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(Circulation. 2007;115:2628-2636.)
© 2007 American Heart Association, Inc.

Epidemiology

Cross-Sectional Correlates of Increased Aortic Stiffness in the Community

The Framingham Heart Study

Gary F. Mitchell, MD; Chao-Yu Guo, PhD; Emelia J. Benjamin, MD, ScM; Martin G. Larson, ScD; Michelle J. Keyes, MA; Joseph A. Vita, MD; Ramachandran S. Vasan, MD; Daniel Levy, MD

From Cardiovascular Engineering, Inc, Waltham, Mass (G.F.M.); National Heart, Lung, and Blood Institute Framingham Study, Framingham, Mass (C.G., E.J.B., M.G.L., M.J.K., R.S.V., D.L.); Department of Mathematics and Statistics, Boston University, Boston, Mass (C.G., M.G.L., M.J.K.); Evans Department of Medicine (E.J.B., J.A.V., R.S.V., D.L.), Whitaker Cardiovascular Institute (E.J.B., J.A.V., R.S.V.), and Section of Preventive Medicine (E.J.B., R.S.V.), Boston University School of Medicine, Boston, Mass; and National Heart, Lung, and Blood Institute, Bethesda, Md (D.L.).

Correspondence to Gary F. Mitchell, MD, Cardiovascular Engineering, Inc, 51 Sawyer Rd, Suite 100, Waltham, MA 02453. E-mail GaryFMitchell{at}mindspring.com

Received October 1, 2006; accepted March 20, 2007.

Background— Increased aortic stiffness is associated with numerous common diseases of aging, including heart disease, stroke, and renal disease. However, the prevalence and correlates of abnormally high aortic stiffness are incompletely understood.

Methods and Results— We evaluated 2 aortic stiffness measures, carotid-femoral pulse wave velocity and forward pressure wave amplitude, in a pooled sample of the Framingham Original, Offspring, and minority Omni cohorts (mean age, 62 years; 56% women). Abnormal stiffness of each measure was defined as a value exceeding the sex-specific 90th percentile of a reference group with a low burden of conventional cardiovascular disease risk factors. Applying this criterion to the entire sample identified a 24% to 33% prevalence of abnormal stiffness measures. The prevalence of abnormal stiffness increased markedly with age, eg, for pulse wave velocity, from a few percent in both sexes aged <50 years to 64% (men) to 74% (women) in those aged 70 years. With adjustment for age, important correlates of abnormal aortic stiffness included higher mean arterial pressure, greater body mass index, impaired glucose metabolism, and abnormal lipids. Correlates of aortic stiffness were similar if we used age-specific rather than fixed criteria for defining abnormal stiffness.

Conclusions— The prevalence of abnormal aortic stiffness increases steeply with advancing age in the community, especially in the presence of obesity or diabetes. Our data suggest that the burden of disease attributable to aortic stiffness is likely to increase considerably over the next few years as the population ages.

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