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Markers of Vascular Function and Future Coronary Artery Disease Risk Among Malaysians with Individual Cardiovascular
Amilia Aminuddin1, Nina Diyana Rusanuar1, Md Rizman Md Lazin Md Lazim2
1Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia.
Insights
Central vascular markers like pulse wave velocity (PWV) and augmentation index (AI) effectively detect coronary artery disease (CAD) risk, while peripheral measures like finger photoplethysmography fitness index (PPGF) offer insights into microvascular function, particularly in dyslipidemia.
Area of Science:
- Cardiovascular Physiology
- Vascular Biology
- Biomedical Engineering
Background:
- Vascular function markers, including central (PWV, AI) and peripheral (PPGF), detect early vascular damage linked to coronary artery disease (CAD) risk factors.
- Hypertension (HPT), dyslipidemia, and obesity are significant CAD risk factors associated with vascular dysfunction.
- Comparing these vascular markers across different risk factor groups is crucial for understanding their clinical relevance.
Purpose of the Study:
- To compare central and peripheral vascular function marker levels in subjects with hypertension, dyslipidemia, and obesity.
- To determine the relationship between vascular function markers and CAD risk factors within these groups.
- To evaluate the utility of PWV, AI, and PPGF in assessing vascular health in individuals with common CAD risk factors.
Main Methods:
- Recruitment of 320 subjects, including healthy controls and individuals with CAD risk factors.
- Assessment of peripheral vascular function using finger photoplethysmography fitness index (PPGF).
- Measurement of central vascular markers, including pulse wave velocity (PWV) and augmentation index (AI), and calculation of Framingham risk score (FRS).
Main Results:
- PWV and AI were significantly elevated in hypertensive subjects compared to controls.
- No significant differences in PPGF levels were observed between the groups.
- PWV correlated with FRS in hypertension and dyslipidemia groups; AI correlated with FRS in the obesity group. PPGF associated with PWV and AI in dyslipidemia.
Conclusions:
- PWV and AI are reliable macrovascular markers for arterial stiffness and systemic vascular resistance related to CAD risk.
- PPGF, a microvascular marker, provides valuable insights into endothelial dysfunction and microcirculatory issues, especially in dyslipidemia.
- Integrating central and peripheral vascular assessments can offer a comprehensive evaluation of cardiovascular risk.
Abstract:
Background/Objectives: Vascular function measurements, including central parameters [pulse wave velocity (PWV) and augmentation index (AI)], as well as peripheral measures [finger photoplethysmography fitness index (PPGF)], have been introduced to detect early vascular damage associated with coronary artery disease (CAD) risk factors. This study aimed to compare peripheral and central vascular function marker levels among subjects with hypertension (HPT), dyslipidemia, and obesity. We also aimed to determine the relationship between these markers and CAD risk factors among these groups. Methods: A total of 320 subjects including healthy individuals and those with CAD risk factors were recruited. Peripheral vascular function was assessed using the PPGF, whereas central vascular markers included measurements of PWV and AI. The Framingham risk score (FRS) was calculated using an online calculator. Results: The mean age of the subjects was 33.73 ± 7.29 years. PWV and AI were significantly higher in HPT subjects (8.03 ± 1.40 m/s and 21.90% ± 10.57%) than the control. PPGF levels showed no significant differences between the groups. PWV was associated with FRS in the HPT and dyslipidemia groups, whereas AI was associated with FRS in the obese group. PPGF showed associations with PWV and AI in the dyslipidemia group. Conclusions: PWV and AI serve as robust macrovascular markers indicating arterial stiffness and systemic vascular resistance linked to CAD risk, while PPGF, as a microvascular marker, offers valuable insights into early endothelial dysfunction and microcirculatory anomalies, especially in dyslipidemia subjects.
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