The aortic-femoral arterial stiffness gradient is blood pressure independent in older adults: the atherosclerosis risk in communities (ARIC) study
Keeron Stone, Simon Fryer, James Faulkner, Michelle L. Meyer, Kevin S. Heffernan, Anna Kucharska‐Newton, Gabriel Zieff, Craig Paterson, Kunihiro Matsushita, Timothy M. Hughes, Hirofumi Tanaka, Lee Stoner
Abstract
Background: Aortic arterial stiffness is a strong independent predictor of cardiovascular disease (CVD); however, its dependence on mean arterial pressure (MAP) limits its clinical utility. The aortic-femoral arterial stiffness gradient (af-SG), a novel marker of CVD risk, may be a promising alternative, but its dependence on MAP is not known. The aim of this study was to determine the relationship between MAP and the af-SG in healthy older adults and those with established disease, including hypertension and diabetes. Method: We evaluated the dependency of the af-SG on MAP in healthy older adults ( n = 694, aged 74 ± 5 years), and adults with hypertension ( n = 2040, aged 76 ± 5 years), and diabetes ( n = 1405, aged 75 ± 5 years) as part of the community-based Atherosclerosis Risk in Communities (ARIC) Study. Carotid-femoral pulse-wave velocity (cfPWV), femoral-ankle PWV (faPWV) and blood pressure were measured using standardized protocols. The af-SG was calculated as faPWV divided by cfPWV. Multivariable regression analysis was performed to test the independent association of MAP with af-SG, with adjustments for known confounders, including age, sex, BMI, blood glucose and heart rate. Results: There was no significant relationship between the af-SG and MAP in healthy (β = 0.002, P = 0.301), hypertension (β = −0.001, P = 0.298) or diabetes (β = −0.001, P = 0.063) population groups, with MAP explaining less than 0.1, less than 0.1 and 0.2% of the variance in the af-SG, respectively. Conclusion: These findings suggest that the af-SG may be regarded as a MAP independent index of arterial health and CVD risk in older adults.