Lifestyle, cardio-metabolic risk and arterial stiffness

Area of Science:

• Cardiovascular Medicine
• Metabolic Syndrome
• Arterial Physiology

Background:

• High-density lipoprotein cholesterol (HDL-C) is crucial for arterial health and cardiovascular risk assessment.
• Arterial stiffness is a significant indicator of cardiovascular risk.
• Insulin resistance is increasingly recognized as a key factor in metabolic and cardiovascular diseases.

Purpose of the Study:

• To evaluate arterial stiffness in asymptomatic individuals stratified by cardiovascular risk.
• To determine the influence of lipid parameters and insulin resistance on arterial stiffness.
• To identify predictors of arterial stiffness in diverse risk groups.

Main Methods:

• Carotid-radial pulse wave velocity (PWV-CR) was measured to assess arterial stiffness.
• Cardiovascular risk was quantified using the SCORE chart.
• Metabolic risk was assessed via fasting lipid profiles (TC, TG, HDL, LDL) and HOMA-IR for insulin resistance (HOMA-IR > 1).

Main Results:

• In low-risk subjects (SCORE < 5%), low HDL (< 40 mg/dL) and elevated TG/HDL ratio influenced PWV-CR. LDL levels (< 115 mg/dL) and combined lipid alterations strongly predicted increased PWV-CR (R2=0.85, p=0.008).
• In high-risk subjects (SCORE ≥ 5%), protective HDL levels (≥ 40 mg/dL) and insulin resistance (HOMA-IR > 1) were strongly associated with PWV-CR (R2=0.74, p=0.02).
• The association of insulin resistance with LDL levels further amplified PWV-CR prediction in high-risk individuals (R2=0.92, p=0.01).

Conclusions:

• Lipid alterations, particularly low HDL, contribute to arterial stiffness in asymptomatic individuals with low cardiovascular risk.
• In high-risk asymptomatic subjects, elevated HDL and insulin resistance are key predictors of arterial stiffness.
• The interplay between LDL and insulin resistance intensifies the prediction of arterial stiffness, highlighting the need for targeted HDL and TG levels in prevention guidelines.