Brachial Flow-Mediated Dilation Predicts Incident Cardiovascular Events in Older Adults

Abstract

Background-The relationship between impaired brachial flow-mediated dilation (FMD) and subsequent clinical cardiovascular events is not well established, especially in older adults whose FMD is often diminished. We assessed the hypothesis that FMD predicts incident cardiovascular events in a population-based cohort of older adults. Methods and Results-FMD was measured at the 1997 to 1998 Cardiovascular Health Study clinic visit in 2792 adults aged 72 to 98 years (82.7% white, 58.6% women) recruited at 4 clinic sites in the United States. Log-rank test and Cox proportional hazard models were used to examine the association between FMD and adjudicated cardiovascular events. A total of 674 subjects (24.1%) had an adjudicated event over the 5-year follow-up period. Event-free survival rates for cardiovascular events were significantly higher in subjects with FMD greater than the sex-specific medians than in subjects with FMD less than or equal to the sex-specific medians (78.3% versus 73.6%, log-rank Pϭ0.006

The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease

“…87 Similarly, impaired endothelial dysfunction detected by EndoPAT (Itamar Medical Ltd, Caesarea, Israel) was an independent predictor of cardiac death, MI, revascularization or cardiac hospitalization in symptomatic outpatients over 7-year follow-up. 88 Similarly, endothelial function assessed in the brachial artery by flow-mediated dilation 89,90 5 The hsCRP level is an independent predictor of incident coronary events after adjustment for traditional risk factors (ie, age, total cholesterol level, HDL cholesterol level, smoking status, BMI, diabetes, history of hypertension, exercise level, and family history of coronary disease). [92][93][94] Thus, in 2003, the Centers for Disease Control and Prevention and the AHA endorsed measurement of the hsCRP level as an adjunct to global risk prediction, particularly in patients at intermediate risk (10%-20% over 10 years).…”

Nicotinamide mononucleotide supplementation reverses vascular dysfunction and oxidative stress with aging in mice

“…Two key antecedents and independent predictors of clinical CVD in older adults are vascular endothelial dysfunction, assessed by endothelium‐dependent dilation (EDD), and large elastic artery stiffness, measured by aortic pulse wave velocity (aPWV) (Lakatta & Levy, 2003; Deanfield et al ., 2007; Yeboah et al ., 2007; Mitchell et al ., 2010). A common mechanism that contributes to both vascular endothelial dysfunction and large elastic artery stiffness with aging is excessive superoxide‐associated vascular oxidative stress (Seals et al ., 2011; Fleenor et al ., 2012a; Bachschmid et al ., 2013).…”

Acute resveratrol supplementation improves flow-mediated dilatation in overweight/obese individuals with mildly elevated blood pressure

“…Chronically reduced NO bioavailability could play a mechanistic role in the progression of cardiovascular disease (CVD) (2). In fact, impaired FMD is now recognised as an independent risk factor for the development of CVD (4)(5). Several cardiovascular risk factors including hypertension (6) and overweight/obesity (7) are associated with impaired FMD, which may reflect structural and functional changes to the endothelium (8).…”

“…However, it is not known which specific polyphenolic compounds present in these foods are responsible for this beneficial effect. Resveratrol (3,5,4'-trihydroxystilbene) is a polyphenol predominately found in red wine and grapes that has attracted much interest due to its cardioprotective potential shown in vivo (14)(15)(16). Resveratrol exists in cis-and trans-isomeric forms, but only trans-isomer is mainly present in wine (17), which can be found at highest concentration in grape skin in ranges between 50 and 400µg/g of fresh weight (18).…”