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Cross-sectional relations of peripheral microvascular function, cardiovascular disease risk factors, and aortic stiffness: the Framingham Heart Study.
Circulation. 2005 Dec 13; 112(24):3722-8.Circ

Abstract

BACKGROUND

Aortic stiffness and small-artery structure and function share various risk factors; however, relations between these 2 measures of vascular function are complex and incompletely understood.

METHODS AND RESULTS

We examined hyperemic forearm blood flow, an indicator of microvascular structure and function, and aortic stiffness in 2045 participants (1107 women, mean age 61+/-9 years) in the Framingham Heart Study offspring cohort. Using arterial tonometry, we evaluated 3 measures of aortic stiffness: brachial pulse pressure; carotid-femoral pulse wave velocity (CFPWV), which is related directly to aortic wall stiffness; and forward pressure wave amplitude (Pf), which is related directly to aortic wall stiffness and inversely to aortic diameter. Using high-resolution ultrasound and Doppler, we evaluated brachial artery diameter, blood flow, and forearm vascular resistance (FVR) at baseline and during reactive hyperemia after 5 minutes of forearm ischemia. In multivariable models that adjusted for cardiovascular disease risk factors, local brachial pulse pressure, CFPWV, and Pf, considered separately, were associated with increased baseline and hyperemic FVR (P<0.001). In models that further adjusted for mean arterial pressure, each measure of aortic stiffness was associated with reduced hyperemic flow (P<0.001). In risk factor-adjusted models that simultaneously considered CFPWV and Pf, both were associated with increased FVR at baseline (P<0.01) and during hyperemia (P<0.001).

CONCLUSIONS

Our findings indicate that abnormal aortic stiffness and increased pressure pulsatility are associated with blunted microvascular reactivity to ischemic stress that is in excess of changes attributable to conventional cardiovascular disease risk factors alone, including mean arterial pressure.

Authors+Show Affiliations

Cardiovascular Engineering, Inc, Waltham, MA 02453, USA. GaryFMitchell@mindspring.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16330686

Citation

Mitchell, Gary F., et al. "Cross-sectional Relations of Peripheral Microvascular Function, Cardiovascular Disease Risk Factors, and Aortic Stiffness: the Framingham Heart Study." Circulation, vol. 112, no. 24, 2005, pp. 3722-8.
Mitchell GF, Vita JA, Larson MG, et al. Cross-sectional relations of peripheral microvascular function, cardiovascular disease risk factors, and aortic stiffness: the Framingham Heart Study. Circulation. 2005;112(24):3722-8.
Mitchell, G. F., Vita, J. A., Larson, M. G., Parise, H., Keyes, M. J., Warner, E., Vasan, R. S., Levy, D., & Benjamin, E. J. (2005). Cross-sectional relations of peripheral microvascular function, cardiovascular disease risk factors, and aortic stiffness: the Framingham Heart Study. Circulation, 112(24), 3722-8.
Mitchell GF, et al. Cross-sectional Relations of Peripheral Microvascular Function, Cardiovascular Disease Risk Factors, and Aortic Stiffness: the Framingham Heart Study. Circulation. 2005 Dec 13;112(24):3722-8. PubMed PMID: 16330686.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cross-sectional relations of peripheral microvascular function, cardiovascular disease risk factors, and aortic stiffness: the Framingham Heart Study. AU - Mitchell,Gary F, AU - Vita,Joseph A, AU - Larson,Martin G, AU - Parise,Helen, AU - Keyes,Michelle J, AU - Warner,Elaine, AU - Vasan,Ramachandran S, AU - Levy,Daniel, AU - Benjamin,Emelia J, Y1 - 2005/12/05/ PY - 2005/12/7/pubmed PY - 2006/2/24/medline PY - 2005/12/7/entrez SP - 3722 EP - 8 JF - Circulation JO - Circulation VL - 112 IS - 24 N2 - BACKGROUND: Aortic stiffness and small-artery structure and function share various risk factors; however, relations between these 2 measures of vascular function are complex and incompletely understood. METHODS AND RESULTS: We examined hyperemic forearm blood flow, an indicator of microvascular structure and function, and aortic stiffness in 2045 participants (1107 women, mean age 61+/-9 years) in the Framingham Heart Study offspring cohort. Using arterial tonometry, we evaluated 3 measures of aortic stiffness: brachial pulse pressure; carotid-femoral pulse wave velocity (CFPWV), which is related directly to aortic wall stiffness; and forward pressure wave amplitude (Pf), which is related directly to aortic wall stiffness and inversely to aortic diameter. Using high-resolution ultrasound and Doppler, we evaluated brachial artery diameter, blood flow, and forearm vascular resistance (FVR) at baseline and during reactive hyperemia after 5 minutes of forearm ischemia. In multivariable models that adjusted for cardiovascular disease risk factors, local brachial pulse pressure, CFPWV, and Pf, considered separately, were associated with increased baseline and hyperemic FVR (P<0.001). In models that further adjusted for mean arterial pressure, each measure of aortic stiffness was associated with reduced hyperemic flow (P<0.001). In risk factor-adjusted models that simultaneously considered CFPWV and Pf, both were associated with increased FVR at baseline (P<0.01) and during hyperemia (P<0.001). CONCLUSIONS: Our findings indicate that abnormal aortic stiffness and increased pressure pulsatility are associated with blunted microvascular reactivity to ischemic stress that is in excess of changes attributable to conventional cardiovascular disease risk factors alone, including mean arterial pressure. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/16330686/Cross_sectional_relations_of_peripheral_microvascular_function_cardiovascular_disease_risk_factors_and_aortic_stiffness:_the_Framingham_Heart_Study_ L2 - https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.105.551168?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -