06.01 The Influence of Cardiovascular Disease and Risk Factors on Age-Related Changes in Aortic Pulse Wave Velocity

Abstract

We have demonstrated previously that age-related changes in aortic pulse wave velocity (PWV) are more prominent in individuals over the age of 50 years, suggesting that aortic PWV might provide a sensitive marker of risk in older subjects. Therefore, the aim of this investigation was to assess the impact of cardiovascular disease and risk factors on age-related changes in aortic PWV.

Data from 4219 participants in the ACCT Study^† cohort were analysed (aged 18-92 years). In all subjects, seated and supine brachial BP was measured following at least 10 minutes of rest. Central (aortic) BP was derived by pulse wave analysis, and aortic (carotid-femoral) and brachial PWV were recorded (SphygmoCor). Subjects were then divided into groups based on the presence of cardiovascular disease (n = 445) or risk factors: diabetes (n = 311), hypertension (n = 952), hypercholesterolaemia (n = 196) and smoking (n = 318), leaving 1997 control subjects, all of whom were free of cardiovascular risk factors and medication. Peripheral and central blood pressure and aortic PWV all increased significantly with age (P<0.001). However, compared with healthy controls, there was a steeper age-related rise in aortic PWV after the age of 50 years in subjects with cardiovascular disease or risk factors (P<0.001, Figure), even after adjusting for differences in mean pressure. In multivariate analyses, hypertension, diabetes, smoking and the presence of cardiovascular disease were independently associated with aortic PWV (R² = 0.65, P<0.001). In conclusion, aortic PWV appears to be a sensitive marker of cardiovascular risk in individuals aged over 50 years.