Document Detail


An analysis of prospective risk factors for aortic stiffness in men: 20-year follow-up from the Caerphilly prospective study.
MedLine Citation:
PMID:  20530296     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Carmel M McEniery; Michael Spratt; Margaret Munnery; John Yarnell; Gordon D Lowe; Ann Rumley; John Gallacher; Yoav Ben-Shlomo; John R Cockcroft; Ian B Wilkinson
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Publication Detail:
Type:  Clinical Trial, Phase I; Clinical Trial, Phase II; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-06-07
Journal Detail:
Title:  Hypertension     Volume:  56     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-17     Completed Date:  2010-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  36-43     Citation Subset:  IM    
Affiliation:
Clinical Pharmacology Unit, University of Cambridge, Addenbrooke's Hospital, Box 110, Cambridge CB2 0QQ, UK. cmm41@cam.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Aged
Aorta / physiology*
Cardiovascular Diseases / epidemiology,  physiopathology
Cross-Sectional Studies
Follow-Up Studies
Great Britain / epidemiology
Heart Rate
Humans
Incidence
Male
Middle Aged
Prognosis
Prospective Studies
Pulsatile Flow / physiology*
Questionnaires
Risk Assessment / methods*
Risk Factors
Sphygmomanometers
Time Factors
Vascular Resistance / physiology*
Grant Support
ID/Acronym/Agency:
//British Heart Foundation
Comments/Corrections
Comment In:
Hypertension. 2010 Jul;56(1):29-30   [PMID:  20530292 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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