Endothelial reactivity and cardiac risk factors in older patients with peripheral arterial disease

Alberto Rafael Yataco, Mary Concepta Corretti, Andrew Gardner, Christopher Joseph Womack, Leslie Ira Katzel

Research output: Contribution to journalArticle

91 Citations (Scopus)

Abstract

Peripheral arterial disease (PAD) is a major cause of morbidity and mortality. Endothelium-dependent vasoreactivity, which is advocated as a measure of vascular health, is impaired in persons with cardiac risk factors and coronary artery disease. Few studies have examined the degree of endothelial dysfunction in patients with PAD. Using high-resolution external vascular ultrasound, we measured brachial artery diameter and flow at rest, and in response to reactive hyperemia (flow-mediated dilation) in 50 older patients (age 69 ± 1 year) with PAD (ankle-to-brachial artery index of 0.67 ± 0.03), and 50 age-matched non-PAD patients. Coronary artery disease was more prevalent in PAD than in non-PAD patients (40% vs 4%, p <0.001). Systolic blood pressure (153 ± 4 vs 141 ± 3 mm Hg, p <0.01), fasting glucose (129 ± 6 vs 109 ± 5 mg/dl, p <0.001), and pack-years smoked (54 ± 7 vs 25 ± 3, p <0.01) were higher in the PAD than in non-PAD patients. There were no differences in baseline brachial artery diameter, blood velocity, or flow between the 2 groups. However, the 1-minute postocclusion percent change in diameter (6.5 ± 0.7% vs 9.8 ± 0.7%, p <0.001) and the change in diameter (0.22 ± 0.02 vs 0.33 ± 0.02 mm, p <0.001) were lower in PAD than in non- PAD patients, suggesting impaired endothelium-dependent dilation. The postocclusion hyperemic velocity and blood flow were also lower in PAD than in non-PAD patients. In multiple regression analyses the low-density lipoprotein-to-high-density lipoprotein cholesterol ratio, elevated fasting glucose, and high systolic blood pressure were independent predictors of percent change in brachial artery diameter (r2 = 0.37, p <0.001). Thus, older patients with PAD had impaired endothelial dependent vasodilation compared with controls that was associated with the presence of cardiac risk factors. The effect of cardiac risk factor intervention on endothelial function in patients with PAD remains to be determined.

Original languageEnglish (US)
Pages (from-to)754-758
Number of pages5
JournalAmerican Journal of Cardiology
Volume83
Issue number5
DOIs
StatePublished - Mar 1 1999

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Peripheral Arterial Disease
Brachial Artery
Blood Flow Velocity
Blood Pressure
Endothelium
Blood Vessels
Coronary Artery Disease
Dilatation
Fasting
Glucose
Hyperemia
LDL Lipoproteins
Ankle
Vasodilation
HDL Cholesterol
Regression Analysis
Hypertension
Morbidity
Mortality

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Yataco, Alberto Rafael ; Corretti, Mary Concepta ; Gardner, Andrew ; Womack, Christopher Joseph ; Katzel, Leslie Ira. / Endothelial reactivity and cardiac risk factors in older patients with peripheral arterial disease. In: American Journal of Cardiology. 1999 ; Vol. 83, No. 5. pp. 754-758.
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abstract = "Peripheral arterial disease (PAD) is a major cause of morbidity and mortality. Endothelium-dependent vasoreactivity, which is advocated as a measure of vascular health, is impaired in persons with cardiac risk factors and coronary artery disease. Few studies have examined the degree of endothelial dysfunction in patients with PAD. Using high-resolution external vascular ultrasound, we measured brachial artery diameter and flow at rest, and in response to reactive hyperemia (flow-mediated dilation) in 50 older patients (age 69 ± 1 year) with PAD (ankle-to-brachial artery index of 0.67 ± 0.03), and 50 age-matched non-PAD patients. Coronary artery disease was more prevalent in PAD than in non-PAD patients (40{\%} vs 4{\%}, p <0.001). Systolic blood pressure (153 ± 4 vs 141 ± 3 mm Hg, p <0.01), fasting glucose (129 ± 6 vs 109 ± 5 mg/dl, p <0.001), and pack-years smoked (54 ± 7 vs 25 ± 3, p <0.01) were higher in the PAD than in non-PAD patients. There were no differences in baseline brachial artery diameter, blood velocity, or flow between the 2 groups. However, the 1-minute postocclusion percent change in diameter (6.5 ± 0.7{\%} vs 9.8 ± 0.7{\%}, p <0.001) and the change in diameter (0.22 ± 0.02 vs 0.33 ± 0.02 mm, p <0.001) were lower in PAD than in non- PAD patients, suggesting impaired endothelium-dependent dilation. The postocclusion hyperemic velocity and blood flow were also lower in PAD than in non-PAD patients. In multiple regression analyses the low-density lipoprotein-to-high-density lipoprotein cholesterol ratio, elevated fasting glucose, and high systolic blood pressure were independent predictors of percent change in brachial artery diameter (r2 = 0.37, p <0.001). Thus, older patients with PAD had impaired endothelial dependent vasodilation compared with controls that was associated with the presence of cardiac risk factors. The effect of cardiac risk factor intervention on endothelial function in patients with PAD remains to be determined.",
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Endothelial reactivity and cardiac risk factors in older patients with peripheral arterial disease. / Yataco, Alberto Rafael; Corretti, Mary Concepta; Gardner, Andrew; Womack, Christopher Joseph; Katzel, Leslie Ira.

