Relative contributions of different cardiovascular risk factors to significant arterial stiffness

Background: Although arterial stiffness has been known to be related to many cardiovascular (CV) risk factors, the level of contribution of each risk factor to significant arterial stiffness is not yet clear. Methods: We studied an out-patient cohort of 835 subjects who were without a history of CV disease. Brachial-ankle pulse wave velocity (baPWV) measurement and Framingham risk score (FRS) calculation were performed for all subjects. Results: baPWV was well correlated with FRS (r=0.523, P<0.001) and it could independently predict it (P<0.001) after adjusting for the conventional CVrisk factors.We defined a baPWV>1710 cm/s as significant arterial stiffness on the basis of its ability to detect a high 10-year risk of coronary heart disease (FRS>20%).Multiple logistic regression analysis revealed that the adjusted odds ratios of significant arterial stiffness for an age >60 years, hypertension, male gender, smoking and diabetes were 6.2 (95% CI 4.4-8.7), 3.4 (95% CI 2.1-5.3), 1.9 (95% CI 1.3-2.8), 1.9 (95% CI 1.2-3.2) and 1.6 (95% CI 1.1-2.4), respectively. Hyperlipidemia and obesity were not statistically significant. Conclusions: Old age and hypertension were the strongest independent predictors of significant arterial stiffness. Male gender, smoking and diabetes followed in order of strength as independent predictors.