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Submitted on August 23, 2004
Accepted on November 10, 2004
From the Clinical Pharmacology Unit (C.M.M., Y., S.W., Z.D., M.J.A., I.B.W.), University of Cambridge Addenbrooke’s Hospital Cambridge, United Kingdom; and Department of Cardiology (P.P., J.R.C.) University of Wales College of Medicine, University Hospital Cardiff, United Kingdom.
* To whom correspondence should be addressed. E-mail: my105{at}medschl.cam.ac.uk.
Background--Arterial stiffness is an independent determinant of cardiovascular risk, and arterial stiffening is the predominant abnormality in systolic hypertension. Elastin is the main elastic component of the arterial wall and can be degraded by a number of enzymes, including matrix metalloproteinase-9 (MMP-9) and MMP-2. We hypothesized that elastase activity would be related to arterial stiffness and tested this using isolated systolic hypertension (ISH) as a model of stiffening and separately in a large cohort of healthy individuals.
Methods and Results--A total of 116 subjects with ISH and 114 matched controls, as well as 447 individuals free from cardiovascular disease were studied. Aortic and brachial pulse wave velocity (PWV) and augmentation index were determined. Blood pressure, lipids, C-reactive protein, MMP-9, MMP-2, serum elastase activity (SEA), and tissue-specific inhibitor 2 of metalloproteinases were measured. Aortic and brachial PWV, MMP-9, MMP-2, and SEA levels were increased in ISH subjects compared with controls (P=0.001). MMP-9 levels correlated linearly and significantly with aortic (r=0.45; P=0.001) and brachial PWV (r=0.22; P=0.002), even after adjustments for confounding variables. In the younger, healthy subjects, MMP-9 and SEA were also independently associated with aortic PWV.
Conclusions--Aortic stiffness is related to MMP-9 levels and SEA, not only in ISH, but also in apparently younger, healthy individuals. This suggests that elastases including MMP-9 may be involved in the process of arterial stiffening and development of ISH.
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