Artery Atherosclerosis In Women Research Articles

Abdominal Fat Depots and Subclinical Carotid Artery Atherosclerosis in Women With and Without HIV Infection

Data on associations between abdominal fat depot mass and subclinical atherosclerosis are limited, especially in women with HIV. We assessed cross-sectional associations of dual X-ray absorptiometry scan-derived estimates of visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (SAT) with 3 measures of subclinical carotid artery atherosclerosis-carotid artery stiffness (Young's modulus of elasticity), presence of carotid artery lesions, and carotid artery intima-media thickness-in a subsample of participants in the Women's Interagency HIV Study. Statistical models adjusted for demographic variables, HIV serostatus, behavioral variables, and cardiovascular risk factors. There were 244 women with and 99 without HIV infection (median age 42, 62% black). VAT mass (but not SAT) was associated with greater carotid artery stiffness in a fully adjusted linear regression model, including adjustment for SAT (β = 11.3 log 10·N·m per kg VAT, 95% confidence interval: 1.0 to 21.7). Greater SAT mass was associated with lower odds of having a carotid artery lesion in a fully adjusted model, including adjustment for VAT [adjusted odds ratio, 0.49 per kg of SAT (0.25 to 0.94)]. Neither VAT nor SAT was associated with carotid artery intima-media thickness. The VAT/SAT ratio was not statistically associated with any of the outcomes after covariate adjustment. In our cross-sectional study of women, the majority of whom had HIV, greater VAT mass was associated with increased carotid artery stiffness, whereas greater SAT mass was associated with a reduced odds of prevalent carotid artery lesions.

Adherence to 2005 Dietary Guidelines for Americans is associated with a reduced progression of coronary artery atherosclerosis in women with established coronary artery disease

Background:A premise of the 2005Dietary Guidelines for Americans (DGA) is chronic disease prevention. Objective:The goal was to determine whether a diet meeting the DGA is associated with less atherosclerotic lesion progression. Design:We used the data from 224 postmenopausal women with established coronary artery disease enrolled in the Estrogen Replacement and Atherosclerosis Study. Atherosclerosis progression was defined by repeated measures of quantitative angiography over a 3-y period. Adherence to the key DGA recommendations was measured by using the DGA Adherence Index (DGAI; possible range: 0–20), with each component weighted equally, and the modified DGAI score (wDGAI; possible range: −0.19–0.51), with each component weighted based on its relation to atherosclerosis progression. Mixed-model regression analyses were performed to assess the association between diet and atherosclerosis progression. Results:No women consumed a diet meeting all of the DGA recommendations. The mean (range) of the DGAI score was 14.1 (8.0–19.0). DGAI was not associated with atherosclerosis progression (P = 0.44), whereas wDGAI was inversely associated; a 1-SD difference in wDGAI was related to 0.049-mm less narrowing of the coronary arteries (SE = 0.017,P = 0.004). Conclusions:In postmenopausal women with established heart disease, under the assumption that all DGA recommendations are similarly effective, overall adherence was not associated with atherosclerosis progression. However, assigning differential weights to the DGA recommendations, the adherence was significantly associated with slower atherosclerosis progression. Assuming equity of associations between all dietary recommendations and disease outcomes is a limitation in accurately examining the effectiveness of the DGA.

Commentary on Viewpoint: Exercise and cardiovascular risk reduction: Time to update the rationale for exercise?

VIEWPOINTCommentary on Viewpoint: Exercise and cardiovascular risk reduction: Time to update the rationale for exercise?Beth Parker, and David ProctorBeth Parker, and David ProctorPublished Online:01 Aug 2008https://doi.org/10.1152/japplphysiol.00141.2008MoreSectionsPDF (27 KB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInWeChat CONSIDERING THE ROLE OF SEX IN MODULATING DIRECT EFFECTS OF EXERCISE ON THE VASCULATUREto the editor: We commend the recent publication by Green et al. (2) regarding exercise and cardiovascular disease (CVD). However, we think it important to extend this line of thinking to involve sex-specific mechanisms that may modulate the impact of exercise on CVD, as both the vascular manifestations of CVD as well as the impact of exercise on the vasculature differs between men and women. For example, progression of diabetes in women involves greater endothelial dysfunction than in men (1) and measurements of C-reactive protein suggest that inflammation may play a more substantial role in increasing carotid artery atherosclerosis in women than men (5).With respect to exercise, Martin et al. (3) found that exercise training resulted in large improvements in peak blood flow and vascular conductance in older men, whereas results in older women were marginally significant and much more variable. Recently we demonstrated that the influence of aerobic fitness on leg blood flow responses to small muscle mass (i.e., knee extensor) exercise in older adults may also be influenced by sex, as high and low V̇o2max values distinguished leg blood flow responses in older men but not women (4).Vascular changes associated both with CVD and exercise may be sex specific. Accordingly, the suggestion that “future studies should focus on the direct impacts of exercise on vasculature function (2)” should be broadened such that researchers take into account the role of sex when investigating the direct effects of exercise on the vasculature with respect to reduction of cardiovascular risk.REFERENCES1 Donahue RP, Rejman K, Rafalson LB, Dmochowski J, Stranges S, Trevisan M. Sex differences in endothelial function markers before conversion to pre-diabetes: does the clock start ticking earlier among women? The Western New York Study. Diabetes Care 30: 354–359, 2007.Crossref | ISI | Google Scholar2 Green DJ, O'Driscoll G, Joyner MJ, Cable NT. Viewpoint: Exercise and cardiovascular risk reduction: time to update the rationale for exercise? J Appl Physiol; doi:10.1152/japplphysiol.01028.2007.Link | ISI | Google Scholar3 Martin WH, Kohrt WM, Malley MT, Korte E, Stoltz S. Exercise training enhances leg vasodilatory capacity of 65-yr-old men and women. J Appl Physiol 69: 1804–1809, 1990.Link | ISI | Google Scholar4 Parker BA, Smithmyer SL, Pelberg JA, Mishkin AD, Proctor DN. Sex-specific influence of aging on exercising leg blood flow. J Appl Physiol 104: 655–664, 2008.Link | ISI | Google Scholar5 Sander K, Horn CS, Briesenick C, Sander D. High-sensitivity C-reactive protein is independently associated with early carotid artery progression in women but not in men: the INVADE Study. Stroke 38: 2881–2886, 2007.Crossref | ISI | Google ScholarAUTHOR NOTESAddress for reprint requests and other correspondence: D. Proctor, 105 Noll Laboratory, Univ. Park, PA 16802 (e-mail: [email protected]) Download PDF Previous Back to Top FiguresReferencesRelatedInformation More from this issue > Volume 105Issue 2August 2008Pages 778-778 Copyright & PermissionsCopyright © 2008 the American Physiological Societyhttps://doi.org/10.1152/japplphysiol.00141.2008PubMed18678641History Published online 1 August 2008 Published in print 1 August 2008 Metrics

