RELATION OF AORTIC STIFFNESS TO FACTORS MODIFYING THE RISK OF ATHEROSCLEROSIS IN HEALTHY PEOPLE

To identify factors predicting aortic stiffness, we studied the modulus of elasticity of the thoracic aorta in relation to sex, obesity, blood pressure, physical activity, smoking, ethanol consumption, salt intake, and serum lipid and insulin levels in 55 healthy people born in 1954. A transverse cine magnetic resonance image of the thoracic aorta was made, and the modulus of elasticity was determined as brachial artery cuff pulse pressure/aortic strain, where strain was determined as the ratio of pulsatile aortic luminal area change to the diastolic luminal area. The average of measurements made in the ascending and descending aorta was used as the elastic modulus of the thoracic aorta. Habitual physical activity, smoking, and alcohol use were quantified by 2-month prospective daily recording and salt intake by 7-day food records. The aortic elastic modulus ranged from 100 to 2091 10(3) dyne/cm(2) (median, 390 10(3) dyne/cm(2)). In multiple regression analyses, log(10) aortic elastic modulus was related directly to mean blood pressure (standardized coefficient [beta]=.37, P=.002), serum high-density lipoprotein cholesterol (beta=.36, P=.012), square root of daily energy expenditure in physical activity (beta=.33, P=.005), and log(10) serum insulin (beta=.27, P=.047) and inversely to serum low-density lipoprotein cholesterol (beta=-.26, P=.035). A relation to salt intake was also observed, but the regression slope was dependent on mean blood pressure (P=.005 for interaction). These data suggest that many modifiable constitutional and lifestyle characteristics may contribute to the stiffness of the thoracic aorta.