Relation of Brachial and Digital Measures of Vascular Function in the Community The Framingham Heart Study

被引:311
作者
Hamburg, Naomi M. [1 ,3 ]
Palmisano, Joseph [4 ]
Larson, Martin G. [5 ,6 ,8 ,9 ]
Sullivan, Lisa M. [4 ]
Lehman, Birgitta T. [8 ,9 ]
Vasan, Ramachandran S. [1 ,2 ,3 ,8 ,9 ]
Levy, Daniel [8 ,9 ]
Mitchell, Gary F. [7 ]
Vita, Joseph A. [1 ,3 ]
Benjamin, Emelia J. [1 ,2 ,3 ,4 ,8 ,9 ]
机构
[1] Boston Univ, Cardiol Sect, Boston, MA 02118 USA
[2] Boston Univ, Prevent Med Sect, Boston, MA 02118 USA
[3] Boston Univ, Sch Med, Whitaker Cardiovasc Inst, Boston, MA 02118 USA
[4] Boston Univ, Sch Publ Hlth, Boston, MA 02118 USA
[5] Boston Univ, Dept Math, Boston, MA 02118 USA
[6] Boston Univ, Dept Stat, Boston, MA 02118 USA
[7] Cardiovasc Engn Inc, Holliston, MA USA
[8] NHLBI, Framingham Heart Study, Framingham, MA USA
[9] Boston Univ, Framingham Heart Study, Framingham, MA USA
基金
美国国家卫生研究院;
关键词
cohort study; endothelium; epidemiology; risk factors; vascular function; FLOW-MEDIATED DILATION; ENDOTHELIUM-DEPENDENT VASODILATION; INCIDENT CARDIOVASCULAR EVENTS; CROSS-SECTIONAL RELATIONS; NITRIC-OXIDE; RISK-FACTORS; AORTIC STIFFNESS; PREDICTIVE-VALUE; AMPLITUDE; DISEASE;
D O I
10.1161/HYPERTENSIONAHA.110.160812
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Impaired vascular function contributes to the development of clinical cardiovascular disease. The relation between vasodilator function assessed noninvasively in the brachial and digital arteries remains incompletely defined. In the Framingham Offspring, Third Generation and Omni Cohorts, we measured flow-mediated dilation (FMD; n=7031; age 48 +/- 13 years; age range, 19 to 88 years; 54% women) and peripheral arterial tonometry (PAT) ratio (n=4352; 55 +/- 16 years; age range, 19 to 90 years; 51% women). Abnormal vascular function for each measure was defined by the sex-specific fifth percentile in a reference group free of conventional cardiovascular risk factors. The prevalence of abnormal FMD but not abnormal PAT ratio was higher with advancing age. In multivariable models, higher body mass index was associated with a higher prevalence of both abnormal FMD and PAT ratio. Additional correlates of abnormal FMD included increasing age and higher systolic blood pressure. In contrast, correlates of abnormal PAT ratio included lower systolic blood pressure, increasing total/high-density lipoprotein cholesterol ratio, diabetes, smoking, and lipid-lowering medication. Whereas women had higher FMD and PAT ratios compared with men, using sex-specific reference values, women had a higher prevalence of abnormal brachial and digital vascular function. In participants who had concurrent testing (n=1843), PAT ratio was not significantly associated with FMD in multivariable models. In this large, community-based cohort, brachial and digital measures of vascular function had differing relations with cardiovascular risk factors and were nearly uncorrelated with each other. These results suggest that FMD and PAT provide distinct information regarding vascular function in conduit versus smaller digital vessels. (Hypertension. 2011;57:390-396.). Online Data Supplement
引用
收藏
页码:390 / U81
页数:11
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