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Aortic pulse wave velocity predicts cardiovascular mortality in subjects >70 years of age
S Meaume1, A Benetos, O F Henry
1Geriatrics Department of Charles-Foix Hospital, Limeil-Brevannes, France.
Insights
Aortic pulse wave velocity (PWV) predicts cardiovascular death in older adults. This measure is a stronger predictor than blood pressure in individuals aged 70-100.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Clinical Epidemiology
Background:
- Aortic pulse wave velocity (PWV) is a known predictor of cardiovascular mortality in hypertensive and end-stage renal disease patients.
- The role of PWV in cardiovascular risk assessment for the elderly (70-100 years) remains largely untested.
Purpose of the Study:
- To investigate aortic PWV as a predictor of cardiovascular mortality in elderly individuals aged 70 to 100 years.
- To compare the predictive value of PWV against traditional blood pressure parameters in this age group.
Main Methods:
- A prospective cohort study involving 141 subjects (mean age 87.1 years) across three geriatric departments.
- Aortic PWV was measured using a validated automatic device, alongside standard sphygmomanometric blood pressure.
- Logistic regression analysis was employed to identify mortality predictors over a 30-month follow-up period.
Main Results:
- Aortic PWV emerged as the primary independent predictor of cardiovascular mortality (P=0.016, OR=1.19).
- Age and loss of autonomy were significant predictors of overall mortality.
- Neither antihypertensive treatment nor blood pressure parameters (systolic, pulse pressure) showed additive predictive value for cardiovascular death.
Conclusions:
- Aortic PWV is a robust and independent predictor of cardiovascular death in individuals aged 70 to 100 years.
- PWV is a more significant cardiovascular risk marker in this elderly population than conventional blood pressure measurements.
- Further intervention trials are warranted to confirm these findings.
Abstract:
Aortic pulse wave velocity (PWV) is a significant and independent predictor of cardiovascular mortality in subjects with essential hypertension and in patients with end-stage renal disease. Its contribution to cardiovascular risk in subjects 70 to 100 years old has never been tested. A cohort of 141 subjects (mean+/-SD age, 87.1+/-6.6 years) was studied in 3 geriatrics departments in a Paris suburb. Together with sphygmomanometric blood pressure measurements, aortic PWV was measured with a validated automatic device. During the 30-month follow-up, 56 patients died (27 from cardiovascular events). Logistic regressions indicated that age (P=0.005) and a loss of autonomy (P=0.01) were the best predictors of overall mortality. For cardiovascular mortality, aortic PWV was the major risk predictor (P=0.016). The odds ratio was 1.19 (95% confidence interval, 1.03 to 1.37). Antihypertensive drug treatment and blood pressure, including systolic and pulse pressure, had no additive role. In subjects 70 to 100 years old, aortic PWV is a strong, independent predictor of cardiovascular death, whereas systolic or pulse pressure was not. This prospective result will need to be confirmed in an intervention trial.