title: Modestly overweight women have vascular endothelial dysfunction.
abstract: BACKGROUND
  Vascular endothelial dysfunction occurs early in the atherosclerotic process and is predictive of cardiovascular prognosis. However, the association between specific cardiovascular risk factors and endothelial dysfunction in women has not been well characterized. This study examined the relationship between endothelial dysfunction and cardiovascular risk factors (body mass index [BMI] >or= 25 kg/m(2), current smoking, age, diabetes, hypertension, hypercholesterolemia, and family history of early coronary heart disease) in a population of women that included those already being treated for risk factors.
  
  
  METHODS
  Endothelial function was assessed by brachial artery ultrasound flow-mediated vasodilation (FMD) in 185 consecutive women without a history of coronary heart disease. Women with hypertension, diabetes, or hyperlipidemia were allowed to continue on their usual therapy.
  
  
  RESULTS
  There was an inverse linear association between age and FMD. Subjects who were active smokers had lower FMD compared with nonsmokers, and subjects with BMI >or= 25 kg/m(2) had lower FMD than subjects with BMI < 25 kg/m(2). FMD in overweight women (BMI >or= 25 and < 30 kg/m(2)) was similar to that of obese women (BMI >or= 30 kg/m(2)). Multivariate analysis demonstrated that body mass index, current smoking, and age were independent predictors of endothelial dysfunction in this population.
  
  
  CONCLUSIONS
  Modestly elevated BMI, smoking, and age predict endothelial dysfunction in women, even in the presence of treatment for other atherosclerotic risk factors. These findings demonstrate the importance of modest elevation in BMI as a risk factor for impaired vascular health in women, and underscore the need for focusing further attention on lifestyle modification as a component of cardiovascular disease prevention.
authors.affiliation: Division of Cardiology, Tufts Medical Center, Boston, Massachusetts, USA.
authors.forename: Ayan R
authors.initials: AR
authors.lastname: Patel
authors.forename: Han
authors.initials: H
authors.lastname: Hui
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Kuvin
authors.forename: Natesa G
authors.initials: NG
authors.lastname: Pandian
authors.forename: Richard H
authors.initials: RH
authors.lastname: Karas
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D015992:Body Mass Index; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D004730:Endothelium, Vascular / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D050177:Overweight / Q000150:complications / Q000503:physiopathology*; D011379:Prognosis; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D014463:Ultrasonography; D014664:Vasodilation; D055815:Young Adult