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(Hypertension. 2005;46:194.)
© 2005 American Heart Association, Inc.

Fifth International Workshop on Structure and Function of Large Arteries

Arterial Stiffness in Chronic Inflammatory Diseases

Mary J. Roman; Richard B. Devereux; Joseph E. Schwartz; Michael D. Lockshin; Stephen A. Paget; Adrienne Davis; Mary K. Crow; Lisa Sammaritano; Daniel M. Levine; Beth-Ann Shankar; Elfi Moeller; Jane E. Salmon

From the Divisions of Cardiology (M.J.R., R.B.D.) and Rheumatology (M.D.L., S.A.P., A.D., M.K.C., L.S., B.A.S., E.M., J.E.S.) and The Rogosin Institute (D.M.L.), Weill Medical College of Cornell University, The Hospital for Special Surgery, New York, NY; and the Department of Psychiatry (J.E.S.), SUNY-Stony Brook, NY.

Correspondence to Mary J. Roman, MD, Division of Cardiology, Weill Medical College of Cornell University, 525 East 68th St, New York, NY 10021. E-mail mroman{at}med.cornell.edu

Chronic inflammatory diseases are associated with premature atherosclerosis; however, it is unknown whether arterial stiffness is increased in this setting, possibly as a manifestation of vascular disease preceding and/or independent of atherosclerosis. Carotid ultrasonography and radial applanation tonometry were performed in 101 patients with systemic lupus erythematosus, 80 patients with rheumatoid arthritis, and 105 healthy control subjects. The 3 groups were comparable in age, gender, and carotid artery absolute and relative wall thickness. Atherosclerotic plaque was more common in lupus (46%) and rheumatoid arthritis (38%) patients than in controls (23%) (P<0.003). Although control subjects had higher central and peripheral blood pressures, arterial stiffness was increased in patient groups compared with controls (lupus, rheumatoid arthritis, controls, respectively: ß: 3.36 versus 3.22 versus 2.60, P<0.001; Young’s modulus: 441 versus 452 versus 366 mm Hg/cm, P=0.004; Peterson’s elastic modulus: 278 versus 273 versus 216 mm Hg, P<0.001) after adjustment for differences in mean brachial pressure. In multivariate analysis involving the entire population, arterial stiffness was independently related to age, serum glucose, and the presence of chronic inflammatory disease. In multivariate analysis restricted to the patients, arterial stiffness was independently related to age at diagnosis, disease duration, serum cholesterol, and C-reactive protein (and IL-6, when substituted for C-reactive protein). When analyses were repeated in the 186 study subjects without carotid plaque, arterial stiffness remained significantly elevated in patient groups after adjustment for differences in age and mean brachial pressure. In conclusion, arterial stiffness is increased in chronic inflammatory disorders independent of the presence of atherosclerosis and is related to disease duration, cholesterol, and the inflammatory mediator C-reactive protein and the cytokine that stimulates its production, IL-6.

Key Words: arterial pressure • arteriosclerosis • carotid arteries • elasticity • vascular disease

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