title: Free androgen index as a predictor of blood pressure progression and accelerated vascular aging in menopause.
abstract: OBJECTIVE
  We aimed to assess the prognostic value of free androgen index (FAI) and its change over time in arterial stiffness progression, endothelial function and hypertension in postmenopausal women.
  
  
  METHODS
  Postmenopausal women (n = 180) without clinically overt cardiovascular disease or diabetes were consecutively recruited and followed for a median of 29 months. The main outcome measures were changes over time in endothelial function (FMD), reflected waves, localized and systemic (PWV) arterial stiffness and hypertension.
  
  
  RESULTS
  Increased baseline FAI was significantly associated with new onset hypertension (OR for each SD, 2.71, 95% CI 1.14-6.41, p = 0.024), deterioration of pulse wave velocity (PWV) (0.414 m/s per SD), flow-mediated dilation (FMD) (-0.42% per SD), systolic (2.5 mmHg per SD) and pulse pressure progression (2.3 mmHg per SD, p < 0.05 for all). Baseline FAI remained an independent predictor of changes in PWV (p = 0.006), FMD (p = 0.02), peripheral pulse pressure (p = 0.028), transition to new onset hypertension (p = 0.001) and higher BP category (p = 0.012), after adjustment for age, changes in systolic blood pressure, traditional risk factors, vasoactive medication or total testosterone. Baseline FAI improved reclassification for the risk of transition into higher BP category (NRI = 47.5 ± 20.3%, p = 0.02) and abnormal PWV (NRI = 53.4 ± 23.2%, p = 0.021). Similarly, in a subgroup of patients with measured FAI at follow-up, its changes over time predicted changes in PWV, peripheral pulse pressure and hypertension status (p < 0.05 for all).
  
  
  CONCLUSIONS
  In apparently healthy postmenopausal women, FAI could be a novel biomarker superior to total testosterone for accelerated vascular aging and hypertension status.
authors.affiliation: Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, 80 Vas. Sofias Str, PO Box 11528, Athens, Greece.
authors.forename: Georgios A
authors.initials: GA
authors.lastname: Georgiopoulos
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece.
authors.forename: Irene
authors.initials: I
authors.lastname: Lambrinoudaki
authors.affiliation: Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, 80 Vas. Sofias Str, PO Box 11528, Athens, Greece.
authors.forename: Fani
authors.initials: F
authors.lastname: Athanasouli
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Armeni
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece.
authors.forename: Demetrios
authors.initials: D
authors.lastname: Rizos
authors.affiliation: Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, 80 Vas. Sofias Str, PO Box 11528, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Kazani
authors.affiliation: Department of Community Medicine and Health, Lausanne University Hospital (DUMSC/CHUV), Lausanne, Switzerland.
authors.forename: Marianna
authors.initials: M
authors.lastname: Karamanou
authors.affiliation: Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, 80 Vas. Sofias Str, PO Box 11528, Athens, Greece.
authors.forename: Efstathios
authors.initials: E
authors.lastname: Manios
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece.
authors.forename: Areti
authors.initials: A
authors.lastname: Augoulea
authors.affiliation: Department of Cardiology, Johann-Wolfgang-Goethe-University Frankfurt, Frankfurt am Main, Germany.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Stellos
authors.affiliation: Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, 80 Vas. Sofias Str, PO Box 11528, Athens, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Papamichael
authors.affiliation: Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, 80 Vas. Sofias Str, PO Box 11528, Athens, Greece. Electronic address: stamatelopoulosk@yahoo.gr.
authors.forename: Kimon
authors.initials: K
authors.lastname: Stamatelopoulos
mesh_terms: D000367:Age Factors; D000375:Aging / Q000097:blood*; D000728:Androgens / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D018450:Disease Progression; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006728:Hormones / Q000097:blood*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D008875:Middle Aged; D017698:Postmenopause / Q000097:blood*; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D059289:Vascular Stiffness
chemical_list: D000728:Androgens; D015415:Biomarkers; D006728:Hormones
keywords: Androgens; Arterial stiffness; FAI; Hemodynamics; Menopause