Pulse wave velocity distribution in a cohort study: from arterial stiffness to early vascular aging

Background: By contrast with other southern European people, north Portuguese population registers an especially high prevalence of hypertension and stroke incidence. We designed a cohort study to identify individuals presenting accelerated and premature arterial aging in the Portuguese population. Method: Pulse wave velocity (PWV) was measured in randomly sampled population dwellers aged 18–96 years from northern Portugal, and used as a marker of early vascular aging (EVA). Of the 3038 individuals enrolled, 2542 completed the evaluation. Results: Mean PWV value for the entire population was 8.4 m/s (men: 8.6 m/s; women: 8.2 m/s; P < 0.02). The individuals were classified with EVA if their PWV was at least 97.5th percentile of z-score for mean PWV values adjusted for age (using normal European reference values as comparators). The overall prevalence of EVA was 12.5%; 26.1% of individuals below 30 years presented this feature and 40.2% of individuals in that same age strata were placed above the 90th percentile of PWV; and 18.7% of the population exhibited PWV values above 10 m/s, with male predominance (17.2% of men aged 40–49 years had PWV > 10 m/s). Logistic regression models indicated gender differences concerning the risk of developing large artery damage, with women having the same odds of PWV above 10 m/s 10 years later than men. Conclusion: The population PWV values were higher than expected in a low cardiovascular risk area (Portugal). High prevalence rates of EVA and noteworthy large artery damage in young ages were found.

[1]  N. Sousa,et al.  An epidemiological study determining blood pressure in a Portuguese cohort: the Guimarães/Vizela study , 2014, Journal of Human Hypertension.

[2]  J. Polónia,et al.  Prevalence, awareness, treatment and control of hypertension and salt intake in Portugal: changes over a decade. The PHYSA study , 2014, Journal of hypertension.

[3]  N. Sousa,et al.  The Rationale/Design of the Guimarães/Vizela Study , 2014, Journal of Investigative Medicine.

[4]  A. Hofman,et al.  Arterial stiffness and influences of the metabolic syndrome: a cross-countries study. , 2014, Atherosclerosis.

[5]  Yoav Ben-Shlomo,et al.  Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects. , 2014, Journal of the American College of Cardiology.

[6]  P. Nilsson,et al.  Blood pressure and pulse wave velocity as metrics for evaluating pathologic ageing of the cardiovascular system , 2014, Blood pressure.

[7]  L. Ferrucci,et al.  Longitudinal Trajectories of Arterial Stiffness and the Role of Blood Pressure: The Baltimore Longitudinal Study of Aging , 2013, Hypertension.

[8]  P. Oliveira,et al.  Salt intake in children 10–12 years old and its modification by active working practices in a school garden , 2013, Journal of hypertension.

[9]  G. Parati,et al.  Early vascular ageing in translation: from laboratory investigations to clinical applications in cardiovascular prevention. , 2013, Journal of hypertension.

[10]  G. MacGregor,et al.  Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials , 2013, BMJ : British Medical Journal.

[11]  Mikael Fogelholm,et al.  Faculty of 1000 evaluation for Primary prevention of cardiovascular disease with a Mediterranean diet. , 2013 .

[12]  P. Lucatelli,et al.  Heritability of central blood pressure and arterial stiffness: a twin study , 2012, Journal of hypertension.

[13]  Giacomo Pucci,et al.  Relationship Between Short-Term Blood Pressure Variability and Large-Artery Stiffness in Human Hypertension: Findings From 2 Large Databases , 2012, Hypertension.

[14]  G. Mancia,et al.  Vascular aging: shifting the paradigm of risk assessment and reduction in hypertension. , 2012, Journal of hypertension.

[15]  S. Laurent Defining vascular aging and cardiovascular risk , 2012, Journal of hypertension.

[16]  M. Kivimäki,et al.  Determinants of Aortic Stiffness: 16-Year Follow-Up of the Whitehall II Study , 2012, PloS one.

[17]  R. Armentano,et al.  Pulse Wave Velocity as Marker of Preclinical Arterial Disease: Reference Levels in a Uruguayan Population Considering Wave Detection Algorithms, Path Lengths, Aging, and Blood Pressure , 2012, International journal of hypertension.

[18]  J. Filipovský,et al.  Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. , 2012, Journal of hypertension.

[19]  E. Mohammadi,et al.  Barriers and facilitators related to the implementation of a physiological track and trigger system: A systematic review of the qualitative evidence , 2017, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[20]  Andrew D. Johnson,et al.  Common Genetic Variation in the 3′-BCL11B Gene Desert Is Associated With Carotid-Femoral Pulse Wave Velocity and Excess Cardiovascular Disease Risk: The AortaGen Consortium , 2012, Circulation. Cardiovascular genetics.

