The presence of high blood pressure, high heart rate, and high serum creatinine were the major determinants of accelerated progression of aortic stiffness in treated hypertensives. This is the first longitudinal study to evaluate the determinants of arterial aging over an extended period of time.

Abstract-Chronological age is the primary determinant of stiffness of central arteries. Increased stiffness is an independent indicator of cardiovascular risk. The aim of this study was to determine whether telomere length, a possible index of biological aging, provides a better account than chronological age for variation in arterial stiffness, evaluated by measuring pulse pressure and aortic pulse wave velocity. The study population included 193 French subjects (120 men, 73 women), with a mean age of 56Ϯ11 years, who were not on any antihypertensive medications. Telomere length was evaluated in white blood cells by measuring the mean length of the terminal restriction fragments. Age-adjusted telomere length was longer in women than in men (8.67Ϯ0.09 versus 8.37Ϯ0.07 kb; Pϭ0.016). In both genders, telomere length was inversely correlated with age (PϽ0.01). Multivariate analysis showed that in men, but not in women, telomere length significantly contributed to pulse pressure and pulse wave velocity variations. In conclusion, telomere length provides an additional account to chronological age of variations in both pulse pressure and pulse wave velocity among men, such that men with shorter telomere length are more likely to exhibit high pulse pressure and pulse wave velocity, which are indices of large artery stiffness. The longer telomere length in women suggests that for a given chronological age, biological aging of men is more advanced than that of women. Key Words: blood pressure Ⅲ aorta Ⅲ genetics Ⅲ aging Ⅲ sex T elomeres, the TTAGGG tandem repeats at the ends of mammalian chromosomes, undergo attrition with each division of somatic cells in culture and their length is, hence, an indicator of replicative history and replicative potential of these cells. 1 This feature of telomere biology is at the core of the concept that, at the cellular level, telomeres serve as a mitotic clock. 1 In human beings, telomere length is heritable, 2,3 relatively short, highly variable, and with regard to replicating somatic cells, inversely related with donor age. 2,4 -6 Because of the long lifespan of humans and their short telomeres, attrition in telomere length may be a major determinant of human aging not only at the cellular level, but also at the organ and perhaps the systemic levels.Pulse pressure (PP), a clinical marker of large artery stiffness, increases with chronological age. 7,8 An increase in PP is a strong predictor of cardiovascular mortality, especially coronary mortality, independently of mean blood pressure (MAP). 7 Also, large artery stiffness, assessed by pulse wave velocity (PWV) measurements, greatly increases with age 9 and could be an independent cardiovascular risk factor. 10 Collectively, these observations suggest that large artery stiffness and its clinical manifestations (PP, PWV) are phenotypes of biologic aging of the arterial system.In a previous work, using telomere length as an indicator of biologic aging of a person, we found that, in young subjects (mean age, 37 years), after age-adjustme...

Abstract-Recent studies have shown that individuals with shorter telomeres present a higher prevalence of arterial lesions and higher risk of cardiovascular disease mortality. As a group, patients with high blood pressure are at an increased risk for cardiovascular diseases. However, some hypertensive patients are more prone than others to atherosclerotic lesions. The main objective of this study was to examine the relationship between telomere length, as expressed in white blood cells, and carotid artery atherosclerotic plaques in hypertensive males. Data from 163 treated hypertensive men who were volunteers for a free medical examination were analyzed. Extracranial carotid plaques were assessed with B-mode ultrasound. Telomere length was measured from DNA samples extracted from white blood cells. The results of this study show that telomere length was shorter in hypertensive men with carotid artery plaques versus hypertensive men without plaques (8.17Ϯ0.07 kb versus 8.46Ϯ0.07 kb; PϽ0.01). Multivariate analysis showed that in addition to age, telomere length was a significant predictor of the presence of carotid artery plaques. The findings from this study suggest that in the presence of chronic hypertension, which is a major risk factor for atherosclerotic lesions, shorter telomere length in white blood cells is associated with an increased predilection to carotid artery atherosclerosis.

We found a positive independent relationship between lung function impairment and metabolic syndrome in both sexes, predominantly due to abdominal obesity. Further studies are required to clarify the underlying mechanisms.

