Background: Cross-sectional data suggest that aortic calcification (AC) is independently associated with arterial stiffness, yet no previous study has examined the association prospectively. We hypothesize that increase in AC has a positive association with the progression of arterial stiffness assessed by brachial-ankle pulse-wave velocity (baPWV). To test our hypothesis, we examined data from our population-based samples of healthy middle-aged men (ERA JUMP Study).
Method: Participants (n=635) aged 40-49 at baseline (207 White American, 45 African American, 142 Japanese American and 241 Japanese in Japan, all men) were examined for AC, baPWV, and other factors at baseline and repeated 4-7 years later. The associations of baPWV progression (relative annual change) with annual change in AC were analyzed using general linear models and logistic regression, after adjusting for age, race, blood pressure and other risk factors.
Results: Annual change in AC was significantly associated with baPWV progression. Fully-adjusted means (standard error) of relative annual change in baPWV(%) from the 1st to 4th quartile (Q) of annual change in AC were 0.26(0.15), 0.44(0.16), 0.88(0.14) and 0.96(0.16), respectively (trend p=0.002) (Table). Similarly, fully-adjusted odds ratios (95% confidence interval) for baPWV progression > 0 comparing annual change in AC Q2 to Q4 versus Q1 were 1.04 (0.62-1.77), 1.83 (1.06-3.16) and 3.10 (1.60-5.99), respectively (trend p=0.004) (Table).
Conclusion: AC, which primarily represents calcification in the medial arterial layer or combination of media and intima, was strongly and progressively associated with increasing arterial stiffness, suggesting that calcification may casually link to arterial stiffness progression.