In: American Journal of Cardiology, Vol. 83, No. 5, 01.03.1999, p. 754-758.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Endothelial reactivity and cardiac risk factors in older patients with peripheral arterial disease

AU - Yataco, Alberto Rafael

AU - Corretti, Mary Concepta

AU - Gardner, Andrew

AU - Womack, Christopher Joseph

AU - Katzel, Leslie Ira

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N2 - Peripheral arterial disease (PAD) is a major cause of morbidity and mortality. Endothelium-dependent vasoreactivity, which is advocated as a measure of vascular health, is impaired in persons with cardiac risk factors and coronary artery disease. Few studies have examined the degree of endothelial dysfunction in patients with PAD. Using high-resolution external vascular ultrasound, we measured brachial artery diameter and flow at rest, and in response to reactive hyperemia (flow-mediated dilation) in 50 older patients (age 69 ± 1 year) with PAD (ankle-to-brachial artery index of 0.67 ± 0.03), and 50 age-matched non-PAD patients. Coronary artery disease was more prevalent in PAD than in non-PAD patients (40% vs 4%, p <0.001). Systolic blood pressure (153 ± 4 vs 141 ± 3 mm Hg, p <0.01), fasting glucose (129 ± 6 vs 109 ± 5 mg/dl, p <0.001), and pack-years smoked (54 ± 7 vs 25 ± 3, p <0.01) were higher in the PAD than in non-PAD patients. There were no differences in baseline brachial artery diameter, blood velocity, or flow between the 2 groups. However, the 1-minute postocclusion percent change in diameter (6.5 ± 0.7% vs 9.8 ± 0.7%, p <0.001) and the change in diameter (0.22 ± 0.02 vs 0.33 ± 0.02 mm, p <0.001) were lower in PAD than in non- PAD patients, suggesting impaired endothelium-dependent dilation. The postocclusion hyperemic velocity and blood flow were also lower in PAD than in non-PAD patients. In multiple regression analyses the low-density lipoprotein-to-high-density lipoprotein cholesterol ratio, elevated fasting glucose, and high systolic blood pressure were independent predictors of percent change in brachial artery diameter (r2 = 0.37, p <0.001). Thus, older patients with PAD had impaired endothelial dependent vasodilation compared with controls that was associated with the presence of cardiac risk factors. The effect of cardiac risk factor intervention on endothelial function in patients with PAD remains to be determined.

AB - Peripheral arterial disease (PAD) is a major cause of morbidity and mortality. Endothelium-dependent vasoreactivity, which is advocated as a measure of vascular health, is impaired in persons with cardiac risk factors and coronary artery disease. Few studies have examined the degree of endothelial dysfunction in patients with PAD. Using high-resolution external vascular ultrasound, we measured brachial artery diameter and flow at rest, and in response to reactive hyperemia (flow-mediated dilation) in 50 older patients (age 69 ± 1 year) with PAD (ankle-to-brachial artery index of 0.67 ± 0.03), and 50 age-matched non-PAD patients. Coronary artery disease was more prevalent in PAD than in non-PAD patients (40% vs 4%, p <0.001). Systolic blood pressure (153 ± 4 vs 141 ± 3 mm Hg, p <0.01), fasting glucose (129 ± 6 vs 109 ± 5 mg/dl, p <0.001), and pack-years smoked (54 ± 7 vs 25 ± 3, p <0.01) were higher in the PAD than in non-PAD patients. There were no differences in baseline brachial artery diameter, blood velocity, or flow between the 2 groups. However, the 1-minute postocclusion percent change in diameter (6.5 ± 0.7% vs 9.8 ± 0.7%, p <0.001) and the change in diameter (0.22 ± 0.02 vs 0.33 ± 0.02 mm, p <0.001) were lower in PAD than in non- PAD patients, suggesting impaired endothelium-dependent dilation. The postocclusion hyperemic velocity and blood flow were also lower in PAD than in non-PAD patients. In multiple regression analyses the low-density lipoprotein-to-high-density lipoprotein cholesterol ratio, elevated fasting glucose, and high systolic blood pressure were independent predictors of percent change in brachial artery diameter (r2 = 0.37, p <0.001). Thus, older patients with PAD had impaired endothelial dependent vasodilation compared with controls that was associated with the presence of cardiac risk factors. The effect of cardiac risk factor intervention on endothelial function in patients with PAD remains to be determined.

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