Abstract 1189: Relation of Cardiovascular Risk Factors With Abnormal Brachial and Digital Vascular Function in the Community: The Framingham Heart Study
Background: Impaired vascular function contributes to the development of clinical cardiovascular disease. However, the prevalence and correlates of reduced vasodilator function are unknown. In addition, the relation of vascular function measured in the brachial and digital arteries remains incompletely defined.
Methods: In a total of 8830 participants in the Framingham Offspring, Third Generation and minority Omni cohort, we measured vasodilator function in the brachial artery (flow-mediated dilation (FMD) by ultrasound, n=6325, age
48±13 years, 54% women) and digital arteries (pulse amplitude tonometry (PAT) ratio by EndoPAT, n=4348, 55±16 years, 51% women). Abnormal vascular function of each measure was defined as a value below the sex-specific 5th percentile in a reference group without conventional cardiovascular risk factors. Applying these criteria to the entire sample identified 8–12% prevalence of abnormal vasodilator function. The prevalence of abnormal FMD increased markedly with age whereas abnormal PAT ratio did not (33% abnormal FMD and 10% abnormal PAT ratio in those aged≥70 years.) In stepwise logistic regression, correlates of abnormal FMD included increasing age, female sex, higher systolic blood pressure, higher body mass index, and hypertension. Correlates of abnormal PAT ratio included female sex, lower systolic blood pressure, increasing body mass index, increasing total/HDL cholesterol ratio, diabetes, smoking, and lipid-lowering treatment. With adjustment for age and sex, PAT ratio and FMD were unrelated in a subset of 1843 Third Generation participants who had concurrent brachial and digital vascular function testing.
Conclusions: Reduced brachial and digital artery function had differing relations with cardiovascular risk factors, suggesting that FMD and PAT provide complementary rather than redundant assessments of vascular function.