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An analysis of prospective risk factors for aortic stiffness in men: 20-Year follow-up from the Caerphilly prospective study

McEniery, Carmel M., Spratt, Michael, Munnery, Margaret, Yarnell, John, Lowe, Gordon D., Rumley, Ann, Gallacher, John Edward, Ben-Shlomo, Yoav, Cockcroft, John and Wilkinson, Ian 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. 26-43. 10.1161/HYPERTENSIONAHA.110.150896

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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 β-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.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Systems Immunity Research Institute (SIURI)
Subjects: R Medicine > RC Internal medicine
Uncontrolled Keywords: arterial stiffness; pulse wave velocity; aorta; blood pressure, heart rate
Additional Information: Pdf uploaded in accordance with publisher's policy at http://www.sherpa.ac.uk/romeo/issn/0194-911X/ (accessed 19/02/2014).
Publisher: American Heart Association
ISSN: 0194-911X
Date of First Compliant Deposit: 30 March 2016
Last Modified: 04 Jun 2017 03:51
URI: http://orca-mwe.cf.ac.uk/id/eprint/28024

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