PREVALENCE AND DETERMINANTS OF VASCULAR AGING IN AUSTRIA – A HOLISTIC VIEW: THE LEAD STUDY

Objective:
Vascular aging (VA) is an important and prognostically relevant aspect of biological aging. Its determinants are incompletely understood, and a holistic view is missing.

Design and method:
The LEAD (Lung, Heart, Social, Body) study is an ongoing, longitudinal, population-based observational study, which started in 2011 in Vienna and six villages from Lower Austria. As part of the study, carotid-femoral pulse wave velocity (cfPWV) was measured non-invasively using applanation tonometry. In a predefined healthy normal population (non-smokers without known hypertension, diabetes, hyperlipidemia or cardiovascular disease, free from antihypertensive and lipid-lowering medication, blood pressure below 130/85 mmHg), age-specific Z-scores for cfPWV were calculated. Healthy (HVA), normal (NVA) and early (EVA) VA was defined as cfPWV value < 10th, 10th-90th, and >90th percentile, respectively.

Results:
In the overall population (n = 7924, 54.2% women, age 6-82 years), the prevalence of HVA/NVA/EVA was 7.3/70.3/22.4%, respectively, with EVA prevalence increasing in older age. NVA and EVA, as compared to HVA, were independently associated with age, hemodynamic parameters (blood pressure, heart rate), metabolic factors (diabetes), body composition (lean mass index), psychosocial (marital status), and socio-economic (socioeconomic status score, income, educational level) factors.

Conclusions:
In this large population-based study we observed a high percentage of early vascular aging in Austria. Besides age itself, hemodynamic factors and diabetes, body composition, psychosocial and socio-economic factors play an independent role in vascular aging. Cardiovascular prevention clearly needs to be improved and should be targeted towards high blood pressure on the one hand, but be holistically oriented on the other side.