Correlation between Vascular Age and surrogate markers of atherosclerosis and vascular aging

Aims: The evaluation of Vascular Age, according to the definition given using the cardiovascular risk score tables, is a method of estimating individual cardiovascular risk, which may represent a new therapeutic target for physicians. However, the association of Vascular Age with surrogate markers of atherosclerosis and vascular aging, able to identify vascular alterations at the sub-clinical, asymptomatic stages, has not been determined yet. Thus we explored such relationship in 222 individuals at different cardiovascular risk. Methods: A software for Vascular Age calculation was developed as a part of an App specifically directed to physicians. Vascular Age was defined as the age of a person with the same predicted risk but with all other risk factors in normal range. The risk factors considered were age, gender, smoking, total cholesterol and systolic blood pressure. We used the SCORE project scales for European countries with low cardiovascular risk, considering 10-year fatal cardiovascular disease risk as the probability of cardiovascular death. In 222 individuals (116 M, 106 F, age 56±9 years, 14% smokers), data on common carotid artery intima-media thickness (CCIMT), obtained using echotracking systems, and on arterial stiffness, measured through pulse wave velocity (PWV), were obtained and correlated to Vascular Age and to classical risk factors through Kendall rank correlation test followed by Bonferroni correction or by t test when appropriate. Results: Cardiovascular risk (by SCORE) resulted 2.7±3.5%. Vascular Age resulted significantly higher (62±11 years) than actual age, with an average increase of 6±5 years. The increase was greater in males than in females (M: 7±5 years; F:4±4 years, p<0.0005). CCIMT (mean value: 0.7±0.1 mm) was significantly associated with sex and systolic blood pressure; PWV (mean value: 8.4±1.7 m/s) was significantly associated with smoking and systolic blood pressure. Both CCIMT and PWV showed a significant correlation with Vascular Age (CCIMT: tau=0.18, p<0.001; PWV: tau=0.28, p<0.00000005). CCIMT and PWV values were also significantly correlated (tau=0.14, p<0.05). Conclusions: The correlation between Vascular Age and measures of vascular damage such as CCIMT and PWV (used for screening, prevention and improvement of subject stratification beyond classical risk factors) supports the clinical usefulness of Vascular Age. Therefore, a model based not only on the calculation of the traditional risk, but also on Vascular Age could lead to an improvement in the treatment of cardiovascular risk factors, motivating patients to change their lifestyle and follow therapeutic indications.