Abstract:Aim To observe the distribution and consistency of estimated pulse wave velocity (ePWV) and brachial-ankle pulse wave velocity (baPWV) in the Kailuan study population. Methods A total of 43 235 employees with complete baseline data participated in the baPWV test. The participants were divided into the risk population and normal population according to the presence or absence of conventional cardiovascular risk factors. Multivariate linear regression was used to establish the regression equations between baPWV and quadratic age and mean arterial pressure in the two populations. The ePWV in the two populations was calculated according to the equations. The distribution of ePWV and baPWV was observed. The relationship between ePWV and baPWV was analyzed by paired sample t-test and linear regression. Results In the normal population, ePWV and baPWV were 11.38±0.70 m/s and 12.90±1.17 m/s, respectively. In the risk population, ePWV and baPWV were 14.29±1.85 m/s and 15.74±1.76 m/s, respectively. In the both of two populations, ePWV and baPWV increased with age, higher in men than those in women. ePWV was slightly lower than baPWV (P＜0.001). The results of linear regression analysis indicated that ePWV and baPWV had a good linear correlation in the total population, normal population and risk population, and the linear R2 was 0.8,0.279 and 0.388, respectively. Conclusions ePWV and baPWV had a similar age and sex distribution. The difference was relatively small and a good linear correlation was found between ePWV and baPWV. Therefore, ePWV can be a good substitute for baPWV.

Abstract:Aim To evaluate the characteristics of cardiac structure and function in atherosclerotic adults during quietness and exercise in order to assess the risk and adverse consequences of cardiac changes during exercise. Methods 107 Beijing residents aged 40-59, including 21 males and 86 females, were selected. According to the criteria of brachial-ankle pulse wave velocity (baPWV), the participants were divided into normal arterial stiffness group (n＝71) and arteriosclerosis group (n＝36). After resting echocardiography, all participants performed a horizontal exercise test that the initial load was 25 W, increasing 25 W every two minutes. Echocardiography and blood pressure data were obtained at 30 seconds before the end of each exercise and convalescence. Results (1)Compared with the normal arterial stiffness group, the arteriosclerosis group showed increasing interventricular septum thickness at end-diastole, left ventricular posterior wall thickness at end-diastole (LVPWd), left ventricular mass, left ventricular mass index, ejection fraction (EF), fractional shortening (FS) (P＜0.05) and decreasing peak flow velocity of early diastole/peak flow velocity of atrial contraction (E/A) (P＜0.05). (2)Left ventricular hypertrophy in the arteriosclerosis group was much higher than the normal arterial stiffness group (P＜0.05). (3)BaPWV was positively correlated with heart rate, EF, stroke volume and FS (P＜0.05). (4)During exercise, left ventricular end-diastolic diameter, LVPWd and systolic blood pressure in atherosclerosis group were significantly higher than those in normal arterial stiffness group (P＜0.05). Conclusions Cardiac manifestations of atherosclerosis individuals include thickening of ventricular wall, increase of left ventricular mass, enhancement of systolic function, decrease of diastolic function, and remodeling of left ventricular geometry, and the change of systolic function is independent on the change of blood pressure. Compared with heart changes, arteriosclerotic people should prevent excessive blood pressure during exercise.

