Endothelial dysfunction is associated with carotid plaque: A cross-sectional study from the population based Northern Manhattan Study

Tatjana Rundek, Rameet Hundle, Elizabeth Ratchford, Romel Ramas, Robert Sciacca, Marco R. Di Tullio, Bernadette Boden-Albala, Yumiko Miyake, Mitchell S V Elkind, Ralph L Sacco, Shunichi Homma

Research output: Contribution to journalArticle

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Abstract

Background: Impaired vascular function occurs early in atherogenesis. Brachial flow mediated dilatation (FMD) is a non-invasive measure of vascular function and may be an important marker of preclinical atherosclerosis. Data on the association between FMD and carotid plaque in multiethnic populations are limited. The objective of this study was to determine whether endothelial dysfunction is independently associated with carotid plaque in a community of northern Manhattan. Methods: In the population-based Northern Manhattan Study (NOMAS), high-resolution B-mode ultrasound images of the brachial and carotid arteries were obtained in 643 stroke-free subjects (mean age 66 years; 55% women; 65% Caribbean-Hispanic, 17% African-American, 16% Caucasian). Brachial FMD was measured during reactive hyperemia. Maximum carotid plaque thickness (MCPT) was measured at the peak plaque prominence. Results: The mean brachial FMD was 5.78 ± 3.83%. Carotid plaque was present in 339 (53%) subjects. The mean MCFT was 1.68 ± 0.82 mm, and the 75th percentile was 2.0 mm. Reduced FMD was significantly associated with increased MCPT. After adjusting for demographics, vascular risk factors, and education, each percent of FMD decrease was associated with a significant 0.02 mm increase in MCPT (p = 0.028). In a dichotomous adjusted model, blunted FMD was associated with an increased risk of MCPT ≥ 2.0 mm (OR, 1.11 for every 1% decrease in FMD; 95% CI, 1.03-1.19). Conclusion: Decreased brachial FMD is independently associated with carotid plaque. Noninvasive evaluation of endothelial dysfunction may be a useful marker of preclinical atherosclerosis and help to individualize cardiovascular risk assessment beyond traditional risk factors.

Original languageEnglish
Article number35
JournalBMC Cardiovascular Disorders
Volume6
DOIs
StatePublished - Aug 17 2006
Externally publishedYes

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Dilatation
Cross-Sectional Studies
Population
Arm
Atherosclerosis
Blood Vessels
Brachial Artery
Hyperemia
Carotid Arteries
Hispanic Americans
African Americans
Stroke
Demography
Education

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Endothelial dysfunction is associated with carotid plaque : A cross-sectional study from the population based Northern Manhattan Study. / Rundek, Tatjana; Hundle, Rameet; Ratchford, Elizabeth; Ramas, Romel; Sciacca, Robert; Di Tullio, Marco R.; Boden-Albala, Bernadette; Miyake, Yumiko; Elkind, Mitchell S V; Sacco, Ralph L; Homma, Shunichi.

In: BMC Cardiovascular Disorders, Vol. 6, 35, 17.08.2006.

Research output: Contribution to journalArticle

Rundek, Tatjana ; Hundle, Rameet ; Ratchford, Elizabeth ; Ramas, Romel ; Sciacca, Robert ; Di Tullio, Marco R. ; Boden-Albala, Bernadette ; Miyake, Yumiko ; Elkind, Mitchell S V ; Sacco, Ralph L ; Homma, Shunichi. / Endothelial dysfunction is associated with carotid plaque : A cross-sectional study from the population based Northern Manhattan Study. In: BMC Cardiovascular Disorders. 2006 ; Vol. 6.
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abstract = "Background: Impaired vascular function occurs early in atherogenesis. Brachial flow mediated dilatation (FMD) is a non-invasive measure of vascular function and may be an important marker of preclinical atherosclerosis. Data on the association between FMD and carotid plaque in multiethnic populations are limited. The objective of this study was to determine whether endothelial dysfunction is independently associated with carotid plaque in a community of northern Manhattan. Methods: In the population-based Northern Manhattan Study (NOMAS), high-resolution B-mode ultrasound images of the brachial and carotid arteries were obtained in 643 stroke-free subjects (mean age 66 years; 55{\%} women; 65{\%} Caribbean-Hispanic, 17{\%} African-American, 16{\%} Caucasian). Brachial FMD was measured during reactive hyperemia. Maximum carotid plaque thickness (MCPT) was measured at the peak plaque prominence. Results: The mean brachial FMD was 5.78 ± 3.83{\%}. Carotid plaque was present in 339 (53{\%}) subjects. The mean MCFT was 1.68 ± 0.82 mm, and the 75th percentile was 2.0 mm. Reduced FMD was significantly associated with increased MCPT. After adjusting for demographics, vascular risk factors, and education, each percent of FMD decrease was associated with a significant 0.02 mm increase in MCPT (p = 0.028). In a dichotomous adjusted model, blunted FMD was associated with an increased risk of MCPT ≥ 2.0 mm (OR, 1.11 for every 1{\%} decrease in FMD; 95{\%} CI, 1.03-1.19). Conclusion: Decreased brachial FMD is independently associated with carotid plaque. Noninvasive evaluation of endothelial dysfunction may be a useful marker of preclinical atherosclerosis and help to individualize cardiovascular risk assessment beyond traditional risk factors.",
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T2 - A cross-sectional study from the population based Northern Manhattan Study

