Nonsteroidal antiinflammatory drugs are associated with increased aortic stiffness.
OBJECTIVE
Nonsteroidal antiinflammatory drugs (NSAIDS) have been shown to retard aneurysm growth in animal models. In vitro studies have shown an inhibitory effect of NSAIDS on matrix metalloproteinase-9, interleukin-1beta, and IL-6 mediated arterial wall elastolysis. The aim of this study was to investigate the effects of NSAIDs on arterial stiffness, a surrogate marker of elastolysis.


METHODS
447 subjects enrolled in a community-based abdominal aortic aneurysm (AAA) screening program were assessed for age, blood pressure, smoking status, and drug history. Aortic diameter and stiffness were measured by M-Mode ultrasound. The concentration of the amino-terminal propeptide of type III procollagen was used as a proxy measurement of type III collagen turnover.


RESULTS
NSAID ingestion was significantly (p = 0.006) associated with increased aortic wall stiffness after adjusting for age, aortic diameter, blood pressure, and smoking status. No such effect was seen for beta-blockers, calcium channel antagonists, nitrates, angiotensin-converting enzyme inhibitors, diuretics, or antiplatelet agents.


CONCLUSIONS
These novel data show that NSAIDS are associated with increased aortic stiffness, possibly through the effects of cytokine mediated elastolysis. This in turn may prevent aortic expansion and the development of AAA.
Claridge
Martin
M
Department of Vascular Surgery, University of Birmingham, Birmingham Heartlands Hospital, UK.
Hobbs
Simon
S
Quick
Clive
C
Day
Nick
N
Bradbury
Andrew
A
Wilmink
Teun
T
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology* / Q000627:therapeutic use; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D017544:Aortic Aneurysm, Abdominal / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology* / Q000517:prevention & control; D016022:Case-Control Studies; D003187:Compliance / Q000187:drug effects; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood; D011347:Procollagen / Q000097:blood; D011446:Prospective Studies; D014463:Ultrasonography
D000894:Anti-Inflammatory Agents, Non-Steroidal; D010446:Peptide Fragments; D011347:Procollagen; C041876:procollagen Type III-N-terminal peptide