The Presence of Simple Renal Cysts Is Associated With Increased Arterial Stiffness in Patients With Abdominal Aortic Aneurysm

Abstract

Simple renal cysts (SRC) are associated with the development of abdominal aortic aneurysms (AAA). We hypothesized that patients with AAA and SRC have increased arterial stiffness (AS) compared with patients without SRC . Patients (n=223) with an infrarenal AAA undergoing pulse wave analysis were recruited. Brachial-ankle pulse wave velocity (PWV) was measured (automated oscillometric method) as an index of AS. Participants were categorized into those with increased AS and those with normal/borderline AS (threshold: 1800 cm/s); 134 patients (60.1%) had increased AS and 89 (39.9%) patients had normal/borderline AS. Multivariable analyses showed that age ≥75 years (odds ratio [OR], 2.83; 95% confidence interval [CI], 1.51–5.72; P=.002), systolic blood pressure ≥140 mmHg (OR, 5.05; 95% CI, 2.35–10.83; P<.001), hypertension (OR, 2.28; 95% CI, 1.08–4.79; P=.030), and presence of SRC (OR, 1.89; 95% CI, 1.03–3.46; P=.040) were independent risk factors for increased AS. The presence of SRC is an independent risk factor for increased AS in patients with an AAA. This association suggests that patients with SRC may have severe aortic wall degeneration and thus the presence of SRC may be pathologically linked to the development of AAA.

Overlooked Factors Affecting Arterial Stiffness Beyond Simple Renal Cyst Which Is the New Cardiovascular Risk Predictor

“…Also, the presence of SRC was an independent predictor of increased arterial stiffness like with increased age and hypertension. 1…”

“…5 Novel anti-diabetic agents like DPP-4 (dipeptidyl peptidase-4) inhibitors, GLP-1 (glucagon-like peptide-1) receptor agonists, and SGLT-2 (sodium-glucose cotransporter 2) inhibitors have favorable effects on arterial stiffness. 6,7 In the Nishibe et al 1 study, the use of RAS blockers and oral antidiabetic agents was not assessed. These parameters might have influenced the results.…”

“…

Nishibe et al 1 proposed that simple renal cysts (SRC) were present in the majority of patients with abdominal aortic aneurysm (AAA). Also, the presence of SRC was an independent predictor of increased arterial stiffness like with increased age and hypertension.

…”

“…Also, the presence of SRC was an independent predictor of increased arterial stiffness like with increased age and hypertension. 1 Parameters of hypertension and high systolic blood pressure (>140 mmHg) were both included in the multivariable regression analysis. 1 As the two parameters are correlated and converge with each other, it could have been better to include only one of them in the regression model.Atrial fibrillation (AF) is the most common chronic arrhythmia and its prevalence increases with age.…”

“…1 Parameters of hypertension and high systolic blood pressure (>140 mmHg) were both included in the multivariable regression analysis. 1 As the two parameters are correlated and converge with each other, it could have been better to include only one of them in the regression model.Atrial fibrillation (AF) is the most common chronic arrhythmia and its prevalence increases with age. 2 Although it was reported that non-invasive measurement of arterial stiffness is reliable in patients with AF, it was demonstrated that pulse wave velocity reduced after cardioversion due to the decreased mean arterial pressure.…”