An Analysis of Prospective Risk Factors for Aortic Stiffness in Men 20-Year Follow-Up From the Caerphilly Prospective Study

McEniery, C. M., Spratt, M., Munnery, M., Yarnell, J., Lowe, G. D., Rumley, A., Gallacher, J., Ben Shlomo, Y., Cockcroft, J. R. and Wilkinson, I. B. (2010) An Analysis of Prospective Risk Factors for Aortic Stiffness in Men 20-Year Follow-Up From the Caerphilly Prospective Study. Hypertension, 56(1), pp. 36-43. (doi: 10.1161/HYPERTENSIONAHA.110.150896)

Abstract

Arterial stiffness is an important determinant of cardiovascular risk. The precise risk factors for arterial stiffening remain unclear. We aimed to identify potential risk factors using prospective exposure data from the Caerphilly Prospective Study. Aortic pulse wave velocity and augmentation index were measured in 825 men and related to current (2004) and baseline (1979-1988) anthropometric, hemodynamic, and biochemical factors. The mean age of the men was 74 years, with an average follow-up of 20 years. The only independent baseline predictors of current velocity were pulse pressure (standardized beta-coefficient: 0.58), C-reactive protein (0.35), glucose (0.25), and waist circumference (0.23). The sole baseline predictor of current augmentation index was fibrinogen (0.78). After additional adjustment for the corresponding current risk factor, pulse wave velocity was best related to cumulative exposure to C-reactive protein, whereas augmentation index was most strongly related to current levels. Velocity was also more strongly correlated with baseline levels of triglycerides and smoking but with current waist circumference. The pulse pressure heart rate product assessed over the whole of 20 years was independently correlated with aortic pulse wave velocity but not augmentation index. Other than blood pressure, established cardiovascular risk factors have only a modest effect on aortic stiffness and wave reflection. Inflammation and the level of repetitive cyclic stress are important predictors of aortic stiffness, whereas wave reflection is predicted by acute inflammation only. Adequate control of pulse pressure and heart rate, as well as reducing inflammation, may, in the long-term, retard aortic stiffening, although this remains to be tested directly. (Hypertension. 2010; 56: 36-43.)

• Item Type: Articles
• Keywords: AGE aorta ARTERIAL STIFFNESS ARTERIOSCLEROSIS ARTERY ATHEROSCLEROSIS AUGMENTATION INDEX BLOOD blood pressure BLOOD-FLOW BLOOD-PRESSURE C-REACTIVE PROTEIN CARDIOVASCULAR MORTALITY cardiovascular risk CENTRAL BLOOD-PRESSURE diabetes DISEASE ENGLAND EXPOSURE fibrinogen FOLLOW-UP GLUCOSE HEART heart rate hypertension INDEX inflammation Kidney LEVEL LONG-TERM MEN METABOLIC SYNDROME predictors PRODUCT Prospective Prospective study PROTEIN pulse wave velocity PULSE-WAVE VELOCITY RISK risk factors RISK-FACTOR RISK-FACTORS SMOKING STRESS UNIT vascular disease WAIST CIRCUMFERENCE
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Rumley, Dr Ann and Lowe, Professor Gordon
• Authors: McEniery, C. M., Spratt, M., Munnery, M., Yarnell, J., Lowe, G. D., Rumley, A., Gallacher, J., Ben Shlomo, Y., Cockcroft, J. R., and Wilkinson, I. B.
• College/School: College of Medical Veterinary and Life Sciences
• Journal Name: Hypertension
• ISSN: 0194-911X