title: Predictors of Calf Arterial Compliance in Male Veterans With Psychiatric Diagnoses.
abstract: BACKGROUND
  Peripheral arterial compliance (PAC) is a measure of the ability of the vascular tree to dilate in response to a pressure wave. Reduced PAC is seen in patients with psychiatric diagnoses and has been associated with increased risk for stroke, myocardial infarction, and mortality. The objective of this pilot study was to identify predictors of reduced PAC in subjects with psychiatric diagnoses.
  
  
  METHODS
  Male psychiatric subjects (N = 77) were studied in a cross-sectional study of medication effects on PAC conducted from August 2005 to February 2010. Calf and thigh compliance were modeled in separate linear regressions. The models were adjusted for age, race, smoking status, presence or absence of the metabolic syndrome, current treatment with a statin, diagnosis of schizophrenia or schizoaffective disorder, current antipsychotic treatment, and body mass index (BMI).
  
  
  RESULTS
  Of the 77 subjects (mean ± SD age of 53.7 ± 8.8 years), 41 were white, 36 were black, and 27 were diagnosed with schizophrenia or schizoaffective disorder (DSM-IVcriteria). Fifty participants were being treated with an antipsychotic medication, while the remaining 27 were off of antipsychotics for at least 2 months. Our model explained 27% of the variance in calf compliance. Black subjects had reduced calf compliance compared to white subjects (P= .02). Having metabolic syndrome was associated with reduced PAC at a trend level (P< .08), and BMI (P= .004) and BMI2(P= .011) were significant predictors of calf compliance. Schizophrenia versus other psychiatric diagnoses and antipsychotic treatment were not significantly associated with calf compliance.
  
  
  CONCLUSIONS
  In this pilot study, significant predictors of calf compliance were race (black vs white) and BMI. PAC is a noninvasive measure that may be a predictor of cardiovascular risk in psychiatric patients. The reduced PAC seen in patients with psychiatric diagnoses does not appear to be directly related to their diagnosis or antipsychotic treatment but rather to other characteristics inherent to the subject. Future studies are warranted to better understand the pathophysiology of PAC including but not limited to inflammation in psychiatric patients.
authors.affiliation: Clinical Research Program, Sheppard Pratt Health System, Baltimore, Maryland, and Department of Psychiatry and Behavioral Sciences, George Washington University School of Medicine and Health Sciences, Washington, DC.
authors.forename: Maju Mathew
authors.initials: MM
authors.lastname: Koola
authors.affiliation: Baltimore Veterans Affairs Medical Center Geriatric Research, Education, and Clinical Center, Division of Gerontology and Geriatric Medicine, University of Maryland School of Medicine, Baltimore.
authors.forename: John D
authors.initials: JD
authors.lastname: Sorkin
authors.affiliation: Mental Health Service, Atlanta Veterans Affairs Medical Center, Decatur, Georgia.
authors.forename: Molly
authors.initials: M
authors.lastname: Fargotstein
authors.affiliation: Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: W Virgil
authors.initials: WV
authors.lastname: Brown
authors.affiliation: Mental Health Service, Atlanta Veterans Affairs Medical Center, Decatur, Georgia; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Bruce
authors.initials: B
authors.lastname: Cuthbert
authors.affiliation: Department of Internal Medicine, Mount Sinai Beth Israel Hospital, New York, New York.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Hollis
authors.affiliation: University of Miami School of Medicine, Miami, Florida.
authors.forename: Jeffrey K
authors.initials: JK
authors.lastname: Raines
authors.affiliation: Mental Health Service, Atlanta Veterans Affairs Medical Center, Decatur, Georgia; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Erica J
authors.initials: EJ
authors.lastname: Duncan
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001158:Arteries / Q000503:physiopathology*; D003187:Compliance; D003430:Cross-Sectional Studies; D006801:Humans; D007866:Leg / Q000098:blood supply*; D016014:Linear Models; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D008875:Middle Aged; D015999:Multivariate Analysis; D010865:Pilot Projects; D011312:Pressure; D012307:Risk Factors; D059289:Vascular Stiffness; D014728:Veterans; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents