Objective: To investigate the relationship of arterial wall parameters (flow-mediated dilatation of the brachial artery, augmentation index, pulse wave velocity, stiffness index, carotid intima-media thickness) to conventional cardiovascular risk factors and cardiovascular risk assessed by SCORE system.
Material and methods: A total of 209 subjects aged 40-65 years without clinically overt cardiovascular disease were examined. Parameters of arterial stiffness were obtained by two methods: augmentation index and carotid-radial pulse wave velocity by applanation tonometry and stiffness index by the means of finger photoplethysmography. Flow-mediated dilatation of the brachial artery, reflecting endothelial function, and carotid intima-media thickness was determined using a high-resolution B-mode ultrasonography.
Results: Age and the presence of diabetes strongly influenced all parameters of the arterial wall (diabetes was not independent predictor when evaluating augmentation index). Mean arterial pressure and gender were independent predictors for arterial stiffness parameters--carotid-radial pulse wave velocity and augmentation index. Flow-mediated dilatation was strongly dependent on the diameter of the brachial artery, age, and body mass index. Using logistic regression, it was found that pulse wave velocity (P=0.014), intima-media thickness (P=0.004), and flow-mediated dilatation (P=0.020) were important parameters dividing subjects to the groups of increased (> or =5%) and low (<5%) cardiovascular risk assessed by SCORE system. The cutoff values for intima-media thickness and pulse wave velocity were 0.078 cm and 8.95 m/s, respectively.
Conclusions: Arterial wall parameters are closely associated with conventional risk factors; they are influenced by age and the presence of diabetes. Arterial stiffness parameters are also influenced by mean arterial pressure; high-density lipoprotein cholesterol has influence on carotid intima-media thickness. Cutoff values for carotid intima-media thickness and carotid-radial pulse wave velocity could help to discriminate patients with increased cardiovascular risk.