Low-flow mediated constriction incorporated indices as indicators of cardiovascular risk in smokers.
Low-flow-mediated constriction (L-FMC), the endothelial response to reduced blood flow by forearm compression, is present in some smokers. The differences between smokers with and without L-FMC are unclear. It is also unknown whether flow-mediated total dilation (FMTD) or modified flow-mediated dilation (mFMD), both of which incorporate information concerning L-FMC, could be used to estimate cardiovascular risk. We sought to clarify the clinical factors associated with the presence of L-FMC in smokers according to sex and examine whether L-FMC incorporated indices would be better than a conventional index to estimate cardiovascular risk in smokers.



In total, 140 consecutive smokers (58 ± 13 years old) with no coronary heart disease and 48 non-smokers, who comprised the age- and sex-matched control group, were enrolled.



L-FMC was demonstrated in 33.6% (47/140) and 25% (12/48) of the smokers and non-smokers, respectively. In male smokers, the predictors of the presence of L-FMC were age (p = 0.014), body mass index (BMI) (p = 0.045), and baseline brachial arterial diameter (Dbase) (p = 0.048). In female smokers, there were no predictors of the presence of L-FMC. The correlations between the Framingham risk score (FRS) and %FMTD (r = -0.34) and between FRS and %mFMD (r = -0.33) were stronger than that between FRS and conventional flow-mediated dilation (%cFMD) (r = -0.20).



Independent predictors of the presence of L-FMC were age, BMI, and Dbase in male smokers. L-FMC incorporated indices may be good alternatives to cFMD to estimate cardiovascular risk.
Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
Naoki
N
Norioka
Department of Medical Education and General Practice, Osaka City University Graduate School of Medicine, Osaka, Japan. Electronic address: yatakemoto@med.osaka-cu.ac.jp.
Yasuhiko
Y
Takemoto
Department of Medical Education and General Practice, Osaka City University Graduate School of Medicine, Osaka, Japan.
Masanori
M
Kobayashi
Department of Medical Education and General Practice, Osaka City University Graduate School of Medicine, Osaka, Japan.
Ayako
A
Makuuchi
Department of Medical Education and General Practice, Osaka City University Graduate School of Medicine, Osaka, Japan.
Junichi
J
Yoshikawa
Knowledge Hub of Aichi, Priority Research Project, Aichi Science and Technology Foundation, Toyota, Japan.
Yoichi
Y
Yamazaki
School of Information Science and Technology, Aichi Prefectural University, Nagakute, Japan.
Yoshimi
Y
Kamiyama
Department of Medical Education and General Practice, Osaka City University Graduate School of Medicine, Osaka, Japan.
Taichi
T
Shuto
Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
Minoru
M
Yoshiyama
D000367:Age Factors; D000368:Aged; D001783:Blood Flow Velocity; D015992:Body Mass Index; D001916:Brachial Artery / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D003327:Coronary Disease / Q000175:diagnosis*; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012039:Regional Blood Flow; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D014661:Vasoconstriction
Flow-mediated dilation; Framingham risk score; Low-flow-mediated constriction; Smoking