Association of incremental pulse wave velocity with cardiometabolic risk factors

Abstract

We investigate the association of incremental pulse wave velocity (ΔC; the change in pulse wave velocity over a cardiac cycle) with cardiometabolic risk factors and report the first and (currently) the largest population-level data. In a cross-sectional study performed in a cohort of 1373 general population participants, ΔC was measured using clinically validated ARTSENS devices. There were 455 participants in the metabolic syndrome (MetS) group whose average ΔC was ~ 28.4% higher than that of the non-metabolic syndrome (Non-MetS) group. Females with MetS showed ~ 10.9% elevated average ΔC compared to males of the Non-MetS group. As the number of risk factors increased from 0 to 5, the average ΔC escalated by ~ 55% (1.50 ± 0.52 m/s to 2.33 ± 0.91 m/s). A gradual increase in average ΔC was observed across each decade from the younger (ΔC = 1.53 ± 0.54 m/s) to geriatric (ΔC = 2.34 ± 0.59 m/s) populations. There was also a significant difference in ΔC among the blood pressure categories. Most importantly, ΔC ≥ 1.81 m/s predicted a constellation of ≥ 3 risks with AUC = 0.615, OR = 2.309, and RR = 1.703. All statistical trends remained significant, even after adjusting for covariates. The study provides initial evidence for the potential use of ΔC as a tool for the early detection and screening of vascular dysfunction, which opens up avenues for active clinical and epidemiological studies. Further investigations are encouraged to confirm and establish the causative mechanism for the reported associations.

Figure 1

Venn diagrams showing the number of subjects in risk factor combinations of the Non-MetS and MetS groups.

Figure 2

Incremental pulse wave velocity, ΔC, of (A) male versus female subjects for Non-MetS and MetS groups, (B) Non-MetS and MetS groups with multiple risk factors, (C) subjects based on their chronologic age, (D) subjects with/without the presence of individual metabolic abnormality (ns p > 0.05, * p ≤ 0.05, ** p ≤ 0.001, *** p ≤ 0.0001).

Figure 3

Clustering effect of multiple (3, 4, and 5) risk factors on ΔC across MetS group (N = 455) (ns p > 0.05, * p ≤ 0.05, ** p ≤ 0.001).

Figure 4

(A) Incremental pulse wave velocity, ΔC, versus sensitivity and specificity for the occurrence of ≥ 3 risk factors, (B) Receiver Operating Characteristic (ROC) curves for prediction of MetS with 3, 4, 5 or ≥ 3 risk factors.