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Our aim was to investigate whether estimated vascular age (eVA) was elevated in subjects with metabolic syndrome (MetS) and/or known cardiovascular disease (CVD), what determined an elevated eVA, and whether eVA added prognostic information.

Design and Method:

During 1993, 2366 subjects, 41, 51, 61 and 71 years old, had traditional cardiovascular (CV) risk factors and carotid-femoral pulse wave velocity (cfPWV) measured. They were divided in risk groups based on known CVD, MetS components, SCORE and Framingham risk score (FRS). From age, mean arterial blood pressure and cfPWV, eVA and estimated cfPWV (ePWV) were estimated. In 2006 a combined CV endpoint (CEP) of CV death, non-fatal myocardial infarction, non-fatal stroke and hospitalization for ischemic heart disease was registered.


cfPWV and ePWV increased with ageing and higher CV risk (all P < 0.001), but ePWV increased more with ageing than cfPWV, because ePWV was lower than cfPWV in 41 years old subjects (7.1 vs. 7.6, P < 0.001) and higher in 61 years old (10.1 vs. 9.2, P < 0.001). Prevalence of elevated eVA increased significantly with higher CV risk and age 51or 71 years (both P < 0.01). The difference between eVA and chronological age, was in the study group associated with male gender (β = 0.14), higher heart rate (β = 0.16 both P < 0.001), fasting glucose (β = 0.08) suPAR (β = 0.06, both P < 0.01) and known CVD (β = 0.06, P < 0.05) (Table 1). In Cox-regression among subjects without CVD, stratified by age, SCORE, FRS and standardized with standard deviation, eVA predicted CEP in all groups except subjects with low/low intermediate FRS risk and stronger than cfPWV in subjects with high SCORE risk. Both eVA and cfPWV predicted CEP in all risk groups, but hazard ratios did not reach significance among non-smokers without components of MetS (Figure 1).


Elevated eVA was associated with male gender, plasma glucose, suPAR and known CVD. Independently of SCORE and CVD, eVA predicted CEP at least as good as cfPWV.

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