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Prevalence, Correlates, and Prognosis of Healthy Vascular Aging in a Western Community-Dwelling Cohort: The Framingham Heart Study
Open accessAbstract
Hypertension and increased vascular stiffness are viewed as inevitable parts of aging. To elucidate whether the age-related decrease in vascular function is avoidable, we assessed the prevalence, correlates, and prognosis of healthy vascular aging (HVA) in 3196 Framingham Study participants aged ≥50 years. We defined HVA as absence of hypertension and pulse wave velocity <7.6 m/s (mean+2 SD of a reference sample aged <30 years). Overall, 566 (17.7%) individuals had HVA, with prevalence decreasing from 30.3% in people aged 50 to 59 to 1% in those aged ≥70 years. In regression models adjusted for physical activity, caloric intake, and traditional cardiovascular disease (CVD) risk factors, we observed that lower age, female sex, lower body mass index, use of lipid-lowering drugs, and absence of diabetes mellitus were cross-sectionally associated with HVA ( P <0.001 for all). A unit increase in a cardiovascular health score (Life’s Simple 7) was associated with 1.55-fold (95% confidence interval, 1.38–1.74) age- and sex-adjusted odds of HVA. During a follow-up of 9.6 years, 391 CVD events occurred. In Cox regression models adjusted for traditional CVD risk factors, including blood pressure, HVA was associated with a hazard ratio of 0.45 (95% confidence interval, 0.26–0.77) for CVD relative to absence of HVA. Although HVA is achievable in individuals acculturated to a Western lifestyle, maintaining normal vascular function beyond 70 years of age is challenging. Although our data are observational, our findings support prevention strategies targeting modifiable factors and behaviors and obesity, in particular, to prevent or delay vascular aging and the associated risk of CVD.
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“This observational study provides support for prevention strategies focused on modifiable health factors and behaviors to prevent or delay vascular aging and risk of cardiovascular disease and possibly other health consequences associated with aging such as cognitive impairment.179”
From Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association (2017) · cites this paper as [179]
In the citing paper
“Furthermore, the development of vascular arterial stiffness, a measure of vascular aging, may not be inevitable.179”
From Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association (2017) · cites this paper as [179]
In the citing paper
“In the Framingham study, lower age, female sex, lower BMI, use of lipid-lowering drugs, and absence of diabetes mellitus in a cross-sectional study were associated with healthy vascular aging.”
From Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association (2017) · cites this paper as [179]
In the citing paper
“In addition, for every 1-unit higher AHA’s Life’s Simple 7 score (ie, 1 more factor or behavior at ideal levels), there was a 1.55-fold age- and sex-adjusted odds of healthy vascular aging.”
From Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association (2017) · cites this paper as [179]
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Arterial Stiffness and Cardiovascular Events: The Framingham Heart Study
Mitchell, G. F., Hwang, S.-J., Vasan, R. S., Larson, M. G., Pencina, M. J., Hamburg, N. M., Vita, J. A., Levy, D., & Benjamin, E. J. (2010) · Circulation · doi:10.1161/circulationaha.109.886655 · Cited by 2,225
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- 10.1001/archinte.1979.03630450011006 · DOI
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Diretrizes Brasileiras de Hipertensão Arterial – 2020
Barroso, W. K. S., Rodrigues, C. I. S., Bortolotto, L. A., Gomes, M. A. M., Brandão, A. A., Feitosa, A. D. M., Machado, C. A., Poli‐de‐Figueiredo, C. E., Amodeo, C., Mion, D., et al. (2021) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20201238 · Cited by 1,389
Arterial Stiffness and Cardiovascular Risk in Hypertension
Boutouyrie, P., Chowienczyk, P., Humphrey, J. D., & Mitchell, G. F. (2021) · Circulation Research · doi:10.1161/circresaha.121.318061 · Cited by 814
Self-citationRossman, M. J., Santos-Parker, J. R., Steward, C. A. C., Bispham, N. Z., Cuevas, L. M., Rosenberg, H. L., Woodward, K. A., Chonchol, M., Gioscia-Ryan, R. A., Murphy, M. P., et al. (2018) · Hypertension · doi:10.1161/hypertensionaha.117.10787 · Cited by 456
Gorelick, P. B., Furie, K. L., Iadecola, C., Smith, E. E., Waddy, S. P., Lloyd-Jones, D. M., Bae, H.-J., Bauman, M. A., Dichgans, M., Duncan, P. W., et al. (2017) · Stroke · doi:10.1161/str.0000000000000148 · Cited by 411
“179 In the Framingham study, lower age, female sex, lower BMI, use of lipid-lowering drugs, and absence of diabetes mellitus in a cross-sectional study were associated with healthy vascular aging.”
Aerobic exercise training and vascular function with ageing in healthy men and women
Seals, D. R., Nagy, E., & Moreau, K. L. (2019) · The Journal of Physiology · doi:10.1113/jp277764 · Cited by 231
“A major target for the prevention of CVD in middle-aged and older adults is vascular ageing (Najjar et al. 2005; Lakatta, 2015; Niiranen et al. 2017; Nowak et al. 2018; Seals et al. 2018; Rossman et al. 2018).”
Background
Metadata
- Authors
- Niiranen, T. J., Lyass, A., Larson, M. G., Hamburg, N. M., Benjamin, E. J., Mitchell, G. F., & Vasan, R. S.
- Affiliations
- Boston University (US)
- ORCID
- Venue
- Hypertension
- Published
- 2017-08
- Volume
- 70
- Issue
- 2
- Pages
- 267-274
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- PMC
- PMC5509504
- OpenAlex
- W2763062395
- Cited by
- 126
- References
- 51
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 14 · 2023: 11 · 2022: 16 · 2021: 15 · 2020: 16 · 2019: 13 · 2018: 21 · 2017: 5
- FWCI
- 11.62
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (n01hc25195-41-0-1)
- National Heart, Lung, and Blood Institute (HHSN268201500001I, HHSN268201500001C, R01HL094898, N01-HC-025195, R01HL107385, R01HL070100, R01HL104184, R01HL126136, R01HL060040)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK082447)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- pulse wave velocity, vascular stiffness, cardiovascular risk, Life's Essential 8, cardiovascular health, body mass index, diabetes mellitus, lipid-lowering drugs, obesity, Framingham Heart Study, community-dwelling older adults, cardiovascular disease prevention
- MeSH terms
- Adult, Age Factors, Aged, Hypolipidemic Agents, Blood Pressure, Cardiovascular Diseases, Female, Humans, Hypertension, Life Style, Male, Middle Aged, Prognosis, Research Design, Risk Factors, Sex Factors, Statistics as Topic, Exercise, Body Mass Index, Prevalence, Risk Assessment, Vascular Stiffness, Pulse Wave Analysis, Protective Factors, Diet, Western
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