Association of endothelial function and vascular data with LDL-c and HDL-c in a homogeneous population of middle-aged, healthy military men: Evidence for a critical role of optimal lipid levels

Laclaustra, Martín; Frangi, Alejandro F.; Frangi, Andres G.; Casasnovas, José A.; Cía, P.

doi:10.1016/j.ijcard.2007.03.001

Cited by 20 publications

(25 citation statements)

References 39 publications

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“…Endothelial function improves with lowering of LDL-c in patients with hypercholesterolemia. 39 In our study, there was an Ϸ16% increase in LDL-c in LC dieters (Table 1). Patients with LDL-c levels Ͻ80 mg/dL have better FMD compared with levels of 80 to 100 mg/dL.…”

Section: Discussionsupporting

confidence: 52%

Benefit of Low-Fat Over Low-Carbohydrate Diet on Endothelial Health in Obesity

et al. 2008

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Abstract-Obesity is associated with impaired endothelial-dependent flow-mediated dilation, a precursor to hypertension and atherosclerosis. Although dieting generally improves cardiovascular risk factors, the direct effect of different dietary strategies on vascular endothelial function is not known. The purpose of this study was to test the hypothesis that a low-fat (LF) diet improves endothelial function compared with an isocaloric low-carbohydrate (LC) diet. Obese (nϭ20; body mass index: 29 to 39; mean systolic blood pressure: 107 to 125 mm Hg) and otherwise healthy volunteers were randomly assigned to either the American Heart Association modeled LF (30% fat calories) diet or an isocaloric LC Atkins' style diet (20 g of carbohydrates) for 6 weeks (4-week weight loss and 2-week maintenance phase). Brachial flow-mediated dilation and dilation to nitroglycerin were measured with ultrasound using automated edge detection technology (baseline, week 2, and week 6). Blood pressure, weight loss, and cholesterol profiles were measured throughout the study. Key Words: diet Ⅲ weight loss Ⅲ endothelium Ⅲ obesity Ⅲ blood pressure O besity is a risk factor for atherosclerosis, a major cause of morbidity and mortality throughout the world. In the United States, the incidence of obesity has risen dramatically in the past decade. Public awareness of the "obesity epidemic" has resulted in various dietary weight loss strategies, and it is estimated that 45% of American women and 30% of American men diet to lose weight. 1 However, the nutrientspecific effects of these diets on cardiovascular health are largely unknown.Mounting evidence suggests that the integrity of the vascular endothelium is critical in the prevention of atherosclerosis, likely through release of endothelial-derived factors such as NO, which confer antiproliferative, antiinflammatory, and antithrombotic properties, in addition to vasodilation. 2,3 Abnormal endothelial function marked by reduced dilation to an increase in flow (endotheliumdependent flow-mediated dilation [FMD]) is an early hallmark of cardiovascular disease and a strong prognostic factor for future cardiovascular events. 4 -9 Most risk factors for coronary artery disease are associated with reduced FMD. 10 Weight loss through conventional low-fat (LF) diets improve endothelial function 11,12 ; however, some currently popular diets emphasize low-carbohydrate (LC) intake supplemented by high dietary fat and protein. Initial reports show sustained weight loss while on LC diets without detrimental effects on serum lipid levels. 13,14 Further benefit may be derived from the reduction in arterial pressure from either LF or LC diets. However, it is unclear whether these cardiovascular benefits of weight loss on a LC diet are negated by the known detrimental effects on endothelial function of even a single high-fat meal. [15][16][17] Weight loss is similar on LC and LF diets, but effects on cardiovascular health, a major anticipated benefit of most weight-loss regimens, may diverge. Therefore, the pur...

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Section: Discussionsupporting

confidence: 52%

Benefit of Low-Fat Over Low-Carbohydrate Diet on Endothelial Health in Obesity

et al. 2008

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“…This suggests that LDL-C within the normal range does not influence brachial FMD in young healthy men without risk factors for CVD. Our observations are unique in that a recent study found that brachial FMD was modestly, but significantly, greater in young (33–39 years) Spanish military men with optimal/near optimal LDL-C compared to men with less favorable LDL-C 21. However, some of the soldiers smoked, had hypertension, and had high LDL-C (up to 232 mg/dl).…”

Section: Discussioncontrasting

confidence: 46%

Modulation of Vascular Endothelial Function by Low-Density Lipoprotein Cholesterol With Aging: Influence of Habitual Exercise