Abstract:Aim To explore the relationship between cumulative heart rate exposure (cumHR) and brachial-ankle pulse wave velocity (baPWV). Methods A total of 7904 participants were selected from Kailuan Study stroke cohort and elderly population cohort to compose observation population, and finally 5153 cases were included in the study cohort. According to cumHR, the research subjects were divided into four groups. The correlation between cumHR and baPWV was analyzed by partial correlation analysis. The effects of cumHR on baPWV were analyzed by multivariate linear regression and multivariate Logistic regression. Results With the increase of cumHR, the average level of baPWV and the detection rate of baPWV≥1400 cm/s were on the rise. The results of partial correlation analysis showed that cumHR was positively correlated with baPWV (r＝0.35, P＜0.05), and after adjusting age and sex, cumHR was still positively correlated with baPWV (r＝0.24, P＜0.05). Multivariate linear regression analysis showed that cumHR increased by 1 beat/minute, baPWV increased 1.071 cm/s. Logistic regression analysis showed that after correction of other confounding factors, compared with the cumHR first group, cumHR second group, third group and fourth group were risk factors for baPWV≥1400 cm/s, and OR values (95%CI) were respectively 1.432 (1.121-1.829), 1.738 (1.371-2.204) and 2.475 (1.949-3.143). Conclusions cumHR is positively correlated with baPWV. cumHR is a risk factor for the increase of pulse wave velocity.

Abstract:Aim To explore the relationship between cumulative triglyceride exposure (cumTG) and ankle-brachial pulse wave velocity(BaPWV). Methods A total of 23499 participants was selected from Kailuan Study stroke cohort, hypertensive population and elderly population cohort to compose observation population, and finally 14662 cases were included in the study cohort. According to cumTG, the research subjects were divided into four groups. The correlation between cumTG and BaPWV was analyzed by partial correlation analysis. Multivariate linear regression and multivariate Logistic regression were used to analyze the effects of cumTG on BaPWV. Results With the increase of cumTG, the average BaPWV level and the detection rate of BaPWV≥ 1400 cm/s showed an increasing trend. The correlation analysis showed that cumTG was positively correlated with BaPWV (r=0.512, P<0.05), and cumTG was positively correlated with BaPWV (r=0.322, P<0.05) after adjustment for age and sex. Multivariate linear regression analysis showed an increase in BaPWV of 4.507 cm/s for each increase in cumTG. Logistic regression analysis showed that the cumTG second quartile, the third quartile, and the fourth quartile were significantly associated with BaPWV≥1400 cm/s compared with the cumTG first quartile after adjustment for other confounders (95%CI) which were 1.667(1.505～1.845), 2.384 (2.111～2.691) and 3.287(2.887～3.741), respectively. Conclusion cumTG is positively correlated with BaPWV.cumTG is a risk factor for the increase of pulse wave velocity.

Abstract:Aim To investigate the relationship between body mass index (BMI) and arterial stiffness. Methods 6143 cases with 2006-7,8-9,0-2011 body examination and brachial-ankle pulse wave velocity (BaPWV) of 2010-2011 were analyzed. The average age was 49.68 years old. Among them, 4230 cases (68.9%) were male. All of them were divided into four groups according to the BMI locus, the BMI locus and arteriosclerosis were tested by χ2 and the multiple factors logistic regression analysis was conducted to observe the effect of BMI locus on arteriosclerosis. Results With the increase of BMI trajectory, arteriosclerosis detection rate increased gradually, the trajectory of arteriosclerosis detection rates were 52.4%, 63.3%, 67.9%, 70.1%; in a multivariate logistic regression analysis adjusted for age, gender and other confounding factors, compared with the low stable group, the other three groups (ABI＜0.9 value of OR 95%CI) were 1.34(1.08～1.66),1.57(1.16～2.13),1.77(1.13～2.79). Conclusion High BMI locus is a risk factor for atherosclerosis and is independent of other risk factors for target organ damage.

