Arterial Stiffness: Determinants and Relationship to the Metabolic Syndrome

Abstract

This study aimed to investigate independent determinants of arterial stiffness and evaluate the association of arterial stiffness with the presence of metabolic syndrome (MS). Demographic characteristics, hemodynamic parameters, and cardiovascular (CV) risk factors were assessed in Greek food industry employees with no history of diabetes or CV disease in order to isolate multiple correlates of arterial stiffness as assessed by pulse wave velocity (PWV). Subsequently, logistic regression analysis was performed using as end point the presence of MS, defined according to the National Cholesterol Education Program. Data from 424 participants (mean age 45.3 -/+ 15.5 years, 298 [70.3%] males, average PWV 8.5 -/+ 3.6 m/s) were analyzed. PWV was higher in men (8.8 -/+ 3.1 m/s) compared to women (7.7 -/+ 2.9 m/s, p < 0.01). Age, systolic blood pressure, and heart rate were isolated as multivariate determinants of PWV (adjusted R2 0.511 [p < 0.0001] in men and 0.538 [p < 0.0001] in women). The overall prevalence of the MS was 14.6%, being similar in both genders. Four variables were shown to be independent predictors of the presence of MS: waist circumference >102 cm (men)/88 cm (women) (OR 8.6, [95% CI 2.8, 20.6], p < 0.001), insulin resistance (homeostasis model assessment >4) (6.3, [2.1, 17.6], p < 0.001), total cholesterol >240 mg/dL (5.5, [1.7, 12.4], p < 0.01), PWV >9 m/s (4.1, [1.5, 9.9], p < 0.01). High PWV, which was found to be mostly determined by advanced age, elevated systolic BP, and accelerated heart rate, appeared to exhibit a strong independent association with the presence of MS together with adiposity and insulin resistance. This index should be considered as a useful marker for CV risk stratification.

In Addition to Insulin Resistance and Obesity, Brachial-Ankle Pulse Wave Velocity is Strongly Associated with Metabolic Syndrome in Chinese - A Population-Based Study (Taichung Community Health Study, TCHS)

“…The cut-off values of baPWV to predict diabetes, hypertension, and MetS were found to be higher than Yamashina's suggestion. Although the association between MetS and arterial stiffness had been proved by many studies 11,[17][18][19][20] , there seems to be a gender difference. For example, a previous study in Korea found that MetS is associated with baPWV in women, but not in men 21) .…”

“…As we know that age is one of the major determinants of baPWV, in the present study, we proved that baPWV was not only associated with MetS after adjustment for obesity, insulin resistance, age, and other lifestyle factors but was also associated with the number of MetS components. Blood pressure is another major determinant of baPWV 20) , but hyperglycemia, central obesity, and dyslipidemia were the traits associated with arterial stiffness 17) . In addition to high blood pressure, however, central obesity, dyslipidemia, and hyperglycemia were all significantly associated with baPWV in our study.…”

Metabolic Syndrome and Vascular Alterations in Normotensive Subjects at Risk of Diabetes Mellitus

“…6 -10 In most of these studies, however, the presence of overt hypertension or diabetes, or even of pharmacological treatment, was not an exclusion criterion. [7][8][9] This could represent a potential bias in interpreting results, because it is well known that hypertension induces arterial stiffness and that, conversely, increased central arterial stiffness and peripheral wave reflection are potent mechanisms to further increase peripheral and central systolic BP and pulse pressure. 18 -20 Indeed, in these studies systolic BP resulted an independent predictor of increased arterial stiffness.…”

Cardiothoracic Ratio, Malnutrition, Inflammation, and Two-Year Mortality in Non-Diabetic Patients on Maintenance Hemodialysis

“…Age is an important determinant of arterial stiffness and a non-modifiable cardiovascular risk factor [17][18][19] . Vascular aging occurs with advancing age, and is associated with vascular wall changes which can increase arterial stiffness [20] .…”