title: Prevalence of arterial stiffness and the risk of myocardial diastolic dysfunction in women.
abstract: The present study determines the prevalence of vascular dysfunction and arterial stiffness (ASt) in a female urban population by measuring the brachial augmentation index (AIx) and aortic pulse wave velocity (PWV). The study tests the hypothesis that the measurement of AIx and PWV is useful in addition to that of traditional cardiovascular risk factors when assessing the risk for left ventricular diastolic dysfunction (LVDD). This cross-sectional study recruited 965 women aged 25-75 years from 12 districts of Berlin. The ASt indices, brachial AIx, aortic PWV and the central blood pressure were measured by an oscillometric method. A randomly selected subgroup (n=343) was examined by echocardiography. Trans-mitral inflow E/A ratio and diastolic mitral annulus velocity (é) were assessed. Questionnaires, medical history and blood sampling were used for the evaluation of individual risk factors. Normal vascular function was found in 55% of the women included. The prevalence of women with pathological AIx only (AIx ⩾ -10%, PWV normal) was 21.5%, whereas 17.9% were affected by increased AIx and PWV (AIx ⩾ -10%, PWV ⩾9.7 m/s), and 6% with only pathological PWV values. The prevalence of LVDD was 31.7%. LVDD was significantly associated with pathological PWV ⩾ 9.7 m/s [OR: 1.27, 95%CI: 1.02-1.57], age [OR: 4.17, 95%CI: 2.87-6.07] and a waist circumference >80 cm [OR: 3.61, 95%CI: 1.85-7.04] in multiple regression analysis. The high prevalence of markers for vascular dysfunction and ASt in a general female population and their importance as a mediator of diastolic dysfunction should encourage implementation of aortic PWV measurement to improve cardiovascular-risk assessment in particular to identify subclinical myocardial diastolic dysfunction.
authors.affiliation: Institute of Gender in Medicine, Charité University Hospital, 10115 Berlin, Germany German Center for Cardiovascular Research (DZHK), 10115 Berlin, Germany ute.seeland@charite.de.
authors.forename: Ute
authors.initials: U
authors.lastname: Seeland
authors.affiliation: Department of Cardiology and Angiology, Charité University Hospital, 10117 Berlin, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Brecht
authors.affiliation: Institute of Gender in Medicine, Charité University Hospital, 10115 Berlin, Germany.
authors.forename: Ahmad T
authors.initials: AT
authors.lastname: Nauman
authors.affiliation: Institute of Gender in Medicine, Charité University Hospital, 10115 Berlin, Germany German Center for Cardiovascular Research (DZHK), 10115 Berlin, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Oertelt-Prigione
authors.affiliation: Institute of Gender in Medicine, Charité University Hospital, 10115 Berlin, Germany.
authors.forename: Mirjam
authors.initials: M
authors.lastname: Ruecke
authors.affiliation: Department of Cardiology and Angiology, Charité University Hospital, 10117 Berlin, Germany.
authors.forename: Fabian
authors.initials: F
authors.lastname: Knebel
authors.affiliation: German Center for Cardiovascular Research (DZHK), 10115 Berlin, Germany Department of Cardiology and Angiology, Charité University Hospital, 10117 Berlin, Germany.
authors.forename: Verena
authors.initials: V
authors.lastname: Stangl
authors.affiliation: Institute of Gender in Medicine, Charité University Hospital, 10115 Berlin, Germany German Center for Cardiovascular Research (DZHK), 10115 Berlin, Germany Center of Cardiovascular Research (CCR), Charité University Hospital, 10115 Berlin, Germany.
authors.forename: Vera
authors.initials: V
authors.lastname: Regitz-Zagrosek
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000473:pathology; D009202:Cardiomyopathies / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D063177:Pulse Wave Analysis; D012307:Risk Factors; D012308:Risk Management; D059289:Vascular Stiffness
keywords: arterial stiffness; augmentation index; diastolic dysfunction; pulse wave velocity; vascular dysfunction; vascular phenotypes