[21]  P. Nilsson,et al.  Early vascular aging and the role of central blood pressure , 2011, Journal of hypertension.

[22]  M. Safar,et al.  The Cardiovascular Continuum extended: Aging effects on the aorta and microvasculature , 2010, Vascular medicine.

[23]  M. Muiesan,et al.  Pulse wave velocity and cardiovascular risk stratification in a general population: the Vobarno study , 2010, Journal of hypertension.

[24]  Christodoulos Stefanadis,et al.  Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis. , 2010, European heart journal.

[25]  J. Gallacher,et al.  An Analysis of Prospective Risk Factors for Aortic Stiffness in Men: 20-Year Follow-Up From the Caerphilly Prospective Study , 2010, Hypertension.

[26]  Yasmin,et al.  Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘establishing normal and reference values’ , 2010, European heart journal.

[27]  T. Hansen,et al.  Risk prediction is improved by adding markers of subclinical organ damage to SCORE. , 2010, European heart journal.

[28]  C. Vlachopoulos,et al.  Prediction of Cardiovascular Events and All-Cause Mortality With Arterial Stiffness , 2011 .

[29]  Hao-Min Cheng,et al.  Wave Reflection and Arterial Stiffness in the Prediction of 15-Year All-Cause and Cardiovascular Mortalities: A Community-Based Study , 2010, Hypertension.

[30]  L. Ferrucci,et al.  The central arterial burden of the metabolic syndrome is similar in men and women: the SardiNIA Study. , 2010, European heart journal.

[31]  Michael J. Pencina,et al.  Arterial Stiffness and Cardiovascular Events: The Framingham Heart Study , 2010, Circulation.

[32]  Philip Chowienczyk,et al.  Dissociation of Aortic Pulse Wave Velocity With Risk Factors for Cardiovascular Disease Other Than Hypertension: A Systematic Review , 2009, Hypertension.

[33]  Stéphane Laurent,et al.  Vascular aging: A tale of EVA and ADAM in cardiovascular risk assessment and prevention. , 2009, Hypertension.

[34]  Toshiko Tanaka,et al.  COL4A1 Is Associated With Arterial Stiffness by Genome-Wide Association Scan , 2009, Circulation. Cardiovascular genetics.

[35]  D. Panagiotakos,et al.  Exercise Capacity and Mortality in Hypertensive Men With and Without Additional Risk Factors , 2009, Hypertension.

[36]  P. Nilsson,et al.  The early life origins of vascular ageing and cardiovascular risk: the EVA syndrome , 2008, Journal of hypertension.

[37]  P. Nilsson Early vascular aging (EVA): consequences and prevention , 2008, Vascular health and risk management.

[38]  Michael F O'Rourke,et al.  Arterial aging: pathophysiological principles , 2007, Vascular medicine.

[39]  Chao-Yu Guo,et al.  Cross-Sectional Correlates of Increased Aortic Stiffness in the Community: The Framingham Heart Study , 2007, Circulation.

[40]  Wei Chen,et al.  Correlates of vascular structure and function measures in asymptomatic young adults: the Bogalusa Heart Study. , 2006, Atherosclerosis.

[41]  Albert Hofman,et al.  Arterial Stiffness and Risk of Coronary Heart Disease and Stroke: The Rotterdam Study , 2006, Circulation.

[42]  Tine Willum Hansen,et al.  Prognostic Value of Aortic Pulse Wave Velocity as Index of Arterial Stiffness in the General Population , 2006, Circulation.

[43]  Yasmin,et al.  Normal vascular aging: differential effects on wave reflection and aortic pulse wave velocity: the Anglo-Cardiff Collaborative Trial (ACCT). , 2005, Journal of the American College of Cardiology.

[44]  Edward G Lakatta,et al.  Arterial aging: is it an immutable cardiovascular risk factor? , 2005, Hypertension.

[45]  Morris J. Brown,et al.  Increased Stroke Volume and Aortic Stiffness Contribute to Isolated Systolic Hypertension in Young Adults , 2005, Hypertension.

[46]  Stéphane Laurent,et al.  Structural and Genetic Bases of Arterial Stiffness , 2005, Hypertension.

[47]  J. Ferro,et al.  Prospective Community-Based Study of Stroke in Northern Portugal: Incidence and Case Fatality in Rural and Urban Populations , 2004, Stroke.

[48]  M. Bots,et al.  Aortic stiffness and carotid intima‐media thickness: two independent markers of subclinical vascular damage in young adults? , 2003, European journal of clinical investigation.

[49]  E. Rodney,et al.  Young Adults , 2018, Cannabis Consulting.

[50]  A P Avolio,et al.  Effects of aging on changing arterial compliance and left ventricular load in a northern Chinese urban community. , 1983, Circulation.