AU - Rundek, Tatjana

AU - Hundle, Rameet

AU - Ratchford, Elizabeth

AU - Ramas, Romel

AU - Sciacca, Robert

AU - Di Tullio, Marco R.

AU - Boden-Albala, Bernadette

AU - Miyake, Yumiko

AU - Elkind, Mitchell S V

AU - Sacco, Ralph L

AU - Homma, Shunichi

PY - 2006/8/17

Y1 - 2006/8/17

N2 - Background: Impaired vascular function occurs early in atherogenesis. Brachial flow mediated dilatation (FMD) is a non-invasive measure of vascular function and may be an important marker of preclinical atherosclerosis. Data on the association between FMD and carotid plaque in multiethnic populations are limited. The objective of this study was to determine whether endothelial dysfunction is independently associated with carotid plaque in a community of northern Manhattan. Methods: In the population-based Northern Manhattan Study (NOMAS), high-resolution B-mode ultrasound images of the brachial and carotid arteries were obtained in 643 stroke-free subjects (mean age 66 years; 55% women; 65% Caribbean-Hispanic, 17% African-American, 16% Caucasian). Brachial FMD was measured during reactive hyperemia. Maximum carotid plaque thickness (MCPT) was measured at the peak plaque prominence. Results: The mean brachial FMD was 5.78 ± 3.83%. Carotid plaque was present in 339 (53%) subjects. The mean MCFT was 1.68 ± 0.82 mm, and the 75th percentile was 2.0 mm. Reduced FMD was significantly associated with increased MCPT. After adjusting for demographics, vascular risk factors, and education, each percent of FMD decrease was associated with a significant 0.02 mm increase in MCPT (p = 0.028). In a dichotomous adjusted model, blunted FMD was associated with an increased risk of MCPT ≥ 2.0 mm (OR, 1.11 for every 1% decrease in FMD; 95% CI, 1.03-1.19). Conclusion: Decreased brachial FMD is independently associated with carotid plaque. Noninvasive evaluation of endothelial dysfunction may be a useful marker of preclinical atherosclerosis and help to individualize cardiovascular risk assessment beyond traditional risk factors.

AB - Background: Impaired vascular function occurs early in atherogenesis. Brachial flow mediated dilatation (FMD) is a non-invasive measure of vascular function and may be an important marker of preclinical atherosclerosis. Data on the association between FMD and carotid plaque in multiethnic populations are limited. The objective of this study was to determine whether endothelial dysfunction is independently associated with carotid plaque in a community of northern Manhattan. Methods: In the population-based Northern Manhattan Study (NOMAS), high-resolution B-mode ultrasound images of the brachial and carotid arteries were obtained in 643 stroke-free subjects (mean age 66 years; 55% women; 65% Caribbean-Hispanic, 17% African-American, 16% Caucasian). Brachial FMD was measured during reactive hyperemia. Maximum carotid plaque thickness (MCPT) was measured at the peak plaque prominence. Results: The mean brachial FMD was 5.78 ± 3.83%. Carotid plaque was present in 339 (53%) subjects. The mean MCFT was 1.68 ± 0.82 mm, and the 75th percentile was 2.0 mm. Reduced FMD was significantly associated with increased MCPT. After adjusting for demographics, vascular risk factors, and education, each percent of FMD decrease was associated with a significant 0.02 mm increase in MCPT (p = 0.028). In a dichotomous adjusted model, blunted FMD was associated with an increased risk of MCPT ≥ 2.0 mm (OR, 1.11 for every 1% decrease in FMD; 95% CI, 1.03-1.19). Conclusion: Decreased brachial FMD is independently associated with carotid plaque. Noninvasive evaluation of endothelial dysfunction may be a useful marker of preclinical atherosclerosis and help to individualize cardiovascular risk assessment beyond traditional risk factors.

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