Association between brachial artery reactivity and cardiovascular disease status in an elderly cohort: the cardiovascular health study.
OBJECTIVE
The association of brachial flow-mediated dilation (FMD) and cardiovascular disease (CVD) status is unclear especially in older adults whose FMD is greatly diminished. We assessed the association of FMD and the presence or absence of subclinical and clinical CVD in a population based cohort of older adults.


RESULTS
FMD was measured in 2971 adults aged 72-98 years (mean age 78.6 years) who participated in the Cardiovascular Health Study. Multiple linear regression analysis was used to examine the association between FMD and CVD status (clinical, subclinical and free of CVD). Out of 2791 with complete data, 82.7% were Caucasians and 59% females. Seven hundred and forty-three were classified as having clinical CVD, 607 as subclinical CVD and 1441 as neither clinical CVD nor subclinical CVD (CVD free). FMD was higher in the CVD free group compared with either the clinical (3.13+/-0.05% vs 2.93+/-0.07%, p=0.025) or the subclinical CVD group (3.13+/-0.05% vs 2.95+/-0.08%, p=0.05) after adjusting for covariates. There was no significant difference between the FMD of subjects with clinical and subclinical CVD (2.93+/-0.07% vs 2.95+/-0.08%, p=0.84). Similar but inverted associations were observed between height adjusted brachial artery diameter (BAD) and CVD status. However, FMD and BAD had poor diagnostic accuracies for identifying older adults with subclinical CVD.


CONCLUSIONS
Among older adults, those with either clinical or subclinical CVD have lower FMD than CVD free subjects. BAD showed similar but inverted associations with CVD status in this cohort. FMD and BAD had poor diagnostic accuracies for identifying older adults with subclinical CVD.
Yeboah
Joseph
J
Department of Internal Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston- Salem, NC 27157, United States. jyeboah@wfubmc.edu
Sutton-Tyrrell
Kim
K
Mcburnie
Mary Ann
MA
Burke
Gregory L
GL
Herrington
David M
DM
Crouse
John R
JR
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000145:classification / Q000175:diagnosis / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D018056:Hemorheology; D006801:Humans; D008297:Male; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D012372:ROC Curve; D014463:Ultrasonography; D014664:Vasodilation / Q000502:physiology*
D015415:Biomarkers
J Am Coll Cardiol. 2003 May 21;41(10):1769-75
12767663
Am J Physiol Heart Circ Physiol. 2006 Dec;291(6):H3043-9
16861699
Circulation. 2003 Oct 28;108(17):2093-8
14530195
Am J Geriatr Cardiol. 2004 May-Jun;13(3):137-51
15133417
N Engl J Med. 1987 May 28;316(22):1371-5
3574413
Biometrics. 1988 Sep;44(3):837-45
3203132
Stroke. 1991 Sep;22(9):1155-63
1926258
J Am Soc Echocardiogr. 1992 Jan-Feb;5(1):63-72
1739473
Lancet. 1992 Nov 7;340(8828):1111-5
1359209
Stroke. 1992 Dec;23(12):1752-60
1448826
Circulation. 1993 Sep;88(3):837-45
8353913
Ann Epidemiol. 1991 Feb;1(3):263-76
1669507
JAMA. 1994 Jan 26;271(4):289-94
8295288
Am J Epidemiol. 1994 Jun 15;139(12):1164-79
8209875
Stroke. 1994 Jul;25(7):1354-9
8023349
Clin Chem. 1995 Feb;41(2):264-70
7874780
Circulation. 1995 Aug 15;92(4):720-6
7641349
Stroke. 1996 Apr;27(4):654-60
8614925
Stroke. 1996 Nov;27(11):2012-5
8898807
Arterioscler Thromb Vasc Biol. 1997 Nov;17(11):3057-63
9409293
N Engl J Med. 1999 Jan 7;340(1):14-22
9878640
Arterioscler Thromb Vasc Biol. 1999 Jun;19(6):1491-8
10364080
Stroke. 1999 Aug;30(8):1572-6
10436103
J Am Geriatr Soc. 2005 Feb;53(2):211-8
15673343
Stroke. 2005 Apr;36(4):762-7
15746451
J Biomech. 2005 Oct;38(10):1949-71
16084198
Am J Cardiol. 2006 Jan 1;97(1):77-82
16377288
Arch Intern Med. 2006 Jan 9;166(1):71-8
16401813
Intern Med. 2006;45(8):503-9
16702741
Curr Med Chem. 2006;13(14):1655-65
16787211
Atherosclerosis. 2000 Mar;149(1):19-24
10704610
Arterioscler Thromb Vasc Biol. 2000 Mar;20(3):823-9
10712409
Am J Cardiol. 2001 May 15;87(10):1154-9
11356389
J Cardiovasc Risk. 2001 Oct;8(5):319-28
11702039
Arterioscler Thromb Vasc Biol. 2001 Dec;21(12):1955-61
11742870
Circulation. 2002 Apr 2;105(13):1567-72
11927524
Circulation. 2003 Mar 4;107(8):1146-51
12615793
Prog Biophys Mol Biol. 2003 Apr;81(3):177-99
12732261
Kidney Int. 2006 Sep;70(5):840-53
16837917
Neurology. 2006 Sep 26;67(6):1056-8
17000977
J Am Coll Cardiol. 2003 Oct 1;42(7):1149-60
14522472