04.03 Aortic Stiffness, Central Pulse Pressure and the Risk of Primary Coronary Heart Disease in Older Adults. The Rotterdam Study

Abstract

Aim

We investigated whether aortic stiffness and central pulse pressure were predictors of coronary heart disease in apparently healthy subjects.

Methods and Results

We included 2024 subjects participating the third examination phase of the Rotterdam Study, a large ongoing population-based study. Aortic stiffness was measured as the carotid-femoral pulse wave velocity. Finger blood pressure was measured (Finapres) and central pulse pressure was calculated using upper arm level correction and a generalized transfer function. Information on smoking habits and previous cardiovascular disease were obtained. Body mass index was calculated. Serum total cholesterol and HDL cholesterol values were determined and diabetes mellitus was defined. The carotid IMT was assessed. Subjects with previous coronary heart disease were excluded from the analyses. Cox’s proportional hazard regression analysis, adjusted for cardiovascular risk factors was carried out. To facilitate comparisons among central pulse pressure and aortic stiffness each measure was divided by its standard deviation. The mean age of the participants was 71.4 years, 39.5% were men. During a mean follow-up time of 6.1 years, 109 subjects developed coronary heart disease. Hazard ratios and corresponding 95%CI of coronary heart disease for change of 1 standard deviation of aortic stiffness and central pulse pressure were 1.27 (1.06–1.51) and 1.20 (1.00–1.44), respectively. When both measures were included in the same statistical model, the prognostic value of aortic stiffness remained significant [1.22 (1.02–1.47)] whereas estimates of pulse pressure were slightly decreased [1.13 (0.93–1.37)].

Conclusions

Aortic stiffness is an independent predictor of coronary heart disease in apparently healthy subjects.