Osteocalcin: A Potential Marker of Peripheral Arterial Stiffness in Hypertensive Patients.

Background and Objectives: Brachial-ankle pulse wave velocity (baPWV) is an established independent risk factor for cardiovascular events, cardiovascular mortality, and all-cause mortality. Osteocalcin (OC) is recognized to be associated with vascular function. The present study assessed the correlation between serum OC levels and peripheral arterial stiffness (PAS) measured through baPWV in hypertensive patients. Materials and Methods: Fasting blood samples were collected from 120 hypertensive participants. The serum total OC levels were measured using a commercial enzyme-linked immunosorbent assay kit, whereas the baPWV device was used to detect PAS. The PAS group had left or right baPWV > 18.0 m/s. Results: Among the hypertensive patients, 24 (20.0%) were classified into the PAS group. The PAS group exhibited a significantly older age (p = 0.011), higher prevalence of diabetes (p = 0.010), systolic blood pressure (p = 0.019), levels of serum fasting glucose (p = 0.003), blood urea nitrogen (p = 0.024), creatinine (p = 0.004), C-reactive protein (p = 0.007), OC (p = 0.002), and lower estimated glomerular filtration rate (p = 0.004) than the non-PAS group. Age (odds ratio [OR]: 1.076, 95% CI: 1.004-1.153, p = 0.037) and serum OC level (OR: 1.797, 95% confidence interval (CI): 1.077-3.000, p = 0.025) were independent factors linked to PAS in hypertensive patients in the multivariate logistic regression analysis. Conclusions: Serum OC levels and older age are positively associated with PAS in hypertensive patients.

Serum Malondialdehyde-Modified Low-Density Lipoprotein as a Risk Marker for Peripheral Arterial Stiffness in Maintenance Hemodialysis Patients.

Background and Objectives: Peripheral arterial stiffness (PAS), assessed by brachial-ankle pulse wave velocity (baPWV), is an independent biomarker of cardiovascular diseases (CVD) in patients on maintenance hemodialysis (HD). Malondialdehyde-modified low-density lipoprotein (MDA-LDL), an oxidative stress marker, has been linked to atherosclerosis and CVD. However, the association between serum MDA-LDL and PAS among HD patients has not been fully elucidated. This study aimed to examine the association of serum MDA-LDL with PAS in HD patients and to identify the optimal cutoff value of serum MDA-LDL for predicting PAS. Materials and Methods: A cross-sectional study was conducted in 100 HD patients. Serum MDA-LDL was quantified using an enzyme-linked immunosorbent assay (ELISA), and baPWV was measured using a volume plethysmographic device. Patients were divided into the PAS group (baPWV > 18.0 m/s) and the non-PAS group (baPWV ≤ 18.0 m/s). The associations of baPWV and other clinical and biochemical parameters with serum MDA-LDL were assessed by multivariable logistic regression analyses. A receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cutoff value of serum MDA-LDL for predicting PAS. Results: In multivariable logistic regression analysis, higher serum MDA-LDL, older age, and higher serum C-reactive protein [odds ratios (ORs) and 95% confidence intervals: 1.014 (1.004-1.025), 1.044 (1.004-1.085) and 3.697 (1.149-11.893)] were significantly associated with PAS. In the ROC curve analysis, the optimal cutoff value of MDA-LDL for predicting PAS was 80.91 mg/dL, with a sensitivity of 79.25% and a specificity of 59.57%. Conclusions: Greater serum MDA-LDL levels, particularly ≥80.91 mg/dL, were independently associated with PAS in HD patients. The findings suggest that oxidative stress plays a crucial role in the pathogenesis of PAS, and targeting MDA-LDL may be a potential therapeutic strategy for reducing cardiovascular risk in HD patients.

Serum Angiopoietin-like Protein 3 Level Is Associated with Peripheral Arterial Stiffness in Patients with Coronary Artery Disease.

