Increased Aortic Calcification Is Associated With Arterial Stiffness Progression in Multiethnic Middle-Aged Men.
Arterial stiffness is established as an independent predictor of cardiovascular morbidity and mortality. The objective was to prospectively evaluate association of aortic calcification burden with progression of arterial stiffness in population-based samples of healthy middle-aged men from ERA JUMP cohort (Electron-Beam Computed Tomography and Risk Factor Assessment in Japanese and US Men in the Post-World War II Birth Cohort). Men (n=635) aged 40 to 49 years (207 white American, 45 black American, 142 Japanese American, and 241 Japanese in Japan) were examined at baseline and 4 to 7 years later. Aortic calcification was evaluated from level of aortic arch to iliac bifurcation. Arterial stiffness progression was measured as annual change in brachial-ankle pulse wave velocity. Multivariable-adjusted general linear models were applied to investigate associations of longitudinal change in aortic calcification with arterial stiffness progression in participants overall, as well as in subgroups without or with prevalent aortic calcification at baseline. Annual change in aortic calcification was positively and significantly associated with arterial stiffness progression. In participants with annual changes in aortic calcium score of ≤0, 1 to 10, 11 to 100, and >100, the adjusted means (SD) for the annual change in brachial-ankle pulse wave velocity were 3.8 (2.2), 7.2 (2.2), 12.2 (1.8), and 15.6 (2.6) cm/s, respectively (P for trend <0.01) adjusted for baseline aortic calcification, arterial stiffness, and standard cardiovascular risk factors. Arterial stiffness was associated with the incidence of aortic calcification over the follow-up period among participants without aortic calcification (n=297) and with an increase in aortic calcification among participants with prevalent aortic calcification at baseline (n=388). Our findings suggest aortic calcification may be causally linked to arterial stiffness.
From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.).
Jingchuan
J
Guo
From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.).
Akira
A
Fujiyoshi
From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.).
Bradley
B
Willcox
From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.).
Jina
J
Choo
From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.).
Abhishek
A
Vishnu
From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.).
Takashi
T
Hisamatsu
From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.).
Vasudha
V
Ahuja
From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.).
Naoyuki
N
Takashima
From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.).
Emma
E
Barinas-Mitchell
From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.).
Aya
A
Kadota
From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.).
Rhobert W
RW
Evans
From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.).
Katsuyuki
K
Miura
From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.).
Daniel
D
Edmundowicz
From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.).
Kamal
K
Masaki
From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.).
Chol
C
Shin
From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.).
Lewis H
LH
Kuller
From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.).
Hirotsugu
H
Ueshima
From the Department of Epidemiology, University of Pittsburgh, PA (J.G., A.V., V.A., E.B.-M., R.W.E., L.H.K., A.S.); Department of Public Health (A.F., N.T., A.K., K.M.) and Center for Epidemiologic Research in Asia (A.K., K.M., H.U.), Shiga University of Medical Science, Japan; Department of Research, Kuakini Medical Center, Honolulu, HI (B.W.); Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI (B.W., K.M.); College of Nursing, Korea University, Seoul, South Korea (J.C.); Department of Environmental Medicine and Public Health, Shimane University, Japan (T.H.); Department of Cardiology, Temple University Hospital, Philadelphia, PA (D.E.); Department of Geriatric Medicine, Kuakini Medical Center, Honolulu, Hawaii (K.M.); and Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea (C.S.). akira@pitt.edu.
Akira
A
Sekikawa
D000328:Adult; D055109:Ankle Brachial Index; D001018:Aortic Diseases / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D018450:Disease Progression; D005006:Ethnicity; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D061330:Multidetector Computed Tomography; D011153:Population; D011446:Prospective Studies; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D061205:Vascular Calcification / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D059289:Vascular Stiffness / Q000502:physiology*
aortic calcification; arterial stiffness; multiethnic; prospective cohort study; pulse wave velocity