Key result
Nitroglycerine-induced vasodilation was significantly smaller in patients with cardiovascular disease (10.5%) than in subjects with (13.7%) and without (15.3%) cardiovascular risk factors (P<0.001).
Why the study?
Is nitroglycerine-induced vasodilation associated with cardiovascular risk factors and atherosclerosis?
Cross-Sectional (n=436)
Is nitroglycerine-induced vasodilation associated with cardiovascular risk factors and atherosclerosis?
Absolute Event Rate: 10.5% vs 15.3%
p-value: p=<0.001
Nitroglycerine-induced vasodilation is impaired in patients with cardiovascular disease and correlates with cardiovascular risk factors, suggesting it may serve as a marker for atherosclerosis grading.
Impaired nitroglycerin-induced vasodilation was associated with cardiovascular disease; hypothesis-generating for atherosclerosis grading and requires prospective validation before clinical adoption.
OBJECTIVE: Nitroglycerine-induced vasodilation has been used as a control test for flow-mediated vasodilation (FMD) to differentiate endothelium-dependent from endothelium-independent response when evaluating endothelial function in humans. Recently, nitroglycerine-induced vasodilation has also been reported to be impaired in patients with atherosclerosis. The purpose of this study was to determine the relationships between nitroglycerine-induced vasodilation and cardiovascular risk factors. APPROACH AND RESULTS: We measured nitroglycerine-induced vasodilation and FMD in 436 subjects who underwent health examinations (mean age, 53 ± 19 years; age range, 19-86 years), including patients with cardiovascular diseases. There was a significant relationship between nitroglycerine-induced vasodilation and FMD (r=0.42; P<0.001). Univariate regression analysis revealed that nitroglycerine-induced vasodilation correlated with age (r=-0.34; P<0.001), systolic blood pressure (r=-0.32; P<0.001), diastolic blood pressure (r=-0.24; P<0.001), heart rate (r=-0.21; P<0.001), glucose (r=-0.23; P<0.001), and smoking pack-year (r=-0.12; P=0.01), as well as Framingham risk score (r=-0.30; P<0.001). Nitroglycerine-induced vasodilation was significantly smaller in patients with cardiovascular disease than in both subjects with and without cardiovascular risk factors (10.5 ± 5.6% versus 13.7 ± 5.4% and 15.3 ± 4.3%; P<0.001, respectively), whereas there was no significant difference in nitroglycerine-induced vasodilation between subjects with and without cardiovascular risk factors. Multivariate analysis revealed that male sex, body mass index, hypertension, diabetes mellitus, baseline brachial artery diameter, and FMD were independent predictors of nitroglycerine-induced vasodilation. CONCLUSIONS: These findings suggest that nitroglycerine-induced vasodilation may be a marker of the grade of atherosclerosis. FMD should be interpreted as an index of vascular function reflecting both endothelium-dependent vasodilation and endothelium-independent vasodilation in subjects with impaired nitroglycerine-induced vasodilation.
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Maruhashi et al. (2013) conducted a cross-sectional in Cardiovascular risk factors and disease (n=436). Nitroglycerine-induced vasodilation vs. Subjects with and without cardiovascular risk factors was evaluated on Nitroglycerine-induced vasodilation in patients with cardiovascular disease versus subjects with and without cardiovascular risk factors (p=<0.001). Nitroglycerine-induced vasodilation was significantly smaller in patients with cardiovascular disease (10.5%) than in subjects with (13.7%) and without (15.3%) cardiovascular risk factors (P<0.001).
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