AUTHOR=Zhang Xujie , Jiang Yumin , Liang Fuyou , Lu Jianping 

TITLE=Threshold values of brachial cuff-measured arterial stiffness indices determined by comparisons with the brachial–ankle pulse wave velocity: a cross-sectional study in the Chinese population

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1131962

DOI=10.3389/fcvm.2023.1131962

ISSN=2297-055X

ABSTRACT=Background: Arterial Velocity-pulse Index (AVI) and Arterial Pressure-volume Index (API) measured by a brachial cuff have been demonstrated to be indicative of arterial stiffness and correlated with the risk of cardiovascular events. However, the threshold values of AVI and API for screening increased arterial stiffness in the general population are yet to be established. This study aims to determine the threshold values of AVI and API in the Chinese population through statistical comparisons with the brachial-ankle pulse wave velocity (baPWV). 
Methods: The study involved 860 subjects who underwent general physical examinations (M/F = 422/438, age 53.4±12.7 years). In addition to the measurements of AVI, API and baPWV, demographic information, arterial blood pressures and data of blood and urine tests were collected. The threshold values of AVI and API were determined by receiver operating characteristic (ROC) analyses and covariate-adjusted ROC (AROC) analyses against baPWV, whose threshold for diagnosing high arterial stiffness was set at 18 m/s. Additional statistical analyses were performed to examine the correlations among AVI, API and baPWV and their correlations with other bio-indices.
Results: The area under the curve (AUC) values in ROC analysis for the diagnosis with AVI/API were 0.745/0.819, 0.788/0.837, and 0.772/0.825 (95% CI) in males, females, and all subjects, respectively. Setting the threshold values of AVI and API to 21 and 27 resulted in the highest accuracy of diagnosis in the total cohort, whereas they should be increased respectively to 24 and 29 in order to improve the diagnosis performance in the female group. The AROC analyses performed for the entire cohort indicated that the threshold values of AVI and API increased markedly with age and pulse pressure (PP), respectively.
Conclusions: With appropriate threshold values, AVI and API can be used to perform preliminary screening of individuals with increased arterial stiffness in the general population. On the other hand, the significant variations in their threshold values in the AROC analyses imply that threshold values adjusted for confounding factors could provide additional information to refine diagnosis.