Assessment of arterial stiffness during a five-years follow up in a general population in northern Italy

Abstract

Background: Carotid-femoral pulse wave velocity (cfPWV) is an independent predictor of cardiovascular events and its measurement is recommended by current hypertension guidelines. Very few data are available on the progression of PWV over time. The aim of the present longitudinal study was to compare the progression of aortic stiffness over a 5-year period in a general population in Northern Italy (Vobarno Study). Methods: 227 subjects, 42% males (age 50 4 years and hypertension in 51% at baseline visit), underwent a baseline (BL) and a follow up (FU) visit, after 5.1 0.4 years. In all subjects laboratory examinations, measurement of clinic and 24 hours blood pressure (BP) and of PWV were performed at BL and at FU. Results: In the overall population cfPWV increased from 8.28 1.27 at BL to 8.51 3.2 m/s at FU (p<0.05), change: 0.22 1.25. cfPWV significantly increased from BL to FU in hypertensive subjects (HT) (from 8.61 1.41 to 8.90 1.40, p<0.01) but not in normotensives (NT) (from 7.97 1.03 to 8.11 1.11, p n.s). The absolute change in cfPWV from BL to FU progressively increased from -0.052 0.108 in NT, to 0.480 0.163 in treated HT and to 0.483 0.138 in untreated HT (p for linear trend<0.01); after adjustment for possible confounders (age, gender, BMI, baseline cfPWV and change in mean BP from baseline) the difference remained statistically significant. At multivariate analysis the variables independently related to the progression of cfPWV were age (beta 0.18, p<0.01) and cfPWV, mean BP at BL (beta -0.55, p<0.01, and beta 0.18, p<0.01, respectively) and the change in mean BP during follow-up (beta 0.20, p1⁄40.001). Conclusions: In a general population sample in Northern Italy the main determinants of the increase in arterial stiffness during a 5 years FU were age, cfPWV and mean BP at BL and change in mean BP over time.