1. ¹Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
2. ²Divisions of Geriatric Medicine and Cardiology, University of Michigan School of Medicine, Veterans Affairs, Ann Arbor Healthcare System/Geriatric Research Education and Clinic Center, Ann Arbor, Michigan, USA
3. ³Department of Pathology, Stanford University Medical Center, Stanford, California, USA
4. ⁴Department of Pathology, University of Vermont, Burlington, Vermont, USA
5. ⁵Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
6. ⁶Gerontology Research Center, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA

Correspondence: Kim Sutton-Tyrrell, Dr. PH, Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, 130 DeSoto Street, Pittsburgh, PA 15261 USA. E-mail: tyrrell@edc.gsph.pitt.edu

^*This project was funded by the National Heart, Lung, and Blood Institute grant for the Cardiovascular Health Study (NO1-HC-85082). The vascular stiffness measures were supported by the Department of Epidemiology Ultrasound Research Laboratory, University of Pittsburgh Graduate School of Public Health. Support was provided by the National Institute on Aging Intramural Research Program (to HS and EL). This research was conducted under the tenure of an established investigator from the American Heart Association (KST). Preliminary results were presented as a poster at the American Heart Association's 38th Annual Conference on Cardiovascular Disease Epidemiology and Prevention, March 18–20, 1998, and published in abstract form (Circulation 1998;97:828).

Received 10 January 2001; Accepted 16 July 2001.

Abstract

Background: Arterial stiffness has been associated with aging, hypertension, and diabetes; however, little data has been published examining risk factors associated with arterial stiffness in elderly individuals.

Methods: Longitudinal associations were made between aortic stiffness and risk factors measured approximately 4 years earlier. Aortic pulse wave velocity (PWV), an established index of arterial stiffness, was measured in 356 participants (53.4% women, 25.3% African American), aged 70 to 96 years, from the Pittsburgh site of the Cardiovascular Health Study during 1996 to 1998.

Results: Mean aortic pulse wave velocity (850 cm/sec, range 365 to 1863) did not differ by ethnicity or sex. Increased aortic stiffness was positively associated with higher systolic blood pressure (SBP), age, fasting and 2-h postload glucose, fasting and 2-h insulin, triglycerides, waist circumference, body mass index, truncal fat, decreased physical activity, heart rate, and common carotid artery wall thickness (P < .05). After controlling for age and SBP, the strongest predictors of aortic stiffness in men were heart rate (P = .001) and 2-h glucose (P = .063). In women, PWV was positively associated with heart rate (P = .018), use of antihypertensive medication (P = .035), waist circumference (P = .030), and triglycerides (P = .081), and was negatively associated with physical activity (P = .111). Results were similar when the analysis was repeated in nondiabetic individuals and in those free of clinical or subclinical cardiovascular disease in 1992 to 1993.

Conclusions: In these elderly participants, aortic stiffness was positively associated with risk factors associated with the insulin resistance syndrome, increased common carotid intima–media thickness, heart rate, and decreased physical activity measured several years earlier.