Modeling preclinical cardiovascular risk for use in epidemiologic studies - Miami community health study

To develop a method for assessing preclinical cardiovascular disease risk, models of resting cardiovascular regulation and of insulin metabolic syndro me were derived from information collected from 1991 to 1996 in a culturall y heterogeneous sample of 319 healthy men and women (aged 25-44 years) from Miami-Dade County, Florida. The model of resting cardiovascular regulation used 8 noninvasive measures of autonomic and cardiovascular function. Thre e factors were derived: 1) parasympathetic, 2) inotropy, and 3) systemic va scular resistance. The model of insulin metabolic syndrome used 12 measures assessing body mass, insulin, glucose, and lipid metabolism. Four factors were derived: 1) body mass and fat distribution, 2) glucose level and regul ation, 3) insulin level and regulation, and 4) plasma lipid levels, Analyse s of the association of the two models revealed that subjects with lower ca rdiac contractility had greater body mass, higher fasting and postload insu lin and glucose levels, and lower insulin sensitivity. Subjects with greate r vascular resistance had greater body mass, higher total cholesterol and t riglyceride levels, and lower high density lipoprotein cholesterol levels. These findings indicate that preclinical cardiovascular disease risk may in volve pathophysiologic processes in which cardiac inotropic and vasodilator y functions are linked to specific aspects of insulin metabolic syndrome.