Prognostic role of flow-mediated dilation and cardiac risk factors in post-menopausal women
Rosario Rossi1, Annachiara Nuzzo, Giorgia Origliani
1Institute of Cardiology, Policlinico Hospital, University of Modena and Reggio Emilia, Modena, Italy. rossi.rosario@unimore.it
Insights
Brachial artery flow-mediated dilation (FMD) is a valuable tool for predicting cardiovascular events in post-menopausal women. Lower FMD levels significantly correlate with increased risk, offering incremental prognostic information beyond traditional risk factors.
Area of Science:
- Cardiovascular Research
- Endothelial Function Assessment
- Preventive Cardiology
Background:
- Conventional cardiovascular risk factors inadequately predict 50% of events.
- Individualized risk assessment is crucial for primary prevention.
- Endothelial function, measured by brachial artery flow-mediated dilation (FMD), may identify high-risk individuals.
Purpose of the Study:
- To investigate the association between brachial artery flow-mediated dilation (FMD) and cardiovascular events.
- To assess FMD's prognostic value in initially asymptomatic post-menopausal women.
- To adjust for major cardiovascular risk factors in the analysis.
Main Methods:
- Prospective study of 2,264 post-menopausal women (age 54 ± 6 years).
- Follow-up duration of 45 ± 13 months.
- Analysis of brachial artery flow-mediated dilation (FMD) tertiles and cardiovascular event rates.
Main Results:
- A significant trend (p < 0.0001) showed increased cardiovascular event risk with lower FMD tertiles.
- Women in the lowest FMD tertile (≤4.5%) had a 4.42-fold higher risk.
- FMD significantly improved cardiovascular event prediction models when added to conventional risk factors.
Conclusions:
- Brachial artery flow-mediated dilation (FMD) provides incremental prognostic information in post-menopausal women.
- FMD knowledge enhances risk stratification for cardiovascular events.
- This noninvasive measure aids in identifying individuals at higher risk.
Objectives:
The aim of this study was to examine the association between brachial artery flow-mediated dilation (FMD) and cardiovascular events in a cohort of initially asymptomatic post-menopausal women, with adjustment for the presence of the major cardiovascular risk factors.
Background:
Conventional major cardiovascular risk factors (cigarette smoking, hypercholesterolemia, hypertension, and diabetes) fail to explain nearly 50% of cardiovascular events. Defining the magnitude of future risk for the development of clinical events is a major focus of effective primary prevention. Evaluation of endothelial function, utilizing the noninvasive measurement of the brachial artery FMD, may serve as a screening tool to individualize high-risk patients.
Methods:
We conducted a prospective study on 2,264 post-menopausal women, age 54 +/- 6 years. The length of the follow-up was 45 +/- 13 months (range 6 to 65 months).
Results:
During observation, 90 major events were recorded. Risk-adjusted relative risk values resulted 1.0, 1.33 (95% confidence interval [CI] 1.09 to 4.09), and 4.42 (95% CI 2.97 to 8.01) for women in the higher, intermediate, and lower tertile of FMD, respectively (p < 0.0001 for trend). The event rate for women in the lower tertile (FMD
Conclusions:
In post-menopausal women, the knowledge of FMD provided incremental prognostic information regarding the risk of developing cardiovascular events.
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