Age-related progressive brachial artery endothelial dysfunction precedes the changed carotid and left ventricular geometry in healthy humans

In this study the authors evaluated correlation between aging and brachial endothelial and vascular smooth muscle dysfunction, changes in carotid geom etry, and left ventricular remodeling. Vasomotor influences of brachial end othelium and brachial smooth muscle function to reactive hyperemia and nitr oglycerin (400 mu g, sublingual spray) were assessed by noninvasive ultraso und in 66 healthy subjects of different ages (20-82 years). Carotid intima- media thickness and left ventricular mass index were also assessed by ultra sound and compared with brachial hemodynamic parameters. All results were a nalyzed by linear regression analysis. The response of brachial artery diastolic diameter to reactive hyperemia de creased with aging (p < 0.0001). Also, the response of brachial artery dias tolic diameter to nitroglycerin increased relative to aging (p < 0.004). Ag e-related correlations between increased carotid intima-media thickness and brachial artery diastolic diameter response to reactive hyperemia (p < 0.0 1) as well as between increased carotid intima-media thickness and increase d left ventricular mass index (p < 0.001) were found. However, there was no correlation between brachial artery diastolic diameter response to reactiv e hyperemia and increased left ventricular mass index (p > 0.05). The study showed that aging influences not only brachial endothelial vasomo tor properties but also vascular and cardiac geometry. The authors believe that modern therapeutic approach should take these results into considerati on to establish new vasculoprotective and cardioprotective strategies.