Background and Objectives: Angiopoietin-like protein 3 (ANGPTL3) is a secretory protein regulating lipid metabolism. This study evaluated the relationship between serum ANGPTL3 level and peripheral arterial stiffness (PAS) in patients with coronary artery disease (CAD). Materials and Methods: Fasting blood samples were collected from 95 CAD patients. PAS was defined as left or right brachial-ankle pulse wave velocity (baPWV) > 18.0 m/s by an oscillometric method. Serum ANGPTL3 levels were assessed using a commercial enzyme-linked immunosorbent assay kit. Results: Seventeen CAD patients (17.9%) had PAS. Patients with PAS had a significantly higher percentage of diabetes (p = 0.002), older age (p = 0.030), higher systolic blood pressure (p = 0.016), higher fasting glucose (p = 0.008), serum C-reactive protein (p = 0.002), and ANGPTL3 level (p = 0.001) than those without PAS. After multivariable logistic regression analysis, serum ANGPTL3 level (Odds ratio (OR): 1.004, 95% confidence interval (CI): 1.000-1.007, p = 0.041) is still independently associated with PAS in CAD patients. The receiver operating characteristic curve for PAS prediction revealed that the area under the curve for ANGPTL3 level was 0.757 (95% CI: 0.645-0.870, p < 0.001). Conclusions: Serum fasting ANGPTL3 level is positively associated with PAS in CAD patients. Further studies are required for clarification.

Relationship between Peripheral Arterial Stiffness and Estimated Pulmonary Pressure by Echocardiography in Systemic Sclerosis.

BACKGROUND: Pulmonary hypertension (PH) is an important lethal manifestation of systemic sclerosis (SSc). Evidence of an association between peripheral and pulmonary arterial vasculopathy in SSc has been demonstrated. We hypothesized that peripheral arterial stiffness could predict PH in SSc. METHODS: We performed a cross-sectional study among patients with SSc who underwent Cardio-Ankle Vascular Index (CAVI, VaSera VS-1000; Fukuda Denshi, Tokyo, Japan) and transthoracic echocardiography (TTE) examination to evaluate peripheral arterial stiffness and PH, respectively. The correlation between CAVI score and PH hemodynamics [right ventricular systolic pressure (RVSP) and tricuspid regurgitation velocity (TRV)] was studied. RESULTS: A total of 145 patients underwent both CAVI and TTE evaluation. The mean (standard deviation, SD) patient age was 51.5 (12.3) years; female patients constituted 72% of the subjects. Diffuse SSc occurred in 75% of the cases. The mean (SD) CAVI score was 7.6 (0.9), and the mean (SD) RVSP was 29.9 (11.2) mmHg. Correlation coefficient (r) between CAVI score and RVSP in overall, limited, and diffuse SSc were 0.107 (p = 0.200), 0.040 (p = 0.815), and 0.194 (p = 0.043), respectively. CAVI scores were borderline or abnormal (≥ 8) in 30.3% of subjects. PH was classified intermediate or high probability (TRVmax ≥ 2.9 m/s) in 19.3% of the subjects. Among the overall population, the odds ratios (95% CI) of CAVI score ≥ 8 for TRVmax ≥ 2.9 m/s in univariate and multivariate analysis were 1.23 (0.46-3.21, p = 0.678), and 0.54 (0.10-2.84, p = 0.471), respectively. CONCLUSIONS: Peripheral arterial stiffness, as measured by CAVI, has a correlation trend with the level of pulmonary arterial pressure assessed by TTE, specifically in the diffuse SSc subgroup.

Twenty-Four-Hour Ambulatory Blood Pressure Monitoring Parameters During Pregnancy: A Pilot Study.

Introduction: Maternal blood pressure (BP) is a critical cardiovascular marker with profound implications for maternal and fetal well-being, particularly in the detection of hypertensive disorders during pregnancy. Although conventional clinic-based BP (CBP) measurements have traditionvally been used, monitoring 24-hour ambulatory BP (ABP) has emerged as a more reliable method for assessing BP levels and diagnosing conditions such as gestational hypertension and preeclampsia/eclampsia. This study aimed to assess the feasibility and acceptability of 24-hour ABP monitoring in pregnant women and report on various ABP parameters, including ambulatory blood pressure variability (ABPV). Method: A prospective cross-sectional study design was employed, involving 55 multipara pregnant women with and without prior adverse pregnancy outcomes (APOs). The participants underwent baseline assessments, including anthropometrics, resting CBP measurements, and the placement of ABP and actigraphy devices. Following a 24-hour period with these devices, participants shared their experiences to gauge device acceptability. Pregnancy outcomes were collected postpartum. Results: Twenty-four-hour ABP monitoring before 20 weeks of gestation is feasible for women with and without prior APOs. Although some inconvenience was noted, the majority of participants wore the ABP monitoring device for the entire 24-hour period. Pregnant women who later experienced APOs exhibited higher 24-hour ABP and ABPV values in the early stages of pregnancy. Conclusion: The study highlights the potential benefits of 24-hour ABP monitoring as a valuable tool in prenatal care, emphasizing the need for further research in this area.

