Comparison between Carotid Distensibility-Based Vascular Age and Risk-Based Vascular Age in Middle-Aged Population Free of Cardiovascular Disease
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population and Protocol
2.2. Body Size and BP Measurement
2.3. Calculation of Vascular Age Based on FRS
2.4. Calculation of Vascular Age Based on SCORE
2.5. Common Carotid Artery Distension Coefficient and Vascular Age
2.6. Statistical Analysis
3. Results
4. Discussion
Study Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Cuende, J.I. Vascular Age Versus Cardiovascular Risk: Clarifying Concepts. Rev. Esp. Cardiol. Engl. Ed. 2016, 69, 243–246. [Google Scholar] [CrossRef] [PubMed]
- Groenewegen, K.A.; den Ruijter, H.M.; Pasterkamp, G.; Polak, J.F.; Bots, M.L.; Peters, S.A. Vascular age to determine cardiovascular disease risk: A systematic review of its concepts, definitions, and clinical applications. Eur. J. Prev. Cardiol. 2016, 23, 264–274. [Google Scholar] [CrossRef]
- Kozakova, M.; Morizzo, C.; Guarino, D.; Federico, G.; Miccoli, M.; Giannattasio, C.; Palombo, C. The impact of age and risk factors on carotid and carotid-femoral pulse wave velocity. J. Hypertens. 2015, 33, 1446–1451. [Google Scholar] [CrossRef] [PubMed]
- D’Agostino, R.B.; Vasan, R.S.; Pencina, M.J.; Wolf, P.A.; Cobain, M.; Massaro, J.M.; Kannel, W.B. General cardiovascular risk profile for use in primary care: The Framingham Heart Study. Circulation 2008, 117, 743–753. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Cuende, J.I.; Cuende, N.; Calaveras-Lagartos, J. How to calculate vascular age with the SCORE project scales: A new method of cardiovascular risk evaluation. Eur. Heart J. 2010, 31, 2351–2358. [Google Scholar] [CrossRef] [PubMed]
- Howard, G.; Sharrett, A.R.; Heiss, G.; Evans, G.W.; Chambless, L.E.; Riley, W.A.; Burke, G.L. Carotid artery intimal-medial thickness distribution in general populations as evaluated by B-mode ultrasound. ARIC Investigators. Stroke 1993, 24, 1297–1304. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Reference Values for Arterial Stiffness’ Collaboration. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘Establishing normal and reference values’. Eur. Heart J. 2010, 31, 2338–2350. [Google Scholar] [CrossRef] [PubMed]
- Engelen, L.; Bossuyt, J.; Ferreira, I.; van Bortel, L.M.; Reesink, K.D.; Segers, P.; Stehouwer, C.D.; Laurent, S.; Boutouyrie, P.; Reference Values for Arterial Measurements Collaboration. Reference values for local arterial stiffness. Part A: Carotid artery. J. Hypertens. 2015, 33, 1981–1996. [Google Scholar] [CrossRef]
- Engelen, L.; Ferreira, I.; Stehouwer, C.D.; Boutouyrie, P.; Laurent, S.; Reference Values for Arterial Measurements Collaboration. Reference intervals for common carotid intima-media thickness measured with echotracking: Relation with risk factors. Eur. Heart J. 2013, 34, 2368–2380. [Google Scholar] [CrossRef] [Green Version]
