Endothelial Function Predicts Progression of Carotid Intima-Media Thickness

Halcox, Julian; Donald, Ann; Ellins, Elizabeth A; Witte, Daniel R.; Shipley, Martin J.; Brunner, Eric J.; Marmot, Michael; Deanfield, John

doi:10.1161/circulationaha.108.765701

Cited by 286 publications

(221 citation statements)

References 47 publications

(44 reference statements)

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“…Similar findings have been previously reported in children with type 1 diabetes mellitus; endothelial dysfunction was reported in the absence of structural atherosclerotic changes (37). Previous studies in various populations have shown that endothelial dysfunction is detected long before the angiographic appearance of atherosclerosis on the vessel wall (22) and has been reported to predict the progression of carotid IMT (38). It could be speculated that JIA may be primarily associated with endothelial dysfunction, apparent even at ages 7-10 years, independently of the presence of systemic or nonsystemic disease.…”

Section: Discussionsupporting

confidence: 87%

Changes in vascular function and structure in juvenile idiopathic arthritis

Vlahos¹,

Theocharis²,

Bechlioulis³

et al. 2011

Arthritis Care & Research

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Objective. Chronic inflammatory diseases in adults have been associated with increased cardiovascular risk and impaired vascular function. We aimed to assess the presence of early vascular dysfunction in patients with juvenile idiopathic arthritis (JIA) and investigate the role of inherent inflammatory process of JIA in vascular health. Methods. Thirty patients with JIA (age range 7-18 years) were compared to 33 age-and sex-matched controls. Endothelial function (brachial artery flow-mediated dilation [FMD]), carotid intima-media thickness (IMT), and arterial stiffness were examined. Endothelial inflammation was assessed by intercellular adhesion molecule 1 (ICAM-1) and P-selectin measurements. Results. Patients with JIA showed decreased FMD compared to controls (P ‫؍‬ 0.001), independent of age (P ‫؍‬ 0.9 among age subgroups). Baseline differences in erythrocyte sedimentation rate, ICAM-1, and glucose between the 2 groups accounted for the difference in FMD. The presence of systemic JIA was associated with greater IMT compared to patients with oligoarticular disease, polyarticular disease, or controls (P ‫؍‬ 0.014, P ‫؍‬ 0.069, and P ‫؍‬ 0.046, respectively). The difference in IMT between systemic versus oligoarticular/polyarticular JIA was attributed to the following risk factors: age, body mass index, blood pressure, disease activity, and corticosteroids use. There were no differences in arterial stiffness indices between JIA patients and controls or between patients with systemic versus nonsystemic disease. Conclusion. Endothelial function is impaired in patients with JIA at a very young age, while IMT is increased only in the presence of systemic JIA. Vascular dysfunction may be partly attributed to the effects of disease-related characteristics (inflammation, disease activity, and medications).

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Section: Discussionsupporting

confidence: 87%

Changes in vascular function and structure in juvenile idiopathic arthritis

Vlahos¹,

Theocharis²,

Bechlioulis³

et al. 2011

Arthritis Care & Research

View full text Add to dashboard Cite

show abstract

“…Similarly, FMD was reported to show an inverse association with the index of small artery elasticity in both diabetic and healthy subjects, but not with IMT 26) . Recently, Halcox et al reported that FMD failed to show any significant association with carotid IMT at baseline but that it predicted annual progression of carotid IMT at the 6-year follow-up of 213 non-smoking middle-aged participants who did not initially have clinical CVD and diabetes 27) . In our study, FMD did not show any significant association with IMT, but showed a close association with stiffness parameter β, which is a functional index of the artery.…”

Section: Relationship Of Fmd/nmd Imt and Stiffness Parameter β Withmentioning

confidence: 99%

Association of Endothelial and Vascular Smooth Muscle Dysfunction with Cardiovascular Risk Factors, Vascular Complications, and Subclinical Carotid Atherosclerosis in Type 2 Diabetic Patients

Kawano

Emoto

Mori

et al. 2012

JAT

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Aim: Atherosclerosis and arteriosclerosis are mainly caused by the dysfunction of arterial components, namely, vascular endothelial cells, smooth muscle cells, and the extracellular matrix. Endothelial dysfunction is well established as a predictive surrogate marker of cardiovascular events; however, little is known regarding the clinical implications of vascular smooth muscle dysfunction for cardiovascular disease and microangiopathy. In the present study, we aimed to clarify the association of arterial dysfunction with micro-/macroangiopathy and conventional cardiovascular risk factors in 181 type 2 diabetic patients (T2DM; age±SD, 64±10 years; duration of diabetes, 12±10 years). Methods: Flow-mediated dilatation (FMD) and nitroglycerin-mediated dilatation (NMD) were assessed to evaluate endothelial dysfunction and vascular smooth muscle dysfunction, respectively, by using a novel ultrasound device, UNEXEF18G (Unex Co. Ltd., Japan). Results: The FMD and NMD were 6.4±3.9% and 13.4±6.6%, respectively. No significant differences in FMD were noted between T2DM with and without micro-or macroangiopathy; however, NMD in T2DM patients with micro-and macroangiopathy was significantly lower than that in T2DM patients without angiopathy. NMD decreased with the progression of chronic kidney disease (CKD) stage (p = 0.005), but not FMD (p = 0.071). On multiple regression analysis, significant independent contributors to FMD were age, smoking, systolic blood pressure, glycosylated hemoglobin, and serum total cholesterol, while those for NMD were age, systolic blood pressure, and waist circumference. Conclusion: The relationship of vascular complications and cardiovascular risk factors with NMD is different from that with FMD in type 2 diabetic patients.

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“…Furthermore, endothelial dysfunction predicts progression of atherosclerosis and incidence of cardiovascular events (46,47). Furthermore, endothelial dysfunction is reversed by a number of interventions proven to reduce cardiovascular risk, such as lipidlowering therapy, angiotensin-converting inhibitors, smoking cessation, and weight loss (44).…”

Section: Epidemiologymentioning

confidence: 99%

Grapes and Cardiovascular Disease

Dohadwala

Vita

2009

The Journal of Nutrition

179

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Epidemiological studies suggest that consumption of wine, grape products, and other foods containing polyphenols is associated with decreased risk for cardiovascular disease. The benefits of wine consumption appear to be greater than other alcoholic beverages. Experimental studies indicate that grape polyphenols could reduce atherosclerosis by a number of mechanisms, including inhibition of oxidation of LDL and other favorable effects on cellular redox state, improvement of endothelial function, lowering blood pressure, inhibition of platelet aggregation, reducing inflammation, and activating novel proteins that prevent cell senescence, e.g. Sirtuin 1. Translational studies in humans support these beneficial effects. More clinical studies are needed to confirm these effects and formulate dietary guidelines. The available data, however, strongly support the recommendation that a diet rich in fruits and vegetables, including grapes, can decrease the risk for cardiovascular disease.

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Endothelial Function Predicts Progression of Carotid Intima-Media Thickness

Cited by 286 publications

References 47 publications

Changes in vascular function and structure in juvenile idiopathic arthritis

Changes in vascular function and structure in juvenile idiopathic arthritis

Association of Endothelial and Vascular Smooth Muscle Dysfunction with Cardiovascular Risk Factors, Vascular Complications, and Subclinical Carotid Atherosclerosis in Type 2 Diabetic Patients

Grapes and Cardiovascular Disease

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