Hypertension and arterial stiffness: the atherosclerosis risk in communities study*1

Abstract Background Greater arterial stiffness is associated independently with increased cardiovascular disease risk. The American Heart Association (AHA) has recommended following “Life’s Simple 7 (LS7)” to optimize cardiovascular health; we tested whether better LS7 in middle age is associated with less arterial stiffness in later life. Methods We studied 4,232 black and white participants aged 45–64 years at the baseline (1987–89) visit of the Atherosclerosis Risk in Communities Study cohort who also had arterial stiffness measured in 2011–13 (mean ± SD interval: 23.6 ± 1.0 years). We calculated a 14-point summary score for baseline LS7 and classified participants as having “poor” (0–4), “average” (5–9), or “ideal” (10–14) cardiovascular health. We used logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (95% CI) for arterial stiffening: a high carotid-femoral pulse wave velocity (cfPWV, ≥13.23 m/s) or a high central pulse pressure (central PP, ≥ 82.35 mm Hg). Results The age, race, sex, and heart rate-adjusted ORs (95% CI) for high cfPWV in the “ideal,” “average,” and “poor” LS7 summary categories were 1 (Reference), 1.30 (1.11, 1.53), and 1.68 (1.10,2.56), respectively (P-trend = 0.0003). Similarly, the adjusted ORs (95% CI) for high central PP across LS7 summary categories were 1 (Reference), 1.48 (1.27, 1.74), and 1.63 (1.04, 2.56), respectively (P-trend <0.0001). Conclusion Greater LS7 score in middle age is associated with less arterial stiffness 2–3 decades later. These findings further support the AHA recommendation to follow LS7 for cardiovascular disease prevention.

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Abstract P036: Association Between Circulating Galectin-3 and Arterial Stiffness in the Atherosclerosis Risk in Communities Study

Circulation ◽

10.1161/circ.139.suppl_1.p036 ◽

2019 ◽

Vol 139 (Suppl_1) ◽

Author(s):

Xiaoming Jia ◽

Hirofumi Tanaka ◽

Christie M Ballantyne ◽

Wensheng Sun ◽

Amil M Shah ◽

...

Keyword(s):

Arterial Stiffness ◽

Atherosclerosis Risk In Communities ◽

Atherosclerosis Risk ◽

Galectin 3

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Abstract P168: Parity Is Associated With Higher Arterial Stiffness But Not Its 5-year Change In Older Women: The Atherosclerosis Risk In Communities - Neurocognitive Study

Circulation ◽

10.1161/circ.143.suppl_1.p168 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Alison N Bonner ◽

Shantal Jayawickreme ◽

Angela M Malek ◽

Catherine J Vladutiu ◽

Clare Oliver-Williams ◽

...

Keyword(s):

Arterial Stiffness ◽

Older Women ◽

Regression Models ◽

Pulse Wave ◽

Later Life ◽

Linear Regression Models ◽

Atherosclerosis Risk In Communities ◽

Live Births ◽

Atherosclerosis Risk ◽

Parity Number

Introduction: Although studies have demonstrated a J-shaped association of parity with cardiovascular disease, the association with vascular disease is not fully understood. We examined the association between parity and carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness. Hypothesis: Women who were never pregnant or had no live births and women with 5+ live births would have higher cfPWV and 5-year cfPWV change compared to women with 1-2 live births. Materials and Methods: We included 1220 women (average age 73.7; 21.9% Black) from the Atherosclerosis Risk in Communities - Neurocognitive Study, a cohort of 15,792 adults enrolled in 1987-1989 from four communities: Forsyth Co., NC; Jackson, MS; Minneapolis, MN; and Washington Co., MD. Technicians measured cfPWV at visit 5 (2011-13) and visit 6 or 7 (2016-19). At visit 2 (1990-92), women self-reported parity (number of prior live births), which we categorized as never pregnant or pregnant but no live births, 1-2 (referent), 3-4, and 5+ live births. We used linear regression models to evaluate associations of parity with visit 5 cfPWV and 5-year cfPWV change, adjusting for years between visits 5 and 6 or 7, age, race-center, education, body mass index, heart rate, mean arterial pressure, hypertension medication, and diabetes. Results: Participants reported having had no (7.7%), 1-2 (38.7%), 3-4 (40.0%), or 5+ (13.6%) prior live births. Women with 5+ live births had a higher visit 5 cfPWV (β=50.6 cm/s, 95% confidence interval (CI): 3.6-97.7 cm/s; Table) as compared to those with 1-2 live births. No statistically significant associations were observed for other parity groups and visit 5 cfPWV or cfPWV change. Conclusions: In later life, women with 5+ live births had higher arterial stiffness than those with 1-2 live births, but the rate of cfPWV change did not differ by parity. Longitudinal arterial stiffness measurements at mid-life are needed to better understand the effect of pregnancy on the trajectory of arterial stiffness among women in later life.

