short-term) in 2780 subjects, and the time-average on-treatment BP in 3310 subjects during a median of 4.5-year follow-ups (long-term) were analyzed in the study. After short-term antihypertensive treatment, every 1 m/s increase in baPWV denoted a 7% and 6% decreased chance of achieving systolic BP (SBP) control (odds ratio (OR), 0.93; 95% CI 0.90, 0.96; P < 0.001) and BP control (OR, 0.94; 95% CI 0.91, 0.97; P < 0.001), respectively, after adjustment for age, gender and other variables. After long-term treatment, every 1 m/s increase in baPWV posed an 7% and 6% greater risk of failing to attain SBP control (OR, 0.93; 95% CI 0.90, 0.95; P < 0.001) and BP control (OR, 0.94; 95% CI, 0.92, 0.96; P < 0.001), respectively, not regarding for DBP control after both short- and long-term treatment. Higher baseline baPWV significantly decreased SBP reduction both after three months and the median 4.5-year treatment, while increased DBP reduction after the median 4.5-year treatment. ConclusionsElevated baseline baPWV significantly decreased BP response to short-and long-term treatment in adults with primary hypertensive. Arterial stiffness improvement may be an essential target to achieve adequate BP control.

Positive association between baseline brachial\u2013ankle pulse wave velocity and the risk of new-onset diabetes in hypertensive patients

BackgroundThere is no clearly defined temporal relationship between arterial stiffness and diabetes. We aimed to investigate the prospective association between baseline brachial–ankle pulse wave velocity (baPWV) and the risk of new-onset diabetes during follow-up, and examined whether there were effect modifiers, in hypertensive patients.MethodsWe included 2429 hypertensive patients with all the pertinent data but without diabetes at the baseline, who were part of the China Stroke Primary Prevention Trial (CSPPT), a randomized, double-blind, actively controlled trial conducted in 32 communities in Anhui and Jiangsu provinces in China. The primary outcome was new-onset diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during follow-up, or fasting glucose (FG) ≥ 126.0 mg/dL at the exit visit.ResultsDuring a median follow-up duration of 4.5 years, 287 (11.8%) participants developed diabetes. There was a significant positive association between baseline baPWV and the risk of new-onset diabetes (per SD increment; OR, 1.33; 95% CI 1.13, 1.56). Consistently, when baPWV was assessed as quartiles, a significantly higher risk of new-onset diabetes was found in participants in quartiles 2–4 (≥ 15.9 m/s; OR, 1.80; 95% CI 1.22, 2.65) compared with those in quartile 1 (< 15.9 m/s). The positive association was consistent in participants with (per SD increment; OR, 1.29; 95% CI 1.06, 1.56) or without (per SD increment; OR, 1.40; 95% CI 1.15, 1.71) impaired fasting glucose (IFG, FG ≥ 100.8 and < 126.0 mg/dL, P-interaction = 0.486).ConclusionsIn this sample of hypertensive patients, we found a significant positive association between baseline baPWV and the risk of new-onset diabetes.Clinical trial registration Trial registration: NCT00794885 (clinicaltrials.gov). Retrospectively registered November 20, 2008

Aging, Arterial Stiffness, and Blood Pressure Association in Chinese Adults.