- Gepner, A.D.; Keevil, J.G.; Wyman, R.A.; Korcarz, C.E.; Aeschlimann, S.E.; Busse, K.L.; Stein, J.H. Use of carotid intima-media thickness and vascular age to modify cardiovascular risk prediction. J. Am. Soc. Echocardiogr. 2006, 19, 1170–1174. [Google Scholar] [CrossRef]
- Stein, J.H.; Fraizer, M.C.; Aeschlimann, S.E.; Nelson-Worel, J.; McBride, P.E.; Douglas, P.S. Vascular age: Integrating carotid intima-media thickness measurements with global coronary risk assessment. Clin. Cardiol. 2004, 27, 388–392. [Google Scholar] [CrossRef] [PubMed]
- Łoboz-Rudnicka, M.; Jaroch, J.; Bociąga, Z.; Kruszyńska, E.; Ciecierzyńska, B.; Dziuba, M.; Dudek, K.; Uchmanowicz, I.; Łoboz-Grudzień, K. Relationship between vascular age and classic cardiovascular risk factors and arterial stiffness. Cardiol. J. 2013, 20, 394–401. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Laurent, S.; Boutouyrie, P.; Cunha, P.G.; Lacolley, P.; Nilsson, P.M. Concept of extremes in vascular aging. Hypertension 2019, 74, 218–228. [Google Scholar] [CrossRef] [PubMed]
- Nilsson, P.M.; Boutouyrie, P.; Laurent, S. Vascular aging: A tale of EVA and ADAM in cardiovascular risk assessment and prevention. Hypertension 2009, 54, 3–10. [Google Scholar]
- World Health Organization. Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycaemia: Report of a WHO/IDF Consultation; WHO: Geneva, Switzerland, 2006. [Google Scholar]
- Mancia, G.; Fagard, R.; Narkiewicz, K.; Redón, J.; Zanchetti, A.; Böhm, M.; Christiaens, T.; Cifkova, R.; De Backer, G.; Dominiczak, A.; et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J. Hypertens. 2013, 31, 1281–1357. [Google Scholar] [CrossRef] [Green Version]
- Conroy, R.M.; Pyörälä, K.; Fitzgerald, A.P.; Sans, S.; Menotti, A.; De Backer, G.; De Bacquer, D.; Ducimetière, P.; Jousilahti, P.; Keil, U.; et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: The SCORE project. Eur. Heart J. 2003, 24, 987–1003. [Google Scholar] [CrossRef]
- Palombo, C.; Kozakova, M.; Guraschi, N.; Bini, G.; Cesana, F.; Castoldi, G.; Stella, A.; Morizzo, C.; Giannattasio, C. Radiofrequency-based carotid wall tracking: A comparison between two different systems. J. Hypertens. 2012, 30, 1614–1619. [Google Scholar] [CrossRef]
- Vasan, R.S. Biomarkers of cardiovascular disease: Molecular basis and practical considerations. Circulation 2006, 113, 2335–2362. [Google Scholar] [CrossRef]
- Visseren, F.L.J.; Mach, F.; Smulders, Y.M.; Carballo, D.; Koskinas, K.C.; Bäck, M.; Benetos, A.; Biffi, A.; Boavida, J.M.; Capodanno, D.; et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur. Heart J. 2021, 42, 3227–3337. [Google Scholar] [CrossRef]
- Weber, T.; Mayer, C.C. “Man is as old as his arteries” taken literally: In search of the best metric. Hypertension 2020, 76, 1425–1427. [Google Scholar] [CrossRef]
- Gyöngyösi, H.; Kőrösi, B.; Batta, D.; Nemcsik-Bencze, Z.; László, A.; Tislér, A.; Cseprekál, O.; Torzsa, P.; Eörsi, D.; Nemcsik, J. Comparison of different cardiovascular risk score and pulse wave velocity-based methods for vascular age calculation. Heart Lung Circ. 2021, 30, 1744–1751. [Google Scholar] [CrossRef] [PubMed]