Walker

Eskurza

Pierce

et al. 2009

American Journal of Hypertension

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BACKGROUND Aging is associated with reduced endothelium-dependent dilation (EDD) and increased risk for cardiovascular disease (cVD), but the mechanisms are incompletely understood. clinically elevated plasma low-density lipoprotein cholesterol (LDL-C) is associated with impaired EDD. The purpose of this study was to determine whether circulating LDL-C within the “normal” range modulates EDD in healthy older adults and whether young age or habitual aerobic exercise protects against this adverse effect. METHODS In 83 healthy men with optimal/near optimal LDL-C (<130 mg/dl) or borderline high LDL-C (130–159 mg/dl), EDD (brachial artery flow-mediated dilation, FMD), and endothelium-independent dilation (sublingual glyceryl trinitrate, GTN) were assessed. RESULTS FMD was 35% lower in older nonexercising men with borderline high LDL-C vs. optimal/near optimal LDL-C (3.1 ± 0.5 vs. 4.8 ± 0.4%Δ, P < 0.05), whereas the GTN response did not differ (P = 0.86). In contrast, FMD was similar between groups of young nonexercising men and between groups of older exercising men differing in LDL-C (P = 0.89–0.95). FMD was inversely related to LDL-C among the older nonexercising men (r = −0.43, P < 0.001), whereas there was no relation in the other groups (P > 0.05). CONCLUSIONS Borderline high plasma LDL-C is associated with impaired EDD in older sedentary men, but not in young sedentary or older exercising men. Thus, modest elevations in plasma LDL-C within the normal range may contribute to the increased risk of cVD in sedentary older men by exacerbating vascular endothelial dysfunction, whereas resistance to this adverse influence may help explain the enhanced endothelial function and reduced CVD risk associated with young age and regular aerobic exercise.

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“…The relations between traditional risk factors and arterial wall variables have been investigated in a small number of studies employing populations with small, medium or high cardiovascular disease risk, in children or in women [15,28-32]. Our results show that PWV is related to age, BMI and diastolic blood pressure, while in other studies PWV was also associated with pulse pressure, LDL concentration [15] and blood pressure [30,33].…”

Section: Discussionmentioning

confidence: 51%

Associations among different functional and structural arterial wall properties and their relations to traditional cardiovascular risk factors in healthy subjects: a cross-sectional study

Lunder

Janić

Kejžar

et al. 2012

BMC Cardiovasc Disord

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BackgroundThe arterial wall possesses several functional and structural properties that define arterial health. Once they become impaired, cardiovascular risk increases. We aimed to ascertain the pattern of correlations among different arterial wall properties and to explore their relations to traditional risk factors and cardiovascular risk stratification. To allow such an investigation a middle-aged healthy population was recruited.MethodsThis cross-sectional study included 100 healthy males (aged 41.9 ± 6.4 years). Pulse wave velocity (PWV), β-stiffness and intima-media thickness (IMT) of the carotid artery, and brachial artery flow-mediated dilation (FMD) were measured by a standardized ultrasound approach.ResultsNo correlation between FMD and IMT was found; only relatively poor correlations between PWV (or β-stiffness) and FMD existed, as well as between PWV (or β-stiffness) and IMT. PWV and β-stiffness highly correlated. Unexpectedly, only weak associations between PWV, β-stiffness, FMD, IMT and traditional risk factors were revealed. Hence, traditional risk factors (mainly age) explained only 10-50% of variability for PWV, β-stiffness, FMD and IMT. Although the subjects had low cardiovascular risk according to their Framingham score, their arterial wall properties were already impaired, particularly FMD.ConclusionsIn healthy middle-age males we found: i) absent or poor correlations among arterial stiffness, IMT and endothelial function; ii) a low impact of traditional risk factors on the studied variables, and iii) the presence of impaired arterial wall properties despite low calculated cardiovascular risk. These results provide a deepened understanding of arterial wall properties and could help to improve cardiovascular risk stratification.

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Association of endothelial function and vascular data with LDL-c and HDL-c in a homogeneous population of middle-aged, healthy military men: Evidence for a critical role of optimal lipid levels

Cited by 20 publications

References 39 publications

Benefit of Low-Fat Over Low-Carbohydrate Diet on Endothelial Health in Obesity

Benefit of Low-Fat Over Low-Carbohydrate Diet on Endothelial Health in Obesity

Modulation of Vascular Endothelial Function by Low-Density Lipoprotein Cholesterol With Aging: Influence of Habitual Exercise

Associations among different functional and structural arterial wall properties and their relations to traditional cardiovascular risk factors in healthy subjects: a cross-sectional study

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