Noninvasive characterization of peripheral sympathetic activation across sensory stimuli using a peripheral arterial stiffness index.

Introduction: The peripheral arterial stiffness index has been proposed and validated as a noninvasive measure quantifying stimulus intensity based on amplitude changes induced by sympathetic innervation of vascular tone. However, its temporal response characteristics remain unclear, thus hindering continuous and accurate monitoring of the dynamic process of sympathetic activation. This paper presents a study aimed at modeling the transient response of the index across sensory stimuli to characterize the corresponding peripheral sympathetic activation. Methods: The index was measured using a continuous arterial pressure monitor and a pulse oximeter during experiments with local pain and local cooling stimuli designed to elicit different patterns of sympathetic activation. The corresponding response of the index was modeled to clarify its transient response characteristics across stimuli. Results: The constructed transfer function accurately depicted the transient response of the index to local pain and local cooling stimuli (Fit percentage: 78.4% ± 11.00% and 79.92% ± 8.79%). Differences in dead time (1.17 ± 0.67 and 0.99 ± 0.56 s, p = 0.082), peak time (2.89 ± 0.81 and 2.64 ± 0.68 s, p = 0.006), and rise time (1.81 ± 0.50 and 1.65 ± 0.48 s, p = 0.020) revealed different response patterns of the index across stimuli. The index also accurately characterized similar vasomotor velocities at different normalized peak amplitudes (0.19 ± 0.16 and 0.16 ± 0.19 a.u., p = 0.007). Discussion: Our findings flesh out the characterization of peripheral arterial stiffness index responses to different sensory stimuli and demonstrate its validity in characterizing peripheral sympathetic activation. This study valorizes a noninvasive method to characterize peripheral sympathetic activation, with the potential to use this index to continuously and accurately track sympathetic activators.

Neural basis for anxiety and anxiety-related physiological responses during a driving situation: an fMRI study.

Although the exteroceptive and interoceptive prediction of a negative event increases a person's anxiety in daily life situations, the relationship between the brain mechanism of anxiety and the anxiety-related autonomic response has not been fully understood. In this functional magnetic resonance imaging (fMRI) study, we examined the neural basis of anxiety and anxiety-related autonomic responses in a daily driving situation. Participants viewed a driving video clip in the first-person perspective. During the video clip, participants were presented with a cue to indicate whether a subsequent crash could occur (attention condition) or not (safe condition). Enhanced activities in the anterior insula, bed nucleus of the stria terminalis, thalamus, and periaqueductal gray, and higher sympathetic nerve responses (pupil dilation and peripheral arterial stiffness) were triggered by the attention condition but not with the safe condition. Autonomic response-related functional connectivity was detected in the visual cortex, cerebellum, brainstem, and MCC/PCC with the right anterior insula and its adjacent regions as seed regions. Thus, the right anterior insula and adjacent regions, in collaboration with other regions play a role in eliciting anxiety based on the prediction of negative events, by mediating anxiety-related autonomic responses according to interoceptive information.

Four weeks of lower-limb static stretching reduces regional arterial stiffness in middle-aged and older women.

