Vascular structure and function and their relationship with health-related quality of life in the MARK study

BMC Cardiovasc Disord. 2016 May 12;16:95. doi: 10.1186/s12872-016-0272-9.


Background: There is limited evidence concerning the relationship between vascular disease and health-related quality of life (HRQL). We investigated the relationship between vascular structure and function with health-related quality of life in a population with intermediate cardiovascular risk.

Methods: This study analyzed 303 subjects with ankle-brachial index (ABI) values ranging from 0.9 to 1.4 who were included in the MARK study (age 35 to 74 years; mean:60.5 ± 8.5), of which 50.2 % were women. Measurements included: ABI, brachial-ankle pulse wave velocity (ba-PWV), and cardio-ankle vascular index (CAVI), all measured using the VaSera device. The central augmentation index was adjusted to 75 lpm (AIx_75) using the Mobil-O-Graph device. HRQL was assessed by the Spanish version of the SF-12, version2. The highest obtained CAVI and ba-PWV values and the lowest ABI values were considered for the study.

Results: The cohort was composed of21 % smokers, 76 % hypertensive patients, and 24 % diabetic patients. The ABI mean was 1.09 ± 0.07,the ba-PWV mean was 14.64 ± 2.55 m/s with a 12.9 % of subjects higher than 17.5 m/s, AIx_75 26.46 ± 14.05, and CAVI 8.61 ± 1.08 with a 36.6 % of subjects higher than 9. Men scored higher than women in the HRQL measurements for physical (PSC-12; 49.9 vs. 46.9, p = 0.004) and mental (MSC-12) domains (51.2 vs. 47.7, p = 0.003). Age was positively correlated with CAVI (r = 0.547), ba-PWV (r = 0.469), AIx_75 (r = 0.255, p < 0.01), and the MSC-12 (r = 0.147, p < 0.05), but not the PSC-12. In the adjusted multiple linear regression analysis, the positive association of ABI and CAVI with the PSC-12 was maintained.

Conclusions: The ABI in the normal range has a positive association with the PSC-12 of HRQL evaluated with the SF-12. The CAVI also showed a positive association with the PSC-12 of HRQL.

Trial registration: Identifier: NCT01428934 .

Keywords: Ankle-brachial index; Arterial stiffness; Augmentation index; Brachial ankle pulse wave velocity; Cardio-ankle vascular index; Health-related quality of life.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Ankle Brachial Index
  • Blood Pressure*
  • Cross-Sectional Studies
  • Female
  • Health Status
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pulse Wave Analysis
  • Quality of Life
  • Risk Factors
  • Surveys and Questionnaires
  • Vascular Diseases / diagnosis
  • Vascular Diseases / physiopathology*
  • Vascular Diseases / psychology*
  • Vascular Stiffness*

Associated data