title: Relations of digital vascular function, cardiovascular risk factors, and arterial stiffness: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort study.
abstract: BACKGROUND
  Vascular dysfunction is an early expression of atherosclerosis and predicts cardiovascular (CV) events. Peripheral arterial tonometry (PAT) evaluates basal pulse amplitude (BPA), endothelial function (PAT ratio), and wave reflection (PAT-AIx) in the digital microvessels. In Brazilian adults, we investigated the correlations of PAT responses to CV risk factors and to carotid-femoral pulse wave velocity (PWV), a measure of arterial stiffness.
  
  
  RESULTS
  In a cross-sectional study, 1535 participants of the ELSA-Brasil cohort underwent PAT testing (52±9 years; 44% women). In multivariable analyses, more-impaired BPA and PAT ratios were associated with male sex, higher body mass index (BMI), and total cholesterol/high-density lipoprotein. Higher age and triglycerides were related to higher BPA, whereas lower systolic blood pressure, hypertension (HTN) treatment, and prevalent CV disease (CVD) were associated with lower PAT ratio. PAT-AIx correlated positively with female sex, advancing age, systolic and diastolic blood pressures, and smoking and inversely to heart rate, height, BMI, and prevalent CVD. Black race was associated with lower BPA, higher PAT ratio, and PAT-AIx. Microvessel vasodilator function was not associated with PWV. Higher PAT-AIx was modestly correlated to higher PWV and PAT ratio and inversely correlated to BPA.
  
  
  CONCLUSIONS
  Metabolic risk factors are related to impaired microvessel vasodilator function in Brazil. However, in contrast to studies from the United States, black race was not associated with an impaired microvessel vasodilator response, implying that vascular function may vary by race across populations. PAT-AIx relates to HTN, may be a valid measure of wave reflection, and provides distinct information from arterial stiffness.
authors.affiliation: Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil) Hospital das Clínicas and School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (L.C.B., S.M.B., A.P.R.).
authors.forename: Luisa C C
authors.initials: LC
authors.lastname: Brant
authors.affiliation: Whitaker Cardiovascular Institute, School of Medicine, Boston University, Boston, MA (N.M.H., E.J.B.).
authors.forename: Naomi M
authors.initials: NM
authors.lastname: Hamburg
authors.affiliation: Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil) Hospital das Clínicas and School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (L.C.B., S.M.B., A.P.R.).
authors.forename: Sandhi M
authors.initials: SM
authors.lastname: Barreto
authors.affiliation: Whitaker Cardiovascular Institute, School of Medicine, Boston University, Boston, MA (N.M.H., E.J.B.).
authors.forename: Emelia J
authors.initials: EJ
authors.lastname: Benjamin
authors.affiliation: Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil) Hospital das Clínicas and School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (L.C.B., S.M.B., A.P.R.).
authors.forename: Antonio L P
authors.initials: AL
authors.lastname: Ribeiro
mesh_terms: D000328:Adult; D000367:Age Factors; D044383:Black People; D001794:Blood Pressure; D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000208:ethnology / Q000209:etiology* / Q000503:physiopathology; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005385:Fingers / Q000098:blood supply*; D006801:Humans; D006973:Hypertension / Q000208:ethnology / Q000209:etiology / Q000503:physiopathology; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008833:Microcirculation; D055806:Microvessels / Q000503:physiopathology*; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D063177:Pulse Wave Analysis; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000208:ethnology; D014280:Triglycerides / Q000097:blood; D059289:Vascular Stiffness; D014664:Vasodilation
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides
keywords: arterial stiffness; endothelium; epidemiology; race/ethnicity; vascular function