Subclinical Vascular Damage In Elders What Is Matters?

Objective: Age is one the strongest risk factors of target-organs damage and vascular aging. It is unclear which factors take leading position in determination of vascular changes during advanced age period. The aim of our study was to estimate prevalence and risk factors of subclinical vascular damage in old people survived starvation during early life (siege of Leningrad during Second World War 1941-1944). Design and method: 250 survivors of the siege of Leningrad (70 males, 182 males) aged 64-86 (the mean age 74.4 ± 2.6 years) were examined. All participants were interviewed by special questionnaire regarding risk factors, previous medical history and antihypertensive therapy. Blood pressure (BP) and anthropometry were performed according to standard guidelines. Fasting serum lipids and plasma glucose were measured on (Abbott Architect 8000). Cardio-ankle vascular index (CAVI), and ankle brachial index (ABI) were measured by VaSera VS-1500 (Fukuda, Japan). Carotid-femoral pulse wave velocity (cfPWV) was assessed by SphygmoCor (AtCor, Australia). The subclinical organ damage was detected, if cfPWV>10m/s, CAVI ≥ 9,0, for ABI ≤ 0,9. Statistical analysis was performed using SPSS Statistics 20. Results: Age didn’t have significant correlation with any of subclinical vascular markers. CAVI increasing was significantly associated only with gender (OR 0,29 [0,13;0,68], p = 0,004). Increasing of cfPWV was associated with presence of hypertension (OR 5,0 [2,2;11,4], p < 0,0001) and hypertriglyceridemia (OR 2,3 [1,1;4,7], p = 0,03). Decreasing of ABI was strongly associated with smoking (OR 5,1 [1,5;17,6], p = 0,009) and absence of overweight (OR 2,5 [1,1;6,1], p = 0,03). Conclusions: In elders female gender still have protective role concerning arterial stiffness assessed by volume pletismographia besides hypercholesterolemia. This finding might be associated with higher level of HDL despite of absence of direct associations. Arterial stiffness assessed by applanation tonometry keeps significant blood pressure dependence and can be affected by hypertriglyceridemia. Smoking was confirmed in position of one the most important risk factor for subclinical atherosclerosis.