Relationship Between Vascular Aging and Left Ventricular Concentric Geometry in Community-Dwelling Elderly: The Northern Shanghai Study

Figures & data

Table 1 Participant Characteristics

	Overall (n=3363)	Female (n=1896)	Male (n=1467)	P value
Cardiovascular risk factors
Age (years)	71.1±6.0	71.1±6.1	71.1±5.9	0.93
Family history of premature CVD, n (%)	722 (21.5)	443 (23.4)	279 (19.0)	0.002*
Smoking (n, %)	823 (24.7)	36 (1.9)	797 (54.3)	<0.001*
Waist-to-hip ratio	0.90±0.07	0.88±0.07	0.91±0.06	<0.001*
BMI (kg/m^2)	24.55±3.58	24.57±3.81	24.53±3.26	0.73
Fasting blood glucose (mmol/L)	5.78±1.76	5.74±1.65	5.83±1.87	0.16
Urine acid (μmol/L)	332.6±83.5	308.9±75.3	363.9±83.9	<0.001*
Triglycerides (mmol/L)	1.62±1.02	1.68±1.06	1.54±1.00	<0.001*
HDL/LDL Cholesterol	0.49±0.21	0.49±0.21	0.48±0.21	0.04*
Systolic BP (mmHg)	136±17	136±18	136±16	0.60
Heart rate (beats/min)	72±11	73±11	71±11	<0.001*
Vascular and left ventricular parameters
Cf-PWV (m/s)	9.3±2.3	9.3±2.3	9.3±2.4	0.67
Ba-PWV (cm/s)	1876.0±413.9	1879.6±419.3	1815.5±373.2	<0.001*
ABI<0.9 (n, %)	445 (13.2)	224 (11.8)	221 (15.1)	0.005*
cIMT>0.9 or Plaque (n, %)	2265 (67.4)	1220 (64.3)	1045 (71.2)	<0.001*
eGFR (mL/min/1.73 m^2)	77.8±16.3	84.8±14.0	68.6±16.3	<0.001*
UACR (mg/g)	49.8±59.0	52.4±57.5	46.6±60.7	0.007*
LVMI (g/m^2)	87.0±25.5	85.8±25.6	88.6±25.2	0.002*
RWT	0.39±0.08	0.39±0.07	0.39±0.08	0.368
Diseases and treatment
Hypertension, n (%)	2148 (64.1)	1210 (63.8)	938 (63.9)	0.93
Diabetes, n (%)	756 (22.5)	419 (22.1)	337 (23.0)	0.55
Anti-hypertension treatment (n, %)	1682 (50.0)	943 (49.7)	739 (50.4)	0.713
Anti-diabetic treatment, n (%)	573 (17.0)	312 (16.5)	261 (17.8)	0.307
Statin therapy (n, %)	620 (18.4)	371 (19.6)	249 (17.0)	0.054

Notes: Continuous data were presented as mean ± standard deviation and categorical variables by absolute numbers or percentage. Comparisons between genders were done by independent-sample t-test or chi-squared test. *P<0.05.

Abbreviations: CVD, cardiovascular disease; LVMI, left ventricular mass index; RWT, relative wall thickness; cf-PWV, carotid to femoral aortic pulse wave velocity; ba-pwv, brachial–ankle pulse wave velocity; eGFR, estimated glomerular filtration rate; UACR, urine albumin-to-creatinine ratio; cIMT, carotid artery intima-media thickness; ABI, ankle–brachial index.

Table 2 Correlation of Cardiovascular Risk Factors with LVMI and RWT

Cardiovascular Risk Factors	LVMI		RWT
	r	P	r	P
Age (years)	0.155	<0.001*	0.051	0.003*
Gender (0=Male; 1=Female)	0.054	0.002*	−0.016	0.368
Family history of premature CVD (YES=1, NO=0)	−0.006	0.714	−0.011	0.521
Smoking (YES=1, NO=0)	0.037	0.034*	−0.011	0.512
Waist-to-hip ratio	0.170	<0.001*	−0.014	0.417
BMI (kg/m^2)	0.184	<0.001*	−0.008	0.663
Fasting blood glucose (mmol/L)	0.012	0.496	0.068	<0.001*
Urine acid (μmol/L)	0.116	<0.001*	0.010	0.576
Triglycerides (mmol/L)	0.051	0.004*	0.017	0.318
HDL/LDL cholesterol	−0.016	0.355	0.010	0.552
Systolic BP (mmHg)	0.178	<0.001*	0.002	0.903
Heart rate (beats/min)	−0.077	<0.001*	0.074	<0.001*

Notes: Pearson correlation analyses were applied to investigate the correlation of conventional cardiovascular risk factors with LVMI and RWT. *P<0.05.

