Prevalence and determinants of vascular aging in Austria – a holistic view: the LEAD study

OBJECTIVES: Vascular aging (VA) is a prognostically relevant aspect of biological aging. We investigated its prevalence and determinants in Austria. METHODS: The LEAD (Lung, Heart, Social, Body) study is an ongoing, longitudinal, population-based observational study, which started in 2011 in Vienna and six villages from Lower Austria. Within the study, carotid-femoral pulse wave velocity (cfPWV) was measured using applanation tonometry. Based on a reference population (no history of overt cardiovascular disease, no diabetes, no pharmacological treatment for hypertension or dyslipidemia), sex-, and age-specific Z -scores for cfPWV were calculated. Healthy (HVA), normal (NVA), and early (EVA) vascular aging were defined as cfPWV Z -score 90th percentile, respectively. RESULTS: In the overall population ( n = 7926, 54.2% women, age 18-82 years), the prevalence of HVA/NVA/EVA was 9.1/78.6/12.2%, respectively, with EVA prevalence increasing in older age. The risk of EVA, as compared to HVA, was independently and directly associated with female sex (odds ratio, OR 2.8), systolic (OR 1.04) and diastolic (OR 1.02) blood pressure, heart rate (OR 1.06), body height (OR 1.03), and diabetes mellitus (OR 3.0), and inversely related to appendicular lean mass index (OR 0.82), postbronchodilation FEV1 (OR 0.81), and healthy nutrition (OR 0.69). The results were similar for the comparison of EVA and NVA, adding an independently increased risk for EVA with regular alcohol intake (OR 1.37) and low income (OR 1.21). CONCLUSIONS: We observed a high percentage of EVA in Austria, determined by classical and nonclassical risk factors. The latter may offer novel targets for prevention.