Arterial stiffness and blood pressure (BP) both increase with aging synchronously. Whether elevated BP results from thickening of arterial wall or vice versa is controversial in previous studies. This study included 17 862 participants without history of myocardial infarction, stroke, atrial fibrillation or flutter, or cancer and with brachial-ankle pulse wave velocity (baPWV) and BP measurements during 2010 to 2016. Age was calculated from the self-reported birthdate to the first date of baPWV examination. Mediation analyses were applied to assess the mediation effect by baPWV in the association between age and BP. Temporal relation between baPWV and BP was assessed by cross-lagged analyses among 1508 participants with repeated assessment of baPWV. We found that systolic BP increased 0.47 (95% CI, 0.45-0.49) mm Hg per 1 year older by the mediation effect of baPWV and that the direct effect of aging on systolic BP was -0.07 (95% CI, -0.09 to -0.05) mm Hg per 1 year older. The standard regression coefficient from baseline baPWV to follow-up systolic BP was 0.09 (95% CI, 0.04-0.15), which was greater than the standard regression coefficient from baseline systolic BP to follow-up baPWV (0.01; 95% CI, -0.04 to 0.06). Arterial stiffness mediated the positive association between aging and BP, and arterial stiffness might precede elevated BP. Clinical Trial Registration- URL: http://www.chictr.org.cn . Unique identifier: ChiCTR-TNRC-11001489.

Longitudinal interaction between APOA5 -1131T>C and overweight in the acceleration of age-related increase in arterial stiffness through the regulation of circulating triglycerides.

We aimed to evaluate whether the longitudinal interaction between APOA5-1131C variants and overweight could accelerate age-related increases in arterial stiffness and circulating triglycerides in healthy subjects. This 3-year prospective cohort study included 503 healthy subjects. Brachial-ankle pulse wave velocity (baPWV), triglycerides, APOA5 -1131T > C, apolipoprotein (apo) A-V level, and low-density lipoprotein (LDL) particle size were measured at baseline and within a mean follow-up period of 3 years. At the 3-year follow-up, in the overweight group, subjects with the C allele showed increases in triglycerides and baPWV relative to baseline. Additionally, in the overweight group, there was a genotype effect on changes in triglycerides: subjects with the C allele had greater increases in triglyceride concentrations than subjects with the TT genotype. Furthermore, overweight subjects with the C allele had greater increases in triglyceride concentrations than normal-weight subjects with the C allele (P-interaction = 0.013). Overweight subjects with the C allele had greater increases in baPWV than normal-weight subjects with the C allele (P-interaction = 0.047). Changes in baPWV were affected by age, baseline baPWV, and changes in systolic blood pressure (BP) and triglycerides. Changes in triglycerides were affected by APOA5 -1131T > C genotype, age, baseline triglyceride level, and changes in BMI and apo A-V. In the overweight group, changes in baPWV were affected by changes in systolic BP, LDL particle size, and triglycerides. This prospective study shows that the interactive effect between APOA5 -1131C variants and overweight can accelerate age-related increase in arterial stiffness via the regulation of circulating triglycerides in healthy subjects.

ASSOCIATION OF RETINAL VESSEL CALIBERS AND LONGITUDINAL CHANGES IN ARTERIAL STIFFNESS

Objective: Morphological change in retinal vessel calibers has been reported as a marker of cardiovascular risk, but its association with arterial stiffening, a possible factor relating retinal vessel sings and cardiovascular outcomes, is not clear. The study aim was to clarify the relationship between retinal small vessel calibers and longitudinal change in large arterial stiffness in a sample of the general population. Design and method: The study included 6,720 Japanese participants (52.1 ± 12.8 years). Central retinal arteriolar equivalent (CRAE) and venular equivalent (CRVE) were measured by fundus photography. Arterial stiffness was evaluated by brachial-to-ankle pulse wave velocity (baPWV) at baseline and at 5 years. Results: The overall change in baPWV (δ-baPWV) during mean follow-up 1,814 ± 136 days was 41 ± 131 cm/sec (3.4 ± 9.9 % of baseline), and was significantly larger in men (52 ± 147 cm/sec) than in women (36 ± 122 cm/sec, p < 0.001). δ-baPWV was significantly increased in individuals with narrower CRAE (quartiles: Q1, 4.3 ± 10.6%; Q2, 3.3 ± 10.0%; Q3, 3.1 ± 9.3%; Q4, 3.1 ± 9.7%, p = 0.001), while no significant association was observed with CRVE. Although several factors also significantly differ among the CRAE quartiles, multivariate analysis identified CRAE as a significant inverse determinant of δ-baPWV (β = -0.033, p = 0.006) independent of the possible covariates including age (β = 0.433, p = < 0.001), male sex (β = 0.050, p < 0.001), BMI (β = 0.028, p = 0.024), mean BP (β = 0.059, p < 0.001), and baseline baPWV (β = -0.438, p < 0.001). The association of CRAE with δ-baPWV remained significant in a model further adjusted for CRVE (β = -0.040, p = 0.002). Further, the association between CRAE and δ-baPWV was prominent in a middle-aged (age Q2, β = -0.078, p = 0.002), but not younger (Q1, p = 0.232) or older (Q3, p = 0.427; Q4, p = 0.542) participants. Conclusions: Narrower CRAE in middle-age was associated with the long-term risk of arteriosclerosis in a general population sample.

