Trajectories of arterial stiffness and all-cause mortality among community-dwelling older Japanese.

AIM: Aortic pulse wave velocity (PWV) is a strong predictor of all-cause mortality in later life. The present prospective study used repeated measures analysis to examine sex-specific age trends in brachial-ankle PWV (baPWV), identify baPWV trajectories and determine whether potential baPWV trajectories were associated with all-cause mortality among community-dwelling older Japanese.

METHODS: A total of 1744 adults (mean age 71.0 years [SD 5.8 years]; 57.0% women) aged 65-90 years participated in annual geriatric health assessments during the period from April 2003 through July 2015. The average number of follow-up assessments was 4.3, and the total number of observations was 7419. We checked local registries to identify deaths from any cause; 289 (16.6%) participants died during the period through December 2015.

RESULTS: baPWV similarly and significantly increased with advancing age in men and women. We identified four distinct trajectory patterns (very high, high, moderate, and low) in adults aged 65-90 years, and these trajectories showed parallel increases. After adjusting for important confounders, participants in the moderate, high and very high baPWV trajectory groups had hazard ratios of 1.12 (95% CI 0.84-1.44), 1.04 (95% CI 0.74-1.45) and 1.98 (95% CI 1.20-3.29), respectively, for all-cause mortality, as compared with those in the low trajectory group.

CONCLUSIONS: baPWV increased with age in men and women, and there was no significance between sexes in later life. This prospective study identified four major baPWV trajectory patterns in community-dwelling older adults. Individuals in the very high baPWV trajectory group, especially younger seniors, had a higher mortality risk. Geriatr Gerontol Int 2018; 18: 1108-1113.