Estimated Pulse Wave Velocity for Cardiovascular Risk Assessment in Rural Populations: The ENAH Study.

IF 2.1 4区医学 Q2 PERIPHERAL VASCULAR DISEASE

Kidney & blood pressure research Pub Date : 2026-01-01 Epub Date: 2026-06-16 DOI:10.1159/000552567

Marija Domislović, Ana Jelaković, Vladimir Prelević, Danilo Radunović, Lana Gellineo, Krešimir Đapić, Mirjana Fuček, Josipa Josipović, Jelena Kos, Viktor Domislović, Ivan Pećin, Mirta Abramović Barić, Krunoslav Capak, Bojan Jelaković

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引用次数: 0

Abstract

Introduction: Arterial stiffness, typically measured by pulse wave velocity (PWV), is a recognized biomarker of cardiovascular (CV) risk and mortality. Our study assesses the predictive value of arterial stiffness measured by estimated pulse wave velocity (ePWV) for fatal and nonfatal outcomes in a general rural adult population.

Methods: This prospective observational cohort study was conducted within the ENAH project, which initially included 3,305 adults, with 2,232 participants followed up over a median of 11.3 years. Baseline demographic, clinical, and laboratory data, including blood pressure, anthropometry, and biochemical analyses of blood and urine, were collected using standardized protocols. The primary outcome was all-cause mortality, while secondary outcomes comprised nonfatal CV, cerebrovascular, and renal events, analyzed using Kaplan-Meier survival curves and multivariable regression models.

Results: In this cohort of 1,175 adults followed for a mean of 11.3 years, 263 participants died (22.4%), and 171 (14.5%) experienced a nonfatal event (myocardial infarction, atrial fibrillation, heart failure, stroke, transient ischemic attack, or dialysis). Kaplan-Meier analysis showed lower survival in participants with ePWV of >10 m/s compared to those with ePWV of <10 m/s (hazard ratio [HR] = 12.8, 95% CI 9.9-16.6, p < 0.001). Similarly, event-free survival was lower for nonfatal outcomes in the higher ePWV group (HR = 1.50, 95% CI 1.0-2.1, p = 0.008). In multivariable analysis for mortality, male sex and ePWV remained significant predictors (HR 1.75, 95% CI 1.18-2.61, p = 0.006; HR 1.81, 95% CI 1.08-3.04, p = 0.030). No independent predictors were found for nonfatal outcomes. However, for the composite endpoint, both male sex (HR = 1.54, 95% CI 1.14-2.08, p = 0.006) and ePWV (HR = 1.94, 95% CI 1.50-2.51, p < 0.001) were associated with increased risk.

Conclusion: ePWV was an independent predictor of overall mortality as well as composite fatal and nonfatal outcomes. These findings suggest that this simple measure of arterial stiffness may be useful in clinical practice, particularly in rural settings where direct measurements are not available.

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估计脉搏波速度在农村人群心血管风险评估：ENAH研究。

动脉硬度，通常通过脉搏波速度（PWV）来测量，是公认的心血管（CV）风险和死亡率的生物标志物。我们的研究评估了通过估计脉搏波速度（ePWV）测量动脉硬度对一般农村成年人致命和非致命结果的预测价值。方法：这项前瞻性观察队列研究是在ENAH项目中进行的，该项目最初包括3305名成年人，其中2232名参与者随访时间中位数为11.3年。基线人口统计、临床和实验室数据，包括血压、人体测量和血液和尿液生化分析，采用标准化方案收集。主要结局是全因死亡率，次要结局包括非致死性心脑血管和肾脏事件，使用Kaplan-Meier生存曲线和多变量回归模型进行分析。结果：在我们的队列中，包括1175名成人受试者，平均随访11.3年，总共有263人死亡（22.4%），171人（14.5%）经历了一种非致命性结局（心肌梗死、心房颤动、心力衰竭、中风、TIA（短暂性脑缺血发作）、透析）。Kaplan-Meier分析（KMa）显示，ePWV≤10m/s组的生存率低于ePWV≤10m/s组（HR=12.8, 95%CI 9.9 ~ 16.6, p≤10m/s）（HR=1.50, 95%CI 1.0 ~ 2.1, p=0.008）。在致死性结局预测因素的多因素分析中，男性和ePWV在预测死亡风险增加方面保持统计学意义（HR 1.75, 95%CI 1.18-2.61, p=0.006; HR 1.81, 95%CI 1.08-3.04, p=0.030）。在多因素分析中，没有证实任何非致命结果预测因子的显著性，然而，在复合致命和非致命结果的多因素分析中，男性暴露于比女性更大的风险(HR=1.54；95%CI 1.14-2.08, p=0.006)， ePWV显示为一个危险因素（HR=1.94, 95%CI 1.50-2.51, p）。结论：ePWV被发现是总死亡率和复合致命和非致命结局的重要独立预测因子，这表明这种简单可靠的动脉硬度测量方法至少可以推荐用于临床工作，在偏远农村地区，动脉硬度测量方法是不可行的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Kidney & blood pressure research 医学-泌尿学与肾脏学

CiteScore

4.80

自引率

3.60%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal comprises both clinical and basic studies at the interface of nephrology, hypertension and cardiovascular research. The topics to be covered include the structural organization and biochemistry of the normal and diseased kidney, the molecular biology of transporters, the physiology and pathophysiology of glomerular filtration and tubular transport, endothelial and vascular smooth muscle cell function and blood pressure control, as well as water, electrolyte and mineral metabolism. Also discussed are the (patho)physiology and (patho) biochemistry of renal hormones, the molecular biology, genetics and clinical course of renal disease and hypertension, the renal elimination, action and clinical use of drugs, as well as dialysis and transplantation. Featuring peer-reviewed original papers, editorials translating basic science into patient-oriented research and disease, in depth reviews, and regular special topic sections, ''Kidney & Blood Pressure Research'' is an important source of information for researchers in nephrology and cardiovascular medicine.