Circulation. 2004;109:613-619
doi: 10.1161/01.CIR.0000112565.60887.1E
doi: 10.1161/01.CIR.0000112565.60887.1E
(Circulation. 2004;109:613-619.)
© 2004 American Heart Association, Inc.
Clinical Investigation and Reports |
Clinical Correlates and Heritability of Flow-Mediated Dilation in the Community
The Framingham Heart Study
From the Evans Department of Medicine (E.J.B., J.F.K., J.A.V.), Whitaker Cardiovascular Institute (E.J.B., R.S.V., J.F.K., J.A.V.), and Preventive Medicine Section (E.J.B., M.G.L., R.S.V.), Boston University School of Medicine, Boston, Mass; Cardiovascular Engineering, Inc (G.F.M.), Holliston, Mass; and the Framingham Study (E.J.B., M.G.L., M.J.K., R.S.V., B.T.L., S.F., E.O.), National Heart, Lung and Blood Institute, Framingham, Mass.
Correspondence to Emelia J. Benjamin, MD, ScM, Associate Professor of Medicine, Boston University, Framingham Study, 73 Mt Wayte Avenue No. 2, Framingham, MA 01702-5827. E-mail emelia{at}bu.edu
Received May 6, 2003; de novo received August 27, 2003; revision received October 28, 2003; accepted October 30, 2003.
Background— Studies in selected samples have linked impaired endothelial function with cardiovascular disease and its risk factors. The clinical correlates and heritability of endothelial function in the community have not been described.
Methods and Results— We examined a measure of endothelial function, brachial artery flow-mediated dilation (FMD), expressed as both percent (FMD%) and actual dilation by ultrasound with the occlusion cuff below the elbow in 2883 Framingham Study participants (52.9% women; mean age, 61 years). A subset of 1096 participants performed a 6-minute walk test before FMD determination. Mean FMD% was 3.3±3.0% in women and 2.4±2.4% in men. In stepwise multivariable linear regression models, FMD% was inversely related to age, systolic blood pressure, body mass index (BMI), lipid-lowering medication, and smoking, whereas it was positively related to female gender, heart rate, and prior walk test. The estimated heritability of FMD% was 0.14. FMD actual dilation findings were similar, except that female sex and BMI were not significantly associated.
Conclusions— Increasing age, systolic blood pressure, BMI, and smoking were associated with lower FMD% in our community-based sample, whereas prior exercise and increasing heart rate were associated with higher FMD%. The estimated heritability of FMD was modest. Future research will permit more complete characterization of the genetic and environmental determinants of endothelial function and its prognostic value in the community.
Key Words: endothelium • epidemiology • risk factors • genetics
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