Association between measurements of arterial stiffness and target organ damage in a general Spanish population

Figures & data

Table 1. Baseline demographic and clinical characteristics of participants by sex.

	Overall (n = 494)	Men (n = 245)	Women (n = 249)	p Value
Lifestyles
Alcohol, (gr/W)	46.18 ± 78.49	72.00 ± 95.90	20.78 ± 43.49	<.001
Smoker, n (%)	88 (17.80)	49 (19.70)	41 (16.30)	.430
Smoker, (years)	12.77 ± 17.27	14.01 ± 18.68	11.56 ± 15.70	.115
Mediterraneandiet	7.15 ± 2.08	6.69 ± 1.97	7.61 ± 2.09	<.001
Total physical activity, (h/W)	8.09 ± 0.66	7.86 ± 0.50	8.30 ± 0.73	<.001
Cardiovascular risk factors
Age, years	55.84 ± 14.26	55.87 ± 14.34	55.81 ± 14.20	.962
Family history of premature CVD, n (%)	199 (40.3)	96 (38.6)	107 (42.5)	.389
BMI, kg/m^2	26.41 ± 4.08	26.85 ± 3.49	25.97 ± 4.55	.017
SBP, mmHg	120.52 ± 23.11	126.29 ± 19.40	114.85 ± 25.03	<.001
DBP, mmHg	75.42 ± 10.10	77.29 ± 9.36	73.58 ± 10.48	<.001
FPG, mg/dl	88.08 ± 17.23	89.82 ± 18.44	86.37 ± 15.79	.026
HbA1c, %	5.49 ± 0.55	5.53 ± 0.61	5.44 ± 0.47	.070
T-c, mg/dl	194.56 ± 32.49	192.11 ± 32.11	196.98 ± 32.75	.096
LDL-c, mg/dl	115.28 ± 29.32	117.03 ± 29.95	113.57 ± 28.64	.192
HDL-c, mg/dl	58.83 ± 16.13	53.19 ± 13.95	64.34 ± 16.24	<.001
Triglycerides, mg/dl	102.80 ± 53.34	111.73 ± 54.56	94.02 ± 50.71	<.001
Target organ damage
c-IMT, mm	0.68 ± 0.11	0.70 ± 0.12	0.66 ± 0.10	.001
Vascular TOD, n (%)	58 (11.7)	39 (17.1)	19 (7.5)	.004
ABI	1.11 ± 0.08	1.13 ± 0.08	1.10 ± 0.08	<.001
Cornell	13.22 ± 5.85	14.64 ± 6.14	11.81 ± 5.20	<.001
VDP Cornell	1479.27 ± 607.68	1423.11 ± 711.42	1534.98 ± 478.33	.041
Sokolow	20.67 ± 6.61	22.17 ± 6.85	19.18 ± 6.01	<.001
LVH, n (%)	74 (15.0)	60 (24.4)	15 (6.0)	<.001
Creatinine, mg/dl	0.80 ± 0.19	0.91 ± 0.17	0.69 ± 0.13	<.001
CKD-EPI, mL/(min.1.73 m^2)	93.26 ± 16.29	91.66 ± 16.18	94.83 ± 16.27	.030
ACR, mg/g	14.13 ± 39.26	10.86 ± 31.54	17.36 ± 45.46	.067
Renal TOD, n (%)	59(11.9)	41 (16.7)	18 (7.2)	.001
Diseases and treatment
Hypertension, n (%)	143 (28.9)	82 (32.9)	65 (25.8)	.109
Dyslipidemia, n (%)	320 (64.8)	162 (65.6)	164 (65.1)	.993
Diabetes mellitus, n (%)	37 (7.5)	26 (10.4)	12 (4.8)	.023
Obesity, n (%)	89 (18.0)	42 (16.9)	52 (20.6)	.332
Antihypertensive treatment, n (%)	92 (18.6)	50 (20.1)	46 (18.3)	.751
Lipid-lowering treatment, n (%)	102 (20.6)	49 (19.7)	53 (21.0)	.724
Antidiabetic treatment, n (%)	34 (6.9)	23 (9.2)	12 (4.8)	.068
Vascular function
cf-PWV, m/s	8.15 ± 2.49	8.54 ± 2.68	7.75 ± 2.23	<.001
ba-PWV, m/s	12.92 ± 2.67	13.14 ± 2.45	12.71 ± 2.86	.070
CAVI	8.01 ± 1.44	8.13 ± 1.49	7.88 ± 1.39	.049

The continuous variables were represented as average ± standard deviation; the categorical variables as number and percentage.

^ap Value show differences between men and women.