Abbreviations: LVMI, left ventricular mass index; RWT, relative wall thickness; CVD, cardiovascular disease.

Table 3 Logistic Regression Analysis of LVH and LVCG with Cardiovascular Risk Factors

Cardiovascular Risk Factors	LVH		LVCG
	OR (95% CI)	P	OR (95% CI)	P
Age (years)	1.043(1.028–1.058)	<0.001*	1.017(1.004–1.031)	0.011*
Gender (0=male; 1=female)	3.035(2.365–3.893)	<0.001*	1.073(0.874–1.318)	0.499
Family history of premature CVD (YES=1, NO=0)	1.034(0.838–1.275)	0.757	0.890(0.735–1.078)	0.233
Smoking (YES=1, NO=0)	0.971(0.728–1.295)	0.842	1.048(0.835–1.315)	0.688
Waist-to-hip ratio	10.386(2.374–45.441)	0.002*	0.391(0.098–1.559)	0.183
BMI (kg/m^2)	1.050(1.022–1.079)	<0.001*	0.986(0.961–1.012)	0.297
Fasting blood glucose (mmol/L)	0.982(0.931–1.035)	0.495	1.067(1.022–1.113)	0.003*
Urine acid (μmol/L)	1.001(1.000–1.002)	0.194	1.000(0.999–1.001)	0.388
Triglycerides (mmol/L)	1.014(0.929–1.106)	0.760	1.036(0.958–1.120)	0.377
HDL/LDL cholesterol	1.395(0.904–2.153)	0.132	0.941(0.635–1.395)	0.763
Systolic BP (mmHg)	1.012(1.006–1.017)	<0.001*	0.997(0.992–1.002)	0.188
Heart rate (beats/min)	0.992(0.984–1.000)	0.043*	1.012(1.005–1.019)	0.001*

Notes: Binary logistic regressions were done to obtain the regression coefficients and odds ratios (ORs) of conventional cardiovascular risk factors in LVH and LVCG. *P<0.05.

Abbreviations: LVH, left ventricular hypertrophy; LVCG, left ventricular concentric geometry; LVMI, left ventricular mass index; RWT, relative wall thickness; CVD, cardiovascular disease.

Table 4 Multivariate Linear Regression Analyses of LVMI and RWT with Vascular Parameters

	LVMI			RWT
	β±SE	T	P	β±SE	T	P
Cf-PWV (m/s)	0.743±0.224	3.313	0.001*	0.001±0.001	0.746	0.018*
Ba-PWV (cm/s)	0.003±0.001	2.204	0.028*	0.000006±0.000004	1.459	0.011*
eGFR (mL/min/1.73 m^2)	0.055±0.034	1.586	0.113	−0.000081±0.000106	−0.766	0.444
UACR (mg/g)	0.041±0.008	5.233	<0.001*	0.000043±0.000024	2.578	0.009*
cIMT (mm)	−10.962±2.530	−4.334	<0.001*	−0.002±0.008	−0.248	0.804

Notes: Multivariate linear regressions were conducted to investigate the relations of vascular ageing parameters with LVMI and RWT. Adjusted for conventional cardiovascular risk factors and diseases and treatments, respectively. *P<0.05.

Abbreviations: LVMI, left ventricular mass index; RWT, relative wall thickness; cf-PWV, carotid to femoral aortic pulse wave velocity; ba-pwv, brachial–ankle pulse wave velocity; eGFR, estimated glomerular filtration rate; UACR, urine albumin-to-creatinine ratio.

Table 5 Multivariate Logistic Regression Analysis of Left Ventricular Geometry with Vascular Ageing Parameters