PURPOSE: This study aimed to clarify whether habitual lower-limb stretching intervention reduces regional arterial stiffness at the stretched site in middle-aged and older women. METHODS: In this study, the effects of 4 weeks of lower-limb static stretching (of the hip extensor and flexor, knee extensor and flexor, and plantar flexor muscles) were investigated on systemic, central, and peripheral arterial stiffness using pulse wave velocity in 14 healthy middle-aged and older women randomly assigned to either a sedentary control group (67.3 ± 5.6 years; n = 7) or a stretching intervention group (63.4 ± 6.4 years; n = 7). RESULTS: The femoral-ankle pulse wave velocity (an index of peripheral arterial stiffness) significantly decreased in the intervention group (pre, 1222.4 ± 167.5 cm/s; post, 1122.0 ± 141.1 cm/s) but did not change in the control group (pre, 1122.7 ± 107.7 cm/s; post, 1139.9 ± 77.5 cm/s). However, the brachial-ankle pulse wave velocity as an index of systemic arterial stiffness (control: pre, 1655.7 ± 296.8 cm/s, post, 1646.4 ± 232.1 cm/s; intervention: pre, 1637.6 ± 259.9 cm/s, post, 1560.8 ± 254.7 cm/s) and the carotid-femoral pulse wave velocity as an index of central arterial stiffness (control: pre, 1253.6 ± 346.4 cm/s, post, 1223.6 ± 263.4 cm/s; intervention: pre, 1125.4 ± 204.7 cm/s, post, 1024.9 ± 164.5 cm/s) did not change in either group. CONCLUSION: These findings suggest that lower-limb stretching interventions may reduce regional arterial stiffness at the stretched site.

Relation of Helicobacter pylori infection to peripheral arterial stiffness and 10-year cardiovascular risk in subjects with diabetes mellitus.

PURPOSE: This study was conducted to investigate the relation of HP infection to peripheral arterial stiffness and 10-year cardiovascular risk in diabetes mellitus (DM). METHODS: DM subjects who underwent the C13-breath test were enrolled and divided into DMHP+ and DMHP- groups. Peripheral arterial stiffness was measured using brachial to ankle pulse wave velocity (baPWV). Framingham score (FRS) and Chinese evaluation method of ischemic cardiovascular diseases (ICVD) were used to clarify 10-year cardiovascular risk. RESULTS: A total of 6767 subjects were included, baPWV and proportion of subjects with severe peripheral arterial stiffness were lower in DMHP- group than DMHP+ group (1556.68 ± 227.54 vs 2031.61 ± 525.48 cm/s, p < 0.01; 21.9% vs 62.7%, p < 0.01). Multivariate logistic regression analysis demonstrated that HP infection was independently associated with baPWV. Furthermore, cardiovascular risk score and the proportion of subjects with high risk were lower in DMHP- group than DMHP+ group (FRS: 12.09 ± 3.77 vs 13.91 ± 3.77, 17.2% vs 38.8%; ICVD: 8.56 ± 2.99 vs 10.22 ± 3.16, 43.9% vs 65.4%, with all p < 0.05). CONCLUSION: DM subjects with HP infection had more severe peripheral arterial stiffness compared those without HP infection, a higher cardiovascular risk score and 10-year cardiovascular risk stratification were observed in those subjects.

Association of Low Serum l-Carnitine Levels with Peripheral Arterial Stiffness in Patients Who Undergo Kidney Transplantation.

l-carnitine is an important co-factor in fatty-acid metabolism, and its deficiency is associated with insulin resistance, which is independently associated with arterial stiffness. This study evaluated the relationship between serum l-carnitine level and peripheral arterial stiffness (PAS) in kidney transplantation (KT). Fasting blood samples were collected from 65 patients who underwent KT. We measured the brachial-ankle pulse wave velocity, and 36 patients (55.4%) had PAS. Patients with PAS had a significantly higher percentage of diabetes (p = 0.001), hypertension (p = 0.033), and metabolic syndrome (p = 0.044); higher waist circumference (p = 0.010), systolic blood pressure (p = 0.002), serum triglyceride level (p = 0.040), insulin level (p = 0.002), and homeostasis model assessment of insulin resistance (p = 0.002); lower high-density lipoprotein cholesterol (p = 0.036) and serum l-carnitine levels (p < 0.001); older age (p = 0.041); and a longer KT duration (p = 0.025) than those without PAS. Statistical analysis revealed an independent association between PAS in KT and KT duration (95% confidence interval (CI): 1.003-1.054, p = 0.029) and serum l-carnitine levels (95% CI: 0.842-0.998, p = 0.044). The area under the receiver operating characteristic curve indicated that the diagnostic power of l-carnitine to predict PAS was 0.789 (95% CI: 0.670-0.881, p < 0.001). Serum-free l-carnitine level is negatively associated with PAS in patients who undergo KT.

