Published Online
on May 23, 2005

A more recent version of this article appeared on July 1, 2005

This Article Full Text (PDF) All Versions of this Article: 46/1/194    most recent 01.HYP.0000168055.89955.dbv1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Roman, M. J. Articles by Salmon, J. E. Search for Related Content PubMed PubMed Citation Articles by Roman, M. J. Articles by Salmon, J. E. Pubmed/NCBI databases Medline Plus Health Information Joint Disorders Rheumatoid Arthritis Related Collections Pathophysiology Risk Factors Peripheral vascular disease Doppler ultrasound, Transcranial Doppler etc. Other Vascular biology

Submitted on February 9, 2005
Revised on March 1, 2005

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; and 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.

^* To whom correspondence should be addressed. E-mail: mroman{at}med.cornell.edu.

Abstract--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: : 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

This article has been cited by other articles:

				M. A. Crilly, V. Kumar, H. J. Clark, N. W. Scott, A. G. MacDonald, and D. J. Williams Arterial stiffness and cumulative inflammatory burden in rheumatoid arthritis: a dose-response relationship independent of established cardiovascular risk factors Rheumatology, December 1, 2009; 48(12): 1606 - 1612. [Abstract] [Full Text] [PDF]

				B. Galarraga, F. Khan, P. Kumar, T. Pullar, and J. J. F. Belch Etanercept improves inflammation-associated arterial stiffness in rheumatoid arthritis Rheumatology, November 1, 2009; 48(11): 1418 - 1423. [Abstract] [Full Text] [PDF]

				J. M. SABIO, J. VARGAS-HITOS, M. ZAMORA-PASADAS, J. D. MEDIAVILLA, N. NAVARRETE, A. RAMIREZ, C. HIDALGO-TENORIO, L. JAIMEZ, J. MARTIN, J. JIMENEZ-ALONSO, et al. Metabolic Syndrome Is Associated with Increased Arterial Stiffness and Biomarkers of Subclinical Atherosclerosis in Patients with Systemic Lupus Erythematosus J Rheumatol, October 1, 2009; 36(10): 2204 - 2211. [Abstract] [Full Text] [PDF]

				K. S. Stamatelopoulos, G. D. Kitas, C. M. Papamichael, E. Chryssohoou, K. Kyrkou, G. Georgiopoulos, A. Protogerou, V. F. Panoulas, A. Sandoo, N. Tentolouris, et al. Atherosclerosis in Rheumatoid Arthritis Versus Diabetes: A Comparative Study Arterioscler Thromb Vasc Biol, October 1, 2009; 29(10): 1702 - 1708. [Abstract] [Full Text] [PDF]

				A Cypiene, M Kovaite, A Venalis, J Dadoniene, R Rugiene, Z Petrulioniene, L Ryliskyte, and A Laucevicius Arterial wall dysfunction in systemic lupus erythematosus Lupus, May 1, 2009; 18(6): 522 - 529. [Abstract] [PDF]

				V. F. Panoulas, K. M. J. Douglas, J. P. Smith, A. Stavropoulos-Kalinoglou, G. S. Metsios, P. Nightingale, and G. D. Kitas Transforming growth factor-{beta}1 869T/C, but not interleukin-6 -174G/C, polymorphism associates with hypertension in rheumatoid arthritis Rheumatology, February 1, 2009; 48(2): 113 - 118. [Abstract] [Full Text] [PDF]

				V. F. Panoulas, G. S. Metsios, A. V. Pace, H. John, G. J. Treharne, M. J. Banks, and G. D. Kitas Hypertension in rheumatoid arthritis Rheumatology, September 1, 2008; 47(9): 1286 - 1298. [Abstract] [Full Text] [PDF]

				R. Schnabel, M. G. Larson, J. Dupuis, K. L. Lunetta, I. Lipinska, J. B. Meigs, X. Yin, J. Rong, J. A. Vita, C. Newton-Cheh, et al. Relations of Inflammatory Biomarkers and Common Genetic Variants With Arterial Stiffness and Wave Reflection Hypertension, June 1, 2008; 51(6): 1651 - 1657. [Abstract] [Full Text] [PDF]

				H. MacIver and H. A. Bird Arterial elasticity: asset or liability? Rheumatology, February 1, 2008; 47(2): 117 - 118. [Full Text] [PDF]

				M. J. Roman and J. E. Salmon Cardiovascular Manifestations of Rheumatologic Diseases Circulation, November 13, 2007; 116(20): 2346 - 2355. [Full Text] [PDF]

				W G Dixon and D P M Symmons What effects might anti-TNF{alpha} treatment be expected to have on cardiovascular morbidity and mortality in rheumatoid arthritis? A review of the role of TNF{alpha} in cardiovascular pathophysiology Ann Rheum Dis, September 1, 2007; 66(9): 1132 - 1136. [Abstract] [Full Text] [PDF]

				R. Sabit, C. E. Bolton, P. H. Edwards, R. J. Pettit, W. D. Evans, C. M. McEniery, I. B. Wilkinson, J. R. Cockcroft, and D. J. Shale Arterial Stiffness and Osteoporosis in Chronic Obstructive Pulmonary Disease Am. J. Respir. Crit. Care Med., June 15, 2007; 175(12): 1259 - 1265. [Abstract] [Full Text] [PDF]

				S. Laurent and P. Boutouyrie Recent Advances in Arterial Stiffness and Wave Reflection in Human Hypertension Hypertension, June 1, 2007; 49(6): 1202 - 1206. [Full Text] [PDF]

				C Vlachopoulos, K Aznaouridis, and C Stefanadis Clinical appraisal of arterial stiffness: the Argonauts in front of the Golden Fleece Heart, November 1, 2006; 92(11): 1544 - 1550. [Abstract] [Full Text] [PDF]

				A. A. Quyyumi Inflamed Joints and Stiff Arteries: Is Rheumatoid Arthritis a Cardiovascular Risk Factor? Circulation, September 12, 2006; 114(11): 1137 - 1139. [Full Text] [PDF]