Abstract:Aim To investigate the prognostic significance of brachial-ankle pulse wave velocity on the incidence of hypertension in prehypertensive population. Methods Data of the present retrospective survey were collected from the Health Management Center of the 3rd Xiangya Hospital from 2004.12-2012.12. The baseline characteristics and outcomes of 205 prehypertensive population from the data were analyzed. Results During a median follow-up of 5.89 years, 54 people (26.34%) developed into hypertension; According to the tertiles of baseline brachial-ankle pulse wave velocity values the cases were divided into three groups, the cumulative incidence of hypertension increased from the first tertile to the third tertile, and the differences between three groups were statistically significant(P<0.001); Cox regression analysis showed that brachial-ankle pulse wave velocity was an independent risk factor for hypertension in prehypertensive population after adjusting of baseline age, gender, drinking, education, marriage, body mass index, glomerular filtration rate, fasting plasma glucose, total cholesterol, triglycerides, high density lipoprotein, low density lipoprotein. The risk of development of established hypertension in those individuals with the third, second tertile of brachial-ankle pulse wave velocity at baseline were both higher than those with the lowest tertile of baseline brachial-ankle pulse wave velocity (HR=6.647,P<0.001; HR=3.008, P=0.040). In addition, baseline brachial-ankle pulse wave velocity values increased per 100 cm/s, the risk of development of established hypertension increased 22.3%(P=0.002). Conclusions The brachial-ankle pulse wave velocity is an independent risk factor of hypertension and might be used to predict the risk of development of established hypertension in prehypertensive population.

Abstract:Aim To investigate the relationship between brachial-ankle pulse wave velocity(baPWV) and aortic valve sclerosis(AVS) and the association of their severity, and the predictive value of AVS and baPWV in the diagnosis of coronary heart disease and three-vessel coronary artery disease among a group of hospital patients who underwent coronary angiography. Methods Performing coronary angiography, transthoracic echocardiography and the measurement of baPWV on 485 in-hospital patients, including 297 male cases and 188 female cases(average age 62.52±10.28 years). According to the results of echocardiography, patients were divided into AVS group and non-AVS group. They were also grouped by the number of valves involved and AVS scores. BaPWV was compared between each group. Patients were divided into 5 groups based on the results of coronary angiography:normal coronary, coronary atherosclerosis, 1-vessel disease, 2-vessel disease, 3-vessel±left main disease. To compare sensitivity, specificity, positive predictive value and negative predictive value of baPWV, AVS and their combination in the prediction of coronary heart disease and three-vessel coronary artery disease. To explore whether combining baPWV and AVS can improve the predictive value. Results There were 305 cases in AVS group and 180 cases in non-AVS group. BaPWV of AVS group(1536.57±285.06 cm/s) was significantly higher than non-AVS group(1484.92±241.75 cm/s, P<0.05). With different number of valves involved, baPWV value in 0-valve group was 1484.92±241.75 cm/s, in 1-valve group was 1499.61±259.57 cm/s, in ≥2-valve group was 1593.55±313.07 cm/s, and it had statistically significant difference(P<0.05). With the AVS scores, baPWV value in 0 score group was 1484.92±241.75 cm/s, in 1 score group was 1500.23±271.70 cm/s, in ≥2 scores group was 1586.16±296.26 cm/s, and it had statistically significant difference(P<0.05). AVS was superior to baPWV both in the prediction of coronary heart disease and three-vessel coronary artery disease. AVS had a positive predictive value of 91.1% in predicting coronary heart disease. BaPWV and AVS both positive had a high specificity in the prediction of coronary heart disease and three-vessel coronary artery disease(85.5% and 66.9%), better than separate prediction. High sensitivity appeared in the predicition of coronary heart disease and three-vessel coronary artery disease(90.4% and 95.3%) when either of baPWV and AVS was positive. Although AVS score ≥2 had a low sensitivity(33.6%) in the prediction of coronary heart disease, yet its specificity and positive predictive value were rather high(97.3% and 97.7% respectively). Conclusion BaPWV in AVS group was higher than in non-AVS group. With different number of valves involved, baPWV value in ≥2-valve group was significantly higher than baPWV value in 0-valve group and 1-valve group. With the AVS scores, baPWV value in 2 score group was significantly higher than baPWV value in 0 score group and 1 score group. With the combined application of baPWV and AVS in the prediction of coronary artery disease, both positive had higher specificity, either positive showed higher sensitivity. In the prediction of coronary heart disease, AVS score ≥2 showed low sensitivity but it had very high accuracy.

