Endothelial function and structural markers of atherosclerosis: relationship in old and senile age

Abstract

Endothelial dysfunction (ED), intima-media thickness (IMT), and atherosclerotic plaques (ASPs) of the carotid arteries (CAs) are considered mutually associated markers of subclinical and clinical atherosclerosis. How true this statement is for older age groups remains unclear.Aim. To study the relationship of flow-dependent vasodilation (FDV) with CA IMT and ASPs in a population sample over 58 years old.Material and methods. The study was carried out in a population sample of men and women aged 58-82 years (Novosibirsk, HAPIEE project, n=788, 424 women). CA ultrasound was performed to assess IMT and ASPs. Endothelial function was assessed by postocclusive hyperemia ultrasound test; an increase in brachial artery initial diameter (FDV%) <10% was regarded as ED.Results. The average IMT in men was 0,95 mm (SD 0,18) and was significantly higher than in women: 0,88 mm (SD 0,17), p<0,001. The average FDV% values in men were 2,7% (SD 7,32), while in women — 3,2% (SD 7,19) and did not differ significantly by sex. The incidence of ED was 88,2% in men and 85,8% in women. There was no a significant linear relationship between FDV and IMT neither in men (β=-1,76, SD 2,25, p=0,436), nor in women (β=-2,19, SD 2,15, p=0,309). Also, there were no differences in average IMT and ASP frequency in the groups with and without ED among men and women. When divided into age groups, ED was associated with an increase in IMT only in women aged <78 versus women without ED (p=0,047).Conclusion. In the population sample of 58-82 years old, mutual associations of subclinical markers of atherosclerosis (ED, IMT, ASP of CAs) have not been confirmed. Only in women aged <78 years, ED was associated with an increase in IMT. The results obtained indicate that the treatment approaches proposed for young and middle-aged people may be less effective in old and senile age.