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Published on: December 2, 2014
Determinants of aortic stiffness: 16-year follow-up of the Whitehall II study
Nanna B Johansen1, Dorte Vistisen, Eric J Brunner
1Steno Diabetes Center A/S, Gentofte, Denmark. nabj@steno.dk
Insights
Central obesity strongly predicts aortic stiffness in both sexes. However, heart rate in men and adiponectin in women are key predictors, indicating sex-specific prevention strategies for aortic stiffening are needed.
Area of Science:
- Cardiovascular Science
- Aging Research
- Public Health
Background:
- Aortic stiffness is a significant predictor of cardiovascular disease.
- Long-term impacts of cardiovascular risk factors on aortic stiffness remain unclear.
Purpose of the Study:
- To investigate the prospective associations between cardiovascular risk factors and aortic stiffness.
- To determine sex-specific predictors of aortic pulse wave velocity.
Main Methods:
- Prospective analysis of 3,769 participants from the Whitehall II cohort (1991-2009).
- Assessment of cardiovascular risk factors at baseline and aortic pulse wave velocity at follow-up.
- Sex-stratified linear regression analysis adjusted for confounders; missing data imputed.
Main Results:
- Central obesity (waist circumference, waist-hip ratio) strongly predicted aortic stiffness in both men and women.
- Heart rate and interleukin 1 receptor antagonist were significant predictors in men.
- Adiponectin, triglycerides, and pulse pressure were significant predictors in women.
Conclusions:
- Central obesity is a key predictor of aortic stiffness.
- Sex-specific factors like heart rate (men) and adiponectin (women) influence aortic stiffening.
- Tailored strategies are recommended for preventing aortic stiffness based on sex.
Background:
Aortic stiffness is a strong predictor of cardiovascular disease endpoints. Cross-sectional studies have shown associations of various cardiovascular risk factors with aortic pulse wave velocity, a measure of aortic stiffness, but the long-term impact of these factors on aortic stiffness is unknown.
Methods:
In 3,769 men and women from the Whitehall II cohort, a wide range of traditional and novel cardiovascular risk factors were determined at baseline (1991-1993) and aortic pulse wave velocity was measured at follow-up (2007-2009). The prospective associations between each baseline risk factor and aortic pulse wave velocity at follow-up were assessed through sex stratified linear regression analysis adjusted for relevant confounders. Missing data on baseline determinants were imputed using the Multivariate Imputation by Chained Equations.
Results:
Among men, the strongest predictors were waist circumference, waist-hip ratio, heart rate and interleukin 1 receptor antagonist, and among women, adiponectin, triglycerides, pulse pressure and waist-hip ratio. The impact of 10 centimeter increase in waist circumference on aortic pulse wave velocity was twice as large for men compared with women (men: 0.40 m/s (95%-CI: 0.24;0.56); women: 0.17 m/s (95%-CI: -0.01;0.35)), whereas the opposite was true for the impact of a two-fold increase in adiponectin (men: -0.30 m/s (95%-CI: -0.51;-0.10); women: 0.61 m/s (95%-CI: -0.86;-0.35)).
Conclusion:
In this large prospective study, central obesity was a strong predictor of aortic stiffness. Additionally, heart rate in men and adiponectin in women predicted aortic pulse wave velocity suggesting that strategies to prevent aortic stiffening should be focused differently by sex.
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