Aortic stiffness and calcification in men in a population-based international study

Sekikawa, Akira; Shin, Chol; Curb, J. David; Barinas‐Mitchell, Emma; Masaki, Kamal; El-Saed, Aiman; Seto, Todd B.; Mackey, Rachel H.; Choo, Jina; Fujiyoshi, Akira; Miura, Katsuyuki; Edmundowicz, Daniel; Kuller, Lewis H.; Ueshima, Hirotsugu; Sutton-Tyrrell, Kim

doi:10.1016/j.atherosclerosis.2012.03.027

Cited by 66 publications

(59 citation statements)

References 30 publications

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“…Age‐associated enlargement of AoD is thought to be associated with tissue remodeling of the aortic wall that includes a reduction in elastin fiber, increased collagen deposition, and increased calcification 2, 7. These structural alterations are associated with increased aortic stiffness 2, 7, 21. Thus, we speculate that the resultant functional changes of the aorta might contribute to the relationship between AoD and cardiovascular events observed in this study.…”

Section: Discussionmentioning

confidence: 58%

Increased Proximal Aortic Diameter is Associated With Risk of Cardiovascular Events and All‐Cause Mortality in Blacks The Jackson Heart Study

Kamimura

Suzuki

Musani

et al. 2017

JAHA

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BackgroundEnlargement of the proximal aorta is associated with aortic wall tissue remodeling, including fragmentation of the elastin fibers, increased synthesis of collagen, and calcification, all of which are associated with aortic wall stiffening. We hypothesized that the proximal aortic diameter (AoD) is associated with cardiovascular events in a community‐based cohort of blacks.Methods and ResultsWe investigated the associations between AoD and cardiovascular events among 3018 black participants (mean age, 55.9 years; 69% women) without past history of cardiovascular disease in the Jackson Heart Study. AoD was measured using echocardiography at the level of the sinuses of Valsalva at end diastole. Cardiovascular event was defined as incident myocardial infarction, fatal coronary artery disease, stroke, or heart failure hospitalization. Cox proportional hazards regression models were used to evaluate the association between baseline AoD and cardiovascular events. Over a median follow‐up of 8.3 years, there were 258 cardiovascular events (incident rate, 10.5 per 1000 person‐years). After adjustment for traditional risk factors, increased AoD was significantly associated with cardiovascular events (hazard ratio per 1‐cm increase, 1.72; 95% CI, 1.10–2.69; P<0.05). Participants in the top AoD quintile had a higher incidence of cardiovascular events compared to those not in the top quintile (hazard ratio, 1.47; 95% CI, 1.11–1.94; P<0.005) after adjustment for risk factors.ConclusionsGreater AoD was associated with an increased risk of cardiovascular events in a community‐based cohort of blacks. AoD may be useful as a predictor of incident cardiovascular events and further investigation is warranted.

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Section: Discussionmentioning

confidence: 58%

Increased Proximal Aortic Diameter is Associated With Risk of Cardiovascular Events and All‐Cause Mortality in Blacks The Jackson Heart Study

Kamimura

Suzuki

Musani

et al. 2017

JAHA

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“…Of note, several studies have recently reported that calcification of the aorta is associated positively with arterial stiffening both in hemodialysis patients [37,38] and in other cohorts [39][40][41][42][43] .…”

Section: Discussionmentioning

confidence: 99%

Noninvasive Blood Pressure Measurement in Maintenance Hemodialysis Patients: Comparison of Agreement between Oscillometric and Finger-Cuff Methods

Fontana¹,

Cappelli²

2017

Nephron

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Background: The Nexfin monitor is a device used for measuring arterial blood pressure (BP) continuously and noninvasively through finger-cuff technology. Since it was validated against the auscultatory method using a sphygmomanometer, the aim of this study was to test the ability of the Nexfin to evaluate brachial arterial pressure (BAP) in maintenance hemodialysis patients, quantifying accuracy and precision. Methods: Forty hemodynamically stable hemodialysis patients underwent serial measurements of Nexfix arterial pressure (NAP) and BAP, respectively, through Nexfin and oscillometric devices. All BP measurements were recorded before starting hemodialysis. Results: The mean age of the patients was 68.9 ± 14.9 years with 65% older than 65 years and 30% older than 75; eleven subjects (27%) were diabetic. Vascular calcification, evaluated from the aortic arch to the iliac bifurcation, was detected in 87.5% of patients. Bland-Altman analysis comparing NAP measurements with BAP revealed the following outcomes: a mean bias ± limits of agreements (LA) of 15.3 ± 34.8 mm Hg (29% error) for systolic BP, a mean bias ± LA of -0.9 ± 20.34 mm Hg (32% error) for diastolic BP and a mean bias ± LA of 4.5 ± 21.34 mm Hg (26% error) for mean arterial pressure (MAP). Nexfin had poor precision in the reconstruction of diastolic and mean BP and was extremely inaccurate when evaluating systolic BP. Diabetes mellitus, peripheral neuropathy, and increase in systolic BAP significantly predicted the disagreement in systolic pressure measurement between NAP and MAP, F (3.34) = 10.787, p < 0.005, R² = 0.488. Conclusion: The Nexfin does not meet the criteria of interchangeability with oscillometric method in our hemodialysis patients. The negative influence of diabetes, neuropathy, and increase of systolic BAP on the reconstruction of systemic systolic pressure raises concerns about the feasibility of Nexfin in patients with a high prevalence of vasculopathy.

