Erschienen in:Journal of the American Heart Association
Sprache:
Englisch
DOI:
10.1161/jaha.117.008431
ISSN:
2047-9980
Entstehung:
Anmerkungen:
Beschreibung:
<jats:sec xml:lang="en">
<jats:title>Background</jats:title>
<jats:p xml:lang="en">
Black individuals have greater risk for cardiovascular disease (
<jats:styled-content style="fixed-case">CVD</jats:styled-content>
) than whites. Identifying
<jats:styled-content style="fixed-case">CVD</jats:styled-content>
risk factors associated with abnormal aortic hemodynamics in blacks may optimize
<jats:styled-content style="fixed-case">CVD</jats:styled-content>
prevention and treatment strategies.
</jats:p>
</jats:sec>
<jats:sec xml:lang="en">
<jats:title>Methods and Results</jats:title>
<jats:p xml:lang="en">
Jackson Heart Study participants underwent applanation tonometry (2011–2016) with assessment of carotid‐femoral pulse wave velocity (
<jats:styled-content style="fixed-case">CFPWV</jats:styled-content>
) and forward wave amplitude (
<jats:styled-content style="fixed-case">FWA</jats:styled-content>
).
<jats:styled-content style="fixed-case">CVD</jats:styled-content>
risk factors were assessed during examination 3 (2009–2012). We examined the association of risk factors with binary and continuous
<jats:styled-content style="fixed-case">CFPWV</jats:styled-content>
and
<jats:styled-content style="fixed-case">FWA</jats:styled-content>
in multivariable stepwise models. We evaluated for effect modification by sex to determine differential associations of risk factors with aortic hemodynamics in men and women. We examined 1322 individuals (mean age 66±11 years, 66% women). Age was strongly associated with elevated
<jats:styled-content style="fixed-case">CFPWV</jats:styled-content>
(odds ratio, 4.76; 95% confidence interval, 3.84–5.89 [
<jats:italic>P</jats:italic>
<0.0001]) and
<jats:styled-content style="fixed-case">FWA</jats:styled-content>
(odds ratio, 2.30; 95%
<jats:styled-content style="fixed-case">CI</jats:styled-content>
, 1.98–2.69 [
<jats:italic>P</jats:italic>
<0.0001]). Men had greater odds of elevated
<jats:styled-content style="fixed-case">CFPWV</jats:styled-content>
compared with women (odds ratio, 1.54; 95% confidence interval, 1.11–2.13 [
<jats:italic>P</jats:italic>
=0.009]). Heart rate, mean arterial pressure, and use of antihypertensive medications were associated with elevated
<jats:styled-content style="fixed-case">CFPWV</jats:styled-content>
and
<jats:styled-content style="fixed-case">FWA</jats:styled-content>
(all
<jats:italic>P</jats:italic>
≤0.02). Additionally, total/high‐density lipoprotein cholesterol and fasting glucose were associated with elevated
<jats:styled-content style="fixed-case">CFPWV</jats:styled-content>
(both
<jats:italic>P</jats:italic>
≤0.002) and use of diabetes mellitus medications was associated with elevated
<jats:styled-content style="fixed-case">FWA</jats:styled-content>
(
<jats:italic>P</jats:italic>
≤0.0001). We observed a steeper association of age and mean arterial pressure with unfavorable aortic hemodynamics in women than men.
</jats:p>
</jats:sec>
<jats:sec xml:lang="en">
<jats:title>Conclusions</jats:title>
<jats:p xml:lang="en">
In blacks in the community, differential
<jats:styled-content style="fixed-case">CVD</jats:styled-content>
risk factors are associated with aortic stiffness and FWA. Future work may determine the impact of risk factor modification on abnormal central aortic hemodynamics and
<jats:styled-content style="fixed-case">CVD</jats:styled-content>
outcomes.
</jats:p>
</jats:sec>