Arterial compliance and endothelium-dependent vasodilation are independently related to coronary risk in the elderly: the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study

Authors


Lars Lind, MD, Department of Medicine, University Hospital, 751 85 Uppsala, Sweden
E-mail: lars.lind@medsci.uu.se

Summary

Background:  Measurements of both arterial compliance and endothelium-dependent vasodilation have previously been related to coronary risk factors, but not in the same study. In the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study, we studied the interplay between arterial compliance and endothelium-dependent vasodilation on coronary risk.

Methods:  In the population-based PIVUS study (1016 subjects aged 70 years), arterial compliance was determined by ultrasound in the carotid artery, by pulse wave analysis (augmentation index) and the stroke volume to pulse pressure ratio by echocardiography, while endothelium-dependent vasodilation (EDV) was assessed by the invasive forearm technique with acetylcholine , brachial artery ultrasound [flow-mediated dilatation (FMD)] and pulse wave analysis with terbutaline provocation [change in reflection index (RI)].

Results:  Factor analysis disclosed three major factors. The first factor was reflecting the three arterial compliance methods, the second factor was reflecting EDV and the change in RI, while the third factor mainly was reflecting FMD. All these three factors were independently related to the Framingham risk score in multiple regression analysis (P<0·0001, P = 0·0002 and P = 0·0046, respectively).

Conclusions:  In conclusion, both arterial compliance and endothelium-dependent vasodilation were independently related to the Framingham risk score, suggesting that it is worthwhile to evaluate the parallel use of these two vascular characteristics in a prospective fashion.

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