title: Brachial-ankle pulse wave velocity is associated with coronary calcification among 1131 healthy middle-aged men.
abstract: BACKGROUND
  Brachial-ankle pulse wave velocity (baPWV) is a simple and reproducible measure of arterial stiffness and is extensively used to assess cardiovascular disease (CVD) risk in eastern Asia. We examined whether baPWV is associated with coronary atherosclerosis in an international study of healthy middle-aged men.
  
  
  METHODS
  A population-based sample of 1131 men aged 40-49 years was recruited - 257 Whites and 75 Blacks in Pittsburgh, US, 228 Japanese-Americans in Honolulu, US, 292 Japanese in Otsu, Japan, and 279 Koreans in Ansan, Korea. baPWV was measured with an automated waveform analyzer (VP2000, Omron) and atherosclerosis was examined as coronary artery calcification (CAC) by computed-tomography (GE-Imatron EBT scanner). Association of the presence of CAC (defined as ≥ 10 Agatston unit) was examined with continuous measure as well as with increasing quartiles of baPWV.
  
  
  RESULTS
  As compared to the lowest quartile of baPWV, the multivariable-adjusted odds ratio (95% Confidence Interval [CI]) for the presence of CAC in the combined sample was 1.70 (0.98, 2.94) for 2nd quartile, 1.88 (1.08, 3.28) for 3rd quartile, and 2.16 (1.19, 3.94) for 4th quartile (p-trend = 0.01). The odds for CAC increased by 19% per 100 cm/s increase (p < 0.01), or by 36% per standard-deviation increase (p < 0.01) in baPWV. Similar effect-sizes were observed in individual races, and were significant among Whites, Blacks and Koreans.
  
  
  CONCLUSIONS
  baPWV is cross-sectionally associated with CAC among healthy middle-aged men. The association was significant in Whites and Blacks in the US, and among Koreans. Longitudinal studies are needed to determine its CVD predictive ability.
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Vishnu
authors.affiliation: College of Nursing, Korea University, Ansan, South Korea.
authors.forename: Jina
authors.initials: J
authors.lastname: Choo
authors.affiliation: Department of Geriatric Medicine, University of Hawaii, Honolulu, USA.
authors.forename: Bradley
authors.initials: B
authors.lastname: Wilcox
authors.affiliation: Center for Epidemiologic Research in Asia, Department of Health Science, Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hisamatsu
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA.
authors.forename: Emma J M
authors.initials: EJ
authors.lastname: Barinas-Mitchell
authors.affiliation: Department of Health Science, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Fujiyoshi
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA.
authors.forename: Rachel H
authors.initials: RH
authors.lastname: Mackey
authors.affiliation: Department of School Nursing and Health Education, Osaka Kyoiku University, Kashiwara, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Kadota
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA.
authors.forename: Vasudha
authors.initials: V
authors.lastname: Ahuja
authors.affiliation: Department of Health Science, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kadowaki
authors.affiliation: Department of Medicine, Temple University, Philadelphia, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Edmundowicz
authors.affiliation: Department of Health Science, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Miura
authors.affiliation: Department of Geriatric Medicine, University of Hawaii, Honolulu, USA.
authors.forename: Beatriz L
authors.initials: BL
authors.lastname: Rodriguez
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA.
authors.forename: Lewis H
authors.initials: LH
authors.lastname: Kuller
authors.affiliation: Division of Pulmonary Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea.
authors.forename: Chol
authors.initials: C
authors.lastname: Shin
authors.affiliation: Department of Geriatric Medicine, University of Hawaii, Honolulu, USA.
authors.forename: Kamal
authors.initials: K
authors.lastname: Masaki
authors.affiliation: Department of Health Science, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Ueshima
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA. Electronic address: akira@pitt.edu.
authors.forename: Akira
authors.initials: A
authors.lastname: Sekikawa
mesh_terms: D000328:Adult; D000367:Age Factors; D055109:Ankle Brachial Index; D019540:Area Under Curve; D044383:Black People / Q000706:statistics & numerical data; D015897:Comorbidity; D016001:Confidence Intervals; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005202:Asia, Eastern; D064368:Healthy Volunteers; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D063177:Pulse Wave Analysis; D018570:Risk Assessment; D012720:Severity of Illness Index; D061205:Vascular Calcification / Q000175:diagnosis* / Q000453:epidemiology*; D059289:Vascular Stiffness; D044465:White People / Q000706:statistics & numerical data
keywords: Arteriosclerosis; Atherosclerosis; Pulse wave analysis; Vascular calcification; Vascular stiffness