title: Flow-mediated dilatation (FMD) and prevalence of cardiovascular risk factors: the value of FMD assessment in high risk patients is limited.
abstract: BACKGROUND
  Since flow-mediated dilatation (FMD) is influenced by different factors, its clinical usefulness and validation is widely discussed.
  
  
  OBJECTIVE
  To assess the major factors that determine FMD values in a wide range of subjects with and without cardiovascular (CV) risk factors/diseases (CVRF/CVD).
  
  
  RESULTS
  617 consecutive patients (mean age: 50.1 ± 14.9 years, males: 349/56.5%) hospitalised between 2005 and 2011 were enrolled into the study. Demographic data and CVRF/CVD with a significant impact on FMD values were analysed: hyperlipidaemia, active smoking, arterial hypertension, coronary artery disease, diabetes mellitus and heart valve disease. The population was divided depending on the number of coexisting CVRF/CVD (0-, 1-, 2-, 3-, 4-, 5-CVRF/CVD groups). The median FMD value in the entire group of patients was 10% (5-17). An analysis of the FMD percentage in particular groups showed significantly higher FMD values in patients without any CVRF/CVD (group 0), as well as in patients with one coexisting CVRF/CVD (group 1) compared to the other groups. The presence of two or more CVRF/CVD was not associated with a significantly higher FMD reduction. The analysis of patients with only one CVRF/CVD revealed the lowest FMD values in patients with coronary artery disease.
  
  
  CONCLUSIONS
  FMD is related to the number of traditional CVRF/CVDs; however, coronary artery disease has the most significant influence on FMD decrease among analysed factors. The value of FMD assessment in high risk patients is limited.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Mizia-Stec
authors.affiliation: 1st Department of Cardiology; Medical University of Silesia, Katowice, Poland. wie.joanna@gmail.com.
authors.forename: Joanna
authors.initials: J
authors.lastname: Wieczorek
authors.forename: Michał
authors.initials: M
authors.lastname: Orszulak
authors.forename: Magdalena
authors.initials: M
authors.lastname: Mizia
authors.forename: Klaudia
authors.initials: K
authors.lastname: Gieszczyk-Strózik
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Sikora-Puz
authors.forename: Maciej
authors.initials: M
authors.lastname: Haberka
authors.forename: Bartosz
authors.initials: B
authors.lastname: Lasota
authors.forename: Artur
authors.initials: A
authors.lastname: Chmiel
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D014664:Vasodilation / Q000502:physiology*