title: Longitudinal effects of a decade of aging on carotid artery stiffness: the multiethnic study of atherosclerosis.
abstract: OBJECTIVE
  Arterial stiffening is associated with hypertension, stroke, and cognitive decline; however, the effects of aging and cardiovascular disease risk factors on carotid artery stiffening have not been assessed prospectively in a large multiethnic longitudinal study.
  
  
  METHODS
  Distensibility coefficient and the Young's elastic modulus (YEM) of the right common carotid artery were calculated at baseline and after a mean of 9.4 (standard deviation [SD], 0.5) years in 2650 participants. Effects of age and cardiovascular disease risk factors were evaluated by multivariable mixed regression and ANCOVA models.
  
  
  RESULTS
  At baseline, participants were 59.9 (SD, 9.4) years old (53% women; 25% black, 22% Hispanic, 14% Chinese). YEM increased from 1581 (SD, 927) to 1749 (SD, 1306) mm Hg (P<0.0001), and distensibility coefficient decreased from 3.1 (SD, 1.3) to 2.7 (SD, 1.1)×10(-3) mm Hg(-1) (P<0.001), indicating progressive arterial stiffening. YEM increased more among participants who were aged>75 years old at baseline (P<0.0001). In multivariable analyses, older age and less education independently predicted worsening YEM and distensibility coefficient. Stopping antihypertensive medication during the study period predicted more severe worsening of YEM (β=360.2 mm Hg; P=0.008). Starting antihypertensive medication after examination 1 was predictive of improvements in distensibility coefficient (β=1.1×10(-4) mm Hg(-1); P=0.024).
  
  
  CONCLUSIONS
  Arterial stiffening accelerates with advanced age. Older individuals experience greater increases in YEM than do younger adults, even after considering the effects of traditional risk factors. Treating hypertension may slow the progressive decline in carotid artery distensibility observed with aging and improve cerebrovascular health.
authors.affiliation: From the Department of Medicine, Cardiovascular Medicine Division (A.D.G., C.E.K., M.C.T., J.H.S.), and Department of Medicine, Nephrology Division (B.C.A.), University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (L.A.C., K.L.); and Department of Epidemiology, University of Washington School of Public Health, Seattle, WA (E.K.H., J.D.K.).
authors.forename: Adam D
authors.initials: AD
authors.lastname: Gepner
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Korcarz
authors.forename: Laura A
authors.initials: LA
authors.lastname: Colangelo
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Hom
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Tattersall
authors.forename: Brad C
authors.initials: BC
authors.lastname: Astor
authors.forename: Joel D
authors.initials: JD
authors.lastname: Kaufman
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.forename: James H
authors.initials: JH
authors.lastname: Stein
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D000886:Anthropometry; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D003920:Diabetes Mellitus / Q000503:physiopathology; D055119:Elastic Modulus; D004548:Elasticity; D005006:Ethnicity; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D014463:Ultrasonography; D059289:Vascular Stiffness / Q000502:physiology*
chemical_list: D008055:Lipids
keywords: aging; carotid arteries; elasticity; hypertension