Key result
South Asian ethnicity linked to ~1.4 m/s higher cf-PWV vs White Europeans.
Why the study?
South Asians demonstrate higher cardiovascular disease risk than White Europeans, and differences in arterial stiffness could explain this disparity.
Does South Asian ethnicity impact central and local arterial stiffness compared to White European ethnicity?
Cross-Sectional (n=242)
Yes
Does South Asian ethnicity impact central and local arterial stiffness compared to White European ethnicity?
South Asians exhibit significantly higher central arterial stiffness than White Europeans even after matching for age, sex, and BMI, potentially explaining some of the disparity in cardiovascular disease risk.
South Asian ethnicity is associated with higher cf-PWV; hypothesis-generating for ethnic CVD disparities and requires prospective validation before clinical use.
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.
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Sluijs et al. (2023) conducted a cross-sectional in General adult population (n=242). South Asian ethnicity vs. White European ethnicity was evaluated on Carotid-femoral pulse wave velocity (cf-PWV) (standardized β 0.46, 95% CI 0.35-0.57, p=<0.001). Central arterial stiffness, measured by cf-PWV, was significantly higher in South Asians compared to age-, sex-, and BMI-matched White Europeans (8.2 vs 6.8 m/s, p<0.001).
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