Abstract
Background: Arterial stiffness is a robust subclinical marker of cardiovascular disease (CVD). Furthermore, under the vascular aging concept, arterial stiffness also reflects the cumulative exposure to environment over life. Studying whether and how cardiovascular health (CVH) at a given point in time correlates with arterial stiffness may help identifying asymptomatic subjects who are at high risk for future CVD and who could benefit the most from interventions. Here, we hypothesized that ideal CVH would be inversely associated with arterial stiffness. Methods and results: Common Carotid Artery IMT (CCA-IMT), carotid stiffness (Elastic Young’s modulus) and carotid distensibility were measured by three trained technicians certified in vascular echography using high-precision echotracking device in 6457 participants attending a health check up in a large health center in France between 2008 and 2012. Participants were categorized as having poor, intermediate and ideal cardiovascular health if they had 0-2, 3-4 and 5-7 ideal health metrics (smoking, physical activity, body mass index, diet, blood glucose and total cholesterol, blood pressure). Carotid parameters were dichotomized according to their median value and multivariable logistic regression analysis was performed to examine the relationship between ICVH (exposure variable) with each carotid parameter (outcome). Mean age was 59.4 (SD 6.2) years and 38.2 % were females. Poor, intermediate and ideal cardiovascular health was present in 39.93%, 49.75% and 10.32% of study participants. Mean CCA-IMT was 654.47 (SD 117.77) and 612.45 (SD 113.86) micrometers in subjects with a poor and an ideal CVH respectively, corresponding to an absolute difference of 42 micrometers. After multivariable adjustment and compared to poor ICVH, ideal CVH was associated significantly with lower CCA-IMT (odds ratio = 1.76; 95% CI: 1.46;2.11) and carotid stiffness (odds ratio = 2.19; 95% CI: 1.83;2.63), and higher carotid distension (odds ratio = 2.81; 95% CI: 2.34;3.39). Theses associations were stronger in magnitude with the biological as compared to the behavioral component. Conclusion: In asymptomatic subjects aged 50-75, an ideal cardiovascular health was associated with significantly less arterial stiffening. The absolute difference in CCA-IMT beteween ideal and poor CVH corresponds to a 4.2 years difference in vascular aging. This dramatic difference supports the promotion of ideal cardiovascular health. Key words: Cardiovascular disease prevention, epidemiology, Carotid intima-media thickness, Vascular aging.
Published Version
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