Vascular robustness: The missing parameter in cardiovascular risk prediction

Area of Science:

• Cardiovascular Medicine
• Biomarkers
• Vascular Physiology

Background:

• Undetected high risk for premature cardiovascular disease (CVD) mortality persists despite low-to-moderate risk factor scores.
• Vascular functional robustness may differentiate mortality risk among individuals with similar risk factor loads.
• Assessing vascular robustness could offer a novel approach to CVD risk stratification.

Purpose of the Study:

• To test the hypothesis that vascular robustness inversely correlates with mortality risk, especially in aging populations with cardiovascular risk factors.
• To determine if vascular robustness serves as a discriminator for otherwise undetected high CVD mortality risk.

Main Methods:

• Retrospective cohort study of 372 adults with cardiovascular risk factors.
• Arterial model (VascAssist 2) used to derive global arterial function parameters from pulse pressure waves.
• Multivariate linear regression to derive a robustness score, calibrated against CVD mortality data from the LURIC study.

Main Results:

• Vascular robustness correlated linearly with calendar age in patients with hypertension/hypercholesterolemia (CC) and history of cardiovascular events (CVE).
• This age-related decline in robustness was not observed in apparently healthy individuals (AH).
• Findings support the preferential elimination of less robust individuals under aging and risk factor challenges.

Conclusions:

• Vascular robustness may serve as a crucial biomarker for vulnerability to cardiovascular risk factors.
• This functional measure can prognosticate elevated, otherwise undetectable, risks for premature CVD mortality.
• Assessing vascular robustness offers a promising tool for enhanced CVD prevention strategies.