We have demonstrated previously that age-related changes in aortic pulse wave velocity (PWV) are more prominent in individuals over the age of 50 years, suggesting that aortic PWV might provide a sensitive marker of risk in older subjects. Therefore, the aim of this investigation was to assess the impact of cardiovascular disease and risk factors on age-related changes in aortic PWV.

Data from 4219 participants in the ACCT Study^† cohort were analysed (aged 18–92 years). In all subjects, seated and supine brachial BP was measured following at least 10 minutes of rest. Central (aortic) BP was derived by pulse wave analysis, and aortic (carotid-femoral) and brachial PWV were recorded (SphygmoCor). Subjects were then divided into groups based on the presence of cardiovascular disease (n=445) or risk factors: diabetes (n=311), hypertension (n=952), hypercholesterolaemia (n=196) and smoking (n=318), leaving 1997 control subjects, all of whom were free of cardiovascular risk factors and medication. Peripheral and central blood pressure and aortic PWV all increased significantly with age (P<0.001). However, compared with healthy controls, there was a steeper age-related rise in aortic PWV after the age of 50 years in subjects with cardiovascular disease or risk factors (P<0.001, Figure), even after adjusting for differences in mean pressure. In multivariate analyses, hypertension, diabetes, smoking and the presence of cardiovascular disease were independently associated with aortic PWV (R²=0.65, P<0.001). In conclusion, aortic PWV appears to be a sensitive marker of cardiovascular risk in individuals aged over 50 years.