Arterial stiffness and multiple organ damage: a longitudinal study in population

Abstract

Aims

Previous cross-sectional observation identified arterial aging, indexed as pulse-wave velocity (PWV), as a key determinant of the simultaneous multiple organ damage (heart, carotid artery, and kidney). The aim of the present cohort study is to investigate trajectories of repeated measures of PWV and traditional CV risk factors in subjects who eventually presented clinical evidence of multiple organ damage in the SardiNIA study.

Methods and results

Organ damage was measured in the heart (left ventricular hypertrophy, LVH), the common carotid artery (intima–media thickness > 0.9 mm and/or plaque), and the kidney (eGFR < 60 ml/min/1.73 m2) of 2130 men and women of a broad age range participating the SardiNIA study. SHATS was defined as the simultaneous occurrence of all the three-organ damages. Trajectory in traditional CV risk factors and PWV was analyzed retrospectively (four observations over 9 years) according to the number of organ damage (from 0 to 3). Compared to subjects with no organ damage, after controlling for traditional CV risk factors, each 1 m/s increase in baseline PWV was accompanied by a 93% higher odds of developing SHATS; and each 1 cm/s (0.01 m/s) annual increase in PWV by a 31% greater odds of developing SHATS.

Conclusions

Arterial stiffness, a proxy of arterial aging that can be measured clinically as PWV, is an integrated predictive marker of multiple age-associated organ damage recognized as clinical diseases.

This is a preview of subscription content, log in to check access.

Fig. 1

References

  1. 1.

    Scuteri A, Chen CH, Yin FCP et al (2001) Functional correlates of central arterial geometric phenotypes. Hypertension 38:1471–1475

    CAS  Article  Google Scholar 

  2. 2.

    Adriaans BP, Heuts S, Gerretsen S et al (2018) Aortic elongation part I: the normal aortic ageing process. Heart 104:1772–1777. https://doi.org/10.1136/heartjnl-2017-312866

    Article  PubMed  Google Scholar 

  3. 3.

    Cunha PG, Cotter J, Oliveira P et al (2015) Pulse wave velocity distribution in a cohort study: from arterial stiffness to early vascular aging. J Hypertens 33:1438–1445

    CAS  Article  Google Scholar 

  4. 4.

    Nilsson PN, Laurent S, Cunha PG et al (2018) Characteristics of healthy vascular ageing (HVA) in pooled population-based cohort studies: the Global MARE Consortium. J Hypertens 36:2340–2349

    CAS  Article  Google Scholar 

  5. 5.

    Scuteri A, Orru M, Morrell C et al (2011) Independent and additive effects of cytokine patterns and the metabolic syndrome on arterial aging in the SardiNIA Study. Atherosclerosis 215:459–464

    CAS  Article  Google Scholar 

  6. 6.

    Yang-Sun ZD, Cheriyan J (2019) Non-invasive measurements of arterial function: What? When? Why should we use them? Heart. https://doi.org/10.1136/heartjnl-2018-312970

    Article  Google Scholar 

  7. 7.

    Scuteri A, Morrell CH, Orrù M et al (2014) Longitudinal perspective on the conundrum of central arterial stiffness, blood pressure, and aging. Hypertension 64:1219–1227

    CAS  Article  Google Scholar 

  8. 8.

    Williams B, Mancia G, Spiering W et al (2018) 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J 39:3021–3104

    Article  Google Scholar 

  9. 9.

    Ichikawa K, Sakuragi S, Nishihara T et al (2018) Influence of arterial stiffness on cardiovascular outcome in patients without high blood pressure. Heart 104:318–332

    CAS  Article  Google Scholar 

  10. 10.

    Scuteri A, Wang H (2014) Pulse wave velocity as a marker of cognitive impairment in the elderly. J Alzheimers Dis 42:S401–S410

    Article  Google Scholar 

  11. 11.

    Scuteri A, Coluccia R, Castello L et al (2009) Left ventricular mass increase is associated with cognitive decline and dementia in the elderly independently of blood pressure. Eur Heart J 30:1525–1529

    Article  Google Scholar 

  12. 12.

    Tocci G, Figliuzzi I, Presta V et al (2017) Adding markers of organ damage to risk score models improves cardiovascular risk assessment: prospective analysis of a large cohort of adult outpatients. Int J Cardiol 248:342–348

    Article  Google Scholar 

  13. 13.

    Tomiyama H, Ishizu T, Kohro T et al (2018) Longitudinal association among endothelial function, arterial stiffness and subclinical organ damage in hypertension. Int J Cardiol 253:161–166

    Article  Google Scholar 

  14. 14.

