Document Detail


Pulse pressure is a predictor of vascular endothelial function in middle-aged subjects with no apparent heart disease.
MedLine Citation:
PMID:  20724375     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Elevated pulse pressure (PP) is increasingly being recognized as a cardiovascular risk factor. To investigate whether PP is associated with endothelial function in subjects with no apparent heart disease we prospectively assessed brachial flow-mediated dilation (FMD) in 525 consecutive subjects with no apparent heart disease [323 (61%) men, mean age 52 +/- 11 years, mean body mass index (BMI) 26 +/- 4 kg/m(2)]. Following an overnight fast and discontinuation of all medications for >/= 12 hours, the FMD and endothelium-independent, nitroglycerin-mediated vasodilation (NTG) were assessed using high-resolution linear array ultrasound. Univariate linear analysis revealed a significant inverse association between FMD and PP (r = -0.65, p < 0.01), systolic blood pressure (r = -0.52, p < 0.01) and age (r = -0.21, p < 0.05). Multivariate analysis showed that PP was the strongest independent predictor of FMD. We therefore divided the study population into two groups: group A (n = 290) </= the median PP, and group B (n = 235) > the median PP of 50 mmHg. Male sex, hypertension, diabetes, BMI, heart rate, and the use of aspirin, long-acting nitrates, calcium channel blockers, angiotensin-converting enzyme inhibitors and beta blockers were significantly more common in Group B compared with Group A. FMD but not NTG was significantly greater in patients with PP </= the median PP, compared with > the median PP (14.9 +/- 7.9% vs 10.8 +/- 8.8%, p < 0.001 and 16.1 +/- 9.6% vs 14.8 +/- 8.4%, p = 0.38; respectively). Thus, PP is inversely associated with brachial FMD in middle-aged subjects with no apparent heart disease, suggesting a potential mechanism whereby elevated PP contributes to cardiovascular disease. Long-term follow-up is warranted to elucidate the incidence of coronary artery disease in both study groups.
Authors:
Roy Beigel; Danny Dvir; Yaron Arbel; Alon Shechter; Micha S Feinberg; Michael Shechter
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Vascular medicine (London, England)     Volume:  15     ISSN:  1477-0377     ISO Abbreviation:  Vasc Med     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-20     Completed Date:  2010-12-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9610930     Medline TA:  Vasc Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  299-305     Citation Subset:  IM    
Affiliation:
Leviev Heart Center, Chaim Sheba Medical Center, Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adult
Atherosclerosis / epidemiology,  physiopathology
Blood Pressure*
Brachial Artery / physiology
Coronary Artery Disease / epidemiology*,  physiopathology
Endothelium, Vascular / physiology*
Female
Humans
Hypertension / epidemiology*,  physiopathology
Male
Middle Aged
Predictive Value of Tests
Prognosis
Risk Factors
Vasodilation / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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