Positive correlation of serum leptin levels and peripheral arterial stiffness in patients with type 2 diabetes.

OBJECTIVE: Leptin plays a pathophysiologic role in the pathogenesis of aortic dysfunction and peripheral arterial stiffness (PAS). Our aim was to evaluate the risk factors for developing PAS and the association of leptin and PAS in patients with type 2 diabetes mellitus (DM). MATERIALS AND METHODS: Fasting blood samples were obtained for biochemical data and leptin determinations from 105 patients with type 2 DM. In this study, we applied an automatic pulse wave analyzer (VaSera VS-1000) to measure the brachial-ankle pulse wave velocity (baPWV); a baPWV value >14.0 m/s on either side was considered high PAS. RESULTS: Seventy-five patients (71.4%) had high PAS and they included a higher percentage of patients with hypertension (P < 0.001), older age (P < 0.001), and a higher body fat mass (P = 0.043), systolic blood pressure (P < 0.001), diastolic blood pressure (P = 0.016), serum blood urea nitrogen (P = 0.003), and leptin level (P < 0.001), and lower height (P = 0.027) and glomerular filtration rate (P < 0.001) compared with type 2 DM patients with low PAS. After adjusting for factors significantly associated with PAS in these patients by multivariate logistic regression analysis, age (ß = 0.470, adjusted R2 change = 0.279; P < 0.001), logarithmically transformed leptin (log-leptin, ß = 0.259, adjusted R2 change = 0.085; P = 0.001), and hypertension (ß = 0.197, adjusted R2 change = 0.031; P = 0.011) were significant independent predictors of PAS in type 2 DM patients. CONCLUSION: The serum leptin level could be a predictor of PAS in type 2 DM patients.

Low serum adiponectin level is associated with metabolic syndrome and is an independent marker of peripheral arterial stiffness in hypertensive patients.

BACKGROUND: Adiponectin has been implicated in metabolic syndrome (MetS) and arterial stiffness (AS). We aim to determine the relationship between serum adiponectin concentration as well as peripheral AS in hypertensive patients. METHODS: Fasting blood samples were obtained from 101 hypertensive patients. Brachial-ankle pulse wave velocity (baPWV) was measured with an automatic pulse wave analyzer. Serum adiponectin concentrations were determined by using an enzyme immunoassay kit. A baPWV >14.0 m/s was defined as high AS. RESULTS: MetS and high AS were present in 62.4 and 71.3% of the study population. Adiponectin was inversely associated with MetS and high AS (both P < 0.001). Serum higher high-density lipoprotein cholesterol (HDL-C) (P = 0.012), triglycerides (P = 0.001), C-reactive protein (P < 0.001), insulin (P = 0.027), body weight (P = 0.002), waist circumference (WC, P < 0.001), body mass index (P = 0.001) bilateral-baPWV (P < 0.001), systolic blood pressure (SBP, P < 0.001), diastolic blood pressure (DBP, P = 0.012), pulse pressure (P = 0.019), homeostasis model assessment of insulin resistance (HOMA1-IR (P = 0.026) and HOMA2-IR (P = 0.020)) and lower glomerular filtration rate (GFR, P = 0.029) were significantly associated with high AS. Multivariate logistic regression analysis of the factors significantly associated with AS revealed that adiponectin [odds ratio: 0.932, 95% confidence interval (CI) 0.881-0.985, P = 0.012], and SBP (odds ratio: 1.059, 95% CI 1.008-1.113, P = 0.022) were the independent predictors of arterial stiffness in hypertensive patients. Subgroup analysis revealed that SBP (odds ratio: 1.126, 95% CI 1.024-1.237, P = 0.014) and GFR (odds ratio: 0.858, 95% CI 0.739-0.996, P = 0.043) were the independent predictors of arterial stiffness in hypertensive patients without MetS; adiponectin (odds ratio: 0.909, 95% CI 0.931-0.996, P = 0.040) was the independent predictor of arterial stiffness in hypertensive patients with MetS. CONCLUSIONS: Hypoadiponectinemia has positive association with MetS and peripheral AS in hypertensive patients.

