AzTrials
AzTrials

Aortic StiffnessNCT02663791

Alcohol Consumption and Arterial Stiffness: A Longitudinal Study of Pulse Wave Velocity in the Whitehall II Cohort

An observational study of Aortic Stiffness, run by University College, London at 1 site in United Kingdom.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Arterial stiffness is an important marker of cardiovascular health. Recent evidence from cross-sectional research has suggested it is associated with alcohol consumption. Research that employs a longitudinal perspective may be better equipped to evaluate the nature of this relationship and in particular to determine… Read more about this study

Who is it for?
Ages 34 to 100 years
Conditions the study is for
Aortic Stiffness
How many people
10,308 participants
Where
1 siteUnited Kingdom
Study dates
Jan 2016to Jun 2016
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 34 to 100 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Data will be drawn from the Whitehall II cohort study database. This incorporates longitudinal assessments of 6,895 male (67%) and 3,413 female British civil servants, originally recruited between 1985 and 1988. The overall age range was 34 to 56 years. Of these, 897 were excluded due to having a history of cardiovascular disease. Clinical assessments were repeated at 4-to-5 year intervals. PWV measurement was introduced to the protocol at phase 9, with assessments taking place during 2008 and 2009. 3,869 of the sample participants had a successful PWV assessment during this time. Follow-up testing took place at phase 11, during 2012 and 2013. Of the participants who underwent a PWV assessment at phase 9, 3,130 also had a successful PWV assessment at phase 11. This group included 2,350 males (75%) and 780 females.

Who may be able to join

  • Participated in Whitehall II cohort study
  • Reported alcohol consumption on a minimum of one occasion between phase 1 and phase 9 of the Whitehall II cohort study

Who cannot join

  • Left Whitehall II cohort study prior to phase 9 or did not participate in PWV assessment at Phase 9
  • Had history of coronary heart disease

Trial locations and contacts

1 site in 1 country.

United Kingdom1 site
  • University College London

    London, WC1E 6BT

Other trials in United Kingdom

About this study

Arterial stiffness is an important marker of cardiovascular health. Recent evidence from cross-sectional research has suggested it is associated with alcohol consumption. Research that employs a longitudinal perspective may be better equipped to evaluate the nature of this relationship and in particular to determine whether alcohol consumption is linked to the progression of arterial stiffness over time. The current study will consequently implement a longitudinal cohort design to evaluate the association between long-term alcohol consumption patterns and changes in arterial stiffness. Data will be drawn from the Whitehall II cohort study of British civil servants, in which participants completed repeat pulse wave velocity (PWV) assessments of arterial stiffness across a four-to-five year interval. Repeat measurements of volume of alcohol intake were also recorded for participants, extending back across more than two decades. Intake will be categorised in such a way as to distinguish between different alcohol consumer types, including non-drinkers and former drinkers. Linear mixed effects models will be used with adjustment for potential confounds, such as age, diabetes, mean arterial pressure and heart rate. Results from the modelling work will illustrate the extent and form of the association between alcohol intake and PWV. This work will provide useful insights into the role that alcohol intake plays in the longitudinal progression of an important cardiac marker, and it will have implications for our understanding of alcohol's relationship to cardiovascular health in the general population.

Read the detailed description

Arterial stiffness occurs where the vessel wall lacks elasticity. It is known to be independently associated with both cardiovascular morbidity and mortality, such that it can act as a surrogate end point for studies of cardiovascular disease. Pulse wave velocity (PWV) is an index of this stiffness and has been described as its 'gold standard' measurement.

A number of other clinical factors have been found to show meaningful association with PWV, including heart rate and mean arterial pressure. These findings have highlighted the need for studies of new potential determinants of PWV to account for the potentially confounding influence of these known factors. Additional demographic and lifestyle characteristics have also been shown to act as moderators of PWV. In particular, research has demonstrated that PWV increases with age, and this stiffness is consequently deemed an indicator of vascular ageing.

Alcohol intake is another lifestyle characteristic that has been considered as a potential factor in the loss of arterial elasticity. Evidence to date suggests that a J-shaped association may exist between such intake and PWV, but this work has mostly relied on cross-sectional data or looked at short-term intake patterns only. By adopting a longitudinal perspective, further insight may be garnered into this important epidemiological issue. Consequently, the new study herein proposed will address this research need and investigate how different patterns of alcohol consumption relate to arterial stiffness and to the progression of this stiffness over time. The primary objectives of this study are to (1) examine whether long-term patterns of alcohol consumption are independently associated with a baseline assessment of carotid-femoral PWV and (2) whether alcohol intake is likewise associated with longitudinal changes in this important cardiovascular marker.

Longitudinal alcohol exposure will be determined from reported consumption at phases 1 (1985-1988) through 9 (2007-2009) of the Whitehall II Cohort Study and categorised according to the latest UK recommendations on alcohol intake limits. These guidelines define moderate consumption as weekly ethanol intake volumes of 112g or under for both males and females. As alcohol consumption is recorded in UK units in the Whitehall II database, conversion will be performed using the standard ratio of 1 unit to 8 grams of ethanol prior to categorisation. The subsequent categorisation will draw distinctions between non-drinkers and former drinkers, as well as between moderate and heavy consumers. Those with unstable patterns of consumption will also be identified as there is emerging evidence that such consumers may have a different cardiovascular risk profile compared to consumers with more longitudinally consistent intake patterns.

Demographic and clinical characteristics will be investigated to provide context for the subsequent inferential analyses. As research has also suggested that participant sex can moderate the relationship between alcohol and PWV, this will be tested in the current analysis (through preliminary modelling that includes sex as part of an interaction term with level of alcohol consumption). If this moderation effect is replicated, then our core result reporting will be stratified according to sex.