Cardiovascular risk scores and the presence of subclinical coronary artery atherosclerosis in women with systemic lupus erythematosus

The Framingham risk score is widely used to identify patients at increased cardiovascular risk, and women with systemic lupus erythematosus (SLE) have a marked increased prevalence of cardiovascular events. Thus, we examined the hypothesis that cardiovascular risk scores would identify women with SLE who had asymptomatic coronary atherosclerosis. Ninety-three women with SLE and 65 control subjects were studied. The Framingham score and a score for younger populations developed from the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) study were compared in both groups. Coronary atherosclerosis was ascertained by electron beam computed tomography. There were no significant differences in the median (interquartile range) Framingham [5 (2-10) compared to 7 (0-10), P = 0.88] and PDAY [15 (14-18) compared to 16 (13-18), P = 0.99] scores in patients with SLE and controls, respectively. Coronary atherosclerosis was associated with higher Framingham [12 (3-15) compared to 4 (1-8), P = 0.008] and PDAY [17 (15-19 compared to 15 (12-18), P = 0.03)] scores in patients with SLE; however, 99% of patients were classified as low-risk with a 10-year predicted risk of 1% (<1-3%). Our data indicate that cardiovascular risk scores are not adequate for risk stratification in women with SLE. Measurement of coronary calcification may add information to identify asymptomatic women with lupus who might benefit from aggressive preventive measures.

IGF‐I concentrations are positively associated with carotid artery atherosclerosis in women

BACKGROUND. Alterations in the growth hormone (GH)/insulin‐like growth factor I (IGF‐I) axis are associated with increased cardiovascular morbidity and mortality, but previous studies have yielded conflicting results. In addition, the T1169A polymorphism in the GH1 gene has been associated with IGF‐I levels.AIMS. To investigate whether IGF‐I concentrations and the T1169A polymorphism of the GH1 gene are associated with cardiovascular risk factors and the intima media thickness (IMT) of the carotid artery.METHODS. Fasting plasma IGF‐I concentrations (n = 1008) were measured in a large population‐based OPERA (Oulu Project Elucidating Risk of Atherosclerosis) cohort. Genotype variants were determined by the restriction fragment length polymorphism method.RESULTS. Low IGF‐I concentrations associated with several cardiovascular risk factors including age, adiposity, and high triglyceride, fasting insulin and C‐reactive protein concentrations in the analysis of all subjects. In the multivariate models, however, IGF‐I concentrations were positively associated with the mean IMT of women (ß = 0.127, P = 0.009) whereas the association in men was weaker and negative (ß = −0.088, P = 0.034). The 1169A allele was associated with low low‐density lipoprotein cholesterol in both sexes and with low systolic blood pressure levels in women.CONCLUSIONS. IGF‐I concentrations were associated with several traditional cardiovascular risk factors. The observed gender difference in the association between IGF‐I concentrations and carotid artery atherosclerosis warrants further study. The GH1 1169A allele may be associated with a favourable metabolic profile.

Fish intake is associated with a reduced progression of coronary artery atherosclerosis in postmenopausal women with coronary artery disease

Higher intakes of fish and n-3 fatty acids are associated with a reduced risk of cardiovascular events and mortality. However, limited data exist on the effect of fish intake on actual measures of progression of coronary artery atherosclerosis. The aim was to examine the association between fish intake and the progression of coronary artery atherosclerosis in women with coronary artery disease. This was a prospective cohort study of postmenopausal women (n = 229) participating in the Estrogen Replacement and Atherosclerosis trial. Usual fish intake was estimated at baseline with a food-frequency questionnaire. Quantitative coronary angiography was performed at baseline and after 3.2 +/- 0.6 (x +/- SD) y to evaluate changes in the mean minimum coronary artery diameter, the mean percentage of stenosis, and the development of new coronary lesions. Compared with lower fish intakes, consumption of > or =2 servings of fish or > or =1 serving of tuna or dark fish per week was associated with smaller increases in the percentage of stenosis (4.54 +/- 1.37% compared with -0.06 +/- 1.59% and 5.12 +/- 1.48% compared with 0.35 +/- 1.47%, respectively; P < 0.05 for both) in diabetic women after adjustments for age, cardiovascular disease risk factors, and dietary intakes of fatty acids, cholesterol, fiber, and alcohol. These associations were not significant in nondiabetic women. Higher fish consumption was also associated with smaller decreases in minimum coronary artery diameter and fewer new lesions. Consumption of fish is associated with a significantly reduced progression of coronary artery atherosclerosis in women with coronary artery disease.