OBJECTIVE: The aim of the Advanced Approach to Arterial Stiffness study was to compare arterial stiffness measured simultaneously with two different methods in different age groups of middle-aged and older adults with or without metabolic syndrome (MetS). The specific effects of the different MetS components on arterial stiffness were also studied. METHODS: This prospective, multicentre, international study included 2224 patients aged 40 years and older, 1664 with and 560 without MetS. Patients were enrolled in 32 centres from 18 European countries affiliated to the International Society of Vascular Health & Aging. Arterial stiffness was evaluated using the cardio-ankle vascular index (CAVI) and the carotid-femoral pulse wave velocity (CF-PWV) in four prespecified age groups: 40-49, 50-59, 60-74, 75-90 years. In this report, we present the baseline data of this study. RESULTS: Both CF-PWV and CAVI increased with age, with a higher correlation coefficient for CAVI (comparison of coefficients P < 0.001). Age-adjusted and sex-adjusted values of CF-PWV and CAVI were weakly intercorrelated (r = 0.06, P < 0.001). Age-adjusted and sex-adjusted values for CF-PWV but not CAVI were higher in presence of MetS (CF-PWV: 9.57 ± 0.06 vs. 8.65 ± 0.10, P < 0.001; CAVI: 8.34 ± 0.03 vs. 8.29 ± 0.04, P = 0.40; mean ± SEM; MetS vs. no MetS). The absence of an overall effect of MetS on CAVI was related to the heterogeneous effects of the components of MetS on this parameter: CAVI was positively associated with the high glycaemia and high blood pressure components, whereas lacked significant associations with the HDL and triglycerides components while exhibiting a negative association with the overweight component. In contrast, all five MetS components showed positive associations with CF-PWV. CONCLUSION: This large European multicentre study reveals a differential impact of MetS and age on CAVI and CF-PWV and suggests that age may have a more pronounced effect on CAVI, whereas MetS increases CF-PWV but not CAVI. This important finding may be due to heterogeneous effects of MetS components on CAVI. The clinical significance of these original results will be assessed during the longitudinal phase of the study.

1st Department of Cardiology Interventional Electrocardiology and Hypertension Jagiellonian University Medical College Kraków Poland

Almazov Federal Medical Research Centre St Petersburg

Cardiology Centre P Stradins University Hospital Riga Latvia

Cardiovascular Institute Belgrade Serbia

Center for Cardiovascular Prevention Charles University and Thomayer Hospital Prague Czech Republic

Centre of Preventive Cardiology Institute of Cardiology Yerevan Armenia

Clinic of Cardiac and Vascular Diseases Vilnius University University Hospital Santaros Klinikos Vilnius Lithuania

Department of Angiology Cardiometabolic Centre Szent Imre University Teaching Hospital Budapest Hungary

Department of Biomedical and Diagnostic Sciences University of Salamanca Salamanca Spain

Department of Cardiology and Personified Medicine Pirogov Russian National Research Medical University

Department of Geriatrics CHRU Nancy University Hospital of Nancy Nancy France

Department of Internal Medicine and Cardiology Hopital 64 RUDN University Moscow

Department of Internal Medicine and Gerontology Jagiellonian University Medical College Kraków Poland

Department of Internal Medicine Hospital Mutua Terrassa University of Barcelona Terrassa Spain

Department of Internal Medicine Medical School National and Kapodistrian University of Athens Athens Greece

Department of Medical Sciences Institut Universitari d'Investigació en Atenció Primària Jordi Gol Barcelona

Department of Medicine University of Debrecen Debrecen Hungary

Department of Nephrology Hypertension Dialysis and Transplantation University Hospital Centre Zagreb Croatia

Department of Nutrition and Dietetics School of Health Science and Education Harokopio University Athens Greece

Department of Therapy Ultrasound and Functional Diagnostics Smolensk State Medical Academy Smolensk Russia

Diagnosis and Therapeutic Center Paris Descartes University AP HP Hôtel Dieu Paris

Foundation Medical Research Institutes Paris France

Government Institution L T Malaya Therapy Institute of the National Academy of Medical Sciences of Ukraine Kharkov Ukraine

Inserm U1116 Université de Lorraine

Institute of Cardiology Kiev Ukraine

Karolinska University Hospital Cardiology Department Stockholm Sweden

Policlinicio Tor Vergata Universita di Roma Tor Vergata Roma Italy

Primary Care Services Biomedical Research Institute Institut Català de la Salut Girona Spain

Primary Healthcare Research Unit La Alamedilla Health Centre Biomedical Research Institute of Salamanca

Republican Scientific and Practice Centre 'Cardiology' Minsk Belarus

RUDN University

Russian Cardiology Research and Production Complex Moscow

Russian Clinical and Research Centre of Gerontology Moscow Russia

Scientific and Research Institute of Cardiology and Internal Diseases Almaty Kazakhstan

Section of Geriatric Medicine Department of Medicine University of Verona Verona Italy

University of Girona

J Hypertens. 2018 Apr;36(4):759-764. doi: 10.1097/HJH.0000000000001666. PubMed

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