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Journal article 1390 views

Endothelial Function Predicts Progression of Carotid Intima-Media Thickness

Julian Halcox Orcid Logo, Libby Ellins Orcid Logo

Circulation, Volume: 119, Pages: 1005 - 1012

Swansea University Authors: Julian Halcox Orcid Logo, Libby Ellins Orcid Logo

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DOI (Published version): 10.1161/CIRCULATIONAHA.108.765701

Abstract

Background—Endothelial dysfunction develops early and has been shown to predict the development of clinical complications of atherosclerosis. However, the relationship between early endothelial dysfunction and the progression of arterial disease in the general population is unknown. We investigated...

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Published in: Circulation
Published: 2009
URI: https://cronfa.swan.ac.uk/Record/cronfa16042
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first_indexed 2013-09-26T11:45:54Z
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2013-11-08T10:48:26.0321880</datestamp><bib-version>v2</bib-version><id>16042</id><entry>2013-09-18</entry><title>Endothelial Function Predicts Progression of Carotid Intima-Media Thickness</title><swanseaauthors><author><sid>3676f695eeda169d0f8c618adf27c04b</sid><ORCID>0000-0001-6926-2947</ORCID><firstname>Julian</firstname><surname>Halcox</surname><name>Julian Halcox</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>553ce2abe05a6396e7dd6eadb6b90a6d</sid><ORCID>0000-0001-5164-6416</ORCID><firstname>Libby</firstname><surname>Ellins</surname><name>Libby Ellins</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2013-09-18</date><deptcode>HDAT</deptcode><abstract>Background&#x2014;Endothelial dysfunction develops early and has been shown to predict the development of clinical complications of atherosclerosis. However, the relationship between early endothelial dysfunction and the progression of arterial disease in the general population is unknown. We investigated endothelial dysfunction, risk factors, and progression of carotid intima-media thickness (cIMT) in late-middle-aged individuals at low to intermediate cardiovascular risk in a prospective study between 1997 and 2005. Methods and Results&#x2014;Brachial artery flow-mediated dilatation and cIMT were measured in 213 nonsmoking British civil servants recruited from a prospective cohort (Whitehall II study). Participants (age, 45 to 66 years) were free of clinical cardiovascular disease and diabetes mellitus. Risk factors and Framingham Risk Score were determined at baseline. cIMT was repeated 6.20.4 years later. At baseline, age, blood pressure, low-density lipoprotein cholesterol, and Framingham Risk Score correlated with cIMT. However, only flow-mediated dilatation, not risk factors or Framingham Risk Score, was associated with average annual progression of cIMT. This relationship remained significant after adjustment for risk factors whether entered as separate variables or as Framingham Risk Score. Further adjustment for waist circumference, triglycerides, and employment grade had no significant effect. Conclusions&#x2014;Systemic endothelial function was associated with progression of preclinical carotid arterial disease over a 6-year period and was more closely related to cIMT changes than conventional risk factors. Thus, the relationship between endothelial dysfunction and adverse outcome is likely to be due not only to destabilization of established disease in high-risk populations but also to its impact on the evolution of the atherosclerotic substrate. Flow-mediated dilatation testing provides an integrated vascular measure that may aid the prediction of structural disease evolution and represents a potential short-to intermediate-term outcome measure for evaluation of preventive treatment strategies.</abstract><type>Journal Article</type><journal>Circulation</journal><volume>119</volume><paginationStart>1005</paginationStart><paginationEnd>1012</paginationEnd><publisher/><issnPrint/><issnElectronic/><keywords>atherosclerosis, endothelium, nitric oxide, risk factors</keywords><publishedDay>28</publishedDay><publishedMonth>2</publishedMonth><publishedYear>2009</publishedYear><publishedDate>2009-02-28</publishedDate><doi>10.1161/CIRCULATIONAHA.108.765701</doi><url/><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2013-11-08T10:48:26.0321880</lastEdited><Created>2013-09-18T11:50:26.9343371</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Julian</firstname><surname>Halcox</surname><orcid>0000-0001-6926-2947</orcid><order>1</order></author><author><firstname>Libby</firstname><surname>Ellins</surname><orcid>0000-0001-5164-6416</orcid><order>2</order></author></authors><documents/><OutputDurs/></rfc1807>
