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Does aortic stiffness improve the prediction of coronary heart disease in elderly? The Rotterdam Study

G C Verwoert1, S E Elias-Smale, D Rizopoulos

  • 1Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.

Journal of Human Hypertension
|January 14, 2011
PubMed

Insights

Aortic stiffness measurement in elderly individuals is linked to cardiovascular disease risk but does not improve risk stratification when added to traditional Framingham risk factors. This finding suggests limited additional value for aortic stiffness in clinical practice for this population.

Area of Science:

  • Cardiovascular Medicine
  • Geriatrics
  • Biomedical Engineering

Background:

  • Aortic stiffness is a known independent predictor of cardiovascular disease (CVD).
  • Assessing its utility in clinical risk stratification for elderly populations is crucial.

Purpose of the Study:

  • To investigate the added value of aortic stiffness measurement in cardiovascular risk stratification for elderly subjects.
  • To determine if aortic stiffness reclassifies cardiovascular disease (CVD) risk when combined with Framingham risk factors.

Main Methods:

  • The Rotterdam Study cohort, comprising 2849 elderly participants (mean age 71.5 years) free of coronary heart disease (CHD) at baseline, was analyzed.
  • Subjects were stratified into low, intermediate, and high 10-year CHD risk categories using Framingham risk factors.
  • Reclassification rates were calculated by adding aortic stiffness measurements to the Framingham risk factors.

Main Results:

  • A total of 223 CHD events occurred during a median follow-up of 7.9 years.
  • Adding aortic stiffness resulted in limited reclassification: 5% in the low-risk group, 6% in the high-risk group, 3% to high-risk, and 6% to low-risk from the intermediate group.
  • Aortic stiffness was associated with CHD risk but provided no significant additional value for risk stratification.

Conclusions:

  • In elderly subjects, aortic stiffness measurement offers limited additional value for cardiovascular disease risk stratification beyond established Framingham risk factors.
  • While associated with cardiovascular risk, aortic stiffness does not significantly alter risk category assignments in this population.
  • Further research may explore other applications or refined methodologies for aortic stiffness assessment in elderly cardiovascular risk prediction.

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