Abstract-Recent studies have started to suggest that, beyond effects of individual socioeconomic profiles, socioeconomic characteristics of residential neighborhoods are independently associated with blood pressure. However, mechanisms involved in these associations remain unknown. To distinguish between different mechanisms, we investigated whether specific risk factors of hypertension (physical inactivity, alcohol consumption, smoking, body mass index, waist circumference, and resting heart rate) intervene as mediators in the associations between individual or neighborhood socioeconomic characteristics and systolic blood pressure. We relied on data from the RECORD Cohort Study (Residential Environment and CORonary heart Disease) on 5941 participants recruited in [2007][2008], aged 30 to 79 years, residing in 1824 neighborhoods in the Paris metropolitan area. Systolic blood pressure increased independently and regularly with both decreasing individual education and decreasing residential neighborhood education. Body mass index/waist circumference and resting heart rate mediated an appreciable share of the associations between education and blood pressure and, adding validity to the finding, were the 2 most significant mediators for the effects of both individual education and neighborhood education. We found that 52% (95% CI: 25% to 79%) of the association between neighborhood education and blood pressure was mediated by body mass index/waist circumference and 20% (95% CI: 5% to 36%) by resting heart rate. Future research will have to clarify the exact mechanisms through which body weight and shape and resting heart rate intervene as mediators in the associations between individual/neighborhood education and blood pressure. Key Words: blood pressure Ⅲ socioeconomic factors Ⅲ residence characteristics Ⅲ social environment Ⅲ heart rate Ⅲ obesity C onsidering socioeconomic characteristics is useful both in the clinical setting to improve risk stratification of patients at risk of hypertension and, from a public health perspective, to identify population-level determinants of blood pressure when defining interventions. 1 Regardless of the aim, recent studies suggest that a better assessment of socioeconomic differences in blood pressure may be obtained by considering social circumstances both at the individual level and at the residential neighborhood level. [2][3][4][5] To date, fewer studies have quantified neighborhood socioeconomic influences on blood pressure than on behavioral risk factors of cardiovascular diseases (smoking and physical inactivity) or obesity. 6 As recently emphasized, 7 knowledge useful for public health action is identifying the different mechanisms underlying associations between individual/neighborhood socioeconomic characteristics and blood pressure (eg, through known risk factors of hypertension) on which it would be possible to intervene to address social disparities in blood pressure. 1,8 However, on the one hand, the very few studies that investigated intermediate mechanisms throu...

The association of impaired pulmonary function with cardiovascular morbidity and mortality has been reported in several prospective studies. The nature of this association and the mechanisms underlying it are unknown. Both atherosclerosis and central arterial stiffness might be involved. We recently reported, in a 4-yr longitudinal study, that reduced lung function predicts the development of carotid atherosclerotic plaques. In the present study, we report the associations of aortic stiffness with lung function measurements. One hundred and ninety-four men, aged 30 to 70 yr and free of coronary heart disease, who volunteered for a standard health examination were included. FEV(1) and FVC were used to assess lung function. Aortic stiffness was estimated from the carotid-femoral pulse-wave velocity (PWV), which increases proportionally with an increase in aortic stiffness. PWV was significantly and negatively associated with FEV(1) and FVC (partial correlation coefficients adjusted for age and height: -0.27 [p < 0.001] and -0.24 [p < 0.001], respectively). For every 1 SD increase in PWV (2.5 m/s), FEV(1) decreased by 195.2 +/- 50.1 ml (p < 0.001) in an age- and height-adjusted analysis. The corresponding decrease in FVC was 190.4 +/- 55.0 ml (p < 0.001). Further adjustment for cardiovascular risk factors (weight, smoking habits, hypercholesterolemia, diabetes, and hypertension) did not markedly alter these results. In addition, negative associations of PWV with lung function measurements were observed within each category of cardiovascular risk factors. This study suggests that reduced pulmonary function is independently associated with aortic stiffness in men. The interrelations between pulmonary and vascular alterations should be thoroughly investigated.

Assessment of spontaneous changes of BP over a long period of time can contribute to the evaluation of cardiovascular risk. Subjects whose systolic BP increased while their diastolic BP decreased had the highest cardiovascular risk independently of absolute values of BP or other risk factors.

This study shows that there is a differential association of PWV with CCA-IMT and carotid plaques. The nature of the independent positive association between atherosclerosis and arterial stiffness should be thoroughly investigated.