W: week; CVD: cardiovascular disease; BMI: body mass index; SBP: systolic blood pressure; DBP: diastolic blood pressure; FPG: fasting plasma glucose; HbA1c: glycosylated haemoglobin; T-c: total cholesterol; LDL-c: low density lipoprotein cholesterol; HDL-c: high density lipoprotein cholesterol; c-IMT: carotid intima-medium thickness; ABI: ankle-brachial index; TOD: target organ damage; LVH: left ventricular hypertrophy; VDP: voltage-duration product; CKD-EPI: chronic kidney disease epidemiology collaboration; ACR: albumin-creatinine ratio; cf-PWV: carotid-femoral pulse wave velocity; ba-PWV: brachial-ankle pulse wave velocity; CAVI: cardio-ankle vascular index.

Figure 1. Estimated average and standard deviation of cf-PWV, ba-PWV and CAVI in subjects with and without vascular and renal TOD, and LVH. p-value: differences among groups. TOD: target organ damage; LVH: left ventricular hypertrophy; cf-PWV: carotid-femoral pulse wave velocity; ba-PWV: brachial-ankle pulse wave velocity; CAVI: cardio-ankle vascular index.

Figure 2. Estimated average and standard deviation of cf-PWV, ba-PWV and CAVI in subjects with and without vascular and renal TOD, and LVH. Adjusted for age (years) and sex (0= female, 1 = male). p-value: differences among groups. TOD: target organ damage; LVH: left ventricular hypertrophy; cf-PWV: carotid-femoral pulse wave velocity; ba-PWV: brachial-ankle pulse wave velocity; CAVI: cardio-ankle vascular index.

Table 2. Bivariate correlations of structure and function parameters with cardiovascular risk factors.

	c-IMT	cf-PWV	ba-PWV	CAVI
c-IMT	1	0.563**	0.623**	0.591**
ABI	0.095*	0.015	0.058	0.166**
cf-PWV	0.563**	1	0.734**	0.621**
ba-PWV	0.623**	0.734**	1	0.831**
CAVI	0.591**	0.621**	0.831**	1
Age	0.744**	0.641**	0.734**	0.727**
BMI, kg/m^2	0.310**	0.249**	0.195**	0.026
SBP, mmHg	0.370**	0.339**	0.435**	0.301**
DBP, mmHg	0.219**	0.340**	0.446**	0.284**
FPG, mg/dl	0.284**	0.359**	0.313**	0.238**
HbA1c, %	0.353**	0.423**	0.375**	0.344**
T-c, mg/dl	0.169**	0.076	0.155**	0.115*
LDL-c, mg/dl	0.159**	0.045	0.107*	0.086
HDL-c, mg/dl	−0.047	−0.075	−0.021	0.017
Triglycerides, mg/dl	0.189**	0.229**	0.245**	0.127**
Sokolow	−0.101*	−0.050	−0.045	−0.072
VDP-Cornell	0.036	0.035	0.052	0.018
Creatinine, mg/dl	0.149**	0.166**	0.039	0.066
ACR, mg/g	0.041	0.020	0.110*	0.050
CKD-EPI, mL/(min.1.73 m^2)	−0.503**	−0.439**	−0.418**	−0.434**

^ap-value s were determined by Pearson correlation. *p < .05; **p < .01.

c-IMT: carotid intima-medium thickness; cf-PWV: carotid-femoral pulse wave velocity; ba-PWV: brachial-ankle pulse wave velocity; CAVI: cardio-ankle vascular index; ABI: ankle-brachial index; BMI: body mass index; SBP: systolic blood pressure; DBP: diastolic blood pressure; FPG: fasting plasma glucose; HbA1c: glycosylated haemoglobin; T-c: total cholesterol; LDL-c: low density lipoprotein cholesterol; HDL-c: high density lipoprotein cholesterol; VDP: voltage duration product; ACR: albumin-creatinine ratio; CKD-EPI: chronic kidney disease epidemiology collaboration.

Table 3. Regression analysis of vascular structure and function parameters with vascular, cardiac, and renal parameters.

