From the Journals

Framingham: Arterial stiffening not inevitable with aging

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Healthy vascular aging is possible

The most reassuring finding of Niiranen et al. is that healthy vascular aging can be achieved. It can even be found in the elderly, albeit much less commonly than among adults in their 50s and 60s.

The clinical consequences of these findings are not yet clear, and we don’t yet know what to advise patients who have healthy vascular aging. But this study paves the way for research into protective factors, not just risk factors, for CVD.

Future research in this area will not only improve our understanding of the pathophysiology of vascular disease but also will offer new predictive, diagnostic, and therapeutic tools.

Gemma Currie, MD, and Christian Delles, MD, are at the Institute of Cardiovascular and Medical Sciences at the University of Glasgow, Scotland. Their work is supported by the British Heart Foundation and the European Commission, and they reported having no relevant financial disclosures. Dr. Currie and Dr. Delles made these remarks in an editorial accompanying Dr. Niiranen’s report (Hypertens. 2017 May 30. doi: 10.1161/hypertensionaha.117.09122).



Arterial stiffening is not an inevitable part of aging and did not occur in 18% of 3,196 men and women aged 50 and older participating in certain cohorts of the Framingham Heart Study, according to a report published online May 30 in Hypertension.

Overall, 566 men and women (17.7%) showed healthy vascular aging. The prevalence of healthy vascular aging was 30.3% in people aged 50-59 years, 7.4% in those aged 60-69 years, and 1% in those aged 70 years and older. The cardiovascular risk factors most strongly associated with healthy vascular aging were a low body mass index, an absence of diabetes, and the use of lipid-lowering therapy, Dr. Niiranen and his associates said (Hypertens. 2017 May 30. doi: 10.1161/hypertensionaha.117.09026).

During a mean follow-up of 10 years, 391 study participants developed cardiovascular disease. People with healthy vascular aging were at substantially lower risk than were other participants for CVD (hazard ratio, 0.34), even after the data were adjusted to account for other traditional CVD risk factors. This highlights the importance of arterial stiffness in the pathogenesis of CVD, they added.

Although there are no specific therapies to prevent or treat arterial stiffening at this time, it seems reasonable that standard lifestyle changes and treatments aimed at reducing CVD – particularly maintaining a healthy weight, staving off diabetes, and using lipid-lowering medications – may prevent or delay arterial stiffening, Dr. Niiranen and his associates said.

The National Heart, Lung, and Blood Institutes’s Framingham Heart Study, the National Institutes of Health, and Boston University supported this work. Dr. Niiranen reported having no relevant financial disclosures; one of his associates reported owning Cardiovascular Engineering, Inc., which develops and manufactures devices to measure vascular stiffness, as well as having ties to Merck, Novartis, Philips, and Servier.

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