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Background: Large artery stiffness is an index of vascular ageing associated with cardiovascular mortality. While traditional risk factors for arterial stiffness are known, the contribution of socioeconomic factors are less reported. We sought to determine the relationship between arterial stiffness and socioeconomic deprivation (at the individual and neighborhood levels) in healthy males and females. Methods: In 7803 adults, carotid stiffness was determined by high-precision carotid echotracking. Individual deprivation data included education, living alone, occupation and Evaluation of the Deprivation and Inequalities of Health in Healthcare Centers (EPICES) score. Neighborhood deprivation was determined from commune level data (smallest administrative sub-division) available from French National Institute of statistics and Economic Studies (2011) using principal component analysis. The separate and combined associations between individual and neighborhood deprivation (main exposures) and carotid stiffness (outcome) were quantified using linear and multilevel model adjusted for traditional risk factors including age, mean blood pressure, body mass index, fasting glucose, high density lipoprotein, triglycerides, heart rate, history of cardiovascular disease, smoking, alcohol, and physical activity. Analyses were conducted separately in males and females. Results: Individual deprivation (lower education and occupation in males, and living alone and higher EPICES in both populations) was adversely related to carotid stiffness, independently of potential confounders (p < 0.05). Neighborhood deprivation was adversely related to carotid stiffness in males (p < 0.05) but not in females. Conclusion: Socioeconomic deprivation, both at the individual and, to a lesser extent, neighborhood level are associated with carotid stiffness in males. Only individual deprivation is associated with carotid stiffness in females.

Background: Physical activity (PA) is beneficial for baroreflex sensitivity (BRS), but it is unclear whether the type of PA has similar effects on the neural (nBRS) or vascular (carotid stiffness) components of BRS. We sought to determine this in healthy adults from a community- based study via assessment of occupational (OPA), sport (SPA), leisure (LPA) and total PA (TPA). Methods: In 8649 adults aged 50 to 75 years, resting nBRS (estimated by low frequency gain, from carotid distension rate and heart rate) and carotid stiffness were measured by high-precision carotid echotracking. PA was self-reported using the Baecke questionnaire, which distinguishes OPA, SPA, LPA and TPA. The associations between PA and nBRS and carotid stiffness were quantified using multivariate linear regression analysis. Analyses were conducted separately in the working and non- working population. Results: In working adults (n = 5039), OPA was associated with lower nBRS function (p = 0.026) and borderline higher carotid stiffness (p = 0.08). When stratified by education, this association remained only in those with less than tertiary education. SPA was associated with higher nBRS (p = 0.0005) and borderline lower carotid stiffness (p = 0.052). Neither LPA nor TPA was associated with nBRS or carotid stiffness. In non-working adults (n = 3610), SPA and TPA were both associated with lower carotid stiffness (p = 0.012 and p = 0.020), but not nBRS. LPA was not associated with either parameter. Conclusion: Occupation-related PA is associated with lower nBRS function and higher carotid stiffness, especially in those with lower education. Higher amounts of sport-related PA are associated with higher nBRS and lower carotid stiffness.

Background/Objectives: The baroreflex is a crucial mechanism acutely modulating vascular tone and heart rate response to maintain blood pressure (BP) in an optimal range. A decrease in baroreflex sensitivity (BRS) is associated with ageing, and pathological conditions such as hypertension and diabetes. Antihypertensive agents are generally known to have beneficial effect on the BRS, however it is still uncertain if the effect is mediated through a more compliant arterial wall or a sympathoinhibitory action. Methods: In the Paris Prospective Study III [1], spontaneous baroreflex, carotid stiffness and pharmacological drugs intake were available in 7967 adults (aged 55–75 years). The neural component of the baroreflex sensitivity (nBRS) was obtained with a cross-spectral analysis of variations in carotid distention rate and R-R intervals. Pharmacological classes were analysed according to the Anatomical Therapeutic Chemical (ATC) classification. Individuals with a BP lowering medication (BP-treated) were paired to non-BP treated individuals with a similar cardiovascular risk (controls) using a propensity score matching procedure (n = 1182 pairs). Results: Amongst pharmacological classes of BP lowering agents, only agents acting on the renin-angiotensin system (ACEi-ARB) were associated with nBRS (β = –0.08, p = 0.045). Compared to their matched controls, ACEi-ARB users had lower nBRS (2.79 ± 0.66 vs. 2.90 ± 0.62, p = 0.03). In multivariate analysis, ACEi-ARB remained significant (stdβ = –0.09, p = 0.025) after adjustment for carotid stiffness (stdβ = 0.25, p < 0.001) and systolic pressure (stdβ = –0.20, p < 0.001). Conclusion: In this epidemiological study, ACEi-ARB were negatively associated with nBRS. This effect is independent of BP and stiffness, which may suggest an inhibition of sympathetic activity by ACEi-ARB.

