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Longitudinal Changes in Vascular Risk Markers and Mortality Rates among a Latino Population with Hypertension

Matthew C Pflederer, Carlin S Long, Brenda Beaty

    Texas Heart Institute Journal
    |April 30, 2016
    PubMed

    Insights

    Vascular markers like pulse-wave velocity and carotid intima-media thickness (CIMT) predict cardiovascular disease risk and mortality in minority populations, outperforming inflammatory markers.

    Area of Science:

    • Cardiovascular Disease Epidemiology
    • Vascular Biology
    • Biomarker Research

    Background:

    • Traditional cardiovascular disease risk factors may not fully capture risk in minority populations.
    • Vascular markers like pulse-wave velocity and carotid intima-media thickness (CIMT) show promise for improved risk prediction.
    • Characterization of these markers in diverse populations is limited.

    Purpose of the Study:

    • To evaluate vascular markers (arterial pulse-wave velocity, CIMT) and inflammatory biomarkers for predicting cardiovascular disease and mortality in a hypertensive minority cohort.
    • To assess the longitudinal changes and correlations of these markers over time.
    • To determine if vascular markers offer superior prediction compared to inflammatory markers.

    Main Methods:

    • Prospective, longitudinal cohort study in hypertensive patients at an urban safety-net hospital.
    • Evaluation of inflammatory biomarkers, pulse-wave velocity, and CIMT at baseline, 1 year, and 2 years.
    • Generalized linear mixed-effects models for CIMT associations; administrative and National Death Index data for mortality.

    Main Results:

    • Pulse-wave velocity and CIMT regressed over time and were highly correlated (P <0.001).
    • Only pulse-wave velocity (P=0.002) and total cholesterol (P=0.03) associated with CIMT in time-varying analysis.
    • Higher baseline CIMT and pulse-wave velocity correlated with increased mortality (P <0.01); no inflammatory marker showed significant correlation with CIMT changes or death.

    Conclusions:

    • Arterial stiffness and preclinical carotid atherosclerosis are significant predictors of mortality in this minority population.
    • Vascular markers, specifically pulse-wave velocity and CIMT, may serve as valuable risk-stratification tools.
    • Inflammatory biomarkers did not demonstrate significant utility in predicting longitudinal CIMT changes or mortality in this cohort.

    Keywords:
    Biomarkers/analysisHispanic Americans/ethnologycardiovascular diseases/epidemiology/ethnology/prevention & controlmodels, statisticalphospholipases A2predictive value of testspulse-wave analysis/methodsrisk assessmentrisk factorssocioeconomic factors

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