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Effects of metabolic syndrome on arterial function in different age groups: the Advanced Approach to Arterial Stiffness study

Topouchian, Jirara; Labat, Carlosb; Gautier, Sylviec; Bäck, Magnusb,d; Achimastos, Apostolose; Blacher, Jacquesa; Cwynar, Marcinf; de la Sierra, Alejandrog; Pall, Denesh; Fantin, Francescoi; Farkas, Katalinj; Garcia-Ortiz, Luisk,l; Hakobyan, Zoyam; Jankowski, Piotrn; Jelakovic, Anao; Kobalava, Zhannap; Konradi, Alexandraq; Kotovskaya, Yuliar,s,t; Kotsani, Marinac; Lazareva, Irinau; Litvin, Alexanderv; Milyagin, Viktorw; Mintale, Ivetax; Persson, Oscard; Ramos, Rafaely,z,aa; Rogoza, Anatolyv; Ryliskyte, Ligitabb; Scuteri, Angelocc; Sirenko, Yuriydd; Soulis, Georgesee; Tasic, Nebojsaff; Udovychenko, Marynagg; Urazalina, Saulehh; Wohlfahrt, Peterii; Zelveian, Parounakm; Benetos, Athanaseb,c; Asmar, Rolandjj

doi: 10.1097/HJH.0000000000001631
Original Article: PDF Only

Objective: The aim of the Advanced Approach to Arterial Stiffness study was to compare arterial stiffness measured simultaneously with two different methods in different age groups of middle-aged and older adults with or without metabolic syndrome (MetS). The specific effects of the different MetS components on arterial stiffness were also studied.

Methods: This prospective, multicentre, international study included 2224 patients aged 40 years and older, 1664 with and 560 without MetS. Patients were enrolled in 32 centres from 18 European countries affiliated to the International Society of Vascular Health & Aging. Arterial stiffness was evaluated using the cardio-ankle vascular index (CAVI) and the carotid–femoral pulse wave velocity (CF-PWV) in four prespecified age groups: 40–49, 50–59, 60–74, 75–90 years. In this report, we present the baseline data of this study.

Results: Both CF-PWV and CAVI increased with age, with a higher correlation coefficient for CAVI (comparison of coefficients P < 0.001). Age-adjusted and sex-adjusted values of CF-PWV and CAVI were weakly intercorrelated (r 2 = 0.06, P < 0.001). Age-adjusted and sex-adjusted values for CF-PWV but not CAVI were higher in presence of MetS (CF-PWV: 9.57 ± 0.06 vs. 8.65 ± 0.10, P < 0.001; CAVI: 8.34 ± 0.03 vs. 8.29 ± 0.04, P = 0.40; mean ± SEM; MetS vs. no MetS). The absence of an overall effect of MetS on CAVI was related to the heterogeneous effects of the components of MetS on this parameter: CAVI was positively associated with the high glycaemia and high blood pressure components, whereas lacked significant associations with the HDL and triglycerides components while exhibiting a negative association with the overweight component. In contrast, all five MetS components showed positive associations with CF-PWV.

Conclusion: This large European multicentre study reveals a differential impact of MetS and age on CAVI and CF-PWV and suggests that age may have a more pronounced effect on CAVI, whereas MetS increases CF-PWV but not CAVI. This important finding may be due to heterogeneous effects of MetS components on CAVI. The clinical significance of these original results will be assessed during the longitudinal phase of the study.

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aDiagnosis and Therapeutic Center, Paris-Descartes University, AP-HP, Hôtel Dieu, Paris

bInserm U1116, Université de Lorraine

cDepartment of Geriatrics, CHRU Nancy, University Hospital of Nancy, Nancy, France

dKarolinska University Hospital, Cardiology Department, Stockholm, Sweden

eDepartment of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece

fDepartment of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland

gDepartment of Internal Medicine, Hospital Mutua Terrassa, University of Barcelona, Terrassa, Spain

hDepartment of Medicine, University of Debrecen, Debrecen, Hungary

iSection of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy

jDepartment of Angiology, Cardiometabolic Centre, Szent Imre University Teaching Hospital, Budapest, Hungary

kPrimary Healthcare Research Unit, La Alamedilla Health Centre, Biomedical Research Institute of Salamanca (IBSAL)

lDepartment of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain

mCentre of Preventive Cardiology, Institute of Cardiology, Yerevan, Armenia

nFirst Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland

oDepartment of Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Centre, Zagreb, Croatia

pDepartment of Internal Medicine and Cardiology, Hopital 64, RUDN University, Moscow

qAlmazov Federal Medical Research Centre, St-Petersburg

rRUDN University

sDepartment of Cardiology and Personified Medicine, Pirogov Russian National Research Medical University

tRussian Clinical and Research Centre of Gerontology, Moscow, Russia

uRepublican Scientific and Practice Centre ‘Cardiology’, Minsk, Belarus

vRussian Cardiology Research and Production Complex, Moscow

wDepartment of Therapy, Ultrasound and Functional Diagnostics, Smolensk State Medical Academy, Smolensk, Russia

xCardiology Centre, P. Stradins University Hospital, Riga, Latvia

yDepartment of Medical Sciences, Institut Universitari d’Investigació en Atenció Primària Jordi Gol, Barcelona

zUniversity of Girona

aaPrimary Care Services, Biomedical Research Institute, Institut Català de la Salut, Girona, Spain

bbClinic of Cardiac and Vascular Diseases, Vilnius University, University Hospital Santaros Klinikos, Vilnius, Lithuania

ccPoliclinicio Tor Vergata – Universita di Roma Tor Vergata, Roma, Italy

ddInstitute of Cardiology, Kiev, Ukraine

eeDepartment of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece

ffCardiovascular Institute, Belgrade, Serbia

ggGovernment Institution, L.T. Malaya Therapy Institute of the National Academy of Medical Sciences of Ukraine, Kharkov, Ukraine

hhScientific and Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan

iiCenter for Cardiovascular Prevention, Charles University and Thomayer Hospital, Prague, Czech Republic

jjFoundation-Medical Research Institutes, Paris, France

Correspondence to Prof Athanase Benetos, MD, PhD, Head of Department of Geriatrics, CHRU Nancy, University Hospital of Nancy, Vandoeuvre les Nancy, 54511 Nancy, France. Tel: +33 383 15 33 22; fax: +33 383 15 76 68; e-mail:

Received 8 June, 2017

Revised 29 October, 2017

Accepted 31 October, 2017

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