Background: Individuals whose arteries appears abnormally healthy in comparison to their CV risk factor burden (supernormal vascular aging, SUPERNOVA) represent an ideal model to discover novel pathways of cardiovascular protection. Purpose: 1) to introduce a novel definition of vascular age, as predicted age based on CV risk factors and PWV; 2) to test the hypothesis that individuals with the largest difference between chronological and vascular age (C-Vage) show a lower rate of CV events, and may thus be defined as SUPERNOVA. Methods: The best fitting model for age prediction was investigated in the multicenter, European, cross-sectional Reference Values for Arterial stiffness Collaboration Database (n = 11406). A survival analysis on the longitudinal cohort of the Malmo Diet and Cancer Study (MDCS, n = 2663) was then performed. The main outcome was a composite endpoint of fatal and non-fatal major cardiac events and strokes. Results: In the Reference Values Cohort, the model explained 59.8% of age variance, with PWV being the most relevant predictor (r2: 0.105). The model (derived on population >61 years) was used to calculate vascular age in the MDCS Cohort. In the Cox survival analysis (follow-up 6.6 years, 286 events), C-Vage was significantly and inversely associated with CV events (Figure 1). Individuals in the highest C-Vage decile (>8.8 years) were defined as SUPERNOVA. In the competing risk analysis, SUPERNOVA had a reduced age-adjusted rate of CV events [HR 0.51 (0.34–0.76)]. Figure 1 Conclusion: This proof-of-concept study demonstrated that SUPERNOVA individuals have a disproportionally lower rate of CV events. Future studies are needed to explore genetic/molecular mechanisms for this phenotype.

Background: Late-life depression is related to poor quality of life and increased risk of mortality and cardiovascular disease. Effective interventions for prevention and treatment of late-life depression need to be developed, which requires a better understanding of late-life depression risk factors. Arterial stiffness may contribute to late-life depression via cerebrovascular damage, but evidence is scarce. Aim: To investigate the association between carotid artery stiffness and incident depressive symptoms in a large community-based cohort study. Methods: This longitudinal study included 7,013 participants (60 (SD 6) years; 36% women) free of depressive symptoms at baseline. Carotid stiffness (high-resolution echotracking) was determined at baseline. Presence of depressive symptoms was determined at baseline and at 4 and 6 years of follow-up and was defined as a score ≥7 on a validated 13-item questionnaire (Q2DA) and/or new use of antidepressants. Logistic regression and generalized estimating equations (GEE) were used. Results: In total, 6.9% (n = 484) of the participants had incident depressive symptoms at 4 or 6 years of follow-up. Greater carotid stiffness was associated with a higher incidence of depressive symptoms (Figure). Results were qualitatively similar when GEE was used instead of logistic regression. Conclusions: Greater carotid artery stiffness is associated with a higher incidence of depressive symptoms. This study supports the hypothesis that carotid artery stiffness contributes to the development of late-life depression.

Background: Arterial stiffness is increased with chronic inflammatory disorders. The reduction of inflammation by immunomodulatory therapy is associated with a restoration of arterial function. Objectives: To determine whether carotid-femoral pulse wave velocity (cf-PWV) is increased in subjects with inflammatory bowel disease (IBD). Data sources. A systematic literature search for arterial stiffness in IBD was performed using PubMed and Google Scholar databases (last accessed on 11 June 2015). The search terms were “arterial stiffness,” “vascular stiffness” or “pulse wave velocity” in combination with “inflammatory bowel disease,” “inflammatory bowel diseases,” “Crohn’s disease” or “ulcerative colitis.” Study eligibility criteria. Inclusion criteria included peer-reviewed publications reporting original data; a minimum of 10 subjects tested; and cf-PWV measured via validated devices. Participants. Adults with IBD. Methods: Publications with titles or abstracts appearing to meet the inclusion criteria were selected for detailed review. These articles were reviewed by two authors according to PRISMA 2009 guidelines. Results: A total of 9 cross-sectional studies met the inclusion criteria (234 patients with Crohn’s disease (CD), 342 with ulcerative colitis (UC) and 435 control patients). One study only included patients with UC. Arterial stiffness was significantly increased in subjects with IBD in 8 studies and slightly but not significantly increased in subjects with IBD in one study. Conclusions: Current cross-sectional studies suggest that arterial stiffness is increased in IBD subjects. Longitudinal studies are required to confirm preliminary data showing a reversibility of arterial stiffening by anti-TNF-alpha therapy. Systematic review registration number: CRD42015017364.