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Associations between echocardiographic arterial compliance and incident cardiovascular disease in blacks: the ARIC study.

TitleAssociations between echocardiographic arterial compliance and incident cardiovascular disease in blacks: the ARIC study.
Publication TypeJournal Article
Year of Publication2015
AuthorsCaughey MC, Loehr LR, Cheng S, Solomon SD, Avery C
Secondary AuthorsHinderliter AL
JournalAm J Hypertens
Volume28
Issue1
Pagination81-8
Date Published2015 Jan
ISSN1941-7225
KeywordsAfrican Americans, Aorta, Arterial Pressure, Blood Flow Velocity, Brachial Artery, Cardiovascular Diseases, Chi-Square Distribution, Compliance, Female, Humans, Incidence, Longitudinal Studies, Male, Middle Aged, Odds Ratio, Predictive Value of Tests, Proportional Hazards Models, Risk Factors, Stroke Volume, Time Factors, Ultrasonography, United States, Vascular Stiffness
Abstract

BACKGROUND: Systemic arterial compliance is sometimes derived by echocardiographic stroke volume to pulse pressure ratios. Few studies have assessed echocardiographic arterial compliance in blacks or its associations with explicit, rather than composite, cardiovascular disease (CVD) outcomes.

METHODS: We analyzed a subset (n = 1,887) of blacks (mean age = 59 ± 6 years; 65% women) in the Atherosclerosis Risk in Communities study who were free of prevalent CVD and were imaged by echocardiography in 1993-1995. Arterial compliance was calculated by the aortic velocity time integral and brachial pulse pressure ratio (VTI/PP). Associations between VTI/PP and subsequent CVD (defined as first incident stroke, coronary event, or heart failure) were modeled by Cox regression after controlling for demographics, anthropometry, and cardiac risk factors. For comparison, CVD hazard ratios were also calculated for pulse pressure quartiles.

RESULTS: Over a mean follow-up of 13 ± 4 years, 237 subjects (12%) developed coronary disease, 322 (16%) developed heart failure, and 180 (9%) experienced a stroke. Hazard ratios contrasting lowest with highest quartiles of VTI/PP were 2.3 (95% confidence interval (CI) = 1.7-3.1) for composite CVD, 2.1 (95% CI = 1.3-3.2) for coronary disease, 2.5 (95% CI = 1.7-3.6) for heart failure, and 2.7 (95% CI = 1.6-4.5) for stroke. Hazard ratios contrasting widest with narrowest pulse pressure quartiles were 1.7 (95% CI = 1.3-2.2) for composite CVD, 1.6 (95% CI = 1.0-2.4) for coronary heart disease, 1.8 (95% CI = 1.2-2.6) for heart failure, and 2.3 (95% CI = 1.3-3.9) for stroke.

CONCLUSIONS: In blacks, the VTI/PP ratio has stronger associations with both composite and individual CVD outcomes than does pulse pressure.

DOI10.1093/ajh/hpu087
Alternate JournalAm J Hypertens
PubMed ID24842391
PubMed Central IDPMC4318950
Grant ListR00 HL098458 / HL / NHLBI NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
R00-HL098458 / HL / NHLBI NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
HHSN268201100005G / HL / NHLBI NIH HHS / United States
K99-HL-107642 / HL / NHLBI NIH HHS / United States
HHSN268201100008I / HL / NHLBI NIH HHS / United States
HHSN268201100005C / / PHS HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
HHSN268201100011I / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
HSN268201100006C / / PHS HHS / United States
HHSN268201100010C / / PHS HHS / United States
R00 HL107642 / HL / NHLBI NIH HHS / United States
HHSN268201100008C / / PHS HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
HHSN268201100007C / / PHS HHS / United States
SN268201100012C / / PHS HHS / United States
HHSN268201100011C / / PHS HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
HHSN268201100007I / HL / NHLBI NIH HHS / United States
HSN268201100009C / / PHS HHS / United States
K99 HL107642 / HL / NHLBI NIH HHS / United States