title: Determinants of arterial stiffness progression in a Han-Chinese population in Taiwan: a 4-year longitudinal follow-up.
abstract: BACKGROUND
  Arterial stiffness predicts the future risk of macro- and micro-vascular diseases. Only a few studies have reported longitudinal changes. The present study aimed to investigate the progression rate of arterial stiffness and the factors influencing stiffness progression in a Han Chinese population residing in Taiwan.
  
  
  METHODS
  The pulse wave velocity (PWV), elasticity modulus (Ep) and arterial stiffness index (β) of the common carotid artery were measured in 577 stroke- and myocardial infarction-free subjects at baseline and after an average interval of 4.2 ± 0.8 years. Stepwise multivariate linear regression was conducted to elucidate the predictors of stiffness progression.
  
  
  RESULTS
  For both baseline and follow-up data, men had significantly higher values of PWV, Ep and β in comparison to women. The progression rates of PWV, Ep and β were faster in men, but the difference was not statistically significant (ΔPWV = 0.20 ± 0.20 and 0.18 ± 0.20 m/s/yr; ΔEp = 8.17 ± 8.65 and 6.98 ± 8.26 kPa/yr; Δβ = 0.70 ± 0.64 and 0.67 ± 0.56 for men and women, respectively). In the multivariate regression analyses, age, baseline stiffness parameters, baseline mean arterial pressure (MAP), baseline body mass index (BMI) and changes in MAP (ΔMAP) were independent predictors of PWV and Ep progression. There was an inverse correlation between the stiffness parameters at baseline and their progression rate (correlation coefficient (r) = -0.12 to -0.33, p = 0.032-1.6 × 10(-16)). Changes in MAP (ΔMAP) rather than baseline MAP were more strongly associated with PWV progression (p = 8.5 × 10(-24) and 1.9 × 10(-5) for ΔMAP and baseline MAP, respectively). Sex-specific analyses disclosed that baseline BMI and changes in BMI (ΔBMI) were significantly associated with stiffness progression in men (p = 0.010-0.026), but not in women.
  
  
  CONCLUSIONS
  Aging and elevated blood pressure at baseline and during follow-up were the major determinants of stiffness progression in the Han Chinese population. For men, increased baseline BMI and changes in BMI were additional risk factors.
authors.affiliation: Department of Neurology, Neurological Institute, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 407, Taiwan, ROC. maymei_mei@hotmail.com.
authors.forename: Lien-Ying
authors.initials: LY
authors.lastname: Lin
authors.affiliation: Department of Neurology, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Beitou District, Taipei, 112, Taiwan, ROC. yichu.liao@gmail.com.|Department of Neurology, School of Medicine, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan, ROC. yichu.liao@gmail.com.
authors.forename: Yi-Chu
authors.initials: YC
authors.lastname: Liao
authors.affiliation: Department of Neurology, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Road Kaohsiung, Kaohsiung, 807, Taiwan, ROC. sflin@kmu.edu.tw.|Department of Neurology, College of Medicine, Kaohsiung Medical University, No.100, Shih-Chuan 1st Road, Kaohsiung, 807, Taiwan, ROC. sflin@kmu.edu.tw.
authors.forename: Hsiu-Fen
authors.initials: HF
authors.lastname: Lin
authors.affiliation: Department of Neurology, Neurological Institute, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 407, Taiwan, ROC. yslee@vghtc.gov.tw.
authors.forename: Yu-Shan
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Department of Neurology, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Road Kaohsiung, Kaohsiung, 807, Taiwan, ROC. tay@kmu.edu.tw.|Department of Neurology, College of Medicine, Kaohsiung Medical University, No.100, Shih-Chuan 1st Road, Kaohsiung, 807, Taiwan, ROC. tay@kmu.edu.tw.
authors.forename: Reuy-Tay
authors.initials: RT
authors.lastname: Lin
authors.affiliation: Institute of Clinical Medicine, China Medical University, No.91, Hsueh-Shih Road, Taichung, 404, Taiwan, ROC. hsucy63141@gmail.com.|Department of Neurology, China Medical University Hospital, 2 Yude Road, Taichung, 404, Taiwan, ROC. hsucy63141@gmail.com.
authors.forename: Chung Y
authors.initials: CY
authors.lastname: Hsu
authors.affiliation: Department of Medical Research, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Road Kaohsiung, Kaohsiung, 807, Taiwan, ROC. hjuo@kmu.edu.tw.|Department of Medical Genetics, College of Medicine, Kaohsiung Medical University, No.100, Shih-Chuan 1st Road, Kaohsiung, 807, Taiwan, ROC. hjuo@kmu.edu.tw.
authors.forename: Suh-Hang H
authors.initials: SH
authors.lastname: Juo
mesh_terms: D000367:Age Factors; D000368:Aged; D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D012307:Risk Factors; D012737:Sex Factors; D013624:Taiwan; D014463:Ultrasonography; D059289:Vascular Stiffness