IJCS | Volume 33, Nº4, July and August 2020

DOI: https://doi.org/10.36660/ijcs.20190068 349 ORIGINAL ARTICLE International Journal of Cardiovascular Sciences. 2020; 33(4):349-356 Mailing Address: Telmo Pereira Escola Superior de Tecnologia da Saúde de Coimbra - Rua 5 de Outubro, s/n. Postal Code: 3046-854, Coimbra – Portugal. E-mail: telmo@estescoimbra.pt Determinants of Arterial Stiffness and Vascular Aging in the Older Adult Telmo Pereir a and Tatiana Cost a Instituto Politécnico de Coimbra, Escola Superior de Tecnologia da Saúde de Coimbra, Coimbra - Portugal Manuscript received on April 03, 2019; reviewed on August 29, 2019; accepted on November 03, 2019. Abstract Background: Arterial stiffness (AS) is recognized as an important and independent risk factor for cardiovascular diseases (CVD). Objective: This study was aimed at identifying the main determinants of AS in the elderly. Design and Methods: This was an observational, cross-sectional study of elderly participants. Blood pressure (BP) and parameters of arterial function were measured using a validated device. Clinical and demographic data, global cardiovascular risk, health-related quality of life, dietary profile and cognition data were evaluated. Blood samples were collected for biochemical profiling of the participants. Handgrip strength test was performed. Student’s t-test and the χ 2 or Fisher exact tests were used for between-group comparisons as adequate. Correlational analysis was performed with the Pearson correlation coefficients and linear regression analysis. A two-tailed p < 0.05 was considered significant. Results: Fifty-four participants (81.8 ± 8.8 years; 65-94 years) were included in the study. Central BP was 132.7 ± 23.7 mmHg and 51.5 ± 15.7 mmHg, respectively, for aortic systolic and pulse pressures. Mean pulse wave velocity (PWV) was 12.9 ± 2.1 m/s and augmentation index 30.1 ± 12.9%. The proportion of participants with abnormal AS (increased PWV) was 27.8%. Participants with abnormal AS had higher brachial and central BP, higher BMI and higher abdominal fat. Functionality and nutritional status were worse in participants with abnormal AS. Regression analysis indicated age, brachial and central BP and vascular resistance as main determinants of AS. Conclusions: Abnormal AS is a common finding in the elderly and is highly associated with hypertension, functional decline and impairment of kidney function. (Int J Cardiovasc Sci. 2020; 33(4):349-356) Keywords: Vascular Stiffness; Hypertension; Pulse Wave Analysis; Cardiovascular Diseases; Comorbidity; Risk Factors. Introduction Population aging is amajor challenge for the upcoming decades, as the estimated share of European people aged 65 years or over will increase up to 30% by 2060. 1 Aging, particularly arterial aging, 2 is associated with increased comorbidity; cardiovascular diseases (CVD) account for most of health problems of the elderly and are the leading cause of death and disability. 3 Also, older adults are at higher absolute cardiovascular risk. 4 Cardiovascular risk assessment has been mainly focused on standard variables such as age, gender, concomitant diseases, blood pressure (BP), cholesterol, and smoking habits, among others. However, other risk factors have emerged, as is the case of arterial stiffness (AS), which is an increasingly recognized risk factor for CVD. 5,6 In addition to invasive methods, AS can be measured using non-invasive devices. For example, the Mobil-O-Graph is an oscillometric device that calculates central pressures and velocities from the analysis of the brachial pulse pressurewave velocity andwas validated in comparisonwithnon-invasive 7-10 and invasive 11,12 methods. Central arteries stiffen with age, which affects its buffering function and the normal ventricular-arterial coupling, and consequently reduces the hemodynamic effectiveness of the heart. This causes an increase in