Interrelations Between Arterial Stiffness, Target Organ Damage, and Cardiovascular Disease Outcomes. Issue 14 (16th July 2019)

• Record Type: Journal Article
• Authors: Vasan, Ramachandran S.; Short, Meghan I.; Niiranen, Teemu J.; Xanthakis, Vanessa; DeCarli, Charles; Cheng, Susan; Seshadri, Sudha; Mitchell, Gary F.
• Is Part Of: Journal of the American Heart Association. Volume 8:Issue 14(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-07-16
• Subjects: arterial stiffness -- cardiovascular disease -- epidemiology -- pulse wave velocity -- target organ damage; Heart -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cerebrovascular disease -- Periodicals; Cardiology -- Periodicals; 616.1
• DOI: 10.1161/JAHA.119.012141
• Languages: English
• ISSNs: 2047-9980

Abstract

Abstract : Background: Excess transmission of pressure pulsatility caused by increased arterial stiffness may incur microcirculatory damage in end organs (target organ damage [TOD]) and, in turn, elevate risk for cardiovascular disease (CVD) events. Methods and Results: We related arterial stiffness measures (carotid‐femoral pulse wave velocity, mean arterial pressure, central pulse pressure) to the prevalence and incidence of TOD (defined as albuminuria and/or echocardiographic left ventricular hypertrophy) in up to 6203 Framingham Study participants (mean age 50±15 years, 54% women). We then related presence of TOD to incident CVD in multivariable Cox regression models without and with adjustment for arterial stiffness measures. Cross‐sectionally, greater arterial stiffness was associated with a higher prevalence of TOD (adjusted odds ratios ranging from 1.23 to 1.54 per SD increment in arterial stiffness measure, P <0.01). Prospectively, increased carotid‐femoral pulse wave velocity was associated with incident albuminuria (odds ratio per SD 1.28, 95% CI, 1.02–1.61; P <0.05), whereas higher mean arterial pressure and central pulse pressure were associated with incident left ventricular hypertrophy (odds ratio per SD 1.37 and 1.45, respectively; P <0.01). On follow‐up, 297 of 5803 participants experienced a first CVD event. Presence of TOD was associated with a 33% greater hazard of incident CVD (95% CI, 0–77%; P <0.05), which was attenuated upon adjustment for baseline arterial stiffness measures by 5–21%. Conclusions: Elevated arterial stiffness is associated with presence of TOD and may partially mediate the relations of TOD with incident CVD. Our observations in a large community‐based sample suggest that mitigating arterial stiffness may lower the burden of TOD and, in turn, clinical CVD.