In:
Vascular Medicine, SAGE Publications, Vol. 15, No. 4 ( 2010-08), p. 299-305
Abstract:
Elevated pulse pressure (PP) is increasingly being recognized as a cardiovascular risk factor. To investigate whether PP is associated with endothelial function in subjects with no apparent heart disease we prospectively assessed brachial flow-mediated dilation (FMD) in 525 consecutive subjects with no apparent heart disease [323 (61%) men, mean age 52 ± 11I years, mean body mass index (BMI) 26 ± 4 kg/m 2 ]. Following an overnight fast and discontinuation of all medications for ≥ 12 hours, the FMD and endothelium-independent, nitroglycerin-mediated vasodilation (NTG) were assessed using high-resolution linear array ultrasound. Univariate linear analysis revealed a significant inverse association between FMD and PP ( r = —0.65, p 〈 0.01), systolic blood pressure ( r = —0.52, p 〈 0.01) and age ( r = —0.21, p 〈 0.05). Multivariate analysis showed that PP was the strongest independent predictor of FMD. We therefore divided the study population into two groups: group A ( n = 290) ≤ the median PP, and group B ( n = 235) 〉 the median PP of 50 mmHg. Male sex, hypertension, diabetes, BMI, heart rate, and the use of aspirin, long-acting nitrates, calcium channel blockers, angiotensin-converting enzyme inhibitors and beta blockers were significantly more common in Group B compared with Group A. FMD but not NTG was significantly greater in patients with PP ≤ the median PP, compared with 〉 the median PP (14.9 ± 7.9% vs 10.8 ± 8.8%, p 〈 0.001 and 16.1 ± 9.6% vs 14.8 ± 8.4%, p = 0.38; respectively). Thus, PP is inversely associated with brachial FMD in middle-aged subjects with no apparent heart disease, suggesting a potential mechanism whereby elevated PP contributes to cardiovascular disease. Long-term follow-up is warranted to elucidate the incidence of coronary artery disease in both study groups.
Type of Medium:
Online Resource
ISSN:
1358-863X
,
1477-0377
DOI:
10.1177/1358863X10373300
Language:
English
Publisher:
SAGE Publications
Publication Date:
2010
detail.hit.zdb_id:
2027562-6
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