3.3 Age- and sex-specific reference intervals for brachial artery flow-mediated dilation in healthy individuals and the relation with cardiovascular risk factors

Sophie Holder; Rosa Maria Bruno; Daria Shkredova; Andrew Thompson; Ellen Dawson; Helen Jones; Nicola Hopkins; Maria Hopman; Tom Bailey; Jeff Coombes; Christopher Askew; Louise Naylor; Andrew Maiorana; Lorenzo Ghiadoni; Daniel Green; Dick Thijssen

doi:10.2991/artres.k.191224.016

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Volume 25, Issue Supplement 1, December 2019, Pages S23 - S23

3.3 Age- and sex-specific reference intervals for brachial artery flow-mediated dilation in healthy individuals and the relation with cardiovascular risk factors

Authors

Sophie Holder¹^{, *}, Rosa Maria Bruno², Daria Shkredova³, Andrew Thompson⁴, Ellen Dawson¹, Helen Jones¹, Nicola Hopkins¹, Maria Hopman⁵, Tom Bailey⁶, Jeff Coombes⁷, Christopher Askew⁸, Louise Naylor⁹, Andrew Maiorana¹⁰, Lorenzo Ghiadoni², Daniel Green⁹, Dick Thijssen¹^{, 5}

¹Liverpool John Moores University, Liverpool, United Kingdom

²University of Pisa, Pisa, Italy

³University of British Columbia, Kelowna, Canada

⁴University of Liverpool, Liverpool, United Kingdom

⁵Radboud University Medical Center, Nijmegen, The Netherlands

⁶The University of Queensland, Brisbane, Australia; University of the Sunshine Coast, Sippy Downs, Australia

⁷The University of Queensland, Brisbane, Australia

⁸University of the Sunshine Coast, Birtinya, Australia

⁹The University of Western Australia, Crawley, Australia

¹⁰Curtin University, Perth, Australia; Fiona Stanley Hospital, Perth, Australia

^*Corresponding author. Email: s.holder@2012.ljmu.ac.uk

Corresponding Author

Sophie Holder

Available Online 15 February 2020.

DOI: 10.2991/artres.k.191224.016 How to use a DOI?
Abstract: Background: Assessment of endothelial function using brachial artery flow-mediated dilation (FMD) predicts future cardiovascular disease (CVD) risk. However, poor adherence to protocol guidelines and lack of reference values hinders widespread FMD use. This study established age- and sex-specific reference intervals for brachial artery FMD in healthy individuals and examined the relation with CVD risk factors.

Methods: Collected according to expert-consensus guidelines, we combined brachial artery FMD and subject characteristics/medical history from 5,362 individuals (4–84 years; 2,076 females). We first examined healthy individuals (n = 1,403 [582 females]) to generate age-/sex-specific percentile curves. Subsequently, we included subjects with CVD risk factors but without disease (un-medicated n = 3,167 [1,247 females], and medicated n = 792 [247 females]). Multiple linear regression tested the relation of CVD risk factors with FMD.

Results: Healthy men showed a negative, curvilinear relation between FMD and age, whilst females revealed a linear relation that started higher, but declined at a faster rate. Age-/sex-related differences in FMD, at least partly, relate to baseline artery diameter. FMD was affected by CVD risk factors in un-medicated (e.g. systolic-/diastolic blood pressure, diabetes) and medicated subjects (e.g. dyslipidaemia). Importantly, sex mediated these effects (p < 0.05), with (supra) normalisation of FMD in medicated men, but not in women (except for blood pressure).

Conclusion: Sex alters the age-related decline in FMD, which is partly explained through differences in artery diameter. Sex also altered the effect of some CVD risk factors and medication on FMD. This work improves interpretation and future use of the FMD technique when strictly adhering to FMD protocol guidelines.
Open Access: This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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Journal: Artery Research
Volume-Issue: 25 - Supplement 1
Pages: S23 - S23
Publication Date: 2020/02/15
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.2991/artres.k.191224.016 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Cite this article

ris enw bib

TY  - JOUR
AU  - Sophie Holder
AU  - Rosa Maria Bruno
AU  - Daria Shkredova
AU  - Andrew Thompson
AU  - Ellen Dawson
AU  - Helen Jones
AU  - Nicola Hopkins
AU  - Maria Hopman
AU  - Tom Bailey
AU  - Jeff Coombes
AU  - Christopher Askew
AU  - Louise Naylor
AU  - Andrew Maiorana
AU  - Lorenzo Ghiadoni
AU  - Daniel Green
AU  - Dick Thijssen
PY  - 2020
DA  - 2020/02/15
TI  - 3.3 Age- and sex-specific reference intervals for brachial artery flow-mediated dilation in healthy individuals and the relation with cardiovascular risk factors
JO  - Artery Research
SP  - S23
EP  - S23
VL  - 25
IS  - Supplement 1
SN  - 1876-4401
UR  - https://doi.org/10.2991/artres.k.191224.016
DO  - 10.2991/artres.k.191224.016
ID  - Holder2020
ER  -

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