Differential impact of age, sex, and hypertension on aortic atherosclerosis: the Framingham Heart Study.
OBJECTIVE
The purpose of this study was to investigate the impact of age, sex, and hypertension (HTN) on aortic atherosclerotic burden using cardiovascular MRI (CMR) in a free-living longitudinally followed cohort.


RESULTS
1763 participants (829 M and 934 F; 38 to 88 years of age) of the Framingham Heart Study Offspring cohort underwent CMR of the thoracoabdominal aorta using an ECG-gated 2D T2-weighted black-blood sequence. Of these, 1726 subjects (96%) with interpretable CMR were characterized by sex, age-quartile, and presence or absence of HTN and clinical cardiovascular disease (CVD). Aortic plaque prevalence and volume increased with increasing age in both sexes. For the nonhypertensive (no-HTN) group, plaque was identified in 702 (46%) with greater prevalence in women than in men (P<0.006). HTN was associated with greater aortic plaque burden (P<0.02). The 200 subjects with clinical CVD had greater plaque burden than subjects without CVD (P<0.0001).


CONCLUSIONS
In this free-living longitudinally followed cohort, subclinical aortic atherosclerosis was seen in nearly half of subjects and increased with advancing age. HTN was associated with increased aortic plaque burden. Among no-HTN subjects, women had greater plaque burden than men. These data suggest that subclinical atherosclerosis is more common in no-HTN women and emphasize the importance of focusing on preventive measures in both sexes.
Oyama
Noriko
N
Departments of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
Gona
Philimon
P
Salton
Carol J
CJ
Chuang
Michael L
ML
Jhaveri
Rahul R
RR
Blease
Susan J
SJ
Manning
Anya R
AR
Lahiri
Marc
M
Botnar
René M
RM
Levy
Daniel
D
Larson
Martin G
MG
O'Donnell
Christopher J
CJ
Manning
Warren J
WJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000473:pathology*; D001013:Aorta, Thoracic / Q000473:pathology*; D050197:Atherosclerosis / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology; D018810:Magnetic Resonance Angiography; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D012737:Sex Factors