Association Between Arterial Stiffness and Atherosclerosis

TLDR

Studies of the link between arterial stiffness and atherosclerosis have produced contradictory results. The study aimed to examine the relationship between aortic and carotid artery stiffness and multiple atherosclerosis indicators. Using data from over 3,000 elderly participants in the Rotterdam Study, aortic stiffness was quantified by carotid‑femoral pulse‑wave velocity, carotid stiffness by distensibility, and atherosclerosis was assessed via carotid intima‑media thickness, plaque burden, and peripheral arterial disease, with associations evaluated by ANCOVA adjusting for age, sex, mean arterial pressure, and heart rate. Both aortic and carotid artery stiffness were strongly positively associated with carotid intima‑media thickness, plaque severity in the carotid and aorta, and with peripheral arterial disease, and these associations persisted after further adjustment for cardiovascular risk factors.

Abstract

Background and Purpose —Studies of the association between arterial stiffness and atherosclerosis are contradictory. We studied stiffness of the aorta and the common carotid artery in relation to several indicators of atherosclerosis. Methods —This study was conducted within the Rotterdam Study in >3000 elderly subjects aged 60 to 101 years. Aortic stiffness was assessed by measuring carotid-femoral pulse wave velocity, and common carotid artery stiffness was assessed by measuring common carotid distensibility. Atherosclerosis was assessed by common carotid intima-media thickness, plaques in the carotid artery and in the aorta, and the presence of peripheral arterial disease. Data were analyzed by ANCOVA with adjustment for age, sex, mean arterial pressure, and heart rate. Results —Both aortic and common carotid artery stiffness were found to have a strong positive association with common carotid intima-media thickness, severity of plaques in the carotid artery, and severity of plaques in the aorta ( P for trend <0.01 for all associations). Subjects with peripheral arterial disease had significantly increased aortic stiffness ( P =0.001) and borderline significantly increased common carotid artery stiffness ( P =0.08) compared with subjects without peripheral arterial disease. Results were similar after additional adjustment for cardiovascular risk factors and after exclusion of subjects with prevalent cardiovascular disease. Conclusions —This population-based study shows that arterial stiffness is strongly associated with atherosclerosis at various sites in the vascular tree.