Circulation, Vol 88, 1456-1462, Copyright © 1993 by American Heart Association
PV Vaitkevicius, JL Fleg, JH Engel, FC O'Connor, JG Wright, LE Lakatta, FC Yin and EG Lakatta
BACKGROUND. It has been well established that arterial stiffness, manifest
as an increase in arterial pulse wave velocity or late systolic
amplification of the carotid artery pressure pulse, increases with age.
However, the populations studied in prior investigations were not
rigorously screened to exclude clinical hypertension, occult coronary
disease, or diabetes. Furthermore, it is unknown whether exercise capacity
or chronic physical endurance training affects the age-associated increase
in arterial stiffness. METHODS AND RESULTS. Carotid arterial pressure pulse
augmentation index (AGI), using applanation tonometry, and aortic pulse
wave velocity (APWV) were measured in 146 male and female volunteers 21 to
96 years old from the Baltimore Longitudinal Study of Aging, who were
rigorously screened to exclude clinical and occult cardiovascular disease.
Aerobic capacity was determined in all individuals by measurement of
maximal oxygen consumption (VO2max) during treadmill exercise. In this
healthy, largely sedentary cohort, the arterial stiffness indexes AGI and
APWV increased approximately fivefold and twofold, respectively, across the
age span in both men and women, despite only a 14% increase in systolic
blood pressure (SBP). These age-associated increases in AGI and APWV were
of a similar magnitude to those in prior studies of less rigorously
screened populations. Both AGI and APWV varied inversely with VO2max, and
this relationship, at least for AGI, was independent of age. In endurance
trained male athletes, 54 to 75 years old (VO2max = 44 +/- 3
mL.kg-1.min-1), the arterial stiffness indexes were significantly reduced
relative to their sedentary age peers (AGI, 36% lower; APWV, 26% lower)
despite similar blood pressures. CONCLUSIONS. Even in normotensive,
rigorously screened volunteers in whom SBP increased an average of only 14%
between ages 20 and 90 years, major age-associated increases of arterial
stiffness occur. Higher physical conditioning status, indexed by VO2max,
was associated with reduced arterial stiffness, both within this
predominantly sedentary population and in endurance trained older men
relative to their less active age peers. These findings suggest that
interventions to improve aerobic capacity may mitigate the stiffening of
the arterial tree that accompanies normative aging.
ARTICLES
Effects of age and aerobic capacity on arterial stiffness in healthy adults
Division of Geriatric Medicine, University of Maryland School of Medicine.
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