Brachial-Ankle Pulse Wave Velocity and the Risk Prediction of Cardiovascular Disease

An Individual Participant Data Meta-Analysis

Abstract: An individual participant data meta-analysis was conducted in the data of 14 673 Japanese participants without a history of cardiovascular disease (CVD) to examine the association of the brachial-ankle pulse wave velocity (baPWV) with the risk of development of CVD. During the average 6.4-year follow-up period, 687 participants died and 735 developed cardiovascular events. A higher baPWV was significantly associated with a higher risk of CVD, even after adjustments for conventional risk factors (P for trend <0.001). The present meta-analysis clearly established baPWV as an independent predictor of the risk of development of CVD in Japanese subjects without preexisting CVD. Thus, measurement of the baPWV could enhance the efficacy of prediction of the risk of development of CVD over that of the Framingham risk score, which is based on the traditional cardiovascular risk factors.

Arterial stiffness is well-recognized as an important predictor of development of cardiovascular disease (CVD) and meta-analyses of prospective cohort studies have revealed that increase in the carotid-femoral pulse wave velocity (cfPWV) is associated with an increase in the risk of development of CVD. However, the cfPWV is measured by tonometry or Doppler, which requires specialized training and exposure of the inguinal region.

A recent meta-analysis using summary data from the literature has demonstrated that higher levels of baPWV were associated with an increased risk of development of CVD.

This collaborative study included the data from 14 cohort studies conducted in Japan (9 published and 5 unpublished studies). The study was conducted with the approval of the Ethical Guidelines Committee of Tokyo Medical University (No 2655 2014). To assess the effect of baPWV on the accuracy of the risk assessment for CVD, we compared the area under the receiver operating characteristic 

 (Toshiaki Ohkuma, 2017)