The Product of Resting Heart Rate Times Blood Pressure Is Associated with High Brachial-Ankle Pulse Wave Velocity

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Abstract

Objective

To investigate potential associations between resting heart rate, blood pressure and the product of both, and the brachial-ankle pulse wave velocity (baPWV) as a maker of arterial stiffness.

Methods

The community-based “Asymptomatic Polyvascular Abnormalities in Community (APAC) Study” examined asymptomatic polyvascular abnormalities in a general Chinese population and included participants with an age of 40+ years without history of stroke and coronary heart disease. Arterial stiffness was defined as baPWV≥1400 cm/s. We measured and calculated the product of resting heart rate and systolic blood pressure (RHR-SBP) and the product of resting heart rate and mean arterial pressure (RHR-MAP).

Results

The study included 5153 participants with a mean age of 55.1±11.8 years. Mean baPWV was 1586±400 cm/s. Significant ( P<0.0001) linear relationships were found between higher baPWV and higher resting heart rate or higher arterial blood pressure, with the highest baPWV observed in individuals from the highest quartiles of resting heart rate and blood pressure. After adjusting for confounding parameters such as age, sex, educational level, body mass index, fasting blood concentrations of glucose, blood lipids and high-sensitive C-reactive protein, smoking status and alcohol consumption, prevalence of arterial stiffness increased significantly ( P<0.0001) with increasing RHR-SBP quartile (Odds Ratio (OR): 2.72;95%Confidence interval (CI):1.46,5.08) and increasing RHR-MAP (OR:2.10;95%CI:1.18,3.72). Similar results were obtained in multivariate linear regression analyses with baPWV as continuous variable.

Conclusions

Higher baPWV as a marker of arterial stiffness was associated with a higher product of RHR-SBP and RHR-MAP in multivariate analysis. In addition to other vascular risk factors, higher resting heart rate in combination with higher blood pressure are risk factors for arterial stiffness.

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Most cited references 25

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Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement.

Akira Yamashina, Hirofumi Tomiyama, Kazuhiro Takeda … (2002)

The present study was conducted to evaluate the validity and reproducibility of noninvasive brachial-ankle pulse wave velocity (baPWV) measurements and to examine the alteration of baPWV in patients with coronary artery disease (CAD). Simultaneous recordings of baPWV by a simple, noninvasive method and aortic pulse wave velosity (PWV) using a catheter tip with pressure manometer were performed in 41 patients with CAD, vasospastic angina, or cardiomyopathy. In 32 subjects (15 controls and 17 patients with CAD), baPWV was recorded independently by two observers in a random manner. In 55 subjects (14 controls and 41 patients with CAD), baPWV was recorded twice by a single observer on different days. baPWV were compared among 172 patients with CAD (aged 62 +/- 8 years); 655 age-matched patients without CAD but with hypertension, diabetes mellitus, or dyslipidemia; and 595 age-matched healthy subjects without these risk factors. baPWV correlated well with aortic PWV (r=0.87, p<0.01). Pearson's correlation coefficients of interobserver and intraobserver reproducibility were r=0.98 and r=0.87, respectively. The corresponding coefficients of variation were 8.4% and 10.0%. baPWV were significantly higher in CAD patients than in non-CAD patients with risk factors, for both genders (p<0.01). In addition, baPWV were higher in non-CAD patients with risk factors than in healthy subjects without risk factors. Thus, the validity and reproducibility of baPWV measurements are considerably high, and this method seems to be an acceptable marker reflecting vascular damages. baPWV measured by this simple, noninvasive method is suitable for screening vascular damages in a large population.

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Association between arterial stiffness and atherosclerosis: the Rotterdam Study.

N van Popele, D Grobbee, M L Bots … (2001)

Studies of the association between arterial stiffness and atherosclerosis are contradictory. We studied stiffness of the aorta and the common carotid artery in relation to several indicators of atherosclerosis. This study was conducted within the Rotterdam Study in >3000 elderly subjects aged 60 to 101 years. Aortic stiffness was assessed by measuring carotid-femoral pulse wave velocity, and common carotid artery stiffness was assessed by measuring common carotid distensibility. Atherosclerosis was assessed by common carotid intima-media thickness, plaques in the carotid artery and in the aorta, and the presence of peripheral arterial disease. Data were analyzed by ANCOVA with adjustment for age, sex, mean arterial pressure, and heart rate. Both aortic and common carotid artery stiffness were found to have a strong positive association with common carotid intima-media thickness, severity of plaques in the carotid artery, and severity of plaques in the aorta (P: for trend <0.01 for all associations). Subjects with peripheral arterial disease had significantly increased aortic stiffness (P:=0.001) and borderline significantly increased common carotid artery stiffness (P:=0.08) compared with subjects without peripheral arterial disease. Results were similar after additional adjustment for cardiovascular risk factors and after exclusion of subjects with prevalent cardiovascular disease. This population-based study shows that arterial stiffness is strongly associated with atherosclerosis at various sites in the vascular tree.

