The Temporal Pattern of Arterial Stiffness during Aging: A Large-Scale Cross-Sectional Study

Abstract

Brachial-ankle pulse wave velocity (baPWV) is a noninvasive clinical test that provides quantification for the stiffness of both the aorta and peripheral arteries by measuring the brachial and tibial arterial wave velocities. The temporal pattern of baPWV values during aging was investigated in this paper. A gradual increase in baPWV with respect to age was observed, suggesting an increase in the stiffness of arterial vessels as age increases. The ΔbaPWV value, defined as the absolute value of the difference between bilateral baPWV, also showed a positive correlation with aging. Many underlying physiological conditions such as hyperlipidemia, hypertension, diabetes, and hyperglycemia have previously been shown to elevate baPWV and contribute to the decline of arterial function. The effect of factors including biological sex, blood pressure, and blood glucose levels on the baPWV temporal pattern were also investigated. Between the ages of 18 and 50, men in the study had significantly higher baPWV readings than females of comparable age on average. However, after the age of 50, mean baPWV values increased at a greater rate in females than in males. In addition, blood pressure and blood glucose were shown to be associated with baPWV values. The results will improve existing prediction models for future cardiovascular episodes induced by arterial hardening in different age groups.

Figure 1

The temporal patterns of baPWV in male and female cohorts. The trend of higher baPWV values in males directly corresponded with age and continued until age 60, of which then the baPWV values of both males and females began to converge. At age 50, female cohorts began to show a faster rate of baPWV elevation. Significance level: P < 0.001 (^∗∗∗), P < 0.01 (^∗∗), and P < 0.05 (^∗).

Figure 2

The temporal patterns of baPWV in cohorts with high or low systolic blood pressure (a) and diastolic blood pressure (b). The individuals with raised systolic blood pressure and diastolic blood pressure also exhibited heightened baPWV readings across all age groups. Significance level: P < 0.001 (^∗∗∗), P < 0.01 (^∗∗), and P < 0.05 (^∗).

Figure 3

The temporal patterns of baPWV in cohorts with high or low fasting plasma glucose (FPG) (a) and hemoglobin A1C (HbA1c) (b). The mean baPWV for individuals with high blood glucose was significantly greater than the corresponding mean baPWV for individuals with low blood glucose with the exception of those in the “70s and up” age group. Significance level: P < 0.001 (^∗∗∗), P < 0.01 (^∗∗), and P < 0.05 (^∗).

Figure 4

The temporal pattern of baPWV and bilateral baPWV (ΔbaPWV) values (a) The temporal pattern of baPWV values. A gradual increase in baPWV was observed with respect to age, suggesting an increase in the stiffness of arterial vessels as aging progresses. (b) The temporal pattern of ΔbaPWV values. The absolute value of differences between left and right baPWV values is referred to as bilateral baPWV (ΔbaPWV). Similar to baPWV, the values and variances of ΔbaPWV increase with respect to age.

Figure 5

Two calcification mechanisms of action that drive arterial vessel stiffening. (a) Calcification process of arterial vessels induced by ageing or elevated blood glucose levels. (b) Molecular mechanism in which elevated glucose levels promote calcification and higher baPWV readings.