Determinants of aortic stiffening in elderly subjects: results of a nine-year follow-up.

Objective: To investigate determinants of increase in aortic pulse wave velocity (PWV) in elderly subjects free from overt cardiovascular disease and not treated for arterial hypertension at baseline.

Methods: The present study included 90 lecture attendees ("Continuing Adult Education") who were examined at baseline and after a median follow-up of 9.5 years, including the PWV measurement using SphygmoCor. We used multiple linear regression analyses to assess predictors of PWV change. As independent covariates, we considered parameters with known effect on arterial stiffness and use of antihypertensive and lipid lowering medication.

Results: At baseline, mean age was 66.9 ± 5.1 years, and 37.8% of subjects had arterial hypertension, respectively. The PWV increased from 9.4 to 10.2 m/s; p = 0.035. While accounting for covariates, PWV was significantly and independently associated with four factors: baseline heart rate (β = 0.074, χ(2) = 7.40; p = 0.0079), mean arterial pressure (β = 0.070, χ(2) = 11.39; p = 0.0011), fasting glucose (β = 0.790, χ(2) = 11.30; p = 0.0012), and use of antihypertensive medication (β = - 1.416, χ(2) = 7.95; p = 0.0060). We did not observe correlation between PWV increase and lipid or renal parameters and lipid lowering medication.

Conclusions: In elderly subjects without manifest cardiovascular disease, mechanical load and glucose concentration play a major role in the aortic stiffening. Use of antihypertensive treatment was associated with smaller PWV increase.