Noninvasive Arterial Measurements of Vascular Damage in Healthy Young Adults: Relation to Coronary Heart Disease Risk

Purpose

There is an increasing interest in noninvasive measurements of early structural or functional changes in large arteries such as pulse wave velocity (PWV), carotid intima-media thickness (CIMT), and augmentation index (AIx). These measurements may be applied in etiologic or prognostic research. The role of the AIx as a marker of cardiovascular risk has not fully been established. Our aim was to study whether AIx is related to coronary heart disease (CHD) risk and to compare the strength of the relations of AIx, PWV, and CIMT with cardiovascular risk in healthy young adults.

Methods

Our study included 224 men and 273 women (mean age 28 years, range 27–30 years) from the Atherosclerosis Risk in Young Adults (ARYA) study. Cardiovascular risk profile was determined and CHD risk was estimated using the Framingham risk score. AIx, PWV and CIMT were measured using standard methods. Data were analyzed in strata of gender using linear regression models.

Results

In men, PWV and CIMT were most strongly related to CHD risk. The increase in CHD risk per standard deviation increase in measurement was 0.24%/m/s, 95% CI (0.01;0.33) and 0.32%/mm, 95% CI (0.08;0.55), whereas the AIx was not significantly related to CHD risk (0.09 %/% 95% CI [–0.15;0.33]). In women, AIx, PWV, and CIMT were weakly but significantly related to CHD risk; there was no clear difference between the measurements.

Conclusion

In young men, PWV and CIMT are better measures of CHD risk than AIx. In women, AIx, PWV and CIMT estimate CHD risk equally well.

Key words: Cohort, Stiffness, Atherosclerosis, Adiposity, Vascular

Selected Abbreviations and Acronyms: PWV, pulse wave velocity, CIMT, carotid intima-media thickness coronary heart disease (CHD), ARYA Study, Atherosclerosis Risk in Young Adults Study, MAP, mean arterial pressure, FRS, Framingham Risk Score, AIx, Augmentation Index