	Cf-PWV			ba-PWV			CAVI
	β	(95% CI)	p Value	β	(95% CI)	p Value	β	(95% CI)	p Value
Vascular TOD
c-IMT
M1	0.004	0.001; 0.008	.022	0.005	0.002; 0.009	.004	0.005	− 0.001; 0.012	.108
M2	0.003	− 0.001; 0.006	.172	0.006	0.001; 0.010	.007	0.009	0.003; 0.016	.007
ABI
M1	− 0.005	− 0.009; − 0.002	.006	− 0.002	− 0.006; 0.001	.225	0.009	0.002; 0.016	.015
M2	− 0.004	− 0.008; 0.000	.044	− 0.001	− 0.005; 0.003	.604	0.010	0.002; 0.017	.009
LVH
Sokolow
M1	0.114	− 0.189; 0.416	.460	0.374	0.057; 0.691	.021	0.271	− 0.313; 0.855	.362
M2	0.012	− 0.306; 0.331	.940	0.222	− 0.120; 0.563	.202	− 0.016	− 0.619; 0.586	.957
PDV − Cornell
M1	14.096	− 13.934; 42.126	.324	13.293	− 17.158; 43.745	.391	− 16.042	− 71.974; 39.890	.573
M2	12.604	− 17.238; 42.446	.407	6.007	− 27.189; 39.204	.722	− 28.480	− 86.996; 30.037	.339
Renal TOD
CKD-EPI
M1	− 0.102	− 0.682; 0.479	.731	0.997	0.394; 1.601	.001	1.159	0.044; 2.275	.042
M2	0.071	− 0.546; 0.688	.821	1.316	0.663; 1.969	<.001	1.010	− 0.158; 2.178	.090
ACR
M1	− 1.492	− 3.398; 0.414	.125	0.673	− 1.310; 2.656	.505	− 2.078	− 5.708; 1.552	.261
M2	− 2.221	− 4.260; − 0.182	.033	0.040	− 2.130; 2.210	.971	− 2.594	− 6.409; 1.222	.182

Model 1: Adjusted by age (years), smoking (years), sex, alcohol (gr), total physical activity (hour/week) and Mediterranean Diet (points).

Model 2: Adjusted by age (years), smoking (years), sex, alcohol (gr), total physical activity (hour/week) and Mediterranean Diet (points).

SBP (mmHg), BMI (kg/m²⁾, FPG (mg/dl), and Triglycerides (mg/dl).

^ap-value for statistically significant differences (p < .05).

TOD: target organ damage; c-IMT: carotid intima-medium thickness; LVH: left ventricular hypertrophy; CKD-EPI: chronic kidney disease epidemiology collaboration; ACR: albumin creatinine ratio; β: correlation coefficient; CI: confidence interval;cf-PWV: carotid-femoral pulse wave velocity; ba-PWV: brachial-ankle pulse wave velocity; CAVI: cardio-ankle vascular index; ABI: ankle-brachial index.

Figure 3. A. Logistic regression analysis adjusted by age (years), smoking (years), sex, alcohol (gr), total physical activity (hour/week) and Mediterranean Diet (points), OR of cf-PWV, ba-PWV and CAVI with vascular and renal TOD, and LVH. B. Logistic regression analysis adjusted by age (years), smoking (years), sex, alcohol (gr), total physical activity (hour/week), Mediterranean Diet (points), SBP (mmHg), BMI (kg/m²), FPG (mg/dl) and triglycerides (mg/dl), OR of cf-PWV, ba-PWV and CAVI with vascular and renal TOD, and LVH. TOD: target organ damage; LVH: left ventricular hypertrophy;cf-PWV: carotid-femoral pulse wave velocity; ba-PWV: brachial-ankle pulse wave velocity; CAVI: cardio-ankle vascular index.

Figure 4. Receiver operating curve of cf-PWV, ba-PWV and CAVI to identify vascular TOD (a), LVH (b) and renal TOD (c). Areas under the ROC curves are summarised in Table 4. TOD: target organ damage; LVH: left ventricular hypertrophy; cf-PWV: carotid-femoral pulse wave velocity; ba-PWV: brachial-ankle pulse wave velocity; CAVI: cardio-ankle vascular index.

Table 4. Area under receiver operating characteristics curve and cut-off points sensitivity and specificity for the vascular and renal TOD, and LVH.

	Cut-off value	Sensitivity (%)	Specificity (%)	Area under the curve	p-value
LVH
cf-PWV	8.250	0.661	0.673	0.717	<0.001
ba-PWV	13.320	0.643	0.640	0.692	<0.001
CAVI	8.350	0.625	0.633	0.675	<0.001
Vascular TOD
cf-PWV	7.750	0.615	0.637	0.672	<0.001
ba-PWV	12.775	0.654	0.653	0.711	<0.001
CAVI	8.125	0.659	0.650	0.709	<0.001
Renal TOD
cf-PWV	8.750	0.500	0.500	0.667	<0.001
ba-PWV	14.062	0.500	0.500	0.653	<0.001
CAVI	8.425	0.500	0.500	0.608	0.008

TOD: target organ damage; LVH: left ventricular hypertrophy; cf-PWV: carotid-femoral pulse wave velocity; ba-PWV: brachial-ankle pulse wave velocity; CAVI: cardio-ankle vascular index.