Elevated pulse wave velocity increases the odds of coronary calcification in overweight postmenopausal women
Lakshmi Venkitachalam1, Rachel H Mackey, Kim Sutton-Tyrrell
1Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Insights
Arterial stiffness measures, carotid-femoral pulse wave velocity (cfPWV) and brachial-ankle pulse wave velocity index (baPVI), are linked to coronary artery calcification (CAC) in overweight postmenopausal women. Higher baPVI showed a stronger association with CAC presence and severity.
Area of Science:
- Cardiovascular Health
- Biomedical Engineering
- Gerontology
Background:
- Aortic stiffness, measured by cfPWV, is a known predictor of mortality.
- Brachial-ankle pulse wave velocity index (baPVI) is a novel automated arterial stiffness measure.
- Overweight/obese postmenopausal women without cardiovascular disease were studied.
Purpose of the Study:
- To evaluate the association between cfPWV and baPVI with coronary artery calcification (CAC).
- To assess these arterial stiffness measures in overweight/obese postmenopausal women.
Main Methods:
- 504 postmenopausal women (aged 52-62) underwent electron beam tomography for CAC assessment.
- CAC scores were categorized as CAC >0 and CAC >100.
- cfPWV and baPVI were measured and analyzed in relation to CAC presence and severity.
Main Results:
- 51% of participants had detectable CAC (CAC >0).
- Both cfPWV and baPVI were associated with CAC presence and severity.
- baPVI demonstrated a stronger, more persistent association with CAC after multivariable adjustment.
Conclusions:
- Both cfPWV and baPVI are significantly associated with coronary calcification in overweight postmenopausal women.
- baPVI may be a valuable tool for assessing cardiovascular risk in this population.
Background:
Aortic stiffness, assessed using carotid-femoral pulse wave velocity (cfPWV), predicts all-cause and cardiovascular mortality. Brachial-ankle pulse wave velocity index (baPVI) is a newer measure of arterial stiffness obtained using an automated system. Our aim is to evaluate the association between both these measures of arterial stiffness and coronary calcification (CAC), in overweight/obese postmenopausal women, without apparent cardiovascular disease.
Methods:
The CAC was assessed using electron beam tomography in 504 postmenopausal women, aged 52 to 62 years (88.2% white) with mean body mass index (BMI) 30.8 kg/m(2). The CAC scores were analyzed as CAC >0 and CAC >100 versus CAC = 0, or as ln (CAC + 1).
Results:
The cfPWV was available in 476 women (mean [SD]: 900 (255) cm/sec) and baPVI was available in 441 women (mean [SD]: 1434 (231) cm/sec. Any CAC (CAC >0) was present in approximately 51% of the cohort. Both high cfPWV (RR = 1.5, 1.6, and 1.7 for quartiles 2, 3, and 4 v 1) and baPVI (RR = 2.9, 3.7. and 4.0 for quartiles 2, 3, and 4 v 1) were associated with the presence of calcification (CAC >0). The association was attenuated but remained significant only for baPVI after adjusting for age, systolic blood pressure, average waist circumference, BMI, fasting glucose, insulin, lipids, hormone replacement therapy, and smoking status. High odds of severe calcification (CAC >100) was seen with the highest quartile of the cfPWV (RR = 5.3) and baPVI (RR = 7.8), and these associations remained significant in multivariable analysis.
Conclusions:
Both cfPWV and baPVI are associated with presence and severity of coronary calcification in overweight postmenopausal women.
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