Linear mixed effects models will then be used to examine the effect of long-term alcohol consumption on PWV and its effect on subsequent longitudinal changes in this cardiovascular marker. This modelling approach is particularly suited to analysing the complex data structure under investigation, including the correlation across individual participants' paired measurements. A detailed analytic protocol is available upon request.

Supplementary linear mixed effects modelling will also be performed to look at the association between short-term alcohol consumption patterns and PWV. This will employ the same modelling strategy as used in the primary analysis above, with the categorisation of consumption utilising reported intake at the most recent assessment phase only. This supplementary analysis will offer additional context for the findings of the primary analysis and provide further detail on the relationship that different forms of alcohol consumption have with arterial stiffness.

Through this comprehensive and detailed analysis, it is hoped that new insights on this important issue of cardiovascular health will be obtained.

Keywords
Alcohol, Aortic stiffness, Arterial stiffness, Pulse wave velocity, Longitudinal

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Baseline Carotid-Femoral Pulse Wave Velocity

    A baseline carotid-femoral pulse wave velocity (PWV) assessment occurred at phase 9 (each participant attended an assessment day during 2008 or 2009) of the Whitehall II cohort study. Up to 3 PWV measurements were performed during this assessment, and where a participant underwent multiple measurements, the mean of these will be calculated for that participant and used as their baseline PWV measurement.

    Measured: 1 day

  2. Change from Baseline Carotid-Femoral Pulse Wave Velocity at Follow-Up

    Change in carotid-femoral PWV between the baseline and follow-up PWV assessments will be investigated. The follow-up PWV assessment occurred at phase 11 (2012-2013) of the Whitehall II cohort study. Up to 3 PWV measurements were again performed during this assessment, and where a participant underwent multiple measurements, the mean of these will be calculated for that participant and used as their follow-up PWV measurement.

    Measured: 4 to 5 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Jan 2016 (estimated)
  2. Study startJan 2016
  3. Primary completionApr 2016
  4. Study completionJun 2016

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
10,308 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02663791
Sponsor's protocol ID
Whitehall II - Alcohol PWV 01
Status last verified
May 2023
First submitted
18 Jan 2016
Last updated
11 May 2023
Results posted
No
Data monitoring committee
Yes
Individual data sharing
Yes: Researchers can request access to anonymised data: http://www.ucl.ac.uk/whitehallII/data-sharing

Publications

  • Marmot M, Brunner E. Cohort Profile: the Whitehall II study. Int J Epidemiol. 2005 Apr;34(2):251-6. doi: 10.1093/ije/dyh372. Epub 2004 Dec 2. No abstract available.

    PubMed 15576467
  • Cavalcante JL, Lima JA, Redheuil A, Al-Mallah MH. Aortic stiffness: current understanding and future directions. J Am Coll Cardiol. 2011 Apr 5;57(14):1511-22. doi: 10.1016/j.jacc.2010.12.017.

    PubMed 21453829
  • Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol. 2010 Mar 30;55(13):1318-27. doi: 10.1016/j.jacc.2009.10.061.

    PubMed 20338492
  • Cecelja M, Chowienczyk P. Role of arterial stiffness in cardiovascular disease. JRSM Cardiovasc Dis. 2012 Jul 31;1(4):cvd.2012.012016. doi: 10.1258/cvd.2012.012016.

    PubMed 24175067
  • Cecelja M, Chowienczyk P. Dissociation of aortic pulse wave velocity with risk factors for cardiovascular disease other than hypertension: a systematic review. Hypertension. 2009 Dec;54(6):1328-36. doi: 10.1161/HYPERTENSIONAHA.109.137653. Epub 2009 Nov 2.

    PubMed 19884567
  • Matsumoto C, Tomiyama H, Yamada J, Yoshida M, Shiina K, Nagata M, Yamashina A. Association of blood pressure levels with the effects of alcohol intake on the vasculature in Japanese men. Hypertens Res. 2009 Feb;32(2):127-32. doi: 10.1038/hr.2008.23. Epub 2009 Jan 16.

    PubMed 19262471
  • Beilin L. Alcohol and cardiovascular disease: possible protection via effects on aortic stiffness. J Hypertens. 2005 Apr;23(4):703-5. doi: 10.1097/01.hjh.0000163133.62020.98. No abstract available.

    PubMed 15775769
  • Sasaki S, Yoshioka E, Saijo Y, Kita T, Okada E, Tamakoshi A, Kishi R. Relation between alcohol consumption and arterial stiffness: A cross-sectional study of middle-aged Japanese women and men. Alcohol. 2013 Dec;47(8):643-9. doi: 10.1016/j.alcohol.2013.10.003. Epub 2013 Oct 17.

    PubMed 24239150
  • Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, Pannier B, Vlachopoulos C, Wilkinson I, Struijker-Boudier H; European Network for Non-invasive Investigation of Large Arteries. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006 Nov;27(21):2588-605. doi: 10.1093/eurheartj/ehl254. Epub 2006 Sep 25.

    PubMed 17000623
  • O'Neill D, Britton A, Brunner EJ, Bell S. Twenty-Five-Year Alcohol Consumption Trajectories and Their Association With Arterial Aging: A Prospective Cohort Study. J Am Heart Assoc. 2017 Feb 20;6(2):e005288. doi: 10.1161/JAHA.116.005288.

    PubMed 28219925

Questions about this trial

What is this clinical trial studying?

An observational study of Aortic Stiffness, run by University College, London at 1 site in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 11 May 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Baseline Carotid-Femoral Pulse Wave Velocity (time frame: 1 day). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02663791, which also lists 10 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 May 2023.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in