Augmentation index (AI) in a dose–response relationship with smoking habits in males

Abstract

We investigated the relationship between augmentation index (AI) and smoking habits in community-dwelling Japanese.This cross-sectional study enrolled 1926 subjects (769 males and 1157 females) aged 40 to 95 years who underwent a health check-up in a Japanese cohort of the Seven Countries Study, in Tanushimaru, a typical farming town in Kyushu Island in 2009. The subjects’ medical history, alcohol intake, smoking habit, and current medications for hypertension, dyslipidemia, and diabetes were ascertained by questionnaire. Radial arterial pressure wave analysis was used to obtain AI. We analyzed the data stratified by gender.Age-adjusted means of AI in males showed a clear dose–response relationship in 4 categories of smoking habits (P = 0.010). There was no significant relationship between AI and smoking habits in females (P = 0.127). The significant dose–response relationship (P = 0.036) in males between AI and 4 categories of smoking habits still remained even after adjustment for age, body mass index, systolic blood pressure, estimated glomerular filtration rate, glucose, hypertensive medication, and alcohol intake.The present study demonstrated that AI values were significantly associated with smoking habits in a dose-dependent manner in Japanese males.

Positive correlation of the serum angiopoietin-like protein 3 levels with the aortic augmentation index in patients with coronary artery disease

“… 20 The aortic AIx values were significantly and independently associated with the age. 17 , 21 Our results also noted that the age is positively associated with the aortic AIx values in patients with CAD. In patients with chronic kidney disease, body weight is inversely associated with the aortic AIx values.…”

Effect of present versus previous smoking on non-invasive haemodynamics

“…The level of AIx, a marker of wave reflections, is influenced by arterial stiffness, heart rate, ventricular ejection duration, body height, BP, systemic vascular resistance, and stroke volume 36 , 37 , 39 , 40 , 47 . Previous reports have shown that acute, chronic and passive smoking are associated with increased AIx 14 , 24 – 28 . However, this has not been attributed to the variables that are known to increase the level of augmentation, like lower heart rate, increased arterial stiffness, or higher systemic vascular resistance 24 , 26 , 36 , 48 , 49 , 62 In our study present smokers had higher upright AIx, and higher supine and upright AIx@75, in the absence of changes in BP, heart rate, ejection duration, PWV, and systemic vascular resistance that could explain an increase in AIx.…”

“…Previous reports have shown that acute, chronic and passive smoking are associated with increased AIx 14 , 24 – 28 . However, this has not been attributed to the variables that are known to increase the level of augmentation, like lower heart rate, increased arterial stiffness, or higher systemic vascular resistance 24 , 26 , 36 , 48 , 49 , 62 In our study present smokers had higher upright AIx, and higher supine and upright AIx@75, in the absence of changes in BP, heart rate, ejection duration, PWV, and systemic vascular resistance that could explain an increase in AIx. However, present smokers presented with increased stroke index in supine and upright positions, and decreased upright aortic reflection time versus previous smokers.…”

“…Many studies have reported that chronic smoking is a risk factor for increased arterial stiffness, however, a number of investigations have not found differences in arterial stiffness between smokers and never smokers 22 , 23 . Higher augmentation index (AIx), a marker of wave reflections, has been found to be associated with smoking in several studies 14 , 24 – 27 . Argacha et al .…”

Vascular ageing: moving from bench towards bedside

“… 135 , 235 The adverse changes in stiffness may be dose dependent. 236 In ex-smokers, time since quitting is independently associated with less atherosclerosis 237 and arteriosclerosis parameters may return to non-significant levels after a decade of smoking cessation. 238 Obesity leads to haemodynamic alterations, chronic inflammation, and endothelial dysfunction that impair vascular structure and function.…”