Gender-Based Differences in Brachial Artery Flow-Mediated Vasodilation as an Indicator of Significant Coronary Artery Disease

Patel, Ayan R.; Kuvin, Jeffrey T.; Sliney, Kathleen A.; Rand, William; Chiang, Jessica C.; Udelson, James E.; Pandian, Natesa G.; Karas, Richard H.

doi:10.1016/j.amjcard.2005.06.060

Cited by 21 publications

(17 citation statements)

References 19 publications

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“…1 -3 Furthermore, endothelial dysfunction in both the coronary system and the peripheral circulation is predictive of cardiac events. 1 -4,6 Although there are gender-based differences in vascular endothelial function, 9 there is evidence that the link between vascular endothelial dysfunction and cardiac prognosis is applicable to women as well as men. Bugiardini et al observed that in women with angina and myocardial perfusion abnormalities with normal coronary angiograms, coronary endothelial dysfunction was associated with future coronary atherosclerosis.…”

Section: Endothelial Dysfunction and Cardiovascular Diseasementioning

confidence: 99%

“…There is evidence that there are gender-based differences in vascular endothelial function, supporting the concept of investigating the relationship between atherosclerotic risk factors and endothelial dysfunction specifically in women. 9 The purpose of this study was to examine the relationship between cardiovascular risk factors and endothelial function in a contemporary …”

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confidence: 99%

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Modestly Overweight Women Have Vascular Endothelial Dysfunction

Patel

Han

Kuvin

et al. 2009

Clinical Cardiology

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Background: Vascular endothelial dysfunction occurs early in the atherosclerotic process and is predictive of cardiovascular prognosis. However, the association between specific cardiovascular risk factors and endothelial dysfunction in women has not been well characterized. This study examined the relationship between endothelial dysfunction and cardiovascular risk factors (body mass index [BMI] ≥25 kg/m 2 , current smoking, age, diabetes, hypertension, hypercholesterolemia, and family history of early coronary heart disease) in a population of women that included those already being treated for risk factors. Methods: Endothelial function was assessed by brachial artery ultrasound flow-mediated vasodilation (FMD) in 185 consecutive women without a history of coronary heart disease. Women with hypertension, diabetes, or hyperlipidemia were allowed to continue on their usual therapy. Results: There was an inverse linear association between age and FMD. Subjects who were active smokers had lower FMD compared with nonsmokers, and subjects with BMI ≥25 kg/m 2 had lower FMD than subjects with BMI <25 kg/m 2 . FMD in overweight women (BMI ≥25 and <30 kg/m 2 ) was similar to that of obese women (BMI ≥30 kg/m 2 ). Multivariate analysis demonstrated that body mass index, current smoking, and age were independent predictors of endothelial dysfunction in this population. Conclusion: Modestly elevated BMI, smoking, and age predict endothelial dysfunction in women, even in the presence of treatment for other atherosclerotic risk factors. These findings demonstrate the importance of modest elevation in BMI as a risk factor for impaired vascular health in women, and underscore the need for focusing further attention on lifestyle modification as a component of cardiovascular disease prevention. IntroductionVascular endothelial dysfunction develops early in the atherosclerotic process and cardiac risk factors are associated with vascular endothelial dysfunction. Several studies have demonstrated that the presence of vascular endothelial dysfunction predicts an increase in risk of future cardiac events 1 -5 in both men and women. Cardiovascular risk factors such as hypertension, diabetes, hyperlipidemia, smoking, and obesity have been observed to be associated with vascular endothelial dysfunction, even prior to the development of clinically evident coronary atherosclerosis. Furthermore, treatment of cardiovascular risk factors can reverse endothelial dysfunction 6,7 in some patients.Although the association between cardiac risk factors and endothelial dysfunction has been observed in prior studies, 8 the relationship between specific risk factors and endothelial dysfunction in women in the current treatment era has not been well established. There is evidence that there are gender-based differences in vascular endothelial function, supporting the concept of investigating the relationship between atherosclerotic risk factors and endothelial dysfunction specifically in women. 9 The purpose of this study was to examine the relation...

