Carotid artery stiffness, high-density lipoprotein cholesterol and inflammation in men with pre-hypertension
K S Heffernan1, R H Karas, J T Kuvin
1Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA. KHeffernan@tufts-nemc.org
Insights
Low high-density lipoprotein cholesterol (HDL-C) in pre-hypertensive men is linked to increased carotid artery stiffness. This association appears to be driven by inflammation, not body fat or fitness levels.
Area of Science:
- Cardiovascular Health
- Lipid Metabolism
- Arterial Physiology
Background:
- Low high-density lipoprotein cholesterol (HDL-C) correlates with cardiovascular risk.
- HDL-C's atheroprotective mechanisms, including lipid metabolism and anti-inflammatory effects, are not fully understood.
- Increased arterial stiffness is a significant predictor of cardiovascular events.
Purpose of the Study:
- To investigate the association between HDL-C levels and carotid arterial stiffness in healthy pre-hypertensive men.
- To examine potential mediating factors, including inflammation, cardiorespiratory fitness, and body fat percentage.
Main Methods:
- Carotid artery beta-stiffness measured via ultrasound in 47 healthy pre-hypertensive men.
- Low HDL-C defined as <1.0 mmol/L.
- Assessment of body fat, cardiorespiratory fitness, and inflammatory markers (CRP, WBC, neutrophil count).
Main Results:
- Men with low HDL-C exhibited significantly higher carotid artery stiffness.
- Low HDL-C group also showed elevated CRP, WBC count, neutrophil count, body fat, and fasting glucose, with lower cardiorespiratory fitness.
- Adjusting for cardiorespiratory fitness, body fat, or glucose did not alter the stiffness difference.
- Controlling for inflammatory markers eliminated the difference in carotid artery stiffness between groups.
Conclusions:
- Pre-hypertensive men with low HDL-C levels demonstrate increased carotid artery stiffness compared to those with higher HDL-C.
- Inflammation appears to be the primary mediator of the detrimental effect of low HDL-C on large artery stiffness in this population.
- Cardiorespiratory fitness and body fat percentage do not seem to mediate this association.
Abstract:
Low circulating levels of high-density lipoprotein cholesterol (HDL-C) are associated with increased risk for cardiovascular events. HDL-C has a variety of poorly understood atheroprotective effects, including altering lipid metabolism and reducing inflammation. Increased arterial stiffness is an important predictor of subsequent cardiovascular risk. Therefore, in this study, we sought to determine whether HDL-C levels are associated with carotid arterial stiffness. In addition, we examined potential correlates of this association, such as inflammatory factors, cardiorespiratory fitness and body fat percentage. Carotid artery beta-stiffness was measured by ultrasound in 47 (23 years old) healthy pre-hypertensive men. Low HDL-C was defined as <1.0 mmol l(-1). Body fat was measured by air displacement plethysmography. Cardiorespiratory fitness was measured using a maximal exercise test, with metabolic gas analysis and inflammatory markers consisting of C-reactive protein (CRP), white blood cell (WBC) count and absolute neutrophil count. Men with a low HDL-C had significantly higher carotid artery stiffness, CRP, WBC count, neutrophil count, body fat, fasting glucose and lower cardiorespiratory fitness (P<0.05). Co-varying for cardiorespiratory fitness, % body fat and glucose had no effect on group differences in carotid artery stiffness. Co-varying for inflammatory markers resulted in groups having similar carotid artery stiffness. Pre-hypertensive men with low HDL-C have a higher carotid artery stiffness when compared with those with higher HDL-C. The detrimental effects of low HDL-C on large artery stiffness in pre-hypertensive men may be mediated by inflammation and not by cardiorespiratory fitness or body fat levels.
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