A Vascular Aging Index as Independent Predictor of Cardiovascular Events and Total Mortality in an Elderly Urban Population

Wadström, Benjamin Nilsson; Fatehali, Abd al Hakim; Engström, Gunnar; Nilsson, Peter M.

doi:10.1177/0003319719857270

Cited by 38 publications

(31 citation statements)

References 37 publications

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“…Step 2: The population studied was classified by age and sex in percentiles of Vascular Aging Index (VAI) [9], which was estimated with carotid-femoral pulse wave velocity (cfPWV) and intima-media thickness of the carotid artery, using the following formula VAI = (log (1.09) × 10 cIMT + log (1.14) cfPWV) × 39.1 + 4.76. Thus, values ≥ Percentile 90 were considered EVA and those < Percentile 90 as NVA.…”

Section: Definition Of Healthy Vascular Aging Normal Vascular Aging mentioning

confidence: 99%

“…Different definitions of EVA have also been published [5][6][7][8] in various papers using the highest cfPWV percentiles in their definitions. Recently Nilsson W et al [9] published the vascular aging index, integrating carotid artery intima-media thickness (cIMT) and carotid-femoral pulse wave velocity (cfPWV), which reflect arterial stiffness and subclinical atherosclerosis. Finally, the association of adherence to the Mediterranean diet and its components with EVA, as measured with the vascular aging index [9], has not been studied in the general Spanish population.…”

Section: Introductionmentioning

confidence: 99%

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Adherence to the Mediterranean Diet in Spanish Population and Its Relationship with Early Vascular Aging according to Sex and Age: EVA Study

et al. 2020

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The objective of this study is to analyze the influence of adherence to the Mediterranean diet (MDA) and its components on early vascular aging (EVA) in a Spanish population sample free of cardiovascular disease and to analyze the differences by sex. Methods: We recruited 501 individuals aged 35–75 without cardiovascular disease by random sampling (55.90 ± 14.24 years, 49.70% men). EVA was defined in two steps: Step 1: subjects with vascular damage in carotid arteries or peripheral artery disease were classified as EVA. Step 2: subjects at the percentile of the combined Vascular Aging Index (VAI) were classified; ≥ p90 was considered EVA and < p90 was considered normal vascular aging (NVA), estimated using the following formula (VAI = (log (1.09) × 10 cIMT + log (1.14) cfPWV) × 39.1 + 4.76 by age and sex. Carotid-femoral pulse wave velocity (cfPWV) was measured by SphigmoCor System® and carotid intima-media thickness by Sonosite Micromax® ultrasound and classified thus: values ≥ Percentile 90 were considered EVA and those < Percentile 90 as NVA, with population percentiles analyzed. The principal result variable was assessed using the 14-item MEDAS questionnaire, developed and validated by the PREDIMED group, comprising 12 questions about the frequency of food consumption and two questions regarding the Spanish population’s typical eating habits. Results: MDA was observed by 25% (17% men and 34% women). EVA was present in 17% (29% men and 4% women). The adjusted logistic regression models showed that an increase in MDA decreases the probability of EVA in the global analysis (OR = 0.36; 95% CI: 0.16–0.82). In the analysis by sex, this association was only seen in men (OR = 0.33; 95% CI: 0.12–0.86), but not in women (OR = 0.31; 95% CI: 0.04–2.50). Conclusion: The results of this study suggest that a greater adherence to the Mediterranean diet decreases the probability of presenting EVA. In the analysis by sex, this association applies only to men.

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Section: Definition Of Healthy Vascular Aging Normal Vascular Aging mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adherence to the Mediterranean Diet in Spanish Population and Its Relationship with Early Vascular Aging according to Sex and Age: EVA Study

et al. 2020

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“…Follow-up of our patients revealed a good link between AD and the occurrence of CV events, which matches the results of Nilsson et al, although they used the pulse wave velocity method. 29 It seems that the determination of aortic elastic properties may define abnormalities that do not present on the aortogram or echocardiogram and may predict the natural history of certain diseases. Decreased AD has been linked to increased CV mortality in different patient populations.…”

Section: Discussionmentioning

confidence: 99%

Aortic Distensibility Can Predict Events in Patients With Premature Coronary Artery Disease: A Cardiac Magnetic Resonance Study

et al. 2020

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Noninvasive assessment of aortic distensibility (AD) is feasible with cardiac magnetic resonance (CMR). We investigated the relationship between AD (assessed by CMR) and coronary artery disease (CAD) severity (assessed by the SYNTAX score) in patients with premature CAD. We recruited 125 patients with CAD confirmed by coronary angiography (males were <55 years old and females <65 years old). We excluded patients with significant aortic disease or contraindications to CMR. We also recruited 25 age- and sex-matched healthy patients as controls. One-year follow-up was also carried out. Aortic distensibility at the aortic root (AR) and descending aorta (DA) was significantly ( P < .001 for both) lower in the patient group. There was a significant negative correlation between SYNTAX score and AD at the AR (r = −0.56; P < .001) and DA (r = −0.34; P < .001), but insignificant correlation with distensibility at the ascending aorta (AA; r = −0.03; P = .81). AR, AA, and DA distensibility, as well as left ventricular ejection fraction were predictors of adverse events. The severity of CAD in young patients is associated with decreased AD, especially at the level of the AR. Aortic distensibility can predict adverse events in these patients.

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“…18 The inclusion and exclusion criteria are presented as a flowchart (Figure 1) and in a previous paper. 21 The final study population included 2710 participants, 62% women, with a mean age of 72 years (standard deviation: 5.5 years) at the time of aPWV measurement.…”

Section: Study Populationmentioning

confidence: 99%

Aortic Stiffness, Inflammation, and Incidence of Cardiovascular Events in Elderly Participants From the General Population

et al. 2021

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Low-grade inflammation and arterial stiffness are key factors in the development of vascular aging. However, the interplay between arterial stiffness and inflammation for cardiovascular (CV) disease is unclear. Aortic pulse wave velocity (aPWV) and the inflammatory markers, high-sensitivity C-reactive protein (CRP) and orosomucoid, were measured in 2710 participants (median age: 72 years). These participants were followed up for a mean of 7.6 years for a composite CV disease end point. Per 1 interquartile range increment of CRP and orosomucoid, respectively, aPWV increased by 0.19 m/s (95% CI: 0.07-0.32) and 0.19 m/s (0.11-0.27), after multifactorial adjustment. Mediation analysis showed that aPWV, after multifactorial adjustment, mediated 8% (−4, 20) of the CV disease risk associated with CRP and 8% (−4, 18) of orosomucoid risk. The associated risk increased with combinations of high aPWV and high CRP or orosomucoid. We found no evidence that arterial PWV acted as an important mediator of the relationship between systemic inflammation and CV disease risk in this elderly population. The results instead indicate an additive effect. Our study supports the view that arterial stiffness and chronic inflammation affects CV risk mainly through separate causal pathways.

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A Vascular Aging Index as Independent Predictor of Cardiovascular Events and Total Mortality in an Elderly Urban Population

Cited by 38 publications

References 37 publications

Adherence to the Mediterranean Diet in Spanish Population and Its Relationship with Early Vascular Aging according to Sex and Age: EVA Study

Adherence to the Mediterranean Diet in Spanish Population and Its Relationship with Early Vascular Aging according to Sex and Age: EVA Study

Aortic Distensibility Can Predict Events in Patients With Premature Coronary Artery Disease: A Cardiac Magnetic Resonance Study

Aortic Stiffness, Inflammation, and Incidence of Cardiovascular Events in Elderly Participants From the General Population

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