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Abstract
Communicating cardiovascular risk based on individual vascular age (VA) is a well acknowledged concept in patient education and disease prevention. VA may be derived functionally, e.g. by measurement of pulse wave velocity (PWV), or morphologically, e.g. by assessment of carotid intima-media thickness (cIMT). The purpose of this study was to investigate whether both approaches produce similar results. Within the context of the German subset of the EUROASPIRE IV survey, 501 patients with coronary heart disease underwent (a) oscillometric PWV measurement at the aortic, carotid-femoral and brachial-ankle site (PWVao, PWVcf, PWVba) and derivation of the aortic augmentation index (AIao); (b) bilateral cIMT assessment by high-resolution ultrasound at three sites (common, bulb, internal). Respective VA was calculated using published equations. According to VA derived from PWV, most patients exhibited values below chronological age indicating a counterintuitive healthier-than-anticipated vascular status: for VAPWVao in 68% of patients; for VAAIao in 52% of patients. By contrast, VA derived from cIMT delivered opposite results: e.g. according to VAtotal-cIMT accelerated vascular aging in 75% of patients. To strengthen the concept of VA, further efforts are needed to better standardise the current approaches to estimate VA and, thereby, to improve comparability and clinical utility.
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1 University and University Hospital Würzburg, Comprehensive Heart Failure Center, Würzburg, Germany (GRID:grid.411760.5) (ISNI:0000 0001 1378 7891)
2 University of Würzburg, Institute of Clinical Epidemiology and Biometry, Würzburg, Germany (GRID:grid.8379.5) (ISNI:0000 0001 1958 8658)
3 National Institute for Prevention and Cardiovascular Health, National University of Ireland, Galway, Ireland (GRID:grid.6142.1) (ISNI:0000 0004 0488 0789)
4 National Heart and Lung Institute, Imperial College London, Department of Cardiovascular Medicine, London, UK (GRID:grid.7445.2) (ISNI:0000 0001 2113 8111)
5 University Hospital Würzburg, Department of Cardiothoracic and Thoracic Vascular Surgery, Würzburg, Germany (GRID:grid.411760.5) (ISNI:0000 0001 1378 7891)
6 University and University Hospital Würzburg, Comprehensive Heart Failure Center, Würzburg, Germany (GRID:grid.411760.5) (ISNI:0000 0001 1378 7891); University Hospital Würzburg, Department of Internal Medicine I, Würzburg, Germany (GRID:grid.411760.5) (ISNI:0000 0001 1378 7891)
7 Klinik Kitzinger Land, Department of Medicine, Kitzingen, Germany (GRID:grid.411760.5)
8 University and University Hospital Würzburg, Comprehensive Heart Failure Center, Würzburg, Germany (GRID:grid.411760.5) (ISNI:0000 0001 1378 7891); University of Würzburg, Institute of Clinical Epidemiology and Biometry, Würzburg, Germany (GRID:grid.8379.5) (ISNI:0000 0001 1958 8658)
9 University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands (GRID:grid.7692.a) (ISNI:0000000090126352)