title: Reflection Magnitude, a Measure of Arterial Stiffness, Predicts Incident Heart Failure in Men But Not Women: Multi-Ethnic Study of Atherosclerosis (MESA).
abstract: BACKGROUND
  Arterial stiffness is a risk factor for heart failure (HF) and is higher in women. Our objective was to investigate sex differences between arterial stiffness and incident HF in the Multi-Ethnic Study of Atherosclerosis (MESA) population.
  
  
  RESULTS
  Applanation tonometry from 5959 participants (52.8% women) was used to calculate augmentation index (AIx), pulse pressure amplification (PPA), and reflection magnitude (RM). Sex-specific risk of HF was assessed with the use of a competing-risk regression model. Women had higher AIx (P < .00001), higher RM (P = .023), and lower PPA (P < .00001) indicating greater arterial stiffness in women. However, increasing RM quartile independently predicted HF in men (adjusted hazard ratios and 95% confidence intervals: Q2: 2.05 [1.06-3.96; P = .033]; Q3: 2.49 [1.30-4.73; P = .006]; Q4: 3.26 [1.75-6.08; P = .0002]) but not in women (Q2: 1.04 [0.54-1.98; P = .91]; Q3: 1.30 [0.71-2.37; P = .4]; Q4: 0.79 [0.4-1.55; P = .49]).
  
  
  CONCLUSIONS
  Women demonstrate greater arterial stiffness than men. Despite this, arterial stiffness, as measured by RM, predicts incident HF in men but not in women. RM represents a novel risk factor for HF in men but not in women. Further investigation of risk factors for HF in women is warranted.
  
  
  CONCLUSIONS
  Arterial stiffness, measured by RM, predicts incident HF in men but not in women in this MESA cohort.
authors.affiliation: Mayo Clinic Arizona, Scottsdale, Arizona.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Chester
authors.affiliation: Department of Biomathematics, David Geffen School of Medicine at University of California, Los Angeles, California.
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Gornbein
authors.affiliation: Division of Cardiology, Wake Forest University, Winston-Salem, North Carolina.
authors.forename: W Gregory
authors.initials: WG
authors.lastname: Hundley
authors.affiliation: Division of Endocrinology, David Geffen School of Medicine at University of California, Los Angeles, California.
authors.forename: Preethi
authors.initials: P
authors.lastname: Srikanthan
authors.affiliation: Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, California.
authors.forename: Karol E
authors.initials: KE
authors.lastname: Watson
authors.affiliation: Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, California. Electronic address: thorwich@mednet.ucla.edu.
authors.forename: Tamara
authors.initials: T
authors.lastname: Horwich
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000097:blood / Q000000981:diagnostic imaging* / Q000208:ethnology*; D015331:Cohort Studies; D005006:Ethnicity; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000000981:diagnostic imaging* / Q000208:ethnology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012727:Sex Characteristics; D059289:Vascular Stiffness / Q000502:physiology*
keywords: Sex; augmentation index; congestive heart failure; incidence; pulse pressure amplification