Central and local arterial stiffness in White Europeans compared to age-, sex-, and BMI-matched South Asians

PLoS One. 2023 Aug 24;18(8):e0290118. doi: 10.1371/journal.pone.0290118. eCollection 2023.

Abstract

Background: Ethnicity impacts cardiovascular disease (CVD) risk, and South Asians demonstrate a higher risk than White Europeans. Arterial stiffness is known to contribute to CVD, and differences in arterial stiffness between ethnicities could explain the disparity in CVD risk. We compared central and local arterial stiffness between White Europeans and South Asians and investigated which factors are associated with arterial stiffness.

Methods: Data were collected from cohorts of White Europeans (the Netherlands) and South Asians (India). We matched cohorts on individual level using age, sex, and body mass index (BMI). Arterial stiffness was measured with ARTSENS® Plus. Central stiffness was expressed as carotid-femoral pulse wave velocity (cf-PWV, m/s), and local carotid stiffness was quantified using the carotid stiffness index (Beta) and pressure-strain elastic modulus (Epsilon, kPa). We compared arterial stiffness between cohorts and used multivariable linear regression to identify factors related to stiffness.

Results: We included n = 121 participants per cohort (age 53±10 years, 55% male, BMI 24 kg/m2). Cf-PWV was lower in White Europeans compared to South Asians (6.8±1.9 vs. 8.2±1.8 m/s, p<0.001), but no differences were found for local stiffness parameters Beta (5.4±2.4 vs. 5.8±2.3, p = 0.17) and Epsilon (72±35 vs. 70±31 kPa, p = 0.56). Age (standardized β, 95% confidence interval: 0.28, 0.17-0.39), systolic blood pressure (0.32, 0.21-0.43), and South Asian ethnicity (0.46, 0.35-0.57) were associated with cf-PWV; associations were similar between cohorts (p>0.05 for interaction). Systolic blood pressure was associated with carotid stiffness in both cohorts, whereas age was associated to carotid stiffness only in South Asians and BMI only in White Europeans.

Conclusion: Ethnicity is associated with central but not local arterial stiffness. Conversely, ethnicity seems to modify associations between CVD risk factors and local but not central arterial stiffness. This suggests that ethnicity interacts with arterial stiffness measures and the association of these measures with CVD risk factors.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Body Mass Index
  • Cardiovascular Diseases* / diagnostic imaging
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / ethnology
  • Female
  • Humans
  • India
  • Male
  • Middle Aged
  • Netherlands
  • Pulse Wave Analysis
  • Sex Factors
  • South Asian People*
  • Vascular Stiffness*
  • White People*

Supplementary concepts

  • Indian people

Grants and funding

A.E.F.M. was supported by the European Union-funded Horizon 2020 project InSiDe (Grant No. 871547). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.