    Kario K (2015) Systemic hemodynamic atherothrombotic syndrome: a blind spot in the current management of hypertension. J Clin Hypertens (Greenwich) 17:328–331

    Article  Google Scholar 

  15. 15.

    Scuteri A, Rovella V, Alunni Fegatelli D et al (2018) An operational definition of SHATS (systemic hemodynamic atherosclerotic syndrome): role of arterial stiffness and blood pressure variability in elderly hypertensive subjects. Int J Cardiol 263:132–137

    Article  Google Scholar 

  16. 16.

    Scuteri A, Najjar SS, Orru’ M et al (2009) Age- and gender-specific awareness, treatment, and control of cardiovascular risk factors and subclinical vascular lesions in a founder population: the SardiNIA Study. Nutr Metab Cardiovasc Dis. 19:532–541

    CAS  Article  Google Scholar 

  17. 17.

    Scuteri A, Franco OH, Völzke H et al (2016) The relationship between the metabolic syndrome and arterial wall thickness: a mosaic still to be interpreted. Atherosclerosis 255:11–16

    CAS  Article  Google Scholar 

  18. 18.

    Devereux RB, Alonso DR, Lutas EM et al (1986) Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 57:450–458

    CAS  Article  Google Scholar 

  19. 19.

    National Kidney Foundation (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification. Am J Kidney Dis 39:S1–S266

    Google Scholar 

  20. 20.

    Vlachopoulos C, Xaplanteris P, Aboyans V et al (2015) The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation: Endorsed by the Association for Research into Arterial Structure and Physiology (ARTERY) Society. Atherosclerosis 24:507–532

    Article  Google Scholar 

  21. 21.

    R: R Core Team (2015) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https://www.R-project.org. Accessed Apr 2019

  22. 22.

    Morrell CH, Brant LJ, Ferrucci L (2009) Model choice can obscure results in longitudinal studies. J Gerontol Med Sci 64A:215–222

    Article  Google Scholar 

  23. 23.

    Onder G, Bonassi S, Abbatecola AM et al (2014) High prevalence of poor quality drug prescribing in older individuals: a nationwide report from the Italian Medicines Agency (AIFA). J Gerontol A Biol Sci Med Sci 69:430–437

    Article  Google Scholar 

  24. 24.

    Farasat SM, Morrell CH, Scuteri A et al (2008) Pulse pressure is inversely related to aortic root diameter implications for the pathogenesis of systolic hypertension. Hypertension 51:196–202

    CAS  Article  Google Scholar 

  25. 25.

    Rizzoni D, Agabiti-Rosei C (2017) Relationships between blood pressure variability and indices of large artery stiffness: does the microvasculature play a role? Hypertens Res 40:348–350

    Article  Google Scholar 

  26. 26.

    Scuteri A, Morrell CH, Orru’ M et al (2016) Gender specific profiles of white coat and masked hypertension impacts on arterial structure and function in the SardiNIA study. Int J Cardiol 217:92

    Article  Google Scholar 

  27. 27.

    Laurent S, Briet M, Boutouyrie P (2009) Large and small artery cross-talk and recent morbidity-mortality trials in hypertension. Hypertension 54:388–392

    CAS  Article  Google Scholar 

  28. 28.

    Scuteri A, Stuehlinger MC, Cooke JP et al (2003) Nitric oxide inhibition as a mechanism for blood pressure increase during salt loading in normotensive postmenopausal women. J Hypertens. 21:1339–1346

    CAS  Article  Google Scholar 

  29. 29.

    Lakatta EG (1993) Cardiovascular regulatory mechanisms in advanced age. Physiol Rev 73:413–467

    CAS  Article  Google Scholar 

Download references

Funding

This research was supported in part by the Intramural Research Program of the US National Institutes of Health, National Institute on Aging (Grant No. HHSN271201600005C).

Author information

Affiliations

Authors

Corresponding author

Correspondence to Angelo Scuteri.

Ethics declarations

Conflict of interest

No author has to disclose any conflict of interest that could have direct or potential influence or impart bias on the work.

Statement of human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 175 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Scuteri, A., Morrell, C.H., Fegatelli, D.A. et al. Arterial stiffness and multiple organ damage: a longitudinal study in population. Aging Clin Exp Res 32, 781–788 (2020). https://doi.org/10.1007/s40520-019-01260-0

Download citation

Keywords

  • Arterial stiffness
  • Pulse-wave velocity
  • Left ventricular hypertrophy
  • Chronic kidney disease
  • Multiple organ damage
  • Longitudinal study