Background Cardiovascular risk is an important factor for increased morbidity and mortality in patients with ankylosing spondylitis. Currently, it is estimated that the cardiovascular risk from atherosclerotic origin in patients with ankylosing spondylitis is twice as high compared with aged-matched controls [1–4]. Arterial stiffness appears to contribute to the complex aetiology of cardiovascular disease and is regarded as a predictor of increased cardiovascular risk and all-cause mortality [5].

Objectives To assess arterial stiffness in relation to the disease activity and functional limitation in patients with ankylosing spondylitis.

Methods Twenty four patients (mean age: 45.8±11.7 years) suffering of ankylosing spondylitis (disease duration: 11.1±5.1 years) and twenty four gender and age-matched healthy controls were included in the study. Clinical, biological and functional status of ankylosing spondylitis patients was recorded. Arterial stiffness was assessed by measuring pulse wave velocity (PWV) and pulse wave analysis was performed using applanation tonometry.

Results We found significant differences between ankylosing spondylitis patients and healthy controls in regard to PWV (p=0.047), aortic augmentation pressure - AP (p=0.028), augmentation index - AIx (p=0.038) and aortic augmentation index adjusted for heart rate - AIx75 (p=0.011). PWV and AIx75 were significantly associated with the disease functioning score - BASFI (p=0.012, r =0.504; p=0.041, r=0.421). Aortic AP and augmentation indexes (AIx and AIx75) were all associated to ASDAS score (p=0.028, r=0.448; p=0.005, r=0.549; p=0.025, r=0.455).

Conclusions Our study showed that ankylosing spondylitis patients have a higher arterial stiffness than the age-matched controls, leading to an increased cardiovascular risk. We found that arterial stiffness is positively associated with disease activity and functional impairment. Chronic spondiloarthropaties should be screened for arterial stiffness, even in the absence of traditional cardiovascular risk factors, in order to benefit from primary prevention measures.

1. Sveaas SH, Berg IJ, Provan SA, et al. Efficacy of high intensity exercise on disease activity and cardiovascular risk in active axial spondyloarthritis: a randomized controlled pilot study. PLoS One. 2014 Sep 30;9(9):e108688.

2. Mathieu S, Gossec L, Dougados M, et al. Cardiovascular profile in ankylosing spondylitis: a systematic review and meta-analysis. Arthritis Care Res. 2011;63:557–563.

3. Bremander A, Petersson IF, Bergman S, et al. Population-based estimates of common comorbidities and cardiovascular disease in ankylosing spondylitis. Arthritis Care Res. 2011;63:550–556.

4. Bakland G, Gran JT, Nossent JC. Increased mortality in ankylosing spondylitis is related to disease activity. Ann Rheum Dis. 2011;70:1921–1925.

5. Laurent S, Boutouyrie P. Arterial stiffness: a new surrogate end point for cardiovascular disease? J Nephrol. 2007;12:S45–50.

Disclosure of Interest None declared