Abstract:Aim To investigate the correlation between the 24 hours ambulatory systolic blood pressure (SBP) and brachial-ankle pulse wave velocity (baPWV) in the elderly. Methods The first health examination for in-service and retired staff in Kailuan Group Company was performed from 2006 to 2007, with the second, third health examination from 2008 to 9,0 to 2011 respectively. At the third health examination, a cluster random sample of 2814 cases ≥60 years old and retired employees was selected, and ambulatory blood pressure, baPWV, etc. were examined. 2464 cases met the inclusion criteria, and 1004 cases had complete data. Multivariate linear regression analysis was used to analyze the correlation between 24hSBP, day SBP, night SBP and baPWV. Results (1)Research subjects were divided into three groups according to 24hSBP, day SBP and night SBP tertiles. baPWV was increased with the increase of 24hSBP, day SBP and night SBP (all P＜0.001). (2)Multivariable linear regression analysis showed that when 24hSBP, day SBP, night SBP increased 1 standard deviation, BaPWV was increased by 81.5,3.8,1.30 cm/s, after adjustment for confounding factors. In addition, the diagnosis room SBP also showed a linear positive correlation with baPWV, and the regression coefficient of diagnosis room SBP was larger than that of ambulatory SBP. Conclusion 24hSBP, day SBP and night SBP are positively correlated with baPWV, but the correlation was weaker than that of diagnosis room SBP.

Abstract:Aim To explore the influence of brachial-ankle pulse wave velocity (baPWV) on the urine protein.Methods A total of 5440 participants who were aged over 40 without previous stroke, transient ischemic attack (TIA) and myocardial infarction were randomly selected from serving and retired workers of Tangshan Kailuan Company in 2006-2007 health examination, among which 5012 participants with integrated data were recruited into the study. Urine protein and baPWV were detected. Grouped baPWV using quartile group. The influence of baPWV on urine protein was analyzed by Logistic regression. Results Compared with the first quartile group, baPWV was a risk factor for positive urine protein, OR values were 0.778 (95%CI was 0.463～1.309), 1.323 (95%CI was 0.834～2.096) and 3.172 (95%CI was 2.122～4.741); and adjustment for age, sex, TC, TG, HDLC, LDLC, DBP, SBP, FBG, smoking, and drinking, similar results were obtained, OR values were 0.663 (95%CI was 0.424～1.036), 0.977 (95%CI was 0.640～1.491) and 1.682 (95%CI was 1.073～2.637). Conclusion The increase of baPWV was correlated with urine protein. The increase of baPWV was a risk factor for positive urine protein.

Abstract:Aim To study relevance of essential hypertension (EH) patients with brachial-ankle pulse wave velocity (baPWV), carotid intima-media thickness (cIMT) and homocysteine (Hcy), D-dimer. Methods The study was performed on 246 essential hypertension patients. According to baPWV they were divided into normal group (baPWV＜1700 cm/s) and abnormal group (≥1700 cm/s). According to cIMT they were divided into normal group (cIMT＜0.9 mm), thickening group (0.9 ≤cIMT＜1.2 mm), plaque group (cIMT≥1.2 mm). And Hcy, D-dimer and blood biochemistry were detected. Results Hcy and D-dimer levels in abnormal arterial stiffness group were significantly increased compared with those in normal arterial stiffness group (P＜0.05). Hcy and D-dimer levels in the normal cIMT group, the thickening group, the plaque group were gradually increased. Partial correlation analysis showed that after excluded age, weight, blood lipids and blood glucose, baPWV was positively correlated with Hcy and D-dimer (r＝0.18, r＝0.32, P＜0.05), cIMT was positively correlated with Hcy and D-dimer (r＝0.56, r＝0.27, P＜0.05), BaPWV was positively correlated with cIMT (r＝0.29, P＜0.05). Conclusion The increase of Hcy and D-dimer were correlated with cIMT and baPWV which predicted artery disease.