Brachial-Ankle Pulse Wave Velocity is Associated with the Risk of New Carotid Plaque Formation: Data from a Chinese Community-based Cohort

Artery stiffness is an independent marker for atherosclerotic cardiovascular diseases. However, whether the brachial-ankle pulse wave velocity (ba-PWV) is related to new carotid plaque formation is unresolved. This study aimed to investigate the association between baseline ba-PWV and new carotid plaque formation in a Chinese community-based population without carotid plaques at baseline. This study population consisted of a total of 738 participants from an atherosclerosis cohort in Beijing, China. After a mean 2.3-year follow-up, the incidence of carotid plaques were 21.2% and 36.5% in the groups with ba-PWV < 1,400 cm/s and ≥1,400 cm/s, respectively. Compared with baseline ba-PWV < 1,400 cm/s group, ba-PWV ≥ 1,400 cm/s group was significantly associated with the incidence of new carotid plaque formation (odds ratio [OR] = 2.14, 95% CI: 1.50–3.03, P < 0.01), even after adjusting for common risk factors (OR = 1.52, 95% CI: 1.02–2.25, P = 0.04). Furthermore, there was a strong relationship between baseline ba-PWV and carotid plaque formation in subjects with ba-PWV < 1,400 cm/s, but no such relationship was found in subjects with baseline ba-PWV ≥ 1,400 cm/s. In conclusion, this study suggests that baseline ba-PWV is independently associated with the risk of carotid plaque formation in a Chinese community-based population.

Brachial-Ankle Pulse Wave Velocity Could Be a Predictor of Mortality in Patients on Peritoneal Dialysis.

Elevated pulse wave velocity (PWV) has been associated with higher mortality in the general population, chronic kidney disease (CKD) patients, and hemodialysis patients. However, in peritoneal dialysis (PD) patients, this association has received little attention. The aim of this study was to evaluate the association between baseline brachial-ankle PWV (baPWV) levels and total mortality in PD patients. In this single-center retrospective cohort study, 254 incident PD patients with baseline baPWV were followed up from 1 January 2013 to 31 July 2016. Collected baseline data included demographic characteristics and clinical and laboratory measurements. The association of baseline baPWV levels with total mortality was assessed using multivariable-adjusted Cox models. Of 254 patients, mean age was 61.4 (±15.3) years, 61.4% of patients were men, and 22.4% of patients were diabetic. The mean baseline baPWV level was 17.6 (±5.84) m/s. During a mean 31.5 (±20.8) month follow-up period, 45 patients died, of which 13 deaths were caused by cardiovascular disease. After adjusting for sex, age, blood pressure (BP), body mass index (BMI), and hemoglobin, as well as serum albumin, calcium, phosphorus, intact parathyroid hormone (iPTH), uric acid, and medication use, the highest baPWV tertile was significantly associated with a hazard ratio (HR) for total mortality of 2.97 (95% confidence interval [CI], 1.23 - 7.16; p = 0.02). Each 1 m/s higher baseline baPWV level was associated with a 7% (95% CI, 1.03 - 1.12; p = 0.001) higher risk of total mortality. In sensitivity analyses, individuals with baPWV > 21.0 m/s had the highest adjusted risk for total death (HR, 3.22; 95% CI, 1.71 - 6.08; p < 0.001). Higher baseline baPWV levels at the commencement of PD were independently associated with total mortality, which suggests that clinicians could use baPWV as a predictor of higher risk of mortality in PD patients.

