Gender Differences on Brachial Flow‐mediated Dilation and Carotid Intima‐media Thickness for Prediction of Spontaneous Cardiovascular Events

Hu, Rui; Wang, Weiqun; Lau, Chu‐Pak; Tse, Hung‐Fat

doi:10.1002/clc.20314

Cited by 25 publications

(18 citation statements)

References 21 publications

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“…Furthermore, ED seems to potentiate the negative effect of the metabolic syndrome on mortality and cardiovascular events in women [13], [14]. These observations are consistent with the notion that endothelial function may be a pivotal factor explaining gender differences in CVD.…”

Section: Introductionsupporting

confidence: 86%

Cardiovascular Risk Factors Have Larger Impact on Endothelial Function in Self-Reported Healthy Women than Men in the HUNT3 Fitness Study

et al. 2014

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BackgroundSeveral studies suggest that cardiovascular risk factors comprising the metabolic syndrome have larger effects on the development of cardiovascular disease in women than in men. A recent study in self-reported healthy subjects demonstrated a marked gender difference in endothelial dysfunction that may be an important precursor of manifest cardiovascular disease. The aim of the present study was to determine whether the association between endothelial function and cardiovascular risk factors is different in self-reported healthy women compared to self-reported healthy men.Methods and ResultsAssociations between endothelial function (flow mediated dilation, FMD, of the brachial artery measured by ultrasound), anthropometric variables, peak oxygen uptake (VO2peak), blood pressure, serum lipids, blood glucose and a questionnaire on general health and lifestyle including smoking status were studied by logistic and linear regression in 2 528 women and 2 211 men aged 20–89 years, free from self-reported cardiovascular disease. In women with hyperglycemia, endothelial dysfunction (FMD ≤0%) occurred twice as frequently as in male counterparts. The presence of the metabolic syndrome, high blood pressure and low VO2peak increased the prevalence of endothelial dysfunction more in women than in men.ConclusionEndothelial dysfunction is more strongly associated with cardiovascular risk factors in self-reported healthy women than in self-reported healthy men. This finding could explain why the metabolic syndrome, and especially hyperglycemia, is associated with higher cardiovascular risk and a worse prognosis in women.

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Section: Introductionsupporting

confidence: 86%

Cardiovascular Risk Factors Have Larger Impact on Endothelial Function in Self-Reported Healthy Women than Men in the HUNT3 Fitness Study

et al. 2014

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“…An FMD ≤3.5% is reported to predict future cardiovascular events in women with CVD risk factors [21]; six of our subjects had an FMD below this level. FMD was not associated with the traditional modifiable cardiovascular disease risk factors in this healthy population.…”

Section: Resultsmentioning

confidence: 94%

Soluble TNF and IL-6 receptors: Indicators of vascular health in women without cardiovascular disease

et al. 2013

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Cytokine receptor subunits are released from cells in a regulated manner and circulate in soluble forms at concentrations that are orders of magnitude greater than the concentrations of the cytokines themselves. The purpose of this study was to determine if the circulating concentrations of soluble receptor subunits for interleukin-1 beta (IL-1β), tumor necrosis factor alpha (TNFα) and interleukin-6 (IL-6) might serve as early indicators of vascular dysfunction independent of the traditional cardiovascular disease (CVD) risk factors in women. Healthy women, aged 20-50 years (n = 36), were assessed for circulating concentrations of the cytokines IL-1β, IL-6 and TNFα and the soluble cytokine receptor subunits interleukin-1 receptor type I (sIL-1RI), sIL-1RII, sIL-6Rα, glycoprotein 130 (s-gp130), soluble TNF receptor type 1 (sTNFR1), and sTNFR2, along with traditional CVD risk factors. Cytokine receptor subunit expression on mononuclear cells and the release of these subunits in vitro were also determined. Brachial artery flow-mediated dilation (FMD), carotid intima-media thickness (cIMT) and carotid-femoral pulse wave velocity (cfPWV) were assessed by ultrasonography and Doppler probes. Circulating sIL-6Rα correlated negatively with FMD (r = −0.56, p = 0.007) independent of age and other CVD risk factors. Circulating sTNFR1 correlated positively with cfPWV (r = 0.60, p = 0.002). TNFR1 receptor expression on monocytes correlated positively with cIMT (r = 0.51, p = 0.004). Plasma concentrations of IL-1β, IL-6 and TNFα were not significantly associated with FMD, cIMT or cfPWV. These data suggest that the receptors for IL-6 and TNFα, rather than the cytokines themselves, may be better indicators of early vascular changes that are associated with CVD.

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“…12 Endothelial function can be assessed noninvasively via ultrasound measurement of brachial artery vasodilator responses to hyperemic blood flow (flow-mediated dilation; FMD). 13 Endothelial dysfunction, quantified as reduced FMD, is a predictor of cardiovascular events in general populations, 14,15 cardiac and hypertensive patients, 16,17 and postmenopausal women. 18 …”

mentioning

confidence: 99%

Endothelial function in postmenopausal women with nighttime systolic hypertension

et al. 2015

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Objective Hypertension becomes more prevalent in women during their postmenopausal years. Nighttime systolic blood pressure (SBP) is especially predictive of adverse cardiac events and the relationship between rising nighttime SBP and cardiovascular risk increases more rapidly in women compared to men. The reasons for the prognostic significance of nighttime SBP are not completely known, but may involve vascular endothelial dysfunction. The purpose of this study was to examine the relationship of nighttime SBP and endothelial function, assessed by brachial artery flow-mediated dilation (FMD) and to determine whether postmenopausal women with nighttime hypertension (SBP≥120 mm Hg) evidenced greater endothelial dysfunction compared to women with normal nighttime SBP. Methods One-hundred postmenopausal women (mean age: 65.8 ± 7.5 years, body mass index: 28.3 ± 4.7 kg/m2, hypertension: 47%, coronary artery disease: 51%, mean clinic BP 137 ± 17/67 ± 11 mm Hg, 34 with nighttime hypertension) underwent 24-hour ambulatory BP monitoring, actigraphy, and brachial artery FMD assessments. Results Multivariate regression models showed that higher nighttime SBP and larger baseline artery diameter were inversely related to FMD. Nighttime SBP and baseline artery diameter accounted for 23% of the variance in FMD. After adjusting for baseline artery diameter, women with nighttime hypertension had lower FMD than women with normal nighttime SBP (2.95%±0.65 vs 5.52%±0.46, p = .002). Conclusions In postmenopausal women, nighttime hypertension was associated with reduced endothelial function. Research examining the therapeutic benefits of treating nighttime hypertension on endothelial function and future cardiovascular risk in postmenopausal women is warranted.

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Gender Differences on Brachial Flow‐mediated Dilation and Carotid Intima‐media Thickness for Prediction of Spontaneous Cardiovascular Events

Cited by 25 publications

References 21 publications

Cardiovascular Risk Factors Have Larger Impact on Endothelial Function in Self-Reported Healthy Women than Men in the HUNT3 Fitness Study

Cardiovascular Risk Factors Have Larger Impact on Endothelial Function in Self-Reported Healthy Women than Men in the HUNT3 Fitness Study

Soluble TNF and IL-6 receptors: Indicators of vascular health in women without cardiovascular disease

Endothelial function in postmenopausal women with nighttime systolic hypertension

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