Aortic calcification is associated with aortic stiffness and isolated systolic hypertension in healthy individuals

Article English OPEN
McEniery, Carmel M. ; McDonnell, Barry J. ; So, Alvin ; Aitken, Sri ; Bolton, Charlotte E. ; Munnery, Margaret ; Hickson, Stacey S. ; Yasmin, ; Maki-Petaja, Kaisa M. ; Cockcroft, John ; Dixon, Adrian K. ; Wilkinson, Iain B. (2009)

Arterial stiffening is an independent predictor of mortality and underlies the development of isolated systolic hypertension (ISH). A number of factors regulate stiffness, but arterial calcification is also likely to be important. We tested the hypotheses that aortic calcification is associated with aortic stiffness in healthy individuals and that patients with ISH exhibit exaggerated aortic calcification compared with controls. A total of 193 healthy, medication-free subjects (mean age+/-SD: 66+/-8 years) were recruited from the community, together with 15 patients with resistant ISH. Aortic pulse wave velocity (PWV) was measured noninvasively, and aortic calcium content was quantified from high-resolution, thoraco-lumbar computed tomography images using a volume scoring method. In healthy volunteers, calcification was positively and significantly associated with aortic PWV (r=0.6; P<0.0001) but was not related to augmentation index or brachial PWV. Calcification was significantly higher in treatment-resistant and healthy subjects with ISH compared with controls (mean [interquartile range]: 1.92 [1.14 to 3.66], 0.84 [0.35 to 1.75], and 0.19 [0.1 to 0.78] cm3, respectively; P<0.0001 for both). In a multiple regression model, aortic calcium was independently associated with aortic PWV along with age, mean arterial pressure, heart rate, and estimated glomerular filtration rate (R(2)=0.51; P<0.0001). Only age, calcium phosphate product, and aortic PWV were independently associated with calcification. These data suggest that calcification may be important in the process of aortic stiffening and the development of ISH. Calcification may underlie treatment resistance in ISH, and anticalcification strategies may present a novel therapy.
  • References (45)
    45 references, page 1 of 5

    1. Franklin SS, Gustin IVW, Wong ND, Larson MG, Weber MA, Kannel WB, Levy D. Hemodynamic patterns of age-related changes in blood pressure: the Framingham Heart Study. Circulation. 1997;96: 308 -315.

    2. McEniery CM, Yasmin, Hall IR, Qasem A, Wilkinson IB, Cockcroft JR. Normal vascular ageing: differential effects on wave reflection and aortic pulse wave velocity: the Anglo-Cardiff Collaborative Trial (ACCT 1). J Am Coll Cardiol. 2005;46:1753-1760.

    3. Primatesta P, Poulter NR. Hypertension management and control among English adults aged 65 years and older in 2000 and 2001. J Hypertens. 2004;22:1093-1098.

    4. Laurent S, Cockcroft JR, van Bortel LM, Boutouyrie P, Giannattasio C, Hayoz D, Pannier BM, Vlachopoulos C, Wilkinson IB, Struijker-Boudier H. Abridged version of the expert consensus document on arterial stiffness. Artery Res. 2007;1:2-12.

    5. Nichols WW, O'Rourke MF. McDonald's Blood Flow in Arteries: Theoretical, Experimental and Clinical Principles. 5th ed. London, United Kingdom: Arnold; 2005.

    6. Dao HH, Essalihi R, Bouvet C, Moreau P. Evolution and modulation of age-related medial elastocalcinosis: impact on large artery stiffness and isolated systolic hypertension. Cardiovasc Res. 2005;66:307-317.

    7. Demer LL, Tintut Y. Mineral exploration: search for the mechanism of vascular calcification and beyond: the 2003 Jeffrey M. Hoeg Award lecture. Arterioscler Thromb Vasc Biol. 2003;23:1739 -1743.

    8. Sawabe M, Takahashi R, Matsushita S, Ozawa T, Arai T, Hamamatsu A, Nakahara K, Chida K, Yamanouchi H, Murayama S, Tanaka N. Aortic pulse wave velocity and the degree of atherosclerosis in the elderly: a pathological study based on 304 autopsy cases. Atherosclerosis. 2005; 179:345-351.

    9. van Popele NM, Grobbee DE, Bots ML, Asmar R, Topouchian J, Reneman RS, Hoeks AP, van der Kuip DA, Hofman A, Witteman JC. Association between arterial stiffness and atherosclerosis: the Rotterdam Study. Stroke. 2001;32:454 - 460.

    10. Henrion D, Chillon JM, Godeau G, Muller F, Capdeville-Atkinson C, Hoffman M, Atkinson J. The consequences of aortic calcium overload following vitamin D3 plus nicotine treatment in young rats. J Hypertens. 1991;9:919 -926.

  • Metrics
    No metrics available
Share - Bookmark