Abstract
Background. The effects of smoking, alcohol consumption, obesity, and a sedentary lifestyle on endothelial function (EF) have only been examined separately. The relative contributions of these behaviours on EF have therefore not been compared. Purpose. To compare the relative associations between these four risk factors and brachial artery reactivity in the same sample. Methods. 328 patients referred for single-photon emission computed tomography (SPECT) exercise stress tests completed a nuclear-medicine-based forearm hyperaemic reactivity test. Self-reported exercise behaviour, smoking habits, and alcohol consumption were collected and waist circumference was measured. Results. Adjusting for relevant covariates, logistic regression analyses revealed that waist circumference, abstinence from alcohol, and past smoking significantly predicted poor brachial artery reactivity while physical activity did not. Only waist circumference predicted continuous variations in EF. Conclusions. Central adiposity, alcohol consumption, and smoking habits but not physical activity are each independent predictors of poor brachial artery reactivity in patients with or at high risk for cardiovascular disease.
Highlights
Poor endothelial function (EF) predicts future cardiovascular events [1] and is thought to be influenced by several behavioural risk factors for cardiovascular disease (CVD) including smoking, physical activity, obesity, and alcohol consumption
GLMs for the individual health behaviours with age, sex, CVD status, ace inhibitor use, statin use, hypertension, diabetes, and hypercholesterolemia as covariates were conducted. These analyses revealed that waist circumference (β (SEM) = −.04 (.01), P < .0001) contributed significantly to the variability in EF, while physical activity (β (SEM) = −.01 (.01), P = .398), alcohol consumption (β (SEM) = −.17 (.13), P = .167), and smoking measured according to packyears (β (SEM) = −.01 (.01), P = .203) or smoking status (β (SEM) = −.21 (.15), P = .153) did not
Results of a GLM with all covariates and health behaviours included revealed that waist circumference was a significant independent predictor of EF considered as a continuous variable (Table 3 and Figure 1)
Summary
Poor endothelial function (EF) predicts future cardiovascular events [1] and is thought to be influenced by several behavioural risk factors for cardiovascular disease (CVD) including smoking, physical activity, obesity, and alcohol consumption. To compare the relative associations between these four risk factors and brachial artery reactivity in the same sample. Self-reported exercise behaviour, smoking habits, and alcohol consumption were collected and waist circumference was measured. Adjusting for relevant covariates, logistic regression analyses revealed that waist circumference, abstinence from alcohol, and past smoking significantly predicted poor brachial artery reactivity while physical activity did not. Alcohol consumption, and smoking habits but not physical activity are each independent predictors of poor brachial artery reactivity in patients with or at high risk for cardiovascular disease
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