Relation of Brachial and Digital Measures of Vascular Function in the Community: The Framingham Heart Study

• Published in: Hypertension (Dallas, Tex. 1979) Vol. 57; no. 3; pp. 390 - 396
• Main Authors: Hamburg, Naomi M, Palmisano, Joseph, Larson, Martin G, Sullivan, Lisa M, Lehman, Birgitta T, Vasan, Ramachandran S, Levy, Daniel, Mitchell, Gary F, Vita, Joseph A, Benjamin, Emelia J
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD American Heart Association, Inc 01-03-2011; Lippincott Williams & Wilkins
• Subjects: Adult; Aged; Aged, 80 and over; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood Flow Velocity - physiology; Blood vessels and receptors; Brachial Artery - diagnostic imaging; Brachial Artery - physiology; Cardiology. Vascular system; Endothelium, Vascular - diagnostic imaging; Endothelium, Vascular - physiology; Female; Fundamental and applied biological sciences. Psychology; Humans; Linear Models; Male; Medical sciences; Middle Aged; Regional Blood Flow - physiology; Ultrasonography; Vasodilation - physiology; Vertebrates: cardiovascular system; Hypertension; vascular function; risk factors; Cohort study; Risk factor; Cardiovascular disease; Epidemiology; Endothelium
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/HYPERTENSIONAHA.110.160812

Impaired vascular function contributes to the development of clinical cardiovascular disease. The relation between vasodilator function assessed noninvasively in the brachial and digital arteries remains incompletely defined. In the Framingham Offspring, Third Generation and Omni Cohorts, we measured flow-mediated dilation (FMD; n=7031; age 48±13 years; age range, 19 to 88 years; 54% women) and peripheral arterial tonometry (PAT) ratio (n=4352; 55±16 years; age range, 19 to 90 years; 51% women). Abnormal vascular function for each measure was defined by the sex-specific fifth percentile in a reference group free of conventional cardiovascular risk factors. The prevalence of abnormal FMD but not abnormal PAT ratio was higher with advancing age. In multivariable models, higher body mass index was associated with a higher prevalence of both abnormal FMD and PAT ratio. Additional correlates of abnormal FMD included increasing age and higher systolic blood pressure. In contrast, correlates of abnormal PAT ratio included lower systolic blood pressure, increasing total/high-density lipoprotein cholesterol ratio, diabetes, smoking, and lipid-lowering medication. Whereas women had higher FMD and PAT ratios compared with men, using sex-specific reference values, women had a higher prevalence of abnormal brachial and digital vascular function. In participants who had concurrent testing (n=1843), PAT ratio was not significantly associated with FMD in multivariable models. In this large, community-based cohort, brachial and digital measures of vascular function had differing relations with cardiovascular risk factors and were nearly uncorrelated with each other. These results suggest that FMD and PAT provide distinct information regarding vascular function in conduit versus smaller digital vessels.