Relationships between arterial stiffness and the cluster of cardiovascular disease risk factors
Main Article Content
Abstract
Evidence indicated that individuals with more than one cardiovascular disease (CVD) risk factor were more likely to develop CVD events, compared with those with a single risk factor. Arterial stiffness is known as an independent risk factor for CVD. This study aimed to explore the association of clustering of CVD risk factors and arterial stiffness. Arterial stiffness was measured in both male and female adults aged 49.04 ± 15.79 years who visited the vascular screening clinic at the Physical Therapy Center, Mahidol University. Participants with two or more risk factors were assigned to the cluster of CVD risk factors group. This study was part of a routine-to-research (R2R) project; therefore, all participants who were willing to receive the service from September 2021 to April 2023 were recruited into the study with their permission. The results showed that the brachial-ankle pulse wave velocity (baPWV), an arterial stiffness indicator, was highest in the clustering of CVD risk factors group (1594 cm/sec2), higher in the single CVD risk factor group (1263cm/sec2) than in none of CVD risk factors participant (1148 cm/sec2). The overall mean resting mean arterial blood pressure level was 90 mmHg. In conclusion, clustering of CVD risk factors significantly correlated with arterial stiffness. Lifestyle modification should be strongly encouraged for individuals with more than one CVD risk factor to reduce the burden of CVD.
Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Nedkoff L, Briffa T, Zemedikun D, Herrington S, Wright FL. Global Trends in Atherosclerotic Cardiovascular Disease. Clin Ther 2023; 45(11): 1087-91.
Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004; 364(9438): 937-52.
O’Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P, et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet 2010; 376(9735): 112-23.
Bhatt DL, Steg PG, Ohman EM, Hirsch AT, Ikeda Y, Mas JL, et al. International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA 2006; 295(2): 180-9.
Yang ZJ, Liu J, Ge JP, Chen L, Zhao ZG, Yang WY, et al. Prevalence of cardiovascular disease risk factor in the Chinese population: the 2007-2008 China National Diabetes and Metabolic Disorders Study. Eur Heart J 2012; 33(2): 213-20.
Zhang L, Qin LQ, Cui HY, Liu AP, Wang PY. Prevalence of cardiovascular risk factors clustering among suburban residents in Beijing, China. Int J Cardiol 2011; 151(1): 46-9.
Laurent S, Katsahian S, Fassot C, Tropeano AI, Gautier I, Laloux B, et al. Aortic stiffness is an independent predictor of fatal stroke in essential hypertension. Stroke 2003; 34(5): 1203-6.
Sutton-Tyrrell K, Najjar SS, Boudreau RM, Venkitachalam L, Kupelian V, Simonsick EM, et al. Elevated aortic pulse wave velocity, a marker of arterial stiffness, predicts cardiovascular events in well-functioning older adults. Circulation 2005; 111(25): 3384-90.
Tomiyama H, Matsumoto C, Shiina K, Yamashina A. Brachial-Ankle PWV: Current Status and Future Directions as a Useful Marker in the Management of Cardiovascular Disease and/or Cardiovascular Risk Factors. J Atheroscler Thromb 2016; 23(2): 128-46.
Ohkuma T, Ninomiya T, Tomiyama H, Kario K, Hoshide S, Kita Y, et al. Brachial-Ankle Pulse Wave Velocity and the Risk Prediction of Cardiovascular Disease: An Individual Participant Data Meta-Analysis. Hypertension 2017; 69(6): 1045-52.
Tomiyama H, Hashimoto H, Hirayama Y, Yambe M, Yamada J, Koji Y, et al. Synergistic acceleration of arterial stiffening in the presence of raised blood pressure and raised plasma glucose. Hypertension 2006; 47(2): 180-8.
Prenner SB, Chirinos JA. Arterial stiffness in diabetes mellitus. Atherosclerosis 2015; 238(2): 370-9.
Chung TH, Shim JY, Kwon YJ, Lee YJ. High triglyceride to high-density lipoprotein cholesterol ratio and arterial stiffness in postmenopausal Korean women. J Clin Hypertens (Greenwich) 2019; 21(3): 399-404.
Tang B, Luo F, Zhao J, Ma J, Tan I, Butlin M, et al. Relationship between body mass index and arterial stiffness in a health assessment Chinese population. Medicine (Baltimore) 2020; 99(3): e18793.
AlGhatrif M, Strait JB, Morrell CH, Canepa M, Wright J, Elango P, et al. Longitudinal trajectories of arterial stiffness and the role of blood pressure: the Baltimore Longitudinal Study of Aging. Hypertension 2013; 62(5): 934-41.
Stehouwer CD, Henry RM, Ferreira I. Arterial stiffness in diabetes and the metabolic syndrome: a pathway to cardiovascular disease. Diabetologia 2008; 51(4): 527-39.
Johansen NB, Vistisen D, Brunner EJ, Tabak AG, Shipley MJ, Wilkinson IB, et al. Determinants of aortic stiffness: 16-year follow-up of the Whitehall II study. PLoS One 2012; 7(5): e37165.
Ben-Shlomo Y, Spears M, Boustred C, May M, Anderson SG, Benjamin EJ, et al. Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant metaanalysis of prospective observational data from 17,635 subjects. J Am Coll Cardiol 2014; 63(7): 636-46.
Tedesco MA, Natale F, Di Salvo G, Caputo S, Capasso M, Calabro R. Effects of coexisting hypertension and type II diabetes mellitus on arterial stiffness. J Hum Hypertens 2004; 18(7): 469-73.
Smulyan H, Lieber A, Safar ME. Hypertension, Diabetes Type II, and Their Association: Role of Arterial Stiffness. Am J Hypertens 2016; 29(1): 5-13.
Sun Y, Liu F, Zhang Y, Lu Y, Su Z, Ji H, et al. The relationship of endothelial function and arterial stiffness with subclinical target organ damage in essential hypertension. J Clin Hypertens (Greenwich) 2022; 24(4): 418-29.
Marengoni A, Angleman S, Melis R, Mangialasche F, Karp A, Garmen A, et al. Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev 2011; 10(4): 430-9.
Wu S, Jin C, Li S, Zheng X, Zhang X, Cui L, et al. Aging, Arterial Stiffness, and Blood Pressure Association in Chinese Adults. Hypertension 2019; 73(4): 893-9.
Li P, Wang L, Liu C. Overweightness, obesity and arterial stiffness in healthy subjects: a systematic review and meta-analysis of literature studies. Postgrad Med. 2017;129 (2): 224-30.
Wilson J, Webb AJS. Systolic Blood Pressure and Longitudinal Progression of Arterial Stiffness: A Quantitative Meta-Analysis. J Am Heart Assoc 2020; 9(17): e017804.
Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol 2010; 55(13): 1318-27.
Townsend RR, Wilkinson IB, Schiffrin EL, Avolio AP, Chirinos JA, Cockcroft JR, et al. Recommendations for Improving and Standardizing Vascular Research on Arterial Stiffness: A Scientific Statement From the American Heart Association. Hypertension 2015; 66(3): 698-722.
Yamashina A, Tomiyama H, Takeda K, Tsuda H, Arai T, Hirose K, et al. Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res 2002; 25(3): 359-64.
Tanaka H, Munakata M, Kawano Y, Ohishi M, Shoji T, Sugawara J, et al. Comparison between carotid-femoral and brachial-ankle pulse wave velocity as measures of arterial stiffness. J Hypertens 2009; 27(10): 2022-7.
Seals DR, Nagy EE, Moreau KL. Aerobic exercise training and vascular function with ageing in healthy men and women. J Physiol 2019; 597(19): 4901-14.