Ethnic Difference in Proximal Aortic Stiffness: An Observation From the Dallas Heart Study

Akshay Goel, Christopher D. Maroules, Gary F. Mitchell, Ronald M Peshock, Colby Ayers, Roderick W McColl, Wanpen Vongpatanasin, Kevin S. King

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Abstract

Objectives This study aims to compare ethnic difference in proximal aortic pulse wave velocity (PWV) and characteristic impedance (Zc). Background Increased aortic stiffness is an independent predictor of target organ damage, incident hypertension, and all-cause mortality. However, previous studies have not directly assessed proximal aortic function in Blacks, the ethnic population with disproportionately high risk for incident hypertension and target organ complications. Methods We evaluated the multiethnic, population-based DHS (Dallas Heart Study) participants (N = 2,544, 54.2% women, 49.7% Black) who underwent cardiac magnetic resonance at 1.5-T. Aortic stiffness and Zc were determined from aortic arch PWV and lumen area measurements. Linear regression was used to evaluate ethnic differences in proximal aortic wall stiffness using aortic arch PWV and Zc as dependent variables with and without adjustment for traditional cardiovascular risk factors. Because cardiac output was significantly higher in Blacks compared to Whites and Hispanics, additional comparisons of PWV and Zc were performed after adjustment for cardiac output and peripheral vascular resistance. Results Compared with Whites, both Blacks and Hispanics had higher levels of aortic arch PWV (4.25, 95% confidence interval [CI]: 4.15 to 4.35 m/s, vs. 4.72, 95% CI: 4.64 to 4.81 m/s, vs. 4.48, 95% CI: 4.33 to 4.63 m/s, respectively, both p < 0.05 vs. White), and Zc (64.9, 95% CI: 63.3 to 66.6 dyne·s/cm5, vs. 75.6, 95% CI: 74.0 to 77.2 dyne·s/cm5, vs. 70.1, 95% CI: 67.6 to 72.8 dyne·s/cm5, respectively, both p < 0.01 vs. White) after adjustment for age, age squared, sex, body mass index, height, mean arterial blood pressure, antihypertensive treatment, heart rate, total cholesterol, diabetes mellitus, and smoking. Compared with Hispanics, Blacks also had higher level of both PWV and Zc (both p < 0.01). Ethnic differences in PWV and Zc persisted after adjustment for cardiac output and peripheral vascular resistance. Conclusions In a multiethnic population-based-sample, Blacks and Hispanics had higher proximal aortic stiffness compared with Whites independent of blood pressure and relevant risk factors.

Original languageEnglish (US)
Pages (from-to)54-61
Number of pages8
JournalJACC: Cardiovascular Imaging
Volume10
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Pulse Wave Analysis
Vascular Stiffness
Observation
Confidence Intervals
Hispanic Americans
Vascular Resistance
Cardiac Output
Thoracic Aorta
Arterial Pressure
Population
Hypertension
Electric Impedance
Antihypertensive Agents
Linear Models
Diabetes Mellitus
Body Mass Index
Magnetic Resonance Spectroscopy
Heart Rate
Smoking
Cholesterol

Keywords

  • African Americans
  • aorta
  • arterial stiffness
  • Hispanics
  • impedance
  • magnetic resonance imaging
  • multiethnic

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Ethnic Difference in Proximal Aortic Stiffness : An Observation From the Dallas Heart Study. / Goel, Akshay; Maroules, Christopher D.; Mitchell, Gary F.; Peshock, Ronald M; Ayers, Colby; McColl, Roderick W; Vongpatanasin, Wanpen; King, Kevin S.

In: JACC: Cardiovascular Imaging, Vol. 10, No. 1, 01.01.2017, p. 54-61.

Research output: Contribution to journalArticle

Goel, Akshay ; Maroules, Christopher D. ; Mitchell, Gary F. ; Peshock, Ronald M ; Ayers, Colby ; McColl, Roderick W ; Vongpatanasin, Wanpen ; King, Kevin S. / Ethnic Difference in Proximal Aortic Stiffness : An Observation From the Dallas Heart Study. In: JACC: Cardiovascular Imaging. 2017 ; Vol. 10, No. 1. pp. 54-61.
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abstract = "Objectives This study aims to compare ethnic difference in proximal aortic pulse wave velocity (PWV) and characteristic impedance (Zc). Background Increased aortic stiffness is an independent predictor of target organ damage, incident hypertension, and all-cause mortality. However, previous studies have not directly assessed proximal aortic function in Blacks, the ethnic population with disproportionately high risk for incident hypertension and target organ complications. Methods We evaluated the multiethnic, population-based DHS (Dallas Heart Study) participants (N = 2,544, 54.2{\%} women, 49.7{\%} Black) who underwent cardiac magnetic resonance at 1.5-T. Aortic stiffness and Zc were determined from aortic arch PWV and lumen area measurements. Linear regression was used to evaluate ethnic differences in proximal aortic wall stiffness using aortic arch PWV and Zc as dependent variables with and without adjustment for traditional cardiovascular risk factors. Because cardiac output was significantly higher in Blacks compared to Whites and Hispanics, additional comparisons of PWV and Zc were performed after adjustment for cardiac output and peripheral vascular resistance. Results Compared with Whites, both Blacks and Hispanics had higher levels of aortic arch PWV (4.25, 95{\%} confidence interval [CI]: 4.15 to 4.35 m/s, vs. 4.72, 95{\%} CI: 4.64 to 4.81 m/s, vs. 4.48, 95{\%} CI: 4.33 to 4.63 m/s, respectively, both p < 0.05 vs. White), and Zc (64.9, 95{\%} CI: 63.3 to 66.6 dyne·s/cm5, vs. 75.6, 95{\%} CI: 74.0 to 77.2 dyne·s/cm5, vs. 70.1, 95{\%} CI: 67.6 to 72.8 dyne·s/cm5, respectively, both p < 0.01 vs. White) after adjustment for age, age squared, sex, body mass index, height, mean arterial blood pressure, antihypertensive treatment, heart rate, total cholesterol, diabetes mellitus, and smoking. Compared with Hispanics, Blacks also had higher level of both PWV and Zc (both p < 0.01). Ethnic differences in PWV and Zc persisted after adjustment for cardiac output and peripheral vascular resistance. Conclusions In a multiethnic population-based-sample, Blacks and Hispanics had higher proximal aortic stiffness compared with Whites independent of blood pressure and relevant risk factors.",
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T2 - An Observation From the Dallas Heart Study

