Integrated Evaluation of Age-Related Changes in Structural and Functional Vascular Parameters Used to Assess Arterial Aging, Subclinical Atherosclerosis, and Cardiovascular Risk in Uruguayan Adults: CUiiDARTE Project

Abstract

This work was carried out in a Uruguayan (South American) population to characterize aging-associated physiological arterial changes. Parameters markers of subclinical atherosclerosis and that associate age-related changes were evaluated in healthy people. A conservative approach was used and people with nonphysiological and pathological conditions were excluded. Then, we excluded subjects with (a) cardiovascular (CV) symptoms, (b) CV disease, (c) diabetes mellitus or renal failure, and (d) traditional CV risk factors (other than age and gender). Subjects (n = 388) were submitted to non-invasive vascular studies (gold-standard techniques), to evaluate (1) common (CCA), internal, and external carotid plaque prevalence, (2) CCA intima-media thickness and diameter, (3) CCA stiffness (percentual pulsatility, compliance, distensibility, and stiffness index), (4) aortic stiffness (carotid-femoral pulse wave velocity), and (5) peripheral and central pressure wave-derived parameters. Age groups: ≤20, 21–30, 31–40, 41–50, 51–60, 61–70, and 71–80 years old. Age-related structural and functional vascular parameters profiles were obtained and analyzed considering data from other populations. The work has the strength of being the first, in Latin America, that uses an integrative approach to characterize vascular aging-related changes. Data could be used to define vascular aging and abnormal or disease-related changes.

Overview of the Normal Structure and Function of the Macrocirculation and Microcirculation

“…When using synthesized aortic pressure waves from the GTF approach and brachial pressures obtained from an oscillometric cuff as done in the Anglo-Cardiff Collaborative Trial (ACCT), amplifi cation varies from 1.7 in the young (<20 years of age) to 1.2 in the elderly (>80 years of age) [ 123 ]. These results are similar to those reported by Bia et al [ 127 ] over the same age range in the CUiiDARTE Project and those collected by Nichols et al [ 3 ]. When carotid and/or radial pressure waves obtained from applanation tonometry are calibrated against brachial diastolic and tonometric mean pressures (the latter being obtained from a brachial artery tonometric waveform), as was done in the Asklepios Study, PP amplifi cation values tend to be lower [ 116 ].…”

“…Major changes in aortic pressure wave contour are due to alterations in amplitude and timing of wave refl ections from the macrocirculation, including both elastic and muscular arteries (including arterioles). LV afterload, central aortic and brachial artery systolic, and PP, SPTI, RM, and AIx are increased by elastic artery stiffening and increased wave refl ection amplitude, all of which are alterations associated with aging and resulting in LVH [ 60 , 131 ] and arterial wall damage [ 127 ]-major cardiovascular, cerebrovascular, and renovascular risk factors [ 56 , 154 , 155 ]. Major cardiovascular risk factors resulting from increased aortic stiffness and wave refl ection (LV afterload) include coronary artery atherosclerosis, decreased coronary blood fl ow and coronary fl ow reserve (CFR) (Fig.…”

Hemodialysis Decreases the Etiologically-Related Early Vascular Aging Observed in End-Stage Renal Disease: A 5-Year Follow-Up Study

“…CUiiDARTE Center and Project is a Uruguayan Interdisciplinary University Program for Arterial Disease Early Diagnosis focused on children and adults, supported by the Republic University, the Ministry of Public Health and the National Agency for Research and Innovation (ANII) [18,19] . Using the CUiiDARTE Project database, a total of 384 asymptomatic healthy subjects were selected to comprise the control group.…”

“…To this end, carotid and femoral artery waveforms were recorded using high-fidelity mechano-transducers simultaneously placed on the skin over the carotid and femoral arteries, keeping the patients in the supine position (Arteriometer, Model V100, Oxytech, Buenos Aires, Argentina) [18,[22][23][24] ( fig. 1 ).…”

“…Measurements were done using a properly sized cuff for the circumference of the arm. Venous blood samples were drawn and processed immediately using routine laboratory methods [18,19,21] .…”