Abstract P246: Long-term Optimal Lifestyle and Clinical Factors and Progression in Arterial Stiffness in the Multiethnic Study of Atherosclerosis

Abstract

Introduction: Optimal cardiovascular health (CVH), based on lifestyle and clinical factors, is associated with lower risk of CV events and this may occur partly by preventing progression of arterial stiffness. We assessed the association of optimal lifestyle and clinical factors with changes in arterial stiffness in the Multi-Ethnic Study of Atherosclerosis. Methods: Among 2,729 participants (aged 44-84 years, 46.5% male), number of optimal lifestyle factors (BMI <25 kg/m2, never smoker, never drinkers, exercised >500 METS minutes/week) and optimal clinical factors (systolic BP <140 and diastolic BP <90mmHg, fasting glucose <100mg/dL, and total cholesterol <200mg/dL), across 5 visits, were summed to create an overall optimal score for lifestyle and clinical factors. Carotid arterial stiffness was measured using distensibility coefficient (DC) and Young’s elastic modulus (YEM) at baseline and after a mean of 9.5 years (visit 5). In separate multiple linear regression models, percent changes in DC and YEM between visits 1 and 5 were regressed on quartiles of overall optimal score for lifestyle and clinical factors. Results: On average, DC decreased by 5.3% and YEM increased by 24.4% over ten years. Mean optimal lifestyle score was 10.2 (range: 0-19) and optimal clinical score was 9.1 (range: 0-15) across 5 visits. There was no difference in arterial stiffness progression between individuals in the upper quartiles of optimal lifestyle score and those in the lowest quartile. A higher score on optimal clinical factors was inversely associated with progression in arterial stiffness. Linear trends in the increase of DC (P-trend<0.001 in all) and decrease of YEM (P-trend<0.002 in all) were observed across the quartiles of optimal clinical score and quartiles of CVH score (i.e. combining lifestyle and clinical factors) (Table 1). Conclusion: Optimal CVH was associated with less arterial stiffening, but only the clinical factors were predicting arterial stiffness and lifestyle factors had no influence on arterial stiffness.