title: Association between brachial artery reactivity and cardiovascular disease status in an elderly cohort: the cardiovascular health study.
abstract: 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.
authors: Department of Internal Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston- Salem, NC 27157, United States. jyeboah@wfubmc.edu
authors: Joseph
authors: J
authors: Yeboah
authors: Kim
authors: K
authors: Sutton-Tyrrell
authors: Mary Ann
authors: MA
authors: Mcburnie
authors: Gregory L
authors: GL
authors: Burke
authors: David M
authors: DM
authors: Herrington
authors: John R
authors: JR
authors: Crouse
mesh_terms: 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*
chemical_list: D015415:Biomarkers
references: J Am Coll Cardiol. 2003 May 21;41(10):1769-75
references: 12767663
references: Am J Physiol Heart Circ Physiol. 2006 Dec;291(6):H3043-9
references: 16861699
references: Circulation. 2003 Oct 28;108(17):2093-8
references: 14530195
references: Am J Geriatr Cardiol. 2004 May-Jun;13(3):137-51
references: 15133417
references: N Engl J Med. 1987 May 28;316(22):1371-5
references: 3574413
references: Biometrics. 1988 Sep;44(3):837-45
references: 3203132
references: Stroke. 1991 Sep;22(9):1155-63
references: 1926258
references: J Am Soc Echocardiogr. 1992 Jan-Feb;5(1):63-72
references: 1739473
references: Lancet. 1992 Nov 7;340(8828):1111-5
references: 1359209
references: Stroke. 1992 Dec;23(12):1752-60
references: 1448826
references: Circulation. 1993 Sep;88(3):837-45
references: 8353913
references: Ann Epidemiol. 1991 Feb;1(3):263-76
references: 1669507
references: JAMA. 1994 Jan 26;271(4):289-94
references: 8295288
references: Am J Epidemiol. 1994 Jun 15;139(12):1164-79
references: 8209875
references: Stroke. 1994 Jul;25(7):1354-9
references: 8023349
references: Clin Chem. 1995 Feb;41(2):264-70
references: 7874780
references: Circulation. 1995 Aug 15;92(4):720-6
references: 7641349
references: Stroke. 1996 Apr;27(4):654-60
references: 8614925
references: Stroke. 1996 Nov;27(11):2012-5
references: 8898807
references: Arterioscler Thromb Vasc Biol. 1997 Nov;17(11):3057-63
references: 9409293
references: N Engl J Med. 1999 Jan 7;340(1):14-22
references: 9878640
references: Arterioscler Thromb Vasc Biol. 1999 Jun;19(6):1491-8
references: 10364080
references: Stroke. 1999 Aug;30(8):1572-6
references: 10436103
references: J Am Geriatr Soc. 2005 Feb;53(2):211-8
references: 15673343
references: Stroke. 2005 Apr;36(4):762-7
references: 15746451
references: J Biomech. 2005 Oct;38(10):1949-71
references: 16084198
references: Am J Cardiol. 2006 Jan 1;97(1):77-82
references: 16377288
references: Arch Intern Med. 2006 Jan 9;166(1):71-8
references: 16401813
references: Intern Med. 2006;45(8):503-9
references: 16702741
references: Curr Med Chem. 2006;13(14):1655-65
references: 16787211
references: Atherosclerosis. 2000 Mar;149(1):19-24
references: 10704610
references: Arterioscler Thromb Vasc Biol. 2000 Mar;20(3):823-9
references: 10712409
references: Am J Cardiol. 2001 May 15;87(10):1154-9
references: 11356389
references: J Cardiovasc Risk. 2001 Oct;8(5):319-28
references: 11702039
references: Arterioscler Thromb Vasc Biol. 2001 Dec;21(12):1955-61
references: 11742870
references: Circulation. 2002 Apr 2;105(13):1567-72
references: 11927524
references: Circulation. 2003 Mar 4;107(8):1146-51
references: 12615793
references: Prog Biophys Mol Biol. 2003 Apr;81(3):177-99
references: 12732261
references: Kidney Int. 2006 Sep;70(5):840-53
references: 16837917
references: Neurology. 2006 Sep 26;67(6):1056-8
references: 17000977
references: J Am Coll Cardiol. 2003 Oct 1;42(7):1149-60
references: 14522472