Relationships of drinking and smoking with peripheral arterial stiffness in Chinese community-dwelling population without symptomatic peripheral arterial disease.

BACKGROUND: Peripheral arterial stiffness gives rise to the high prevalence of peripheral arterial disease (PAD). It is necessary to conduct a large-scale study in Chinese community-dwelling population to clarify the relationships of alcohol and tobacco consumption with peripheral arterial stiffness. Most studies had a small sample size, and were not performed in Chinese community-dwelling population without symptomatic PAD. This analysis was designed to examine the relationships of alcohol and tobacco consumption with peripheral arterial stiffness in Chinese community-dwelling population without symptomatic PAD. METHODS: In a large health check-up program in Beijing (2007-2009), 2624 participants were involved in this analysis, and carotid-radial pulse wave velocity (crPWV) was measured following standard procedure. Physical examinations were performed by well-trained physicians. Blood samples were analyzed by qualified technicians in central laboratory. Initially, either alcohol drinking or cigarette smoking, and then both alcohol drinking and cigarette smoking, were put in one model of multivariate Logistic regression analyses. RESULTS: Median age was 54 years, and median value of crPWV was 9.4 m/s; 51.8% were males, 27.6% were smokers and 30.6% were drinkers. In Logistic regression analyses with either alcohol drinking or cigarette smoking, and both alcohol drinking and cigarette smoking, in one model, cigarette smoking was independently associated with crPWV (P < 0.05 for all), and alcohol drinking was not independently associated with crPWV (P > 0.05 for all). CONCLUSIONS: Cigarette smoking had an independent relationship with peripheral artery stiffness, and there was no independent relationship between alcohol drinking and peripheral arterial stiffness in Chinese community-dwelling population without symptomatic PAD.

Peripheral arterial stiffness is associated with higher baseline plasma uric acid: A prospective cohort study.

This prospective cohort study aimed at identifying association between uric acid (UA) and peripheral arterial stiffness. A prospective cohort longitudinal study was performed according to an average of 4.8 years' follow-up. The demographic data, anthropometric parameters, peripheral arterial stiffness (carotid-radial pulse-wave velocity, cr-PWV) and biomarker variables including UA were examined at both baseline and follow-up. Pearson's correlations were used to identify the associations between UA and peripheral arterial stiffness. Further logistic regressions were employed to determine the associations between UA and arterial stiffness. At the end of follow-up, 1447 subjects were included in the analyses. At baseline, cr-PWV (r = 0.200, p < 0.001) was closely associated with UA. Furthermore, the follow-up cr-PWV (r = 0.145, p < 0.001) was also strongly correlated to baseline UA in Pearson's correlation analysis. Multiple regressions also indicated the association between follow-up cr-PWV (ß = 0.493, p = 0.013) and baseline UA level. Logistic regressions revealed that higher baseline UA level was an independent predictor of arterial stiffness severity assessed by cr-PWV at follow-up cross-section. Peripheral arterial stiffness is closely associated with higher baseline UA level. Furthermore, a higher baseline UA level is an independent risk factor and predictor for peripheral arterial stiffness.

Prediabetes and Diabetes Are Associated With Arterial Stiffness in Older Adults: The ARIC Study.

BACKGROUND: To determine whether prediabetes and diabetes in older adults are associated with arterial stiffness measured in central and peripheral arteries and to examine characteristics that modify these associations. METHODS: Cohort members attending the 5th exam (2011-2013) of the Atherosclerosis Risk in Communities (ARIC) study had pulse wave velocity (PWV) measures performed at the carotid-femoral (cfPWV), brachial-ankle (baPWV), and femoral-ankle (faPWV) segments. Fasting glucose ≥126mg/dl, glycated hemoglobin (HbA1c) ≥6.5%, or currently taking diabetes medication defined diabetes. Fasting glucose 100-125mg/dl or HbA1c 5.7%-6.4% among those without diabetes defined prediabetes. Cross-sectional associations were modeled using multivariable linear regression. RESULTS: Among 4,279 eligible participants with cfPWV measures (mean age 75 years), 22% were African-American, 25.5% had diabetes, and 54.7% had prediabetes. Compared to those with normal glucose, cfPWV was 95.8cm/s higher (stiffer) on average for those with diabetes (for reference: being 1 year older was associated with 14.4cm/s higher cfPWV). Similar findings were seen for diabetes and baPWV, although attenuated. Interestingly, faPWV was 17.6cm/s lower for those with diabetes compared to normal glucose. There was a significant positive association between baPWV and prediabetes. Among those with diabetes, cfPWV was higher for those with albuminuria, reduced kidney function, duration of diabetes ≥10 years, and elevated HbA1c (HbA1c ≥7). CONCLUSION: Among older adults, diabetes is associated with higher central arterial stiffness and lower peripheral arterial stiffness, and prediabetes is associated with higher baPWV. Cross-sectionally, the magnitude of the effect of diabetes on central stiffness is equivalent to 6 years of arterial aging.

