Elevated aortic pulse wave velocity, a marker of arterial stiffness, predicts cardiovascular events in well-functioning older adults

Background - Aging results in vascular stiffening and an increase in the velocity of the pressure wave as it travels down the aorta. Increased aortic pulse wave velocity ( aPWV) has been associated with mortality in clinical but not general populations. The objective of this investigation was to determine whether aPWV is associated with total and cardiovascular ( CV) mortality and CV events in a community- dwelling sample of older adults. Methods and Results - aPWV was measured at baseline in 2488 participants from the Health, Aging and Body Composition ( Health ABC) study. Vital status, cause of death and coronary heart disease ( CHD), stroke, and congestive heart failure were determined from medical records. Over 4.6 years, 265 deaths occurred, 111 as a result of cardiovascular causes. There were 341 CHD events, 94 stroke events, and 181 cases of congestive heart failure. Results are presented by quartiles because of a threshold effect between the first and second aPWV quartiles. Higher aPWV was associated with both total mortality ( relative risk, 1.5, 1.6, and 1.7 for aPWV quartiles 2, 3, and 4 versus 1; P = 0.019) and cardiovascular mortality ( relative risk, 2.1, 3.0, and 2.3 for quartiles 2, 3, and 4 versus 1; P = 0.004). aPWV quartile was also significantly associated with CHD ( P = 0.007) and stroke ( P = 0.001). These associations remained after adjustment for age, gender, race, systolic blood pressure, known CV disease, and other variables related to events. Conclusions - Among generally healthy, community- dwelling older adults, aPWV, a marker of arterial stiffness, is associated with higher CV mortality, CHD, and stroke.