- Climie, R.E.; Mayer, C.C.; Bruno, R.M.; Hametner, B. Addressing the unmet needs of measuring vascular ageing in clinical practice-European cooperation in science and technology action VascAgeNet. Artery Res. 2020, 26, 71–75. [Google Scholar] [CrossRef] [Green Version]
- Yuan, C.; Wang, J.; Ying, M. Predictive value of carotid distensibility coefficient for cardiovascular diseases and all-cause mortality: A meta-analysis. PLoS ONE 2016, 11, e0152799. [Google Scholar] [CrossRef] [PubMed]
- Asayama, K.; Satoh, M.; Murakami, Y.; Ohkubo, T.; Nagasawa, S.Y.; Tsuji, I.; Nakayama, T.; Okayama, A.; Miura, K.; Imai, Y.; et al. Cardiovascular risk with and without antihypertensive drug treatment in the Japanese general population: Participant-level meta-analysis. Hypertension 2014, 63, 1189–1197. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Fuchs, F.D.; Whelton, P.K. High blood pressure and cardiovascular disease. Hypertension 2020, 75, 285–292. [Google Scholar] [CrossRef] [PubMed]
- Stehouwer, C.D.; Henry, R.M.; Ferreira, I. Arterial stiffness in diabetes and the metabolic syndrome: A pathway to cardiovascular disease. Diabetologia 2008, 51, 527–539. [Google Scholar] [CrossRef]
- Horváth, T.; Osztovits, J.; Pintér, A.; Littvay, L.; Cseh, D.; Tárnoki, A.D.; Tárnoki, D.L.; Jermendy, A.L.; Steinbach, R.; Métneki, J.; et al. Genetic impact dominates over environmental effects in development of carotid artery stiffness: A twin study. Hypertens. Res. 2014, 37, 88–93. [Google Scholar]
- Riley, W.A.; Freedman, D.S.; Higgs, N.A.; Barnes, R.W.; Zinkgraf, S.A.; Berenson, G.S. Decreased arterial elasticity associated with cardiovascular disease risk factors in the young. Bogalusa Heart Study. Arteriosclerosis 1986, 6, 378–386. [Google Scholar] [CrossRef] [Green Version]
- Kozakova, M.; Palombo, C.; Mhamdi, L.; Konrad, T.; Nilsson, P.; Staehr, P.B.; Paterni, M.; Balkau, B.; RISC Investigators. Habitual physical activity and vascular aging in a young to middle-age population at low cardiovascular risk. Stroke 2007, 38, 2549–2555. [Google Scholar] [CrossRef] [Green Version]
- van de Laar, R.J.; Stehouwer, C.D.; van Bussel, B.C.; te Velde, S.J.; Prins, M.H.; Twisk, J.W.; Ferreira, I. Lower lifetime dietary fiber intake is associated with carotid artery stiffness: The Amsterdam Growth and Health Longitudinal Study. Am. J. Clin. Nutr. 2012, 96, 14–23. [Google Scholar] [CrossRef] [Green Version]
- SCORE2 working group and ESC Cardiovascular risk collaboration. SCORE2 risk prediction algorithms: New models to estimate 10-year risk of cardiovascular disease in Europe. Eur. Heart J. 2021, 42, 2439–2454. [Google Scholar] [CrossRef] [PubMed]
Mean ± SD/Median [IQR]/n(%) | |
---|---|
Gender M F | 266 (50) 262 (50) |
Age (years) | 58.3 ± 5.5 |
BMI (kg/m2) | 27.1 ± 4.7 |
Waist (cm) | 96 ± 13 |
Systolic BP (mmHg) | 132 ± 17 |
Diastolic BP (mmHg) | 80 ± 10 |
Total cholesterol (mmol/L) | 5.4 ± 0.9 |
HDL cholesterol (mmol/L) | 1.6 ± 0.5 |
