title: Arterial stiffness is increased in systemic sclerosis: a cross-sectional comparison with matched controls.
abstract: OBJECTIVE
  Increased arterial stiffness is a predictor of cardiovascular and all-cause mortality. Atherosclerosis may be increased in systemic sclerosis (SSc). Our aims were to determine if arterial stiffness is elevated and to evaluate correlates of arterial stiffness in SSc.
  
  
  METHODS
  We carried out two studies: 1. a comparison of arterial stiffness in 40 SSc patients free from cardiovascular disease or significant vascular manifestations of SSc and 40 healthy controls (HC), and 2. an analysis of determinants of arterial stiffness in 80 SSc patients free from cardiovascular disease.
  
  
  RESULTS
  In Study 1, the groups were well-matched for age (52.2 vs. 50.0 years, p=0.432) and sex (80% female in both). SSc patients had higher augmentation index (AIx) than HC (31.0% [IQR 25.7-38.7] vs. 23.8% [IQR 13.5- 30.1], p<0.001). Pulse wave velocity (PWV) was also higher, however this did not reach statistical significance (6.9 m/s [IQR 6.0-8.3] vs. 6.5 m/s [IQR 6.1-7.4], p=0.275). In Study 2, age (p<0.001) and calcium channel blocker (CCB) therapy (p=0.016) were independently associated with higher AIx; and age (p<0.001), disease duration (p=0.042) and systolic blood pressure (p=0.001) with higher PWV.
  
  
  CONCLUSIONS
  SSc patients had higher AIx than HC. The paradoxical association between CCB therapy and higher AIx could reflect generalised vasculopathy rather than atherosclerotic disease. Prospective studies in larger cohorts are warranted to clarify this point and elucidate other determinants of arterial stiffness in SSc.
authors.affiliation: Department of Medicine (RMH/WH), The University of Melbourne, Parkville, Australia. gene-siew.ngian@mh.org.au.
authors.forename: G-S
authors.initials: GS
authors.lastname: Ngian
authors.forename: J
authors.initials: J
authors.lastname: Sahhar
authors.forename: I P
authors.initials: IP
authors.lastname: Wicks
authors.forename: S
authors.initials: S
authors.lastname: Van Doornum
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000453:epidemiology / Q000503:physiopathology*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000453:epidemiology / Q000503:physiopathology*; D012907:Smoking / Q000453:epidemiology; D059289:Vascular Stiffness / Q000502:physiology*
chemical_list: D002121:Calcium Channel Blockers