	LVH		LVCG		Left Ventricular Geometry
					Concentric Remodelling (n =741)		Eccentric LVH (n =537)		Concentric LVH (n =238)
	OR (95% CI)	P	OR (95% CI)	P	OR (95% CI)	P	OR (95% CI)	P	OR (95% CI)	P
Model 1
Arteriosclerosis	1.417(1.184–1.696)	<0.001*	1.332(1.134–1.564)	<0.001*	1.359(1.131–1.634)	0.001*	1.477(1.193–1.829)	<0.001*	1.880(1.378–2.563)	<0.001*
Peripheral atherosclerosis	1.345(1.058–1.709)	0.015*	1.505(1.214–1.865)	<0.001*	1.524(1.179–1.968)	0.001*	1.376(1.020–1.855)	0.036*	2.016(1.392–2.920)	<0.001*
Micro-albuminuria	1.744(1.444–2.105)	<0.001*	1.177(1.004–1.379)	0.044*	1.261(1.051–1.512)	0.013*	1.968(1.590–2.437)	<0.001*	1.888(1.397–2.550)	<0.001*
Decreased eGFR	0.869(0.707–1.068)	0.181	0.849(0.699–1.033)	0.102	1.206(0.960–1.516)	0.107*	0.885(0.691–1.132)	0.330	1.007(0.712–1.423)	0.970
cIMT>0.9 or plaque	0.929(0.777–1.111)	0.419	1.017(0.864–1.197)	0.839	1.050(0.869–1.267)	0.615*	0.947(0.765–1.173)	0.617	0.889(0.661–1.196)	0.436
Model 2
Arteriosclerosis	1.343(1.112–1.622)	0.002*	1.290(1.090–1.528)	0.003*	1.320(1.088–1.602)	0.005*	1.406(1.125–1.759)	0.003*	1.731(1.253–2.393)	0.001*
Peripheral atherosclerosis	1.376(1.070–1.770)	0.013*	1.526(1.219–1.910)	<0.001*	1.583(1.211–2.069)	0.001*	1.440(1.054–1.968)	0.022*	2.019(1.370–2.976)	<0.001*
Micro-albuminuria	1.829(1.525–2.194)	<0.001*	1.150(0.979–1.352)	0.089	1.229(1.022–1.479)	0.025*	1.969(1.585–2.446)	<0.001*	1.888(1.390–2.564)	<0.001*
Model 3
Arteriosclerosis	1.282(1.046–1.572)	0.017*	1.301(1.085–1.561)	0.005*	1.347(1.094–1.659)	0.005*	1.369(1.075–1.742)	0.011*	1.615(1.143–2.282)	0.007*
Peripheral atherosclerosis	1.236(0.954–1.602)	0.109	1.459(1.163–1.831)	0.001*	1.523(1.164–1.991)	0.002*	1.307(0.951–1.797)	0.099	1.681(1.127–2.506)	0.011*
Micro-albuminuria	1.690(1.398–2.043)	<0.001*	1.170(0.991–1.382)	0.064	1.243(1.028–1.504)	0.025*	1.812(1.446–2.270)	<0.001*	1.783(1.299–2.447)	<0.001*
Model 4
Arteriosclerosis	1.291(1.044–1.598)	0.019*	1.271(1.051–1.537)	0.013*	1.329(1.069–1.651)	0.010*	1.393(1.083–1.791)	0.010*	1.577(1.104–2.254)	0.012*
Peripheral atherosclerosis	1.276(0.973–1.673)	0.078	1.515(1.197–1.918)	0.001*	1.603(1.215–2.116)	0.001*	1.346(0.967–1.874)	0.079	1.704(1.129–2.573)	0.011*
Micro-albuminuria	1.695(1.401–2.051)	<0.001*	1.172(0.990–1.386)	0.065	1.257(1.038–1.522)	0.019*	1.815(1.447–2.277)	<0.001*	1.812(1.320–2.489)	<0.001*

Notes: Multivariate logistic regressions were conducted to detect the regression coefficients and odds ratios (ORs) of vascular ageing parameters in LVH/LVCG, and 3 abnormal LV geometry. Model 1: adjusted for age and gender, respectively. Model 2: adjusted for age and gender, then vascular ageing parameters were incorporated in the model. Model 3: adjusted for conventional cardiovascular risk factors and diseases and treatments, respectively. Model 4: adjusted for conventional cardiovascular risk factors and diseases and treatments, then vascular ageing parameters were incorporated in the model. *P<0.05.

Abbreviations: LVH, left ventricular hypertrophy; LVCG, left ventricular concentric geometry, eGFR, estimated glomerular filtration rate; cIMT, carotid artery intima-media thickness.

Figure 1 (A) Odds ratio of vascular ageing parameters (arteriosclerosis, peripheral atherosclerosis, and micro-albuminuria), adjustment for conventional cardiovascular risk factors and diseases and treatments (Model 4). (B) Prevalence of arteriosclerosis in four different types of LV geometry. (C) Prevalence of peripheral atherosclerosis in LV concentric geometry compared to normal. (D) Prevalence of LV geometry from the first to fourth quartiles of UACR (Q2=16–32 mg/g).

Abbreviations: UACR, urine albumin-to-creatinine ratio; LVH, left ventricular hypertrophy.