BACKGROUND:Peripheral arterial, endothelium-dependent, flow-mediated reactive hyperemia is reduced in individuals with atherosclerosis. This study tested the hypothesis that digital tonometry, as a surrogate of endothelial function, is useful to stratify cardiovascular risk in recently menopausal women who are asymptomatic for cardiovascular disease. METHODS:Women undergoing screening for the Kronos Early Estrogen Prevention Study (KEEPS) were evaluated for conventional risk factors, flow-mediated reactive hyperemia by digital tonometry (RHI), carotid intima-media thickness (CIMT) by ultrasound, and coronary arterial calcium (CAC) by 64-slice CT scanner. RESULTS:One hundred and two non-diabetic Caucasian women (53.0 +/- 2.3 years old, 18.0 +/- 9.0 months past their last menses) participated; 72% were never-smokers. Fourteen women had positive CAC scores (range 0.5-133 Agatston units); CIMT ranged from 0.57 to 1.06 mm. RHI ranged from 1.26 to 5.44. RHI did not correlate with time past menopause, CAC, CIMT, total cholesterol or low density lipoprotein cholesterol. The significant negative correlation of RHI with body mass index (r = -0.21, p = 0.031) was lost in non-smokers (r = - 0.17, p = 0.14). There was also a negative correlation of high density lipoprotein cholesterol with CAC, both in the overall group and non-smokers (rho = -0.20, p = 0.05 and rho = -0.27, p = 0.02, respectively). CONCLUSIONS: RHI varies widely in healthy women within the first 3 years of menopause. RHI was not associated with standard risk assessment algorithms, CAC or CIMT. RHI may indicate an additional, independent component and non-invasive tool to further stratify cardiovascular risk in recently menopausal women. As KEEPS continues, data on RHI will provide information regarding hormonal therapy, endovascular biology and atherosclerotic risk.
RCT Entities:
BACKGROUND: Peripheral arterial, endothelium-dependent, flow-mediated reactive hyperemia is reduced in individuals with atherosclerosis. This study tested the hypothesis that digital tonometry, as a surrogate of endothelial function, is useful to stratify cardiovascular risk in recently menopausal women who are asymptomatic for cardiovascular disease. METHODS:Women undergoing screening for the Kronos Early Estrogen Prevention Study (KEEPS) were evaluated for conventional risk factors, flow-mediated reactive hyperemia by digital tonometry (RHI), carotid intima-media thickness (CIMT) by ultrasound, and coronary arterial calcium (CAC) by 64-slice CT scanner. RESULTS: One hundred and two non-diabetic Caucasian women (53.0 +/- 2.3 years old, 18.0 +/- 9.0 months past their last menses) participated; 72% were never-smokers. Fourteen women had positive CAC scores (range 0.5-133 Agatston units); CIMT ranged from 0.57 to 1.06 mm. RHI ranged from 1.26 to 5.44. RHI did not correlate with time past menopause, CAC, CIMT, total cholesterol or low density lipoprotein cholesterol. The significant negative correlation of RHI with body mass index (r = -0.21, p = 0.031) was lost in non-smokers (r = - 0.17, p = 0.14). There was also a negative correlation of high density lipoprotein cholesterol with CAC, both in the overall group and non-smokers (rho = -0.20, p = 0.05 and rho = -0.27, p = 0.02, respectively). CONCLUSIONS: RHI varies widely in healthy women within the first 3 years of menopause. RHI was not associated with standard risk assessment algorithms, CAC or CIMT. RHI may indicate an additional, independent component and non-invasive tool to further stratify cardiovascular risk in recently menopausal women. As KEEPS continues, data on RHI will provide information regarding hormonal therapy, endovascular biology and atherosclerotic risk.
Authors: Virginia M Miller; Brian D Lahr; Kent R Bailey; Howard N Hodis; Sharon L Mulvagh; Muthuvel Jayachandran Journal: Atherosclerosis Date: 2015-12-28 Impact factor: 5.162
Authors: Virginia M Miller; Tanya M Petterson; Elysia N Jeavons; Abhinita S Lnu; David N Rider; John A Heit; Julie M Cunningham; Gordon S Huggins; Howard N Hodis; Matthew J Budoff; Nanette Santoro; Paul N Hopkins; Rogerio A Lobo; JoAnn E Manson; Frederick Naftolin; Hugh S Taylor; S Mitchell Harman; Mariza de Andrade Journal: Physiol Genomics Date: 2012-11-27 Impact factor: 3.107
Authors: L Raz; L V Hunter; N M Dowling; W Wharton; C E Gleason; M Jayachandran; L Anderson; S Asthana; V M Miller Journal: Climacteric Date: 2015-12-10 Impact factor: 3.005
Authors: Muthuvel Jayachandran; Robert D Litwiller; Brian D Lahr; Kent R Bailey; Whyte G Owen; Sharon L Mulvagh; John A Heit; Howard N Hodis; S Mitchell Harman; Virginia M Miller Journal: J Cardiovasc Transl Res Date: 2011-07-24 Impact factor: 4.132
Authors: Virginia M Miller; Fredrick Naftolin; Sanjay Asthana; Dennis M Black; Eliot A Brinton; Matthew J Budoff; Marcelle I Cedars; N Maritza Dowling; Carey E Gleason; Howard N Hodis; Muthuvel Jayachandran; Kejal Kantarci; Rogerio A Lobo; JoAnn E Manson; Lubna Pal; Nanette F Santoro; Hugh S Taylor; S Mitchell Harman Journal: Menopause Date: 2019-09 Impact factor: 2.953