AU - Goel, Akshay

AU - Maroules, Christopher D.

AU - Mitchell, Gary F.

AU - Peshock, Ronald M

AU - Ayers, Colby

AU - McColl, Roderick W

AU - Vongpatanasin, Wanpen

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N2 - Objectives This study aims to compare ethnic difference in proximal aortic pulse wave velocity (PWV) and characteristic impedance (Zc). Background Increased aortic stiffness is an independent predictor of target organ damage, incident hypertension, and all-cause mortality. However, previous studies have not directly assessed proximal aortic function in Blacks, the ethnic population with disproportionately high risk for incident hypertension and target organ complications. Methods We evaluated the multiethnic, population-based DHS (Dallas Heart Study) participants (N = 2,544, 54.2% women, 49.7% Black) who underwent cardiac magnetic resonance at 1.5-T. Aortic stiffness and Zc were determined from aortic arch PWV and lumen area measurements. Linear regression was used to evaluate ethnic differences in proximal aortic wall stiffness using aortic arch PWV and Zc as dependent variables with and without adjustment for traditional cardiovascular risk factors. Because cardiac output was significantly higher in Blacks compared to Whites and Hispanics, additional comparisons of PWV and Zc were performed after adjustment for cardiac output and peripheral vascular resistance. Results Compared with Whites, both Blacks and Hispanics had higher levels of aortic arch PWV (4.25, 95% confidence interval [CI]: 4.15 to 4.35 m/s, vs. 4.72, 95% CI: 4.64 to 4.81 m/s, vs. 4.48, 95% CI: 4.33 to 4.63 m/s, respectively, both p < 0.05 vs. White), and Zc (64.9, 95% CI: 63.3 to 66.6 dyne·s/cm5, vs. 75.6, 95% CI: 74.0 to 77.2 dyne·s/cm5, vs. 70.1, 95% CI: 67.6 to 72.8 dyne·s/cm5, respectively, both p < 0.01 vs. White) after adjustment for age, age squared, sex, body mass index, height, mean arterial blood pressure, antihypertensive treatment, heart rate, total cholesterol, diabetes mellitus, and smoking. Compared with Hispanics, Blacks also had higher level of both PWV and Zc (both p < 0.01). Ethnic differences in PWV and Zc persisted after adjustment for cardiac output and peripheral vascular resistance. Conclusions In a multiethnic population-based-sample, Blacks and Hispanics had higher proximal aortic stiffness compared with Whites independent of blood pressure and relevant risk factors.

AB - Objectives This study aims to compare ethnic difference in proximal aortic pulse wave velocity (PWV) and characteristic impedance (Zc). Background Increased aortic stiffness is an independent predictor of target organ damage, incident hypertension, and all-cause mortality. However, previous studies have not directly assessed proximal aortic function in Blacks, the ethnic population with disproportionately high risk for incident hypertension and target organ complications. Methods We evaluated the multiethnic, population-based DHS (Dallas Heart Study) participants (N = 2,544, 54.2% women, 49.7% Black) who underwent cardiac magnetic resonance at 1.5-T. Aortic stiffness and Zc were determined from aortic arch PWV and lumen area measurements. Linear regression was used to evaluate ethnic differences in proximal aortic wall stiffness using aortic arch PWV and Zc as dependent variables with and without adjustment for traditional cardiovascular risk factors. Because cardiac output was significantly higher in Blacks compared to Whites and Hispanics, additional comparisons of PWV and Zc were performed after adjustment for cardiac output and peripheral vascular resistance. Results Compared with Whites, both Blacks and Hispanics had higher levels of aortic arch PWV (4.25, 95% confidence interval [CI]: 4.15 to 4.35 m/s, vs. 4.72, 95% CI: 4.64 to 4.81 m/s, vs. 4.48, 95% CI: 4.33 to 4.63 m/s, respectively, both p < 0.05 vs. White), and Zc (64.9, 95% CI: 63.3 to 66.6 dyne·s/cm5, vs. 75.6, 95% CI: 74.0 to 77.2 dyne·s/cm5, vs. 70.1, 95% CI: 67.6 to 72.8 dyne·s/cm5, respectively, both p < 0.01 vs. White) after adjustment for age, age squared, sex, body mass index, height, mean arterial blood pressure, antihypertensive treatment, heart rate, total cholesterol, diabetes mellitus, and smoking. Compared with Hispanics, Blacks also had higher level of both PWV and Zc (both p < 0.01). Ethnic differences in PWV and Zc persisted after adjustment for cardiac output and peripheral vascular resistance. Conclusions In a multiethnic population-based-sample, Blacks and Hispanics had higher proximal aortic stiffness compared with Whites independent of blood pressure and relevant risk factors.

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