on November 8, 2007
Published online before print November 8, 2007, doi: 10.1161/ATVBAHA.107.153544
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Submitted on August 10, 2007
Accepted on October 30, 2007
Differential Impact of Age, Sex, and Hypertension on Aortic Atherosclerosis. The Framingham Heart Study
Noriko Oyama ;
From the Departments of Medicine (Cardiovascular Division) (N.O., C.J.S., M.L.C., R.R.J., A.R.M., M.L., R.M.B., D.L., W.J.M.), and Radiology (W.J.M.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston; the Department of Mathematics, and Statistics (P.G., S.J.B., M.G.L.), Boston University; and the National Heart, Lung, and Blood Institute’s Framingham Heart Study (P.G., D.L., M.G.L., C.J.O.), Framingham, Mass.
* To whom correspondence should be addressed. E-mail: wmanning{at}bidmc.harvard.edu.
Objective—The purpose of this study was to investigate the impact of age, sex, and hypertension (HTN) on aortic atherosclerotic burden using cardiovascular MRI (CMR) in a free-living longitudinally followed cohort.
Methods and Results—1763 participants (829 M and 934 F; 38 to 88 years of age) of the Framingham Heart Study Offspring cohort underwent CMR of the thoracoabdominal aorta using an ECG-gated 2D T2-weighted black-blood sequence. Of these, 1726 subjects (96%) with interpretable CMR were characterized by sex, age-quartile, and presence or absence of HTN and clinical cardiovascular disease (CVD). Aortic plaque prevalence and volume increased with increasing age in both sexes. For the nonhypertensive (no-HTN) group, plaque was identified in 702 (46%) with greater prevalence in women than in men (P<0.006). HTN was associated with greater aortic plaque burden (P<0.02). The 200 subjects with clinical CVD had greater plaque burden than subjects without CVD (P<0.0001).
Conclusions—In this free-living longitudinally followed cohort, subclinical aortic atherosclerosis was seen in nearly half of subjects and increased with advancing age. HTN was associated with increased aortic plaque burden. Among no-HTN subjects, women had greater plaque burden than men. These data suggest that subclinical atherosclerosis is more common in no-HTN women and emphasize the importance of focusing on preventive measures in both sexes.
Key words: MRI • aortic atherosclerosis • hypertension • age • sex
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