Aortic calcification is associated with aortic stiffness and isolated systolic hypertension in healthy individuals

Carmel M. McEniery*, Barry J. McDonnell, Alvin So, Sri Aitken, Charlotte E. Bolton, Margaret Munnery, Stacey S. Hickson, Yasmin, Kaisa M. Maki-Petaja, John R. Cockcroft, Adrian K. Dixon, Ian B. Wilkinson

*Corresponding author for this work

    Research output: Contribution to journalArticle

    140 Citations (Scopus)

    Abstract

    Arterial stiffening is an independent predictor of mortality and underlies the development of isolated systolic hypertension (ISH). A number of factors regulate stiffness, but arterial calcification is also likely to be important. We tested the hypotheses that aortic calcification is associated with aortic stiffness in healthy individuals and that patients with ISH exhibit exaggerated aortic calcification compared with controls. A total of 193 healthy, medication-free subjects (mean age±SD: 66±8 years) were recruited from the community, together with 15 patients with resistant ISH. Aortic pulse wave velocity (PWV) was measured noninvasively, and aortic calcium content was quantified from high-resolution, thoraco-lumbar computed tomography images using a volume scoring method. In healthy volunteers, calcification was positively and significantly associated with aortic PWV (r=0.6; P<0.0001) but was not related to augmentation index or brachial PWV. Calcification was significantly higher in treatment-resistant and healthy subjects with ISH compared with controls (mean [interquartile range]: 1.92 [1.14 to 3.66], 0.84 [0.35 to 1.75], and 0.19 [0.1 to 0.78] cm3, respectively; P<0.0001 for both). In a multiple regression model, aortic calcium was independently associated with aortic PWV along with age, mean arterial pressure, heart rate, and estimated glomerular filtration rate (R2=0.51; P<0.0001). Only age, calcium phosphate product, and aortic PWV were independently associated with calcification. These data suggest that calcification may be important in the process of aortic stiffening and the development of ISH. Calcification may underlie treatment resistance in ISH, and anticalcification strategies may present a novel therapy.

    Original languageEnglish
    Pages (from-to)524-531
    Number of pages8
    JournalHypertension
    Volume53
    Issue number3
    DOIs
    Publication statusPublished - Mar 2009

    Keywords

    • Aorta
    • Artery
    • Calcium
    • Hypertension
    • Stiffness

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    McEniery, C. M., McDonnell, B. J., So, A., Aitken, S., Bolton, C. E., Munnery, M., ... Wilkinson, I. B. (2009). Aortic calcification is associated with aortic stiffness and isolated systolic hypertension in healthy individuals. Hypertension, 53(3), 524-531. https://doi.org/10.1161/HYPERTENSIONAHA.108.126615