Body Mass Index Is Not Independently Associated With Increased Aortic Stiffness in a Brazilian Population

Rodrigues, Sérgio Lamêgo; Baldo, Marcelo Perim; Lani, Lorenzo; Nogueira, Larissa; Mill, José Geraldo; Cunha, Roberto de Sá

doi:10.1038/ajh.2012.91

Cited by 64 publications

(50 citation statements)

References 36 publications

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“…It is important to note that any obesity marker (eg, BMI, weight, or WC) was associated with PWV. These findings are consistent with a previous study by our group22 in which both BMI and WC increased BP levels. When adjusted for BP level, the association between obesity indices (confounders) and cf‐PWV disappeared.…”

Section: Discussionsupporting

confidence: 94%

Racial Differences in Arterial Stiffness are Mainly Determined by Blood Pressure Levels: Results From the ELSA‐Brasil Study

Baldo

Cunha

Ribeiro

et al. 2017

JAHA

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BackgroundBlack people have a higher risk of developing hypertension and presenting higher vascular stiffening. Our aim was to investigate whether the association between race and aortic stiffness could be explained by differences in the primary risk factors.Methods and ResultsWe analyzed data from 11 472 adults (mean age, 51.9±8.9; 53.8% female) self‐reported as white (n=6173), brown (n=3364), or black (n=1935). Their carotid‐to‐femoral pulse wave velocity (cf‐PWV) as well as clinical and anthropometric parameters were measured. cf‐PWV was higher in blacks than in whites or browns (men: white, 9.63±1.81; brown, 9.63±1.88; black, 9.98±1.99; women: white, 8.84±1.64; brown, 9.02±1.68; black, 9.34±1.91; P<0.05). However, this difference disappeared after adjustments for age, mean arterial pressure, heart rate, waist circumference, fasting glucose, and glomerular filtration rate (men: white, 9.68±1.54; brown, 9.68±1.50; black, 9.73±1.52; women: white, 8.93±1.32; brown, 8.98±1.29; black, 9.02±1.32; P>0.05). The association between race and arterial stiffness was significant for brown and black women in the highest cf‐PWV quartile, even after controlling for covariates. There were no differences in the age‐related increase in cf‐PWV among the racial groups after adjustment, confirming the strong effect of age and mean arterial pressure on cf‐PWV revealed by the multiple linear regression.ConclusionsRacial differences in cf‐PWV were mainly attributed to differences in mean arterial pressure and age, although they cannot fully explain the association between race and cf‐PWV in women in the highest cf‐PWV values. This suggests that therapeutic approaches to overcome the effects of aging on the vascular system should focus on blood pressure control, especially in the black population.

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Section: Discussionsupporting

confidence: 94%

Racial Differences in Arterial Stiffness are Mainly Determined by Blood Pressure Levels: Results From the ELSA‐Brasil Study

Baldo

Cunha

Ribeiro

et al. 2017

JAHA

Self Cite

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“…In another study, an increase in waist circumference has also been found to be independently associated with higher cfPWV values among youth with type 1 diabetes (Dabelea et al 2013). However, in contrast, yet another study has noted that cfPWV values are correlated positively with BMI, but are not correlated with waist circumference in a Brazilian population (Rodrigues et al 2012). Increased aortic stiffness, a major mechanical factor predicting cardiovascular risk, has been clearly identified as playing a role in MetS (Safar et al 2013).…”

Section: Discussionmentioning

confidence: 80%

High Serum Osteoprotegerin Is Associated with Arterial Stiffness in Kidney Transplant Patients

Hsu

Shih

Chen

et al. 2015

Tohoku J. Exp. Med.

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Osteoprotegerin (OPG) is a cytokine that regulates bone resorption by inhibiting osteoclastogenesis, and OPG has been implicated in the process that causes vascular stiffness. An increase in serum OPG level has been associated with the development of arterial stiffness. Kidney transplant (KT) patients are susceptible to aortic stiffness, which is considered to be a predictor of cardiovascular events in this patient population. Carotid-femoral pulse wave velocity (cfPWV) has emerged as a gold standard for non-invasive evaluation of aortic stiffness. The aim of this study was to evaluate the relationship between serum OPG concentration and cfPWV among KT patients. Fasting blood samples were obtained from 57 KT patients and their cfPWV was measured using applanation tonometry. The serum OPG levels were measured using an enzyme-linked immunosorbent assay. Univariable linear regression analysis showed that the cfPWV in KT patients was significantly and positively correlated with age, body weight, waist circumference, body mass index, log-creatinine, systolic blood pressure, diastolic blood pressure, pulse pressure, and the log-OPG concentration. KT patients with metabolic syndrome had higher cfPWV values than those without metabolic syndrome (P = 0.036), which indicates a higher incidence of aortic stiffness in this patient population. Multivariable forward stepwise linear regression analysis of the significant variables showed that the log-OPG (P = 0.001), the log-creatinine (P = 0.004), and the SBP (P = 0.005) remained as independent and positive predictors of cfPWV values. These findings indicate that serum OPG levels are positively associated with cfPWV in KT patients.

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“…However, inverse association, 58 or absence of association after adjustment for blood pressure 59 between PWV and visceral obesity were also reported in other studies, indicating the need for additional investigations to detect the causal link between these phenotypes.…”

Section: Review Articlementioning

confidence: 88%

Arterial Stiffness: Pathophysiological and Genetic Aspects

Alvim

Santos

Bortolotto

et al. 2017

International Journal of Cardiovascular Sciences

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Cardiovascular diseases (CVD) are the main cause of mortality and it represents a significant percentage of hospitalizations. In the scenario of minimization of costs of the health system, methods that identify subclinical CVD would be important. Some guidelines include the measures of aortic stiffness and intima-media thickness of the carotid artery as methods to identify subclinical CVD in hypertensive patients. The pulse wave velocity (PWV) is the gold standard for the evaluation of arterial stiffness. In this review, we report the pathophysiology, the determinants of arterial stiffness, and justify its inclusion in the assessment of hypertensive patient due its direct association with cardiovascular risk, as show in the I Diretriz Brasileira de Prevenção Cardiovascular. In addition, we raised the main genetic studies of this phenotype, due to its complexity, can be modulated by dozens of genes. However, a better understanding of the relationship genetic-arterial stiffness and, even an intervention based on genotypes, should be achieved in future studies.

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Body Mass Index Is Not Independently Associated With Increased Aortic Stiffness in a Brazilian Population

Cited by 64 publications

References 36 publications

Racial Differences in Arterial Stiffness are Mainly Determined by Blood Pressure Levels: Results From the ELSA‐Brasil Study

Racial Differences in Arterial Stiffness are Mainly Determined by Blood Pressure Levels: Results From the ELSA‐Brasil Study

High Serum Osteoprotegerin Is Associated with Arterial Stiffness in Kidney Transplant Patients

Arterial Stiffness: Pathophysiological and Genetic Aspects

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