title: Vascular structure and function and their relationship with health-related quality of life in the MARK study.
abstract: BACKGROUND
  There is limited evidence concerning the relationship between vascular disease and health-related quality of life (HRQL). We investigated the relationship between vascular structure and function with health-related quality of life in a population with intermediate cardiovascular risk.
  
  
  METHODS
  This study analyzed 303 subjects with ankle-brachial index (ABI) values ranging from 0.9 to 1.4 who were included in the MARK study (age 35 to 74 years; mean:60.5 ± 8.5), of which 50.2 % were women. Measurements included: ABI, brachial-ankle pulse wave velocity (ba-PWV), and cardio-ankle vascular index (CAVI), all measured using the VaSera device. The central augmentation index was adjusted to 75 lpm (AIx_75) using the Mobil-O-Graph device. HRQL was assessed by the Spanish version of the SF-12, version2. The highest obtained CAVI and ba-PWV values and the lowest ABI values were considered for the study.
  
  
  RESULTS
  The cohort was composed of21 % smokers, 76 % hypertensive patients, and 24 % diabetic patients. The ABI mean was 1.09 ± 0.07,the ba-PWV mean was 14.64 ± 2.55 m/s with a 12.9 % of subjects higher than 17.5 m/s, AIx_75 26.46 ± 14.05, and CAVI 8.61 ± 1.08 with a 36.6 % of subjects higher than 9. Men scored higher than women in the HRQL measurements for physical (PSC-12; 49.9 vs. 46.9, p = 0.004) and mental (MSC-12) domains (51.2 vs. 47.7, p = 0.003). Age was positively correlated with CAVI (r = 0.547), ba-PWV (r = 0.469), AIx_75 (r = 0.255, p < 0.01), and the MSC-12 (r = 0.147, p < 0.05), but not the PSC-12. In the adjusted multiple linear regression analysis, the positive association of ABI and CAVI with the PSC-12 was maintained.
  
  
  CONCLUSIONS
  The ABI in the normal range has a positive association with the PSC-12 of HRQL evaluated with the SF-12. The CAVI also showed a positive association with the PSC-12 of HRQL.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT01428934 .
authors.affiliation: Primary Care Research Unit, The Alamedilla Health Center. Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), 37003, Salamanca, Spain. lgarciao@usal.es.|Biomedical and Diagnostic Sciences Department, University of Salamanca, Salamanca, Spain. lgarciao@usal.es.
authors.forename: Luis
authors.initials: L
authors.lastname: García-Ortiz
authors.affiliation: Primary Care Research Unit, The Alamedilla Health Center. Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), 37003, Salamanca, Spain.
authors.forename: José I
authors.initials: JI
authors.lastname: Recio-Rodríguez
authors.affiliation: Primary Care Research Unit, The Alamedilla Health Center. Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), 37003, Salamanca, Spain.|Basic Psychology, Psychobiology and Behavioral Sciences Methodology Department, University of Salamanca, Salamanca, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Mora-Simón
authors.affiliation: San Agustín Health Center, Illes Balears Health Service (IBSALUT), Palma de Mallorca, Spain.
authors.forename: John
authors.initials: J
authors.lastname: Guillaumet
authors.affiliation: Research Unit Family Medicine, Girona. Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), Catalonia, Spain.|Girona Biomedical Research Institute (IDIBGI), Dr. Trueta University Hospital, Girona, Spain.
authors.forename: Ruth
authors.initials: R
authors.lastname: Martí
authors.affiliation: Primary Care Research Unit, The Alamedilla Health Center. Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), 37003, Salamanca, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Agudo-Conde
authors.affiliation: Primary Care Research Unit, The Alamedilla Health Center. Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), 37003, Salamanca, Spain.|Department of Medicine, University of Salamanca, Salamanca, Spain.
authors.forename: Emiliano
authors.initials: E
authors.lastname: Rodriguez-Sanchez
authors.affiliation: Primary Care Research Unit, The Alamedilla Health Center. Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), 37003, Salamanca, Spain.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Maderuelo-Fernandez
authors.affiliation: Research Unit Family Medicine, Girona. Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), Catalonia, Spain.|Translab Research Group. Medical Sciences Department, School of Medicine, University of Girona, Girona, Spain.|Girona Biomedical Research Institute (IDIBGI), Dr. Trueta University Hospital, Girona, Spain.
authors.forename: Rafel
authors.initials: R
authors.lastname: Ramos-Blanes
authors.affiliation: Primary Care Research Unit, The Alamedilla Health Center. Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), 37003, Salamanca, Spain.|Department of Medicine, University of Salamanca, Salamanca, Spain.
authors.forename: Manuel A
authors.initials: MA
authors.lastname: Gómez-Marcos
mesh_terms: D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D063177:Pulse Wave Analysis; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014652:Vascular Diseases / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology*; D059289:Vascular Stiffness
keywords: Ankle-brachial index; Arterial stiffness; Augmentation index; Brachial ankle pulse wave velocity; Cardio-ankle vascular index; Health-related quality of life