title: Arterial stiffness, physical function, and functional limitation: the Whitehall II Study.
abstract: Arterial stiffness has been proposed as an indicator of vascular aging. We aimed to examine this concept by analyzing associations of arterial stiffness with age, subjective and objective measures of physical functioning, and self-reported functional limitation. We measured aortic pulse wave velocity by applanation tonometry among 5392 men and women aged 55 to 78 years. Arterial stiffness was strongly associated with age (mean difference [SE] per decade: men, 1.37 m/s [0.06 m/s]; women: 1.39 m/s [0.10 m/s]). This association was robust to individual and combined adjustment for pulse pressure, mean arterial pressure, antihypertensive treatment, and chronic disease. Participants took an 8.00-ft (2.44-m) walking speed test, a spirometry lung function test, and completed health functioning and (instrumental) activities of daily living questionnaires. Associations of stiffness and blood pressure with physical function scores scaled to SD of 10 were compared. One-SD higher stiffness was associated with lower walking speed (coefficient [95% CI]: -0.96 [-1.29 to -0.64] m/s) and physical component summary score (-0.91 [-1.21 to -0.60]) and poorer lung function (-1.23 [-1.53 to -0.92] L) adjusted for age, sex, and ethnic group. Pulse pressure and mean arterial pressure were linked inversely only with lung function. Associations of stiffness with functional limitation were robust to multiple adjustment, including pulse pressure and chronic disease. In conclusion, the concept of vascular aging is reinforced by the observation that arterial stiffness is a robust correlate of physical functioning and functional limitation in early old age. The nature of the link between arterial stiffness and quality of life in older people merits attention.
authors: Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK. e.brunner@ucl.ac.uk
authors: Eric J
authors: EJ
authors: Brunner
authors: Martin J
authors: MJ
authors: Shipley
authors: Daniel R
authors: DR
authors: Witte
authors: Archana
authors: A
authors: Singh-Manoux
authors: Annie R
authors: AR
authors: Britton
authors: Adam G
authors: AG
authors: Tabak
authors: Carmel M
authors: CM
authors: McEniery
authors: Ian B
authors: IB
authors: Wilkinson
authors: Mika
authors: M
authors: Kivimaki
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000502:physiology*; D001011:Aorta / Q000503:physiopathology*; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D011673:Pulsatile Flow / Q000502:physiology; D011795:Surveys and Questionnaires; D014655:Vascular Resistance / Q000502:physiology