The aortic-femoral arterial stiffness gradient: an atherosclerosis risk in communities (ARIC) study

Abstract

The aortic to femoral arterial stiffness gradient (af-SG) may be a novel measure of arterial health and cardiovascular disease (CVD) risk, but its association with CVD risk factors and CVD status, and whether or not they differ from the referent measure, carotid-femoral pulse-wave velocity (cfPWV), is not known. Accordingly, we compared the associations of the af-SG and cfPWV with,(1) age and traditional CVD risk factors, and (2) CVD status. We evaluated 4,183 older-aged (75.2±5.0 years) men and women in the community-based Atherosclerosis Risk in Communities (ARIC) Study. cfPWV and femoral-ankle PWV (faPWV) were measured using an automated cardiovascular screening device. The af-SG was calculated as faPWV divided by cfPWV.Associations of af-SG and cfPWV with age, CVD risk factors (age, body mass index, blood pressure, heart rate, glucose and blood lipid levels) and CVD status (hypertension, diabetes, coronary heart disease, heart failure, stroke) were determined using linear and logistic regression analyses. (1) The af-SG and cfPWV demonstrated comparable associations with age and CVD risk factors, except body mass index. (2) A low af-SG was associated with diabetes, coronary heart disease, heart failure and stroke, whilst a high cfPWV was only associated with hypertension. Although future studies are necessary to confirm clinical utility, the af-SG is a promising tool that may provide a unique picture of hemodynamic integration and identification of CVD risk when compared to cfPWV.

Associations of lower-limb atherosclerosis and arteriosclerosis with cardiovascular risk factors and disease in older adults: The Atherosclerosis Risk in Communities (ARIC) study

“…Finally, it has been suggested that loss of elasticity and recoil may not necessarily translate to arterial stiffening, and may occur in the absence of stenosis [52]. But whether through atherosclerotic-dependent or -independent means, low faPWV may contribute to a reduction in the central to peripheral arterial stiffness gradient, augmenting the transmission of excessive forward pressure into the microcirculation, a pathophysiological basis for cardiovascular events and target organ damage [53,54].…”

Modulation of Arterial Stiffness Gradient by Acute Administration of Nitroglycerin

“…In the ARIC study population, a cross-sectional analysis showed that a low arterial stiffness gradient (femoral-ankle PWV/cf-PWV) was associated with diabetes, coronary heart disease, heart failure, and stroke, whereas a high cf-PWV was only associated with hypertension ( Stone et al, 2021 ). It should be mentioned that this is a relatively older cohort (age of 75 years) with a higher prevalence of hypertension (72%) and diabetes (29%).…”

Vascular aging in adult congenital heart disease-a narrative review

“…By the study in aortic aging, the importance of "normal" stiffness gradient has been recently come to light. Agerelated increase in aortic stiffness causes the loss of stiffness gradient and results in increasing forward wave amplitude and pulse pressure (Figure 4B) (43). The loss of stiffness gradient leads to the transmission of a highly pulsatile pressure wave into the microcirculation (44).…”