Interrelations Between Arterial Stiffness, Target Organ Damage, and Cardiovascular Disease Outcomes

Abstract

Background Excess transmission of pressure pulsatility caused by increased arterial stiffness may incur microcirculatory damage in end organs (target organ damage [TOD] ) and, in turn, elevate risk for cardiovascular disease ( CVD ) events. Methods and Results We related arterial stiffness measures (carotid‐femoral pulse wave velocity, mean arterial pressure, central pulse pressure) to the prevalence and incidence of TOD (defined as albuminuria and/or echocardiographic left ventricular hypertrophy) in up to 6203 Framingham Study participants (mean age 50±15 years, 54% women). We then related presence of TOD to incident CVD in multivariable Cox regression models without and with adjustment for arterial stiffness measures. Cross‐sectionally, greater arterial stiffness was associated with a higher prevalence of TOD (adjusted odds ratios ranging from 1.23 to 1.54 per SD increment in arterial stiffness measure, P <0.01). Prospectively, increased carotid‐femoral pulse wave velocity was associated with incident albuminuria (odds ratio per SD 1.28, 95% CI, 1.02–1.61; P <0.05), whereas higher mean arterial pressure and central pulse pressure were associated with incident left ventricular hypertrophy (odds ratio per SD 1.37 and 1.45, respectively; P <0.01). On follow‐up, 297 of 5803 participants experienced a first CVD event. Presence of TOD was associated with a 33% greater hazard of incident CVD (95% CI , 0–77%; P <0.05), which was attenuated upon adjustment for baseline arterial stiffness measures by 5–21%. Conclusions Elevated arterial stiffness is associated with presence of TOD and may partially mediate the relations of TOD with incident CVD . Our observations in a large community‐based sample suggest that mitigating arterial stiffness may lower the burden of TOD and, in turn, clinical CVD .

Cardiac magnetic resonance assessment of aortic distensibility in prediabetic patients

“…Aortic elasticity indices have been linked to the occurrence of CV events and target organ damage in prediabetics, diabetics, and hypertensives, which emphasizes the importance of assessing aortic distensibility (as one of aortic elasticity markers) in these patients [20,21].…”

Insulin Increases The Central-To-Peripheral Arterial Stiffness Gradient in Response To Hyperglycemia in Healthy Humans: A Randomized Four-Way Crossover Study

“…Recruitment for this study was achieved by community advertisement and direct advertisement to healthcare clinics both within and outside the University of Virginia (UVA) Health System. Healthy young adults met inclusion criteria if they were ≥18 and ≤35 years old, had normal body mass index (18)(19)(20)(21)(22)(23)(24)(25) kg/m 2 ), did not have DM, and had fasting plasma glucose <100 mg/dL and blood pressure <140/90 mmHg at time of screening. Subjects were excluded if they were current smokers or quit smoking <5 years ago, had a rst-degree relative with type 2 DM, were taking vasoactive medications (e.g., antihypertensives, diuretics, statins, etc.…”

“…This differential rate of stiffening results in aortic stiffness equaling or exceeding peripheral stiffness in the majority of older individuals [6]. This change of the central-to-peripheral arterial stiffness gradient is associated with a number of adverse cardiovascular consequences, including target organ damage to heart, brain, and kidney [6,[19][20][21].…”

Evoking Awareness toward Muscular Arterial Remodeling and Stiffness

“…However, the remodeling of arteries in-between, muscular arteries, is still poorly understood. Actually, there is no doubt that central arterial stiffness is an independent predictor of cardiovascular events, cardiovascular and all-cause mortality [2,3], and even target organ damage [4,5]. Besides, non-invasively measured central arterial stiffness [carotid-femoral pulse wave velocity (cfPWV)] strongly correlates with invasively measured aortic arterial stiffness [6].…”