spelling 2013-11-08T10:48:26.0321880 v2 16042 2013-09-18 Endothelial Function Predicts Progression of Carotid Intima-Media Thickness 3676f695eeda169d0f8c618adf27c04b 0000-0001-6926-2947 Julian Halcox Julian Halcox true false 553ce2abe05a6396e7dd6eadb6b90a6d 0000-0001-5164-6416 Libby Ellins Libby Ellins true false 2013-09-18 HDAT Background—Endothelial dysfunction develops early and has been shown to predict the development of clinical complications of atherosclerosis. However, the relationship between early endothelial dysfunction and the progression of arterial disease in the general population is unknown. We investigated endothelial dysfunction, risk factors, and progression of carotid intima-media thickness (cIMT) in late-middle-aged individuals at low to intermediate cardiovascular risk in a prospective study between 1997 and 2005. Methods and Results—Brachial artery flow-mediated dilatation and cIMT were measured in 213 nonsmoking British civil servants recruited from a prospective cohort (Whitehall II study). Participants (age, 45 to 66 years) were free of clinical cardiovascular disease and diabetes mellitus. Risk factors and Framingham Risk Score were determined at baseline. cIMT was repeated 6.20.4 years later. At baseline, age, blood pressure, low-density lipoprotein cholesterol, and Framingham Risk Score correlated with cIMT. However, only flow-mediated dilatation, not risk factors or Framingham Risk Score, was associated with average annual progression of cIMT. This relationship remained significant after adjustment for risk factors whether entered as separate variables or as Framingham Risk Score. Further adjustment for waist circumference, triglycerides, and employment grade had no significant effect. Conclusions—Systemic endothelial function was associated with progression of preclinical carotid arterial disease over a 6-year period and was more closely related to cIMT changes than conventional risk factors. Thus, the relationship between endothelial dysfunction and adverse outcome is likely to be due not only to destabilization of established disease in high-risk populations but also to its impact on the evolution of the atherosclerotic substrate. Flow-mediated dilatation testing provides an integrated vascular measure that may aid the prediction of structural disease evolution and represents a potential short-to intermediate-term outcome measure for evaluation of preventive treatment strategies. Journal Article Circulation 119 1005 1012 atherosclerosis, endothelium, nitric oxide, risk factors 28 2 2009 2009-02-28 10.1161/CIRCULATIONAHA.108.765701 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University 2013-11-08T10:48:26.0321880 2013-09-18T11:50:26.9343371 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Julian Halcox 0000-0001-6926-2947 1 Libby Ellins 0000-0001-5164-6416 2
title Endothelial Function Predicts Progression of Carotid Intima-Media Thickness
spellingShingle Endothelial Function Predicts Progression of Carotid Intima-Media Thickness
Julian Halcox
Libby Ellins
title_short Endothelial Function Predicts Progression of Carotid Intima-Media Thickness
title_full Endothelial Function Predicts Progression of Carotid Intima-Media Thickness
title_fullStr Endothelial Function Predicts Progression of Carotid Intima-Media Thickness
title_full_unstemmed Endothelial Function Predicts Progression of Carotid Intima-Media Thickness
title_sort Endothelial Function Predicts Progression of Carotid Intima-Media Thickness
author_id_str_mv 3676f695eeda169d0f8c618adf27c04b
553ce2abe05a6396e7dd6eadb6b90a6d
author_id_fullname_str_mv 3676f695eeda169d0f8c618adf27c04b_***_Julian Halcox
553ce2abe05a6396e7dd6eadb6b90a6d_***_Libby Ellins
author Julian Halcox
Libby Ellins
author2 Julian Halcox
Libby Ellins
format Journal article
container_title Circulation
container_volume 119
container_start_page 1005
publishDate 2009
institution Swansea University
doi_str_mv 10.1161/CIRCULATIONAHA.108.765701
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 0
active_str 0
description Background—Endothelial dysfunction develops early and has been shown to predict the development of clinical complications of atherosclerosis. However, the relationship between early endothelial dysfunction and the progression of arterial disease in the general population is unknown. We investigated endothelial dysfunction, risk factors, and progression of carotid intima-media thickness (cIMT) in late-middle-aged individuals at low to intermediate cardiovascular risk in a prospective study between 1997 and 2005. Methods and Results—Brachial artery flow-mediated dilatation and cIMT were measured in 213 nonsmoking British civil servants recruited from a prospective cohort (Whitehall II study). Participants (age, 45 to 66 years) were free of clinical cardiovascular disease and diabetes mellitus. Risk factors and Framingham Risk Score were determined at baseline. cIMT was repeated 6.20.4 years later. At baseline, age, blood pressure, low-density lipoprotein cholesterol, and Framingham Risk Score correlated with cIMT. However, only flow-mediated dilatation, not risk factors or Framingham Risk Score, was associated with average annual progression of cIMT. This relationship remained significant after adjustment for risk factors whether entered as separate variables or as Framingham Risk Score. Further adjustment for waist circumference, triglycerides, and employment grade had no significant effect. Conclusions—Systemic endothelial function was associated with progression of preclinical carotid arterial disease over a 6-year period and was more closely related to cIMT changes than conventional risk factors. Thus, the relationship between endothelial dysfunction and adverse outcome is likely to be due not only to destabilization of established disease in high-risk populations but also to its impact on the evolution of the atherosclerotic substrate. Flow-mediated dilatation testing provides an integrated vascular measure that may aid the prediction of structural disease evolution and represents a potential short-to intermediate-term outcome measure for evaluation of preventive treatment strategies.
published_date 2009-02-28T03:18:19Z
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score 11.036815

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