ASSOCIATION OF PULSE-WAVE-PATTERN CLASSIFICATION AND TARGET ORGAN DAMAGE IN A CHINESE COMMUNITY-BASED POPULATION

Objective: This study aimed to investigate whether pulse-wave-pattern classification is associated with target organ damage in a Chinese community-based population.Design and method: Participants in this cross-sectional study were from a community in Beijing, China. We excluded participants with prevalent stroke, myocardial infarction, and peripheral artery disease. Type A was defined as participants whose peak systolic pressure (Ppk) occurred in late systole after a inflection point (Pi) and AP/PP>0.12, where AP=Ppk-Pi and PP=pulse pressure. Type B was participants whose peak systolic pressure also occurred in late systole following an inflection point, but AP/PP was between 0.0 and 0.12. Type C was participants whose peak systolic pressure preceded a well-defined inflection point and AP/PP less than 0.0. Indicators of TOD included mean carotid intima-media thickness (cIMT), carotid plaque, and urine albumin-to-creatinine ratio (UACR). We used ANOVA or the Kruskal-Wallis rank sum test for continuous variables as appropriate, and the Pearson chi-square test for categorical variables. Generalized linear regression models were applied to analyze the associations between pulse-wave-pattern groups and TOD. Results: A total of 5,525 participants were included. The number of participants of type A, B, and C were 3,622 (65.557%), 1,443 (26.118%), and 460 (8.326%), respectively. The mean age of participants of type A, B, C was 61.90±7.17, 62.08±7.89, 62.60±8.78, and 2810(77.581%), 745(51.629%), 158(34.348%) were females, respectively. Compared with participants in the type A group, those in type B and C groups had significantly lower mean cIMT (type B: β=0.010, 95%CI[-0.016, -0.003], p=0.006; type C: β=-0.013 95%CI[-0.023, -0.002], p=0.022). Similarly, participants of type B and C had a lower risk of carotid plaque (type B: OR=0.798, 95%CI[0.691, 0.923], p=0.002; type C: OR=0.799, 95%CI[0.636, 1.005], p=0.055). Participants of type C had a higher risk of UACR more than 30 mg/g than type A (OR=1.467, 95%CI[1.046, 2.057], p=0.027). We did not observe significant difference between type B and A. Conclusions: Type B and C are significantly associated with a decreased risk of carotid lesions. Our results suggested that pulse-wave-pattern may serve as a useful marker, providing a superior model to stratify TOD, especially carotid lesions in the general population.