Effect of Endothelin‐Related Gene Polymorphisms on Age‐Related Arterial Stiffening: A 10‐Year Longitudinal Study

Increased arterial stiffness has emerged as a strong predictor of future cardiovascular events and all‐cause mortality. The aim of this study was to elucidate influences of endothelin (ET)‐related genetic polymorphisms on age‐related arterial stiffening through a 10‐year longitudinal study. A decadal change in brachial‐ankle pulse wave velocity (baPWV), an index of arterial stiffness, was evaluated retrospectively among 92 volunteers (63 ± 14yrs, 51 men). The targeted single‐nucleotide polymorphisms were ET‐A receptor SNP rs5333 (ET‐A) and ET‐B receptor SNP rs5351 (ET‐B). Subjects with either ET‐A TC or CC genotypes exhibited significantly greater increases in baPWV (+15.3 ± 11.7 and +16.6 ± 15.7%/dec, respectively) than ET‐A TT genotype holders (+9.2 ± 9.0%/dec), while subjects with the ET‐B GG genotype showed a significantly greater increase in baPWV (+17.7 ± 14.1%/dec) than other ET‐B genotype holders (AA: +9.5 ± 10.0%/dec; AG: +11.2 ± 9.6%/dec). The combination of these ET‐related genetic risks was associated with a 2.4 times greater decadal increase in baPWV compared with no genetic risk (+8.1 ± 8.4 vs. 19.5 ± 16.0%/dec). These differences remained significant after adjusting for confounding factors, including baseline baPWV. Our current longitudinal study found that ET‐related gene polymorphisms contribute to diverse age‐related changes in arterial stiffness.Support or Funding InformationThis study was supported by special coordination funds of the Japanese Ministry of Education, Culture, Sports, Science, and Technology (KAKENHI JP25702045 and JP26670116, to JS).This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Association of retinal vessel calibers and longitudinal changes in arterial stiffness

Morphological change in retinal vessel calibers has been reported as a marker of cardiovascular risk, but its association with arterial stiffening, a possible factor relating retinal vessel sings and cardiovascular outcomes, is not clear. The study aim was to clarify the relationship between retinal small vessel calibers and longitudinal change in large arterial stiffness in a sample of the general population. The study included 6720 Japanese participants (52.1 ± 12.8 years). Central retinal arteriolar equivalent (CRAE) and venular equivalent were measured by fundus photography. Arterial stiffness was evaluated by brachial-to-ankle pulse wave velocity (baPWV) at baseline and at 5 years. The overall change in baPWV (ΔbaPWV) during a mean follow-up 1814 ± 136 days was 41 ± 131 cm/s (3.4 ± 9.9%), and was significantly increased in individuals with narrower CRAE (quartiles: Q1, 4.3 ± 10.6%; Q2, 3.3 ± 10.0%; Q3, 3.1 ± 9.3%; Q4, 3.1 ± 9.7%, P = 0.001). No significant association was observed with central retinal venular equivalent. Multivariate analysis identified CRAE as a significant inverse determinant of ΔbaPWV (β = -0.033, P = 0.006) independent of possible covariates including age, sex, blood pressure, and baseline baPWV. The association between CRAE and ΔbaPWV was prominent in a middle-aged (age Q2, β = -0.078, P = 0.002), but not younger (Q1, P = 0.232) or older (Q3, P = 0.427; Q4, P = 0.542) participants. Narrower CRAE in middle-age was associated with the long-term risk of arteriosclerosis in a general population sample.