LDL cholesterol (mmol/L) | 3.3 ± 0.8 |
Triglycerides (mmol/L) | 1.1 [0.7] |
Fasting glucose (mmol/L) | 5.7 ± 1.4 |
Current smoker yes | 116 (22) |
Hypertension yes | 152 (29) |
Hypertension therapy yes | 120 (23) |
Hypercholesterolemia yes | 297 (56) |
Hypertriglyceridemia yes | 106 (21) |
T2DM yes | 118 (22) |
CCA DC (10−3 kPa−1) | 14.0 ± 5.0 |
FRS-based VA (years) | 65.5 ± 12.0 |
SCORE-based VA (years) | 62.9 ± 7.9 |
CCA DC-based VA (years) | 66.0 ± 13.8 |
Reclassification n (%) | |||||
---|---|---|---|---|---|
Mean Difference (Years) | p | Spearman r | ↑ Risk Category | ↓ Risk Category | |
DC-based VA (years) vs. | |||||
Chronological age (years) | 7.71 ± 13.4 | <0.0001 | 0.26 | ||
FRS-based VA (years) | 0.46 ± 12.2 | 0.29 | 0.56 | 150 (28) | 26 (5) |
SCORE-based VA (years) | 3.07 ± 12.7 | <0.0001 | 0.42 | 258 (49) | 32 (6) |
Risk Categories Low: Intermediate: High | Chronological Age; n (%) | DC-based VA; n (%) | |||
FRS | 219 (41):172 (33):137 (26) | 177 (34):129 (24):222 (42) | |||
SCORE | 281 (53):195 (37):52 (10) | 180 (34):95 (18):253 (48) |
CCA DC (10−3 kPa−1) | |||
---|---|---|---|
<5th Percentile | 5–95th Percentile | >95th Percentile | |
N (%) | 62 (12) | 448 (85) | 18 (3) |
ΔAge FRS (years) | 15.8 ± 7.8 ** | 6.5 ± 10.4 | −4.3 ± 8.7 ** |
ΔAge SCORE (years) | 7.7 ± 5.3 ** | 4.4 ± 4.6 | 0.7 ± 3.1 ** |
Systolic BP (mmHg) | 146 ± 17 ** | 130 ± 15 | 111 ± 7 ** |
HDL cholesterol (mmol/L) | 1.3 ± 0.4 ** | 1.6 ± 0.4 | 1.8 ± 0.6 ** |
Total cholesterol (mmol/L) | 5.2 ± 0.9 | 5.4 ± 0.9 | 6.1 ± 0.8 * |
Hypertensive therapy yes (n (%)) | 24 (39) ** | 96 (21) | 0 ** |
Smoking yes (n (%)) | 16 (25) | 98 (22) | 2 (11) |
T2DM yes (n (%)) | 33 (53) ** | 84 (19) | 1 (6)* |
CCA DC (10−3 kPa−1) | ||
---|---|---|
β ± SE | p | |
Age (years) | −0.18 ± 0.03 | <0.0001 |
Systolic BP (mmHg) | −0.48 ± 0.03 | <0.0001 |
HDL cholesterol (mmol/L) | 0.12 ± 0.03 | 0.001 |
Hypertensive treatment yes | −0.16 ± 0.04 | <0.0005 |
Diabetes mellitus yes | −0.19 ± 0.04 | <0.0001 |
Cumulative R2 | 0.43 | <0.0001 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Kozakova, M.; Morizzo, C.; Jamagidze, G.; Chiappino, D.; Palombo, C. Comparison between Carotid Distensibility-Based Vascular Age and Risk-Based Vascular Age in Middle-Aged Population Free of Cardiovascular Disease. J. Clin. Med. 2022, 11, 4931. https://doi.org/10.3390/jcm11164931
Kozakova M, Morizzo C, Jamagidze G, Chiappino D, Palombo C. Comparison between Carotid Distensibility-Based Vascular Age and Risk-Based Vascular Age in Middle-Aged Population Free of Cardiovascular Disease. Journal of Clinical Medicine. 2022; 11(16):4931. https://doi.org/10.3390/jcm11164931
Chicago/Turabian StyleKozakova, Michaela, Carmela Morizzo, Giuli Jamagidze, Dante Chiappino, and Carlo Palombo. 2022. "Comparison between Carotid Distensibility-Based Vascular Age and Risk-Based Vascular Age in Middle-Aged Population Free of Cardiovascular Disease" Journal of Clinical Medicine 11, no. 16: 4931. https://doi.org/10.3390/jcm11164931