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Association Between Arterial Stiffness and New-Onset Heart Failure: The Kailuan Study
Hongwei Zheng1,2, Shouling Wu3, Xiaokun Liu2
1Department of Internal Medicine, Hebei Medical University, Shijiazhuang, China (H.Z., Q.Z.).
Insights
Arterial stiffness (AS) is linked to a higher risk of developing new-onset heart failure (HF) in community dwellers. This association is independent of other risk factors and shows a dose-response relationship.
Area of Science:
- Cardiology
- Vascular Medicine
- Epidemiology
Background:
- Previous studies on arterial stiffness (AS) and heart failure (HF) used small samples and did not account for age and blood pressure.
- The independent association between AS and new-onset HF in the general population remains under-investigated.
Purpose of the Study:
- To investigate the independent association between AS and new-onset HF in community dwellers.
- To assess the dose-response relationship between AS and HF risk.
Main Methods:
- A cohort of 40,064 participants free of HF and atrial fibrillation at baseline were included.
- Brachial-ankle pulse wave velocity (baPWV) was used to measure AS, categorizing participants into normal (<1400 cm/s), borderline (1400–1800 cm/s), and elevated (≥1800 cm/s) groups.
- Cox proportional hazard regression models were used to calculate hazard ratios for incident HF.
Main Results:
- During a mean 5.53-year follow-up, 411 participants developed HF.
- Compared to normal AS, borderline AS showed a hazard ratio of 1.97 (95% CI: 1.36-2.86) and elevated AS showed 2.24 (95% CI: 1.49-3.38) for incident HF.
- Each 1 SD (359 cm/s) increase in baPWV was associated with a 1.10 (95% CI: 1.02-1.20) increased hazard ratio for new-onset HF.
Conclusions:
- Arterial stiffness is positively associated with an increased risk of new-onset heart failure.
- The association between AS and HF risk is independent of traditional risk factors and exhibits a dose-responsive effect.
Background:
Arterial stiffness (AS) was associated with heart failure (HF) in previous studies based on specific populations with small samples and the effects of age and blood pressure on AS were not taken into account. Whether AS was independently associated with new-onset HF in community dwellers has not been fully investigated to date.
Methods:
Individuals who participated in health evaluations and underwent synchronized brachial-ankle pulse wave velocity (baPWV) screening in 2010 to 2019 were included. They were free of HF and atrial fibrillation at baseline. The participants were allocated to 3 groups according to their baPWV values. Normal AS was defined as baPWV <1400 cm/s, borderline AS was defined as 1400≤baPWV<1800 cm/s, and elevated AS was defined as baPWV ≥1800 cm/s. Cox proportional hazard regression was used to calculate hazard ratios with 95% CIs of new-onset HF across different AS groups.
Results:
A total of 40 064 participants were enrolled with a mean age of 48.81±12.67 years. During a mean 5.53 years of follow-up, 411 participants developed HF. Compared with the normal AS group, the hazard ratio (95% CI) for incident HF was 1.97 (1.36-2.86) for the borderline AS group and 2.24 (1.49-3.38) for the elevated AS group in the multivariable-adjusted model. For each 1 SD (359 cm/s) increase in baPWV, the hazard ratio (95% CI) for new-onset HF was 1.10 (1.02-1.20).
Conclusions:
AS was positively associated with a higher risk of new-onset HF independently of traditional risk factors, with a dose-responsive effect.
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