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Arterial Stiffness and Long-Term Risk of Health Outcomes: The Framingham Heart Study
Vasan RS, Pan S, Xanthakis V, Beiser A, Larson MG, Seshadri S, Mitchell GF.. Hypertension (Dallas, Tex. : 1979), 2022-02-16
Topic: Risk, prevention and care in population studies
Background Arterial stiffness increases with age and is associated with an increased risk of adverse outcomes on short-term follow-up (typically Methods We evaluated 7283 Framingham Study participants (mean age 50 years, 53% women) who underwent assessment of carotid-femoral pulse wave velocity (a marker of arterial stiffness) via applanation tonometry at one or more routine examinations. We used time-dependent Cox proportional hazards regression models to relate carotid-femoral pulse wave velocity to the incidence of health outcomes (updating carotid-femoral pulse wave velocity and all covariates at serial examinations). Results On long-term follow-up (median 15 years; minimum-maximum, 0-20), participants developed cardiometabolic disease (hypertension [1255 events]; diabetes [381 events]), chronic kidney disease (529 events), dementia (235 events), cardiovascular disease (684 events) a
Key findings
- We used time-dependent Cox proportional hazards regression models to relate carotid-femoral pulse wave velocity to the incidence of health outcomes (updating carotid-femoral pulse wave velocity and all covariates at serial examinations).
- Results On long-term follow-up (median 15 years; minimum-maximum, 0-20), participants developed cardiometabolic disease (hypertension [1255 events]; diabetes [381 events]), chronic kidney disease (529 events), dementia (235 events), cardiovascular disease (684 events) and its components (coronary heart disease [314 events], heart failure [191 events], transient ischemic attacks or stroke [250 events]), and death (1086 events).
- In multivariable-adjusted models, each SD increment in carotid-femoral pulse wave velocity was associated with increased risk of hypertension (hazard ratio [HR], 1.32 [95% CI, 1.21-1.44]), diabetes (HR, 1.32 [95% CI, 1.11-1.58]), chronic kidney disease (1.19 [95% CI, 1.05-1.34]), dementia (HR 1.27 [95% CI, 1.06-1.53]), cardiovascular disease (HR, 1.20 [95% CI, 1.06-1.36]) and its components (coronary heart disease, HR 1.37 [95% CI, 1.13-1.65]; transient ischemic attack/stroke, HR, 1.24 [95% CI, 1.00-1.53]), and death (HR, 1.29 [95% CI, 1.17-1.43]).
- The association with heart failure was borderline nonsignificant (HR, 1.21 [95% CI, 0.98-1.51], P =0.08).
Why it matters
This study evaluated whether arterial stiffness, measured by carotid-femoral pulse wave velocity, is associated with long-term risk of health outcomes including dementia. It is an observational study of a possible risk factor and does not test any treatment, cure, or prevention.
Study details
- Effect sizeHR 1.27; HR 1.37
- Evidence strengthLow
How this study scored 52/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Hypertension (Dallas, Tex. : 1979)) |
| Journal's citation record | 3 / 4 | Hypertension: journal h-index 369 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2022 — within 6 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 185 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 30.8 citations a year over 6 year(s) since 2022 |
| Impact for its field and year | 5 / 6 | Cited 23.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 3 / 4 | Cited 144 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Gary F. Mitchell: h-index 93 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Boston University: institution h-index 1,456 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 35168368) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 52 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1161/hypertensionaha.121.18776
- PubMed: 35168368
- Original source →
- Free full text: PubMed Central →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Vasan, R. S., Pan, S., Xanthakis, V., Beiser, A., Larson, M. G., Seshadri, S., et al. (2022). Arterial Stiffness and Long-Term Risk of Health Outcomes: The Framingham Heart Study. Hypertension (Dallas, Tex. : 1979). https://doi.org/10.1161/hypertensionaha.121.18776
Vancouver
Vasan RS, Pan S, Xanthakis V, Beiser A, Larson MG, Seshadri S, et al. Arterial Stiffness and Long-Term Risk of Health Outcomes: The Framingham Heart Study. Hypertension (Dallas, Tex. : 1979). 2022. doi:10.1161/hypertensionaha.121.18776. PMID: 35168368.
BibTeX
@article{vasan2022-35168368,
author = {Vasan, R. S. and Pan, S. and Xanthakis, V. and Beiser, A. and Larson, M. G. and Seshadri, S. and Mitchell, G. F.},
title = {{Arterial Stiffness and Long-Term Risk of Health Outcomes: The Framingham Heart Study}},
journal = {Hypertension (Dallas, Tex. : 1979)},
year = {2022},
doi = {10.1161/hypertensionaha.121.18776},
pmid = {35168368},
url = {https://doi.org/10.1161/hypertensionaha.121.18776}
}
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