title: Simple physical performance measures and vascular health in late midlife women: the Study of Women's Health across the nation.
abstract: BACKGROUND
  Physical performance measures have been shown to predict mortality and incident cardiovascular disease (CVD) mainly in elderly populations. We evaluated whether physical performance measures are associated with vascular health indices (carotid intima-media thickness (cIMT), adventitial diameter (cAD) and carotid plaque) in a large sample of multi-ethnic, late midlife women.
  
  
  METHODS
  Participants from the Study of Women's Health Across the Nation free of CVD and who had carotid ultrasound assessed at the 12th annual visit were evaluated. Physical function (PF) measures at visit 12 included: average 40-foot walking speed and average time needed for sit-to-stand assessment.
  
  
  RESULTS
  A total of 1103 women (53.7% White, 30.5% Black, 15.9% Chinese) aged 59.6±2.7years at visit 12, were included. In models adjusted for study site, race, current age, menopausal status and systolic blood pressure, slower walking speed and longer time needed for sit-to-stand were significantly associated with wider cAD, thicker cIMT and a higher probability of a high level of carotid plaque burden (all P-values<0.05). Associations between walking speed and cAD, and between time needed for sit-to-stand and cAD, remained significant (P=0.04) or marginally significant (P=0.07), respectively, after additional adjustment for CVD risk factors, medications and physical activity. However, the associations between PF measures and cIMT and plaque burden were largely explained by traditional CVD risk factors.
  
  
  CONCLUSIONS
  The current study suggests that worse performance in simple objective PF tests may be an early indicator of vascular structural changes that precede vascular disease among women at late midlife.
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, United States. Electronic address: elkhoudarys@edc.pitt.edu.
authors.forename: Samar R
authors.initials: SR
authors.lastname: El Khoudary
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, United States.
authors.forename: Hsiang-Yu
authors.initials: HY
authors.lastname: Chen
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, United States.
authors.forename: Emma
authors.initials: E
authors.lastname: Barinas-Mitchell
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, United States.
authors.forename: Candace
authors.initials: C
authors.lastname: McClure
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, United States.
authors.forename: Faith
authors.initials: F
authors.lastname: Selzer
authors.affiliation: University of Michigan, Ann Arbor, MI, United States.
authors.forename: Carrie
authors.initials: C
authors.lastname: Karvonen-Gutierrez
authors.affiliation: University of Michigan, Ann Arbor, MI, United States.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Jackson
authors.affiliation: University of Michigan, Ann Arbor, MI, United States.
authors.forename: Kelly R
authors.initials: KR
authors.lastname: Ylitalo
authors.affiliation: Kaiser Permanente, Oakland, CA, United States.
authors.forename: Barbara
authors.initials: B
authors.lastname: Sternfeld
mesh_terms: D000328:Adult; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000208:ethnology / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D005006:Ethnicity; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D016387:Women's Health
keywords: Adventitial diameter; Intima–media thickness; Menopause; Physical performance; Plaque; Vascular health