title: Determinants of arterial stiffness in female patients with Takayasu arteritis.
abstract: OBJECTIVE
  The assessment of pulse wave velocity (PWV) in Takayasu arteritis (TA) is complex because of many confounding factors. We evaluated PWV in female patients with TA and controls with comparable anthropometric and clinical variables and assessed a possible association of TA with disease variables.
  
  
  METHODS
  We evaluated 27 patients with TA consecutively. Exclusion criteria were menopause, smoking, diabetes, renal insufficiency, poorly controlled hypertension, cardiac arrhythmias, obesity, inflammatory comorbidities, pregnancy, and surgical procedures involving the aorta. Disease activity was determined by clinical and laboratory variables. As healthy controls, 27 subjects with comparable age, blood pressure, height, and weight were selected. Carotid-femoral PWV measurements were obtained using the Complior system.
  
  
  RESULTS
  The mean PWV in patients with TA was higher than in healthy controls (9.77 ± 3.49 vs 7.83 ± 1.06 m/s; p = 0.009). Despite our strict selection criteria, patients with TA had an average systolic blood pressure (SBP) 8 mmHg higher than controls (p = NS), and significantly higher pulse pressure values. The multivariate linear regression model shows that 93.8% of the PWV variability is explained by the variables age, mean BP, and the disease itself (adjusted R(2) = 0.938). Stepwise logistic analysis using the PWV cutoff value established by the receiver-operator characteristic curve (> 8.34 m/s) as dependent variable, and measures with significance in univariate analysis as independent variables revealed that TA (OR 4.69; 95% CI 1.31-16.72; p = 0.017) and mean BP (OR 1.06; 95% CI 1.00-1.12; p = 0.048) were independently associated with higher PWV. Further analysis of disease variables revealed that PWV values were not correlated with erythrocyte sedimentation rate, C-reactive protein, cumulative dose of glucocorticoid, or ejection fraction (p > 0.05).
  
  
  CONCLUSIONS
  In our cohort of female patients with TA, the disease itself and mean BP were the strongest determinants associated with arterial stiffness.
authors.affiliation: From the Division of Rheumatology and the Hypertension Unit, the Heart Institute, Faculdade de Medicina da Universidade de São Paulo; and Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.N.S. Rosa Neto, MD, PhD; M. Levy-Neto, MD, PhD, Division of Rheumatology; E.C. Tolezani, MD, PhD, Hypertension Unit, the Heart Institute; E. Bonfá, MD, PhD, Division of Rheumatology; L.A. Bortolotto, MD, PhD, Hypertension Unit, the Heart Institute; R.M.R. Pereira, MD, PhD, Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo.
authors.forename: Nilton
authors.initials: N
authors.lastname: Salles Rosa Neto
authors.affiliation: From the Division of Rheumatology and the Hypertension Unit, the Heart Institute, Faculdade de Medicina da Universidade de São Paulo; and Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.N.S. Rosa Neto, MD, PhD; M. Levy-Neto, MD, PhD, Division of Rheumatology; E.C. Tolezani, MD, PhD, Hypertension Unit, the Heart Institute; E. Bonfá, MD, PhD, Division of Rheumatology; L.A. Bortolotto, MD, PhD, Hypertension Unit, the Heart Institute; R.M.R. Pereira, MD, PhD, Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo.
authors.forename: Maurício
authors.initials: M
authors.lastname: Levy-Neto
authors.affiliation: From the Division of Rheumatology and the Hypertension Unit, the Heart Institute, Faculdade de Medicina da Universidade de São Paulo; and Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.N.S. Rosa Neto, MD, PhD; M. Levy-Neto, MD, PhD, Division of Rheumatology; E.C. Tolezani, MD, PhD, Hypertension Unit, the Heart Institute; E. Bonfá, MD, PhD, Division of Rheumatology; L.A. Bortolotto, MD, PhD, Hypertension Unit, the Heart Institute; R.M.R. Pereira, MD, PhD, Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo.
authors.forename: Elaine Cristina
authors.initials: EC
authors.lastname: Tolezani
authors.affiliation: From the Division of Rheumatology and the Hypertension Unit, the Heart Institute, Faculdade de Medicina da Universidade de São Paulo; and Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.N.S. Rosa Neto, MD, PhD; M. Levy-Neto, MD, PhD, Division of Rheumatology; E.C. Tolezani, MD, PhD, Hypertension Unit, the Heart Institute; E. Bonfá, MD, PhD, Division of Rheumatology; L.A. Bortolotto, MD, PhD, Hypertension Unit, the Heart Institute; R.M.R. Pereira, MD, PhD, Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo.
authors.forename: Eloísa
authors.initials: E
authors.lastname: Bonfá
authors.affiliation: From the Division of Rheumatology and the Hypertension Unit, the Heart Institute, Faculdade de Medicina da Universidade de São Paulo; and Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.N.S. Rosa Neto, MD, PhD; M. Levy-Neto, MD, PhD, Division of Rheumatology; E.C. Tolezani, MD, PhD, Hypertension Unit, the Heart Institute; E. Bonfá, MD, PhD, Division of Rheumatology; L.A. Bortolotto, MD, PhD, Hypertension Unit, the Heart Institute; R.M.R. Pereira, MD, PhD, Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo.
authors.forename: Luiz Aparecido
authors.initials: LA
authors.lastname: Bortolotto
authors.affiliation: From the Division of Rheumatology and the Hypertension Unit, the Heart Institute, Faculdade de Medicina da Universidade de São Paulo; and Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.N.S. Rosa Neto, MD, PhD; M. Levy-Neto, MD, PhD, Division of Rheumatology; E.C. Tolezani, MD, PhD, Hypertension Unit, the Heart Institute; E. Bonfá, MD, PhD, Division of Rheumatology; L.A. Bortolotto, MD, PhD, Hypertension Unit, the Heart Institute; R.M.R. Pereira, MD, PhD, Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo. rosamariarp@yahoo.com.
authors.forename: Rosa Maria Rodrigues
authors.initials: RM
authors.lastname: Pereira
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D006801:Humans; D063177:Pulse Wave Analysis; D013625:Takayasu Arteritis / Q000503:physiopathology*; D059289:Vascular Stiffness / Q000502:physiology*; D055815:Young Adult
keywords: ARTERIAL STIFFNESS; ATHEROSCLEROSIS; HYPERTENSION; PULSE WAVE VELOCITY; TAKAYASU ARTERITIS