title: Brachial-ankle pulse wave velocity predicts the development of cardiovascular disease in a general Japanese population: the Hisayama Study.
abstract: OBJECTIVE
  We examined the relationship between brachial-ankle pulse wave velocity and the development of cardiovascular disease in a general Japanese population.
  
  
  METHODS
  A total of 2916 community-dwelling Japanese individuals without history of cardiovascular disease aged at least 40 years were followed up for an average of 7.1 years, and the relationship between brachial-ankle pulse wave velocity and the cardiovascular risk was estimated using the Cox proportional hazards model. To compare the accuracy of the risk assessment for cardiovascular events between the models adjusted for known cardiovascular risk factors with and without brachial-ankle pulse wave velocity, the area under the receiver-operating characteristic curve and net reclassification improvement were computed.
  
  
  RESULTS
  During the follow-up period, 126 patients experienced cardiovascular events. Age and sex-adjusted incidence rates of cardiovascular disease increased linearly with elevating brachial-ankle pulse wave velocity levels (P for trend <0.001). After adjusting for confounding factors, every 20% increment in brachial-ankle pulse wave velocity was associated with a 1.30-fold [95% confidential interval (CI) 1.10-1.53] greater cardiovascular risk. When brachial-ankle pulse wave velocity was incorporated into a model with known cardiovascular risk factors, the area under the receiver-operating characteristic curve was significantly increased (0.776 vs. 0.760; P = 0.01), and the net reclassification improvement was 0.085 (P = 0.008).
  
  
  CONCLUSIONS
  Our findings suggest that brachial-ankle pulse wave velocity is a significant predictive factor for cardiovascular disease in the general Japanese population and that information on brachial-ankle pulse wave velocity substantially improves cardiovascular risk assessment beyond that achieved by a model based on potential risk factors in general practice.
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. nino@intmed2.med.kyushu-u.ac.jp
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Ninomiya
authors.forename: Iwao
authors.initials: I
authors.lastname: Kojima
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Doi
authors.forename: Masayo
authors.initials: M
authors.lastname: Fukuhara
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Hirakawa
authors.forename: Jun
authors.initials: J
authors.lastname: Hata
authors.forename: Takanari
authors.initials: T
authors.lastname: Kitazono
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kiyohara
mesh_terms: D000328:Adult; D055109:Ankle Brachial Index; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012307:Risk Factors