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Brachial-ankle pulse wave velocity as a marker of atherosclerotic vascular damage and cardiovascular risk.

Yoshio Yamamoto, Akira Yamashina, Yutaka Koji … (2003)

The measurement of brachial-ankle pulse wave velocity (baPWV) is simple and applicable for general population studies. The present study was conducted to evaluate the applicability of baPWV for screening cardiovascular risk as well as for use as a marker of the severity of atherosclerotic vascular damage in a general population. baPWV was measured in a cross-sectional study involving two cohorts constituting a total of 10,828 subjects who underwent annual health screening check up examinations (6,716 males and 4,112 females; age 30 to 74 years). The Framingham risk score and Pocock's score were obtained. Multivariate analysis demonstrated that baPWV was associated with both scores, independently from conventional atherosclerotic risk factors. The receiver-operator characteristic curve demonstrated that a baPWV of 14.0 m/s is useful for risk stratification by Framingham score and to discriminate patients with either stroke or coronary heart disease (n=143), but the likelihood ratios were less than 5.0. Logistic regression analysis demonstrated that a baPWV>14.0 m/s is an independent variable for the risk stratification by Framingham score and for the discrimination of patients with atherosclerotic cardiovascular disease. Thus, baPWV has potential as a new marker of cardiovascular risk and may be more useful than other conventional markers; in addition, baPWV is easy to obtain and serves as an indicator of either atherosclerotic cardiovascular risk or severity of atherosclerotic vascular damage; thus it is useful to screen the general population. While the discriminating powers are not sufficiently high, a cutoff value of 14.0 m/s serves to screen subjects, especially in middle-aged ones, of either gender.

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Author and article information

Contributors

Yan Li: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, USA )

ISSN (Electronic): 1932-6203

Publication date Collection: 2014

Publication date (Electronic): 16 September 2014

Volume: 9

Issue: 9

Electronic Location Identifier: e107852

Affiliations

[1 ]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

[2 ]Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China

[3 ]Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China

[4 ]Kailuan Hospital, Hebei United University, Tangshan, China

[5 ]Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany

Shanghai Institute of Hypertension, China

Author notes

* E-mail: zxq@ 123456vip.163.com (XZ); drwusl@ 123456163.com (SW)

Competing Interests: Co-author Jost Jonas is a PLOS ONE Editorial Board member. It is confirmed that this does not alter the authors' adherence to PLOS ONE Editorial policies and criteria, as detailed online in the guide for authors.

Conceived and designed the experiments: AW JT XG XML YL XRL ZH SC XZ JBJ SW. Performed the experiments: AW JT XG XML YL XRL ZH SC XZ SW. Analyzed the data: AW JT XG XML YL XRL ZH SC XZ JBJ SW. Contributed reagents/materials/analysis tools: XZ. Contributed to the writing of the manuscript: AW JT XG XML YL XRL ZH SC XZ JBJ SW.

¶ JBJ and SW are joint last authors on this work.

Article

Publisher ID: PONE-D-14-23550

DOI: 10.1371/journal.pone.0107852

PMC ID: 4166598

PubMed ID: 25225895

SO-VID: 84fe31b9-d3ea-4d6a-8e15-eb46946f9f5a

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 5 June 2014

Date accepted : 14 August 2014

Page count

Pages: 7

Funding

This research was supported by a grant from the National Natural Science Foundation of China (Grant No. 81202279), and by a grant from advanced health care professional development project of Beijing Municipal Health Bureau (Grant No. 2009-3-32). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Data Availability The authors confirm that all data underlying the findings are fully available without restriction. All relevant data are included within the paper.

The Product of Resting Heart Rate Times Blood Pressure Is Associated with High Brachial-Ankle Pulse Wave Velocity

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Abstract

Objective

Methods

Results

Conclusions

Related collections

PLOS Climate

Most cited references 25

Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement.

Association between arterial stiffness and atherosclerosis: the Rotterdam Study.

Brachial-ankle pulse wave velocity as a marker of atherosclerotic vascular damage and cardiovascular risk.

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