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Endothelial reactivity and cardiac risk factors in older patients with peripheral arterial disease
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 d...
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| Published in: | The American journal of cardiology 1999-03, Vol.83 (5), p.754-758 |
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| creator | Yataco, Alberto Rafael Corretti, Mary Concepta Gardner, Andrew William Womack, Christopher Joseph Katzel, Leslie Ira |
| description | 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 |
| doi_str_mv | 10.1016/S0002-9149(98)00984-9 |
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2 = 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.]]></description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/S0002-9149(98)00984-9</identifier><identifier>PMID: 10080432</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Age Factors ; Aged ; Arterial Occlusive Diseases - complications ; Arterial Occlusive Diseases - diagnostic imaging ; Arterial Occlusive Diseases - physiopathology ; Atherosclerosis (general aspects, experimental research) ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood Flow Velocity - physiology ; Blood Glucose - analysis ; Blood Pressure - physiology ; Brachial Artery - diagnostic imaging ; Brachial Artery - physiopathology ; Cardiology. Vascular system ; Cardiovascular disease ; Case-Control Studies ; Cholesterol, HDL - blood ; Cholesterol, LDL - blood ; Coronary Disease - etiology ; Coronary Disease - physiopathology ; Endothelium, Vascular - diagnostic imaging ; Endothelium, Vascular - physiopathology ; Fasting ; Female ; Forecasting ; Health risk assessment ; Heart Diseases - etiology ; Heart Diseases - physiopathology ; Humans ; Hyperemia - diagnostic imaging ; Hyperemia - physiopathology ; Male ; Medical sciences ; Middle Aged ; Older people ; Patients ; Peripheral Vascular Diseases - complications ; Peripheral Vascular Diseases - diagnostic imaging ; Peripheral Vascular Diseases - physiopathology ; Prevalence ; Regional Blood Flow - physiology ; Regression Analysis ; Risk Factors ; Smoking - physiopathology ; Ultrasonography ; Vasodilation - physiology</subject><ispartof>The American journal of cardiology, 1999-03, Vol.83 (5), p.754-758</ispartof><rights>1999 Excerpta Medica Inc.</rights><rights>1999 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. Mar 1, 1999</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c417t-651ccf9282da9f073a94a3711c6d6f2d4fd2d19c97481c508214ac8d187ac8f53</citedby><cites>FETCH-LOGICAL-c417t-651ccf9282da9f073a94a3711c6d6f2d4fd2d19c97481c508214ac8d187ac8f53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1718054$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10080432$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yataco, Alberto Rafael</creatorcontrib><creatorcontrib>Corretti, Mary Concepta</creatorcontrib><creatorcontrib>Gardner, Andrew William</creatorcontrib><creatorcontrib>Womack, Christopher Joseph</creatorcontrib><creatorcontrib>Katzel, Leslie Ira</creatorcontrib><title>Endothelial reactivity and cardiac risk factors in older patients with peripheral arterial disease</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description><![CDATA[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 (r
2 = 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.]]></description><subject>Age Factors</subject><subject>Aged</subject><subject>Arterial Occlusive Diseases - complications</subject><subject>Arterial Occlusive Diseases - diagnostic imaging</subject><subject>Arterial Occlusive Diseases - physiopathology</subject><subject>Atherosclerosis (general aspects, experimental research)</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Blood Flow Velocity - physiology</subject><subject>Blood Glucose - analysis</subject><subject>Blood Pressure - physiology</subject><subject>Brachial Artery - diagnostic imaging</subject><subject>Brachial Artery - physiopathology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular disease</subject><subject>Case-Control Studies</subject><subject>Cholesterol, HDL - blood</subject><subject>Cholesterol, LDL - blood</subject><subject>Coronary Disease - etiology</subject><subject>Coronary Disease - physiopathology</subject><subject>Endothelium, Vascular - diagnostic imaging</subject><subject>Endothelium, Vascular - physiopathology</subject><subject>Fasting</subject><subject>Female</subject><subject>Forecasting</subject><subject>Health risk assessment</subject><subject>Heart Diseases - etiology</subject><subject>Heart Diseases - physiopathology</subject><subject>Humans</subject><subject>Hyperemia - diagnostic imaging</subject><subject>Hyperemia - physiopathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Older people</subject><subject>Patients</subject><subject>Peripheral Vascular Diseases - complications</subject><subject>Peripheral Vascular Diseases - diagnostic imaging</subject><subject>Peripheral Vascular Diseases - physiopathology</subject><subject>Prevalence</subject><subject>Regional Blood Flow - physiology</subject><subject>Regression Analysis</subject><subject>Risk Factors</subject><subject>Smoking - physiopathology</subject><subject>Ultrasonography</subject><subject>Vasodilation - physiology</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><recordid>eNqFkdFrFDEQxoNY7Fn9E5QgIvqwmslmd5OnIqVqodAH9TlMkwmXure7JrlK_3tzvUPFlz5NhvzmY-b7GHsB4j0I6D98FULIxoAyb41-J4TRqjGP2Ar0YBow0D5mqz_IMXua801tAbr-CTsGIbRQrVyx6_PJz2VNY8SRJ0JX4m0sdxwnzx0mH9HxFPMPHurXnDKPE59HT4kvWCJNJfNfsaz5Qikua0pVBVOpTX34mAkzPWNHAcdMzw_1hH3_dP7t7EtzefX54uzjZeMUDKXpO3AuGKmlRxPE0KJR2A4Arvd9kF4FLz0YZwalwXVCS1DotK8H1xK69oS92esuaf65pVzsJmZH44gTzdtse9NLY9od-Oo_8GbepqnuZmUr2h4GMBXq9pBLc86Jgl1S3GC6syDsLgF7n4Dd2WuNtvcJ2N3cy4P49npD_p-pveUVeH0AMDscQ8LJxfyXG0CLTlXsdI9Rtew2UrLZVb8d-ZjIFevn-MAmvwG1naKe</recordid><startdate>19990301</startdate><enddate>19990301</enddate><creator>Yataco, Alberto Rafael</creator><creator>Corretti, Mary Concepta</creator><creator>Gardner, Andrew William</creator><creator>Womack, Christopher Joseph</creator><creator>Katzel, Leslie Ira</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>19990301</creationdate><title>Endothelial reactivity and cardiac risk factors in older patients with peripheral arterial disease</title><author>Yataco, Alberto Rafael ; Corretti, Mary Concepta ; Gardner, Andrew William ; Womack, Christopher Joseph ; Katzel, Leslie Ira</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c417t-651ccf9282da9f073a94a3711c6d6f2d4fd2d19c97481c508214ac8d187ac8f53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Arterial Occlusive Diseases - complications</topic><topic>Arterial Occlusive Diseases - diagnostic imaging</topic><topic>Arterial Occlusive Diseases - physiopathology</topic><topic>Atherosclerosis (general aspects, experimental research)</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Blood Flow Velocity - physiology</topic><topic>Blood Glucose - analysis</topic><topic>Blood Pressure - physiology</topic><topic>Brachial Artery - diagnostic imaging</topic><topic>Brachial Artery - physiopathology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular disease</topic><topic>Case-Control Studies</topic><topic>Cholesterol, HDL - blood</topic><topic>Cholesterol, LDL - blood</topic><topic>Coronary Disease - etiology</topic><topic>Coronary Disease - physiopathology</topic><topic>Endothelium, Vascular - diagnostic imaging</topic><topic>Endothelium, Vascular - physiopathology</topic><topic>Fasting</topic><topic>Female</topic><topic>Forecasting</topic><topic>Health risk assessment</topic><topic>Heart Diseases - etiology</topic><topic>Heart Diseases - physiopathology</topic><topic>Humans</topic><topic>Hyperemia - diagnostic imaging</topic><topic>Hyperemia - physiopathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Older people</topic><topic>Patients</topic><topic>Peripheral Vascular Diseases - complications</topic><topic>Peripheral Vascular Diseases - diagnostic imaging</topic><topic>Peripheral Vascular Diseases - physiopathology</topic><topic>Prevalence</topic><topic>Regional Blood Flow - physiology</topic><topic>Regression Analysis</topic><topic>Risk Factors</topic><topic>Smoking - physiopathology</topic><topic>Ultrasonography</topic><topic>Vasodilation - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yataco, Alberto Rafael</creatorcontrib><creatorcontrib>Corretti, Mary Concepta</creatorcontrib><creatorcontrib>Gardner, Andrew William</creatorcontrib><creatorcontrib>Womack, Christopher Joseph</creatorcontrib><creatorcontrib>Katzel, Leslie Ira</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yataco, Alberto Rafael</au><au>Corretti, Mary Concepta</au><au>Gardner, Andrew William</au><au>Womack, Christopher Joseph</au><au>Katzel, Leslie Ira</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endothelial reactivity and cardiac risk factors in older patients with peripheral arterial disease</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>1999-03-01</date><risdate>1999</risdate><volume>83</volume><issue>5</issue><spage>754</spage><epage>758</epage><pages>754-758</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract><![CDATA[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 (r
2 = 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.]]></abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>10080432</pmid><doi>10.1016/S0002-9149(98)00984-9</doi><tpages>5</tpages></addata></record> |
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| source | ScienceDirect Freedom Collection 2022-2024 |
| subjects | Age Factors Aged Arterial Occlusive Diseases - complications Arterial Occlusive Diseases - diagnostic imaging Arterial Occlusive Diseases - physiopathology Atherosclerosis (general aspects, experimental research) Biological and medical sciences Blood and lymphatic vessels Blood Flow Velocity - physiology Blood Glucose - analysis Blood Pressure - physiology Brachial Artery - diagnostic imaging Brachial Artery - physiopathology Cardiology. Vascular system Cardiovascular disease Case-Control Studies Cholesterol, HDL - blood Cholesterol, LDL - blood Coronary Disease - etiology Coronary Disease - physiopathology Endothelium, Vascular - diagnostic imaging Endothelium, Vascular - physiopathology Fasting Female Forecasting Health risk assessment Heart Diseases - etiology Heart Diseases - physiopathology Humans Hyperemia - diagnostic imaging Hyperemia - physiopathology Male Medical sciences Middle Aged Older people Patients Peripheral Vascular Diseases - complications Peripheral Vascular Diseases - diagnostic imaging Peripheral Vascular Diseases - physiopathology Prevalence Regional Blood Flow - physiology Regression Analysis Risk Factors Smoking - physiopathology Ultrasonography Vasodilation - physiology |
| title | Endothelial reactivity and cardiac risk factors in older patients with peripheral arterial disease |
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