Key result
Flow-mediated vasodilation was independently predicted by age, sex, BMI, systolic blood pressure, diabetes, smoking, and baseline brachial artery diameter (P≤0.01 for all).
Cross-Sectional (n=5,314)
Yes
In a large Japanese cohort, flow-mediated vasodilation was independently associated with traditional cardiovascular risk factors and baseline brachial artery diameter, highlighting the need to account for these confounders in its measurement.
Confirms traditional risk factors and baseline diameter confound FMD; supports adjustment in research but leaves clinical utility open.
OBJECTIVE: To determine the relationships between flow-mediated vasodilation (FMD) and cardiovascular risk factors, and to evaluate confounding factors for measurement of FMD in a large general population in Japan. METHODS: This was a cross-sectional study. A total of 5314 Japanese adults recruited from people who underwent health screening from 1 April 2010 to 31 August 2012 at 3 general hospitals in Japan. Patients' risk factors (age, Body Mass Index, blood pressure, cholesterol parameters, glucose level and HbA1c level) and prevalence of cardiovascular disease (coronary heart disease and cerebrovascular disease) were investigated. RESULTS: Univariate regression analysis revealed that FMD correlated with age (r=-0.27, p<0.001), Body Mass Index (r=-0.14, p<0.001), systolic blood pressure (r=-0.18, p<0.001), diastolic blood pressure (r=-0.13, p<0.001), total cholesterol (r=-0.07, p<0.001), triglycerides (r=-0.10, p<0.001), high-density lipoprotein cholesterol (r=0.06, p<0.001), low-density lipoprotein cholesterol (r=-0.04, p=0.01), glucose level (r=-0.14, p<0.001), HbA1c (r=-0.14, p<0.001), and baseline brachial artery diameter (r=-0.43, p<0.001) as well as Framingham Risk score (r=-0.29, p<0.001). Multivariate analysis revealed that age (t value=-9.17, p<0.001), sex (t value=9.29, p<0.001), Body Mass Index (t value=4.27, p<0.001), systolic blood pressure (t value=-2.86, p=0.004), diabetes mellitus (t value=-4.19, p<0.001), smoking (t value=-2.56, p=0.01), and baseline brachial artery diameter (t value=-29.4, p<0.001) were independent predictors of FMD. CONCLUSIONS: FMD may be a marker of the grade of atherosclerosis and may be used as a surrogate marker of cardiovascular outcomes. Age, sex, Body Mass Index, systolic blood pressure, diabetes mellitus, smoking and, particularly, baseline brachial artery diameter are potential confounding factors in the measurement of FMD.
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Maruhashi et al. (2013) conducted a cross-sectional in Cardiovascular risk factors (n=5,314). Cardiovascular risk factors was evaluated on Independent predictors of flow-mediated vasodilation (FMD). Flow-mediated vasodilation was independently predicted by age, sex, BMI, systolic blood pressure, diabetes, smoking, and baseline brachial artery diameter (P≤0.01 for all).
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