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Section: Endothelial Dysfunction and Cardiovascular Diseasementioning

confidence: 99%

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confidence: 99%

Modestly Overweight Women Have Vascular Endothelial Dysfunction

Patel

Han

Kuvin

et al. 2009

Clinical Cardiology

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“…8 Other studies also revealed that men show a significantly deteriorated endothelial function when compared to pre-and postmenopausal women. 9,10 Interestingly, no difference in FMD was noted between men and women after the age of 70 years, 8 suggesting that age or menopause-related metabolic disturbances may have an effect on endothelial function.…”

Section: Introductionmentioning

confidence: 99%

Correlates of reactive hyperemic index in men and postmenopausal women

et al. 2013

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The aim of the present study was to investigate the differences in digital reactive hyperemic index (RHI) in men and postmenopausal women. We investigated the differences in and correlates of RHI, measured by peripheral artery tonometry (PAT), in a group of 82 men (mean age ± SD: 55.6 ± 8.2 years; body mass index: 29.0 ± 4.2 kg/m 2 ) and 125 postmenopausal women (58.9 ± 5.2 years; 27.7 ± 4.1 kg/m 2 ). We also examined fRHI values (natural log of the PAT ratio of the 90-120 seconds post-occlusion interval) and augmentation index (AIx) as a measure of arterial stiffness. We found that RHI, fRHI and AIx were significantly lower in men compared to postmenopausal women (p<0.0001). We also found that fRHI values were significantly lower in individuals with (MetS+) versus without (MetS-) the metabolic syndrome (MetS). Endothelial inflammation was present in MetS+ subjects as indicated by increased plasma soluble intercellular adhesion molecule-1 (sICAM-1) (p<0.001) and E-selectin (p=0.0519) concentrations compared to MetS-individuals. No significant difference was found in RHI or AIx between MetS+ versus MetS-individuals. In summary, our study reveals that men have an impairment of endothelial function, assessed by digital PAT, compared to postmenopausal women. Furthermore, we show that the presence of the MetS is characterized by endothelial dysfunction, as suggested by lower fRHI, as well as by endothelial inflammation, which likely contributes to the increased cardiovascular disease risk associated with the MetS. ClinicalTrials.gov Identifier: NCT01085019

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“…Endothelial function is affected by chronic conditions such as obesity, diabetes, hypercholesterolemia, smoking and hypertension 5 , and, acutely, by sleeplessness, mental stress, hormonal changes, physical exercise, menstrual cycle and diet 3 . Vascular reactivity changes caused by these conditions can be observed by BAFMD 5 and affect its reliability as well.…”

Section: Introductionmentioning

confidence: 99%

Confiabilidade da medida da dilatação fluxo-mediada da artéria braquial pela ultra-sonografia

Meirelles

Leite²,

Montenegro³

et al. 2007

Arq. Bras. Cardiol.

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SummaryObjective: To determine the reliability of the baseline (BBAB) and post occlusion (POBAD) brachial artery diameters, brachial artery flow-mediated dilatation (BAFMD) measurements, and to quantify the standard error of these measurements (TEM).Methods: Internal consistency (2 measurements on the same day) was determined in 10 volunteers, whereas stability (2 measurements on separate days) was determined in 13 volunteers. All the volunteers were apparently healthy and all were nonsmokers. The brachial artery images were obtained using a two dimensional Doppler ultrasound instrument equipped with a 14 MHz transducer. The distances between the intima-lumen interfaces were measured before and after the blood flow had been stopped by means of a cuff on the arm for five minutes. BAFMD was considered as the percent change of POBAD in relation to BBAD.Results: ANOVA did not identify any significant differences between the measurements taken on the same and separate days. For BAFMD, the intraclass correlation coefficients between the measurements taken on the same and separate days were: R = 0.7001 and R = 0.8420, respectively (p < 0.05). The coefficients of variation were 5.8% and 12.4% and the relative ETMs were 13.8% and 14.9%, respectively, for the measurements taken on the same and separate days. Analysis of the Bland-Altman graphs indicated that the variables did not present heteroscedastic errors. Conclusion:The BBAD, POBAD and BAFMD measurements using the manual ultrasound technique were highly reliable for both the same and separate day measurements and therefore can be used to diagnose and monitor endothelial function. (Arq Bras Cardiol 2007;89(3):160-167)

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Gender-Based Differences in Brachial Artery Flow-Mediated Vasodilation as an Indicator of Significant Coronary Artery Disease

Cited by 21 publications

References 19 publications

Modestly Overweight Women Have Vascular Endothelial Dysfunction

Modestly Overweight Women Have Vascular Endothelial Dysfunction

Correlates of reactive hyperemic index in men and postmenopausal women

Confiabilidade da medida da dilatação fluxo-mediada da artéria braquial pela ultra-sonografia

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