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“…Several studies have investigated the relation between arterial stiffness and aortic or coronary calcifications. [14][15][16] However, the relationship between arterial stiffness and carotid plaque components, either calcification or vulnerable plaque components, has received less attention. By examining the roll of vascular wall properties in the context of atherosclerosis formation, we…”

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confidence: 99%

Arterial Stiffness Is Associated With Carotid Intraplaque Hemorrhage in the General Population

Selwaness

Bouwhuijsen

Mattace-Raso

et al. 2014

ATVB

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Objective-The relation between arterial stiffness and atherosclerosis, and specifically the influence of arterial stiffness on plaque composition, is largely unknown. In a population-based study, we investigated the association between arterial stiffness and the presence and composition of carotid atherosclerotic plaques. Approach and Results-Arterial stiffness was measured in 6527 participants (67.0±8.6 years) using aortic pulse wave velocity (PWV). Presence of carotid atherosclerotic plaques was assessed with ultrasound. Subsequently, 1059 subjects with carotid plaques (>2.5 mm) underwent MRI to assess plaque composition (presence of intraplaque hemorrhage, lipid, and calcification). Generalized estimation equation analyses adjusted for age, sex, mean arterial pressure, heart rate, carotid wall thickening, pulse pressure, and traditional cardiovascular risk factors were used to study the association between PWV and the presence and composition of carotid atherosclerotic plaques. In multivariable analysis, higher PWV was independently related to higher prevalence of carotid atherosclerotic plaque on ultrasound (odds ratio for highest quartile of PWV compared with lowest quartile, 1.24 [95% confidence interval, 1.02-1.51]). Furthermore, higher PWV was associated with intraplaque hemorrhage (age-and sex-adjusted odds ratio per SD increase in PWV, 1. MRI has emerged as a noninvasive imaging modality that enables accurate identification of the main components of the atherosclerotic plaque. 17,18 The objective of this study was to investigate the association between arterial stiffness, as assessed by PWV, and the presence and various components of carotid atherosclerotic plaque in a large population-based cohort, using both ultrasound and MRI assessment of plaques. Materials and MethodsMaterials and Methods are available in the online-only Supplement. ResultsAmong the 6527 subjects (67.0±8.6 years) who underwent carotid ultrasonography, 2527 (39.6%) subjects had ≥1 carotid plaques of ≥2.5 mm. Table 1 shows population characteristics of participants with ultrasound carotid plaques compared with those without plaques. Comparison of both groups showed that subjects with atherosclerotic plaque had a higher prevalence of various cardiovascular risk factors, including lower high-density lipoprotein cholesterol, higher systolic blood pressure, lower diastolic blood pressure, higher prevalence of smoking, diabetes mellitus, hypertension, antihypertensive medication use, history of myocardial infarction, and stroke (P<0.001). Of all persons with carotid plaque on ultrasound, to date, for 1059 subjects carotid MRI scanning was available (Table 1). Although the MRI population was significantly younger, had lower body mass index, systolic and diastolic blood pressure, lower prevalence of diabetes mellitus, and hypertension compared with subjects with carotid plaque ≥2.5 mm on ultrasound, the differences of the absolute values were small. Table 2 shows the association between PWV and presence of plaque on ultrasound. In all mode...

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Aortic stiffness and calcification in men in a population-based international study

Cited by 66 publications

References 30 publications

Increased Proximal Aortic Diameter is Associated With Risk of Cardiovascular Events and All‐Cause Mortality in Blacks The Jackson Heart Study

Increased Proximal Aortic Diameter is Associated With Risk of Cardiovascular Events and All‐Cause Mortality in Blacks The Jackson Heart Study

Noninvasive Blood Pressure Measurement in Maintenance Hemodialysis Patients: Comparison of Agreement between Oscillometric and Finger-Cuff Methods

Arterial Stiffness Is Associated With Carotid Intraplaque Hemorrhage in the General Population

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