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Variability in ultrasonic measurements of arterial stiffness in the atherosclerosis risk in communities study

Ultrasound in Medicine & Biology ◽

10.1016/s0301-5629(98)00165-3 ◽

1999 ◽

Vol 25 (2) ◽

pp. 175-180 ◽

Cited By ~ 31

Author(s):

Donna K Arnett ◽

Lloyd E Chambless ◽

Ho Kim ◽

Gregory W Evans ◽

Ward Riley

Keyword(s):

Arterial Stiffness ◽

Atherosclerosis Risk In Communities ◽

Atherosclerosis Risk ◽

Ultrasonic Measurements

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Abstract P347: Associations Between Carotid-femoral and Heart-femoral Pulse Wave Velocity in Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽

10.1161/circ.141.suppl_1.p347 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Lee Stoner ◽

Michelle Meyer ◽

Anna Kucharska-newton ◽

Keeron Stone ◽

Simon Fryer ◽

...

Keyword(s):

Blood Flow ◽

Carotid Artery ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Pulse Wave ◽

Regression Line ◽

Atherosclerosis Risk In Communities ◽

Atherosclerosis Risk ◽

Aric Study ◽

Good Agreement

Introduction: Carotid-femoral pulse wave velocity (cfPWV) is widely used in clinical and epidemiological studies to assess central arterial stiffness and predict cardiovascular outcomes. However, cfPWV assessments require applanation of the carotid artery, which may be challenging in some patients, and assessments may be confounded in the presence of carotid artery plaque. Further, since cfPWV is not consistent with the path of blood flow, the measure is adjusted according to an assumed timing of the pressure wave traveling in the opposite direction. Therefore, we hypothesize that heart-femoral PWV (hfPWV) could be a simpler measure of central arterial stiffness that is consistent with the path of blood flow. Objective: To estimate the strength of the association between hfPWV and cfPWV. Methods: We evaluated 4,476 older-aged (75.2 y [SD: 5.0]) adults in the community-based Atherosclerosis Risk in Communities (ARIC) Study. cfPWV and hfPWV were measured using an automated cardiovascular screening device (Omron VP-1000plus) equipped with an electrocardiogram, a phonocardiogram, and 2 applanation tonometry sensors attached to carotid and femoral arteries. Agreement between the two measurements was determined by calculating the intraclass correlation coefficient (ICC) and the standard error of estimate (SEE). We considered ICC value estimates of <0.5, 0.5-0.75, 0.75-0.9, and >0.9 as, respectively, poor, moderate, good, and excellent agreement. The SEE represents the average distance that the observed values fall from the regression line. Smaller values indicate that the observations are closer to the fitted line. The uniformity of error was assessed by visual analysis of regression plot. Results: There was ‘good’ agreement between hfPWV and cfPWV (ICC = 0.83, 95%CI: 0.82, 0.84). While the mean cfPWV (11.6 m/s [SD: 3.0]) and hfPWV (11.5 m/s [SD: 2.3]) were comparable, the SEE was 1.3 (95%CI: 1.27, 1.33) m/s. Inspection of the regression plot revealed bias, with higher PWV further away from the regression line. Conclusions: The current findings suggest good agreement between cfPWV and hfPWV, indicating that hfPWV may be a suitable alternative to cfPWV. Since hfPWV does not require applanation of the carotid artery, the measurement is easier to conduct and may be particularly suited for use in individuals for whom applanation of the carotid artery is challenging.

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