Abstract-The aim of this study was to determine the associations between the presence and extent of calcified atherosclerosis in multiple vascular beds and systolic blood pressure, diastolic blood pressure, pulse pressure, mean arterial pressure, isolated systolic hypertension, and hypertension. A total of 9510 patients (42.5% women) underwent electron beam computed tomography scanning as part of a routine health maintenance screening. At the same visit, blood pressure was measured with the participant in the seated position using a mercury sphygmomanometer. Mean age was 58Ϯ11.4 years, and body mass index was 27.1Ϯ4.5. The prevalences of any calcification in the carotids, coronaries, subclavians, thoracic aorta, abdominal aorta, and iliacs were 31.9%, 57.2%, 31.7%, 37.0%, 54.3%, and 48.8%, respectively. In separate multivariable logistic models containing traditional cardiovascular disease risk factors, pulse pressure and systolic blood pressure were significantly associated with the presence of calcification in all of the vascular beds except the iliacs and subclavians, respectively, with pulse pressure having stronger magnitudes of the associations for most of the vascular beds. Age-stratified analyses indicated that these associations were stronger in those Ͼ60 years of age compared with subjects Ͻ60 years of age, and sex-stratified analyses demonstrated that men had a greater association compared with women. Also, the magnitudes of the associations for isolated systolic hypertension were, in general, larger than those for hypertension. Pulse pressure and isolated systolic hypertension are robust and important correlates for calcified atherosclerosis in different vascular beds. Isolated systolic hypertension may be clinically relevant in diagnosing or preventing calcified atherosclerosis. (Hypertension. 2010;55:990-997.)Key Words: pulse pressure Ⅲ isolated systolic hypertension Ⅲ systolic blood pressure Ⅲ calcification Ⅲ atherosclerosis Ⅲ hypertension Ⅲ vascular beds E pidemiological studies suggest that elevated blood pressure (BP) is an independent and strong predictor of cardiovascular disease (CVD). 1 Controversy exists as to which BP measure is the best predictor of CVD events. Recent data suggest that aortic stiffness is an independent predictor of future heart disease in older individuals. 2 Increases in aortic stiffness are believed to be closely linked to increases in pulse pressure, thereby placing a higher afterload on the left ventricle. 3 Thus, pulse pressure (PP) may be relevant in the pathophysiology of coronary heart disease. 4 Calcium is deposited early in the formation of the atherosclerotic plaque and can be used as a marker of the atherosclerotic process. 5 The use of electron beam computed tomography affords the opportunity to noninvasively construct cross-sectional images of arteries to detect the presence and extent of calcium attributed to atherosclerosis in different vascular beds. 6 The coronary calcium score is significantly predictive of future cardiac events. 7 There are many risk...

Background Sedentary behavior is associated with adiposity and cardiometabolic risk. Purpose To determine the associations between sedentary behavior and measures of adiposity-associated inflammation. Methods Between 2002 and 2005, a total of 1543 Multi-Ethnic Study of Atherosclerosis participants completed detailed health history questionnaires, underwent physical measurements and had blood assayed for adiponectin, leptin, tumor necrosis factor – alpha (TNF - α) and resistin. Analyses included linear regression completed in 2010. The mean age was 64.3 years and nearly 50% were female. Forty-one percent were non-Hispanic white, 24% Hispanic-American, 20% African-American, and 14% Chinese-American. Results In linear regression analyses and with adjustment for age, gender, ethnicity, education, BMI, smoking, alcohol consumption, hypertension, diabetes mellitus, dyslipidemia, hormone therapy and waist circumference, sedentary behavior was associated with higher natural log (“ln”) of leptin and ln TNF - α but a lower ln adiponectin-to-leptin ratio (β = 0.07, β = 0.03 and –0.07, p < 0.05 for all). Compared to the first tertile, and after the same adjustment, the second and third tertiles of sedentary behavior were associated with higher levels of ln leptin (β = 0.11and β = 0.12, respectively; p < 0.05 for both) but lower levels of the adiponectin-to-leptin ratio (β = –0.09 and –0.11, respectively; p < 0.05 for both). Conclusions Sedentary behavior is associated with unfavorable levels of adiposity-associated inflammation.

Objective Both coronary artery calcification (CAC) and the ankle brachial index (ABI) are measures of subclinical atherosclerotic disease. The influence of physical activity on the longitudinal change in these measures remains unclear. To assess this we examined the association between these measures and self-reported physical activity in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods At baseline, the MESA participants were free of clinically evident cardiovascular disease. We included all participants with an ABI between 0.90 and 1.40 (n=5656). Predictor variables were based on self-reported measures with physical activity being assessed using the Typical Week Physical Activity Survey from which metabolic equivalent-minutes/week of activity were calculated. We focused on physical activity intensity, intentional exercise, sedentary behavior, and conditioning. Incident peripheral artery disease (PAD) was defined as the progression of ABI to values below 0.90 (given the baseline range of 0.90 to 1.40). Incident CAC was defined as a CAC score >0 Agatston units upon follow up with a baseline score of 0 Agatston units. Results Mean age was 61 years, 53% were female, and mean body mass index was 28 kg/m2. After adjusting for traditional cardiovascular risk factors and socioeconomic factors, intentional exercise was protective for incident peripheral artery disease (Relative Risk (RR)= 0.85, 95% Confidence Interval (CI): 0.74 to 0.98). After adjusting for traditional cardiovascular risk factors and socioeconomic factors, there was a significant association between vigorous PA and incident CAC (RR=0.97, 95% CI: 0.94 to 1.00). There was also a significant association between sedentary behavior and increased amount of CAC among participants with CAC at baseline (Δlog(Agatston Units +25)=0.027, 95% CI 0.002, 0.052). Conclusions These data suggest that there is an association between physical activity/sedentary behavior and the progression of two different measures of subclinical atherosclerotic disease.

Eccentric resistance exercise produced less cardiopulmonary demands and may be better suited for older persons with low exercise tolerance and at risk of adverse cardiopulmonary events.

Objectives To gain insight into early mechanisms of aortic widening, we examined associations between the diameter of the abdominal aorta (AD) and cardiovascular disease (CVD) risk factors and biomarkers, as well as measures of subclinical atherosclerosis, in a multi-ethnic population. Design Cross-sectional cohort Methods A total of 1926 participants (mean age 62, 50% women) underwent chest and abdomen scanning by computed tomography, ultrasound of the carotid arteries, and CVD risk factor assessment. AD was measured 5 cm above and at the bifurcation. Results In a model containing traditional CVD risk factors, biomarkers and ethnicity, only age (standardized β=0.97), male sex (β=1.88), body surface area (standardized β=0.92), current smoking (β=0.42), D-dimer levels (β=0.19) and hypertension (β=0.53) were independently and significantly associated with increasing AD (in mm) at the bifurcation; use of cholesterol-lowering medications predicted smaller AD (β=-0.70) (P<.01 for all). These findings were similar for AD 5 cm above the bifurcation with one exception: compared to Caucasian-Americans, Americans of Chinese, African and Hispanic descent had significantly smaller AD 5 cm above the bifurcation (β's= -0.59, -0.49, and -0.52, respectively, all P<.01), whereas AD at the bifurcation did not differ by ethnicity. Physical activity, alcohol consumption, diabetes and levels of IL-6, CRP and homocysteine were not independently associated with AD. Higher aortic and coronary artery calcium burden, but not common carotid artery intima-media thickness, were independently, but modestly (β=0.11 to 0.19), associated with larger AD. Conclusions Incremental widening of the aortic diameter shared some, but not all, risk factors for occlusive vascular disease.