Correlates of aortic stiffness in elderly individuals: a subgroup of the cardiovascular health study

Abstract

Background: Arterial stiffness has been associated with aging, hypertension, and diabetes; however, little data has been published examining risk factors associated with arterial stiffness in elderly individuals. Methods: Longitudinal associations were made between aortic stiffness and risk factors measured approximately 4 years earlier. Aortic pulse wave velocity (PWV), an established index of arterial stiffness, was measured in 356 participants (53.4% women, 25.3% African American), aged 70 to 96 years, from the Pittsburgh site of the Cardiovascular Health Study during 1996 to 1998. Results: Mean aortic pulse wave velocity (850 cm/sec, range 365 to 1863) did not differ by ethnicity or sex. Increased aortic stiffness was positively associated with higher systolic blood pressure (SBP), age, fasting and 2-h postload glucose, fasting and 2-h insulin, triglycerides, waist circumference, body mass index, truncal fat, decreased physical activity, heart rate, and common carotid artery wall thickness ( P < .05). After controlling for age and SBP, the strongest predictors of aortic stiffness in men were heart rate ( P = .001) and 2-h glucose ( P = .063). In women, PWV was positively associated with heart rate ( P = .018), use of antihypertensive medication ( P = .035), waist circumference ( P = .030), and triglycerides ( P = .081), and was negatively associated with physical activity ( P = .111). Results were similar when the analysis was repeated in nondiabetic individuals and in those free of clinical or subclinical cardiovascular disease in 1992 to 1993. Conclusions: In these elderly participants, aortic stiffness was positively associated with risk factors associated with the insulin resistance syndrome, increased common carotid intima–media thickness, heart rate, and decreased physical activity measured several years earlier.