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Published on: December 2, 2014
Large artery stiffness is not related to plasma cholesterol in older subjects with hypertension
Anthony M Dart1, Christoph D Gatzka, James D Cameron
1Baker Heart Research Institute, LaTrobe University, Melbourne, Australia.
Insights
In elderly hypertensive individuals, plasma cholesterol levels did not correlate with large artery stiffness. This finding suggests that artery stiffness measurements may offer additional cardiovascular risk assessment value beyond cholesterol levels.
Area of Science:
- Cardiovascular Physiology
- Geriatric Medicine
- Hypertension Research
Background:
- Large artery stiffness is a known prognostic factor in hypertension and coronary artery disease.
- The relationship between plasma cholesterol and large artery properties in hypertensive individuals remains unclear.
Purpose of the Study:
- To investigate the association between plasma cholesterol levels and large artery stiffness in elderly hypertensive subjects.
- To determine if plasma cholesterol influences arterial stiffness independently of other cardiovascular risk factors.
Main Methods:
- A subset of elderly hypertensive participants (65-84 years) from the ANBP2 trial were analyzed.
- Noninvasive measures included augmentation index (AI), systemic arterial compliance (SAC), and aortic distensibility.
- Multiple regression analyses were performed to assess associations between cholesterol and stiffness parameters, controlling for other variables.
Main Results:
- No significant associations were found between total or HDL cholesterol and measures of large artery stiffness (AI, SAC, aortic distensibility).
- Gender, age, height, heart rate, and mean arterial blood pressure were significant independent predictors of arterial stiffness.
- AI and cholesterol were higher in females, while SAC and aortic distensibility were higher in males.
Conclusions:
- Plasma cholesterol levels are not independently associated with large artery stiffness in elderly hypertensive individuals.
- Artery stiffness measurements may provide valuable cardiovascular risk assessment in this population, independent of cholesterol levels.
Objective:
Previous studies have demonstrated a prognostic role of large artery stiffness in hypertensive subjects and increased stiffness in subjects with coronary artery disease. Although plasma cholesterol is an established risk factor for cardiovascular disease, its relationship with large artery properties in a hypertensive population is unclear.
Methods And Results:
Plasma cholesterol and large artery properties were measured at baseline in a subset of participants of a randomized controlled trial (ANBP2) evaluating hypertension treatment in older (65 to 84 years) subjects. Noninvasive measures of large artery behavior were central augmentation index (AI), systemic arterial compliance (SAC), and transverse expansion of the aortic arch (aortic distensibility). Arterial waveforms acceptable for analysis were obtained in approximately 80% of cases yielding valid measurements of AI in 868, SAC in 846, and aortic distensibility in 680 subjects. Mean total and high-density lipoprotein (HDL) concentrations were 5.5+/-1.0 and 1.4+/-0.5 mmol L(-1). Total and HDL cholesterol and AI were greater in females than males, whereas SAC and aortic distensibility were greater in males. In multiple regression analyses there were no significant associations between stiffness parameters and total or HDL cholesterol. Significant independent associations in such analyses were found for mean arterial blood pressure, gender, age, height, and heart rate, in keeping with previous findings.
Conclusions:
In the largest cohort of elderly hypertensive subjects studied to date, plasma cholesterol per se was not associated with large artery stiffness. Such independence from cholesterol increases the potential for artery stiffness measurements to additionally contribute to cardiovascular risk assessment in this population.
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