Nn. Chan et al., Cardiovascular risk factors as determinants of endothelium-dependent and endothelium-independent vascular reactivity in the general population, J AM COL C, 38(7), 2001, pp. 1814-1820
Citations number
38
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Objectives We examined to what extent the variation in risk factors for cor
onary heart disease (CHD) and the Framingham risk score (FRS) explain the v
ariation in vascular reactivity in adults aged 30 to 53 Years.
Background The role of risk factors in determining vascular reactivity in t
he general population has not been quantified.
Methods Risk factors for CHD were measured, and the FRS was calculated in 6
9 healthy volunteers. Lipoprotein particle size was measured using proton-n
uclear magnetic resonance spectroscopy. Forearm plethysmography was used to
assess blood flow responses to acetylcholine (ACh), bradykinin (BK), glyce
ryl trinitrate (GTN), noradrenaline and N-G-monomethyl-L-arginine (L-NMMA).
Results Lower ACh and BK responses were associated with a higher body mass
index (BMI), a higher total cholesterol to high-density lipoprotein (HDL) c
holesterol ratio, lower HDL cholesterol and a cigarette smoking habit (all
p<0.05). Higher low-density lipoprotein (LDL) cholesterol was also associat
ed with a lower BK response (p=0.001). A decreased GTN response was associa
ted with a higher BMI and total cholesterol to HDL cholesterol ratio (both
p<0.05). A decreased L-NMMA response was associated with a smoking habit (p
<0.001). Lipoprotein particle sizes did not independently predict any vascu
lar response. A high FRS was associated with a reduced response to ACh (p=0
.07), BK (p=0.003) and L-NMMA (p=0.003), and the relationship was stronger
in women than in men. Altogether, risk factors explained 13%, 9%, 8% and 15
% of the response to ACh, BK, GTN and L-NMMA, respectively.
Conclusions Lipids, BMI and smoking are important determinants of vascular
reactivity. The FRS is predictive of agonist-stimulated, endothelium-depend
ent vasodilation and basal NO release. However, much of the variation in th
e vascular responses to these drugs, at this age, remains unexplained. (J A
m Coll Cardiol 2001;38:1814-20) (C) 2001 by the American College of Cardiol
ogy.