Association between vascular overload index and arterial stiffness: a secondary analysis of a nationwide...

Current evidence regarding the association between vascular overload index (VOI) and arterial stiffness in Japanese adults remains limited. Given that brachial-ankle pulse wave velocity (baPWV) has been established as a validated biomarker for assessing atherosclerosis, this study aims to comprehensively investigate the association between VOI and arterial stiffness through baPWV measurements.

This secondary analysis utilized health examination data from 912 participants (2004-2012) at Gifu Murakami Memorial Hospital, Japan. The baseline data of participants were divided into four groups according to the quartiles of VOI for comparative analysis. Univariate linear regression and multivariable linear regression were used to investigate the association between VOI and baPWV. Linear scatter plots initially assessed the VOI-baPWV relationship, and Subgroup analyses were stratified by age, sex, BMI, smoking status, regular exercise, and fatty liver. VOI was calculated using the standardized formula: VOI = 1.33 × SBP - 0.33 × DBP - 133.3.

With the increase of VOI level, baPWV increased gradually (1,277.85 ± 162.57 vs. 1,361.45 ± 194.85 vs. 1,415.45 ± 173.10 vs. 1,608.25 ± 299.53, p < 0.05). Multivariable linear regression showed that after adjusting for all covariates, each 0.1-unit increase in VOI was associated with a 0.69-unit increase in baPWV(m/s). Linear correlation scatter revealed a strong positive correlation between VOI and baPWV (r = 0.51, 95% CI 0.461-0.557, p < 0.001). The association between VOI and baPWV was more pronounced in the subgroups of age ≥ 55 years (Beta = 0.90, 95% CI 0.76-1.04, p < 0.001), males (Beta = 0.76, 95% CI 0.66-0.85, p < 0.001), smokers (Beta = 0.81, 95% CI 0.69-0.92, p < 0.001), and those with fatty liver (Beta = 0.85, 95% CI 0.69-1.00, p < 0.001).

VOI is significantly and independently associated with baPWV and may serve as a potential biomarker for early risk assessment of arterial stiffness.