End Point-Based Threshold for the Ambulatory Arterial Stiffness Index

Area of Science:

• Cardiology
• Preventive Medicine
• Biostatistics

Background:

• The ambulatory arterial stiffness index (AASI) is increasingly utilized in clinical research and practice for cardiovascular risk assessment.
• Arterial stiffness is a significant predictor of cardiovascular events and mortality.

Purpose of the Study:

• To consolidate the prognostic accuracy of AASI in the general population.
• To derive an endpoint-based AASI risk threshold for improved cardiovascular risk stratification.

Main Methods:

• An individual-participant meta-analysis of 14 population studies involving 12,558 individuals.
• AASI derived by regressing 24-hour diastolic on systolic blood pressure; Cox regression used to establish risk thresholds.
• Analysis included stepwise increasing AASI levels and determination of AASI yielding a 10-year risk equivalent to office systolic pressure of 140 mmHg.

Main Results:

• Over a median of 10.7 years, 3027 deaths and 2183 cardiovascular events occurred.
• Each 1-SD increment in AASI was associated with increased risk of all-cause death (HR 1.08) and cardiovascular events (HR 1.13).
• A risk-carrying AASI threshold of 0.50 was identified, associated with significantly higher risks for both outcomes, improving model performance.

Conclusions:

• AASI significantly enhances cardiovascular risk stratification beyond traditional risk factors.
• Exceeding the AASI threshold of 0.50 warrants increased vigilance in managing risk factors to prevent cardiovascular complications.