Repeatability of Central and Peripheral Pulse Wave Velocity Measures: The Atherosclerosis Risk in Communities (ARIC) Study.

BACKGROUND: Arterial stiffness measures are emerging tools for risk assessment and stratification for hypertension and cardiovascular disease (CVD). Carotid-femoral pulse wave velocity (cfPWV) is an established measure of central arterial stiffness. Other measures of PWV include femoral-ankle (faPWV), a measure of peripheral stiffness, and brachial-ankle PWV (baPWV), a composite measure of central and peripheral stiffness. Repeatability of central, peripheral, and composite PWV measures has not been adequately examined or compared. METHODS: Participants (n = 79; mean age 75.7 years; USA) from a repeatability study nested within the Atherosclerosis Risk in Communities (ARIC) Study visit 5 (2011-2013) underwent 2 standardized visits, 4-8 weeks apart. Trained technicians obtained 2 PWV measurements at each visit using the VP-1000 Plus system. We calculated the intraclass correlation coefficient (ICC), SE of measurement, and minimal detectable change (MDC95; 95% confidence interval) and difference (MDD). RESULTS: The ICCs and 95% confidence intervals (95% CIs) were 0.70 (0.59, 0.81) for cfPWV, 0.84 (0.78, 0.90) for baPWV, and 0.69 (0.59, 0.79) for faPWV. The MDC95 between repeat measures within an individual was 411.0 cm/s for cfPWV, 370.6 cm/s for baPWV, and 301.4 cm/s for faPWV. The MDD for 2 independent samples of 100 per group was 139.3 cm/s for cfPWV, 172.3 cm/s for baPWV, and 100.4 cm/s for faPWV. CONCLUSIONS: Repeatability was acceptable for all PWV measures in a multicenter, population-based study of older adults and supports its use in epidemiologic studies. Quantifying PWV measurement variation is critical for applications to risk assessment and stratification and eventual translation to clinical practice.

Smoking Behaviors and Arterial Stiffness Measured by Pulse Wave Velocity in Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study.

BACKGROUND: Though smoking is strongly associated with peripheral vascular disease and arteriosclerosis, smoking's association with arterial stiffness has been inconsistent and mostly limited to a single arterial segment. We examined the relationship between smoking behaviors with arterial stiffness in multiple arterial segments among community dwelling older adults. METHODS: The cross-sectional relationship between smoking behavior with carotid-femoral (cfPWV) and femoral-ankle pulse wave velocity (faPWV) was examined in 5,002 men and women, separately, of the Atherosclerosis Risk in Communities (ARIC) cohort study. Brachial-ankle PWV was also assessed and presented in Supplementary Material. Heckman selection models were used to control for selective attrition and death in the ARIC cohort. RESULTS: In women, faPWV was lower in current smokers compared to never smokers (-66.0cm/s; 95% confidence interval (95% CI): -94.6, -37.4), and was 1.0cm/s lower (95% CI: -1.8, -0.2) for every additional year a woman smoked, after adjustment for confounders. Among women, cfPWV was not associated with smoking status or cigarette pack-years. Additionally, no associations of smoking status and cigarette pack-years with PWV were observed among men. Years since smoking cessation was not associated with PWV in either gender. CONCLUSION: Both smoking status and cumulative smoking exposure were associated with lower peripheral arterial stiffness among women, but not among men. We did not observe an association between central arterial stiffness and smoking status in either gender. The profound and well-documented adverse effects of cigarette smoking on the vasculature may not include a sustained stiffening of the arteries measured at older age.