title: A comparison of three different methods to evaluate endothelium-dependent vasodilation in the elderly: the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study.
abstract: BACKGROUND
  Three different techniques to evaluate endothelium-dependent vasodilation in the peripheral circulation have been described but not simultaneously tested in a large-scale population-based setting. This study aimed to evaluate the feasibility and usefulness of these techniques in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study.
  
  
  RESULTS
  In the population-based PIVUS study (1016 subjects aged 70 years), the invasive forearm technique with acetylcholine given in the brachial artery (EDV), the brachial artery ultrasound technique with measurement of flow-mediated dilatation (FMD), and the pulse wave analysis method with beta-2-agonist (terbutaline) provocation were successfully used in 87%, 97%, and 86% of the sample, respectively. The results of EDV and pulse wave analysis were interrelated (r=0.12, P=0.0013), but no relationships were found with FMD measurements. All 3 techniques were correlated to the Framingham risk score (r=0.10 to 0.12, P=0.0007 to 0.001). In multiple regression analysis, however, only EDV and FMD were independently associated with the Framingham score.
  
  
  CONCLUSIONS
  All 3 evaluated techniques were feasible to perform in a general elderly population. Both the invasive forearm technique and FMD were independently associated with increased coronary risk, suggesting that information on conduit artery and resistance artery endothelial function carry different, but important, information in the elderly. If the invasive technique cannot be used, the pulse wave based technique is an alternative.
authors.affiliation: Department of Medicine, Uppsala University Hospital, Mölndal, Sweden. lars.lind@medsci.uu.se
authors.forename: Lars
authors.initials: L
authors.lastname: Lind
authors.forename: Nilla
authors.initials: N
authors.lastname: Fors
authors.forename: Jan
authors.initials: J
authors.lastname: Hall
authors.forename: Kerstin
authors.initials: K
authors.lastname: Marttala
authors.forename: Anna
authors.initials: A
authors.lastname: Stenborg
mesh_terms: D000109:Acetylcholine; D000368:Aged; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D001794:Blood Pressure; D001916:Brachial Artery / Q000502:physiology; D003935:Diagnostic Techniques, Cardiovascular; D004730:Endothelium, Vascular / Q000502:physiology*; D005260:Female; D005542:Forearm / Q000098:blood supply; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011673:Pulsatile Flow; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D013566:Sympathomimetics; D013726:Terbutaline; D014463:Ultrasonography; D014664:Vasodilation; D014665:Vasodilator Agents
chemical_list: D013566:Sympathomimetics; D014665:Vasodilator Agents; D013726:Terbutaline; D000109:Acetylcholine