Artery Research

Volume 25, Issue Supplement 1, December 2019, Pages S23 - S23

3.3 Age- and sex-specific reference intervals for brachial artery flow-mediated dilation in healthy individuals and the relation with cardiovascular risk factors

Authors
Sophie Holder1, *, Rosa Maria Bruno2, Daria Shkredova3, Andrew Thompson4, Ellen Dawson1, Helen Jones1, Nicola Hopkins1, Maria Hopman5, Tom Bailey6, Jeff Coombes7, Christopher Askew8, Louise Naylor9, Andrew Maiorana10, Lorenzo Ghiadoni2, Daniel Green9, Dick Thijssen1, 5
1Liverpool John Moores University, Liverpool, United Kingdom
2University of Pisa, Pisa, Italy
3University of British Columbia, Kelowna, Canada
4University of Liverpool, Liverpool, United Kingdom
5Radboud University Medical Center, Nijmegen, The Netherlands
6The University of Queensland, Brisbane, Australia; University of the Sunshine Coast, Sippy Downs, Australia
7The University of Queensland, Brisbane, Australia
8University of the Sunshine Coast, Birtinya, Australia
9The University of Western Australia, Crawley, Australia
10Curtin University, Perth, Australia; Fiona Stanley Hospital, Perth, Australia
*Corresponding author. Email: s.holder@2012.ljmu.ac.uk
Corresponding Author
Sophie Holder
Available Online 15 February 2020.
DOI
10.2991/artres.k.191224.016How to use a DOI?
Abstract

Background: Assessment of endothelial function using brachial artery flow-mediated dilation (FMD) predicts future cardiovascular disease (CVD) risk. However, poor adherence to protocol guidelines and lack of reference values hinders widespread FMD use. This study established age- and sex-specific reference intervals for brachial artery FMD in healthy individuals and examined the relation with CVD risk factors.

Methods: Collected according to expert-consensus guidelines, we combined brachial artery FMD and subject characteristics/medical history from 5,362 individuals (4–84 years; 2,076 females). We first examined healthy individuals (n = 1,403 [582 females]) to generate age-/sex-specific percentile curves. Subsequently, we included subjects with CVD risk factors but without disease (un-medicated n = 3,167 [1,247 females], and medicated n = 792 [247 females]). Multiple linear regression tested the relation of CVD risk factors with FMD.

Results: Healthy men showed a negative, curvilinear relation between FMD and age, whilst females revealed a linear relation that started higher, but declined at a faster rate. Age-/sex-related differences in FMD, at least partly, relate to baseline artery diameter. FMD was affected by CVD risk factors in un-medicated (e.g. systolic-/diastolic blood pressure, diabetes) and medicated subjects (e.g. dyslipidaemia). Importantly, sex mediated these effects (p < 0.05), with (supra) normalisation of FMD in medicated men, but not in women (except for blood pressure).

Conclusion: Sex alters the age-related decline in FMD, which is partly explained through differences in artery diameter. Sex also altered the effect of some CVD risk factors and medication on FMD. This work improves interpretation and future use of the FMD technique when strictly adhering to FMD protocol guidelines.

Copyright
© 2019 Association for Research into Arterial Structure and Physiology. Publishing services by Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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Journal
Artery Research
Volume-Issue
25 - Supplement 1
Pages
S23 - S23
Publication Date
2020/02/15
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.2991/artres.k.191224.016How to use a DOI?
Copyright
© 2019 Association for Research into Arterial Structure and Physiology. Publishing services by Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Cite this article

TY  - JOUR
AU  - Sophie Holder
AU  - Rosa Maria Bruno
AU  - Daria Shkredova
AU  - Andrew Thompson
AU  - Ellen Dawson
AU  - Helen Jones
AU  - Nicola Hopkins
AU  - Maria Hopman
AU  - Tom Bailey
AU  - Jeff Coombes
AU  - Christopher Askew
AU  - Louise Naylor
AU  - Andrew Maiorana
AU  - Lorenzo Ghiadoni
AU  - Daniel Green
AU  - Dick Thijssen
PY  - 2020
DA  - 2020/02/15
TI  - 3.3 Age- and sex-specific reference intervals for brachial artery flow-mediated dilation in healthy individuals and the relation with cardiovascular risk factors
JO  - Artery Research
SP  - S23
EP  - S23
VL  - 25
IS  - Supplement 1
SN  - 1876-4401
UR  - https://doi.org/10.2991/artres.k.191224.016
DO  - 10.2991/artres.k.191224.016
ID  - Holder2020
ER  -