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Exploring and comparing definitions of healthy vascular ageing in the population : characteristics and prospective cardiovascular risk

Nilsson Wadström, Benjamin ; Engström, Gunnar LU and Nilsson, Peter M. LU (2021) In Journal of Human Hypertension 35(5). p.428-436
Abstract

Different methods can be used to define healthy vascular ageing (HVA). In this prospective cohort study, we explored three different definitions in order to provide guidance for which to use. 2718 subjects were included from the Cardiovascular (CV) arm of the Malmö Diet Cancer Study (MDCS; median age 71.9 years, 62.2% females). Three different definitions of HVA were used: HVA-1 (<15th percentile of aortic pulse wave velocity (aPWV) distribution from age-quintiles); HVA-2 (<35th percentile of aPWV+ <35th percentile of carotid Intima-Media Thickness. cIMT); and HVA-3 (aPWV < 7.6 m/s + no hypertension). The HVA-1 and HVA-2 groups were compared with the HVA-3, and to the corresponding groups without HVA (non-HVA), in... (More)

Different methods can be used to define healthy vascular ageing (HVA). In this prospective cohort study, we explored three different definitions in order to provide guidance for which to use. 2718 subjects were included from the Cardiovascular (CV) arm of the Malmö Diet Cancer Study (MDCS; median age 71.9 years, 62.2% females). Three different definitions of HVA were used: HVA-1 (<15th percentile of aortic pulse wave velocity (aPWV) distribution from age-quintiles); HVA-2 (<35th percentile of aPWV+ <35th percentile of carotid Intima-Media Thickness. cIMT); and HVA-3 (aPWV < 7.6 m/s + no hypertension). The HVA-1 and HVA-2 groups were compared with the HVA-3, and to the corresponding groups without HVA (non-HVA), in cross-sectional analyses for baseline characteristics and using Cox regressions for prospective risk, yielding hazard ratios (HRs) adjusted for conventional risk factors. A composite CVD endpoint was used, consisting of myocardial infarctions, ischemic heart disease mortality, and coronary artery procedures. The baseline characteristics were, with minor exceptions, similar across HVA groups. In the fully adjusted model, the HRs (95%CI) were 0.62 (0.41–0.93), 0.45 (0.26–0.76), and 0.56 (0.34–0.91) for HVA-1, HVA-2, and HVA-3, respectively. In summary, this observational study of elderly subjects provides examples of integrating hypertension and cIMT in the definition of HVA, as compared with only using aPWV. As aPWV itself is such a robust marker of HVA, it is demanding to find additional markers which improve the definition. There is a need to create a generally accepted definition of HVA.

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author
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type
Contribution to journal
publication status
published
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in
Journal of Human Hypertension
volume
35
issue
5
pages
9 pages
publisher
Nature Publishing Group
external identifiers
  • scopus:85106185325
  • pmid:32415282
ISSN
0950-9240
DOI
10.1038/s41371-020-0353-1
language
English
LU publication?
yes
id
654ed888-92cd-4622-941e-560182199967
date added to LUP
2021-12-23 14:48:06
date last changed
2024-06-15 23:17:14
@article{654ed888-92cd-4622-941e-560182199967,
  abstract     = {{<p>Different methods can be used to define healthy vascular ageing (HVA). In this prospective cohort study, we explored three different definitions in order to provide guidance for which to use. 2718 subjects were included from the Cardiovascular (CV) arm of the Malmö Diet Cancer Study (MDCS; median age 71.9 years, 62.2% females). Three different definitions of HVA were used: HVA-1 (&lt;15th percentile of aortic pulse wave velocity (aPWV) distribution from age-quintiles); HVA-2 (&lt;35th percentile of aPWV+ &lt;35th percentile of carotid Intima-Media Thickness. cIMT); and HVA-3 (aPWV &lt; 7.6 m/s + no hypertension). The HVA-1 and HVA-2 groups were compared with the HVA-3, and to the corresponding groups without HVA (non-HVA), in cross-sectional analyses for baseline characteristics and using Cox regressions for prospective risk, yielding hazard ratios (HRs) adjusted for conventional risk factors. A composite CVD endpoint was used, consisting of myocardial infarctions, ischemic heart disease mortality, and coronary artery procedures. The baseline characteristics were, with minor exceptions, similar across HVA groups. In the fully adjusted model, the HRs (95%CI) were 0.62 (0.41–0.93), 0.45 (0.26–0.76), and 0.56 (0.34–0.91) for HVA-1, HVA-2, and HVA-3, respectively. In summary, this observational study of elderly subjects provides examples of integrating hypertension and cIMT in the definition of HVA, as compared with only using aPWV. As aPWV itself is such a robust marker of HVA, it is demanding to find additional markers which improve the definition. There is a need to create a generally accepted definition of HVA.</p>}},
  author       = {{Nilsson Wadström, Benjamin and Engström, Gunnar and Nilsson, Peter M.}},
  issn         = {{0950-9240}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{428--436}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Journal of Human Hypertension}},
  title        = {{Exploring and comparing definitions of healthy vascular ageing in the population : characteristics and prospective cardiovascular risk}},
  url          = {{http://dx.doi.org/10.1038/s41371-020-0353-1}},
  doi          = {{10.1038/s41371-020-0353-1}},
  volume       = {{35}},
  year         = {{2021}},
}