Individuals at increased coronary heart disease risk are characterized by an impaired microvascular function in skin

European Journal of Clinical Investigation - Tập 33 Số 7 - Trang 536-542 - 2003
Richard G. IJzerman1, Renate T. de Jongh1, Marcel A.M. Beijk1, Frank van Bel1, Henriëtte A. Delemarre‐van de Waal1, Erik H. Serné1, Coen D.A. Stehouwer1
1VU University Medical Center, Amsterdam, The Netherlands

Tóm tắt

Abstract

Background To investigate whether microvascular function in skin is a valid model to study the relationships between cardiovascular risk factors and microvascular function, we investigated skin microvascular function in individuals with increased coronary heart disease (CHD) risk.

Materials and methods Forty‐six healthy White individuals aged 30–70 years were studied. Coronary heart disease risk was assessed with the use of the CHD risk score according to the Framingham Heart Study, which is based on the risk factors age, blood pressure, cigarette smoking, total cholesterol, HDL cholesterol and diabetes. Endothelium‐dependent and ‐independent vasodilation in skin were evaluated with laser Doppler after iontophoresis of acetylcholine and sodium nitroprusside. Videomicroscopy was used to measure recruitment of skin capillaries after arterial occlusion.

Results Coronary heart disease risk score (i.e. the 10‐year probability of CHD) varied from 1–37%. Microvascular function decreased with increasing quartiles of CHD risk (for acetylcholine‐mediated vasodilation: 687, 585, 420 and 326%, P = 0·002; for nitroprusside‐mediated vasodilation: 776, 582, 513 and 366%, P = 0·02; for capillary recruitment: 49·9, 44·6, 27·2 and 26·7%, P = 0·001). These trends were similar in men and women (P for interaction > 0·2) and independent of body mass index.

Conclusions Increased CHD risk is associated with an impaired endothelium‐dependent vasodilatation and capillary recruitment in skin, suggesting that microvascular function in skin is a valid model to study the relationships between cardiovascular risk factors and microvascular function.

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Tài liệu tham khảo

10.1056/NEJM199604043341403

10.1161/01.CIR.82.1.1

10.1161/01.CIR.95.2.522

10.1056/NEJM196705112761904

10.1016/0002-9149(85)90613-7

10.1056/NEJM198811173192002

10.1056/NEJM199306103282302

10.1056/NEJM200003233421201

10.1016/S0002-9149(99)00361-6

10.1161/01.CIR.97.8.765

10.1053/euhj.2000.2442

10.2337/diabetes.48.9.1856

10.1161/01.HYP.38.2.238

10.1161/01.CIR.99.7.896

10.1016/S0008-6363(01)00450-3

10.1161/01.HYP.34.4.655

10.1016/S0008-6363(00)00198-X

10.1161/01.CIR.97.18.1837

10.1136/hrt.81.1.40

10.1161/01.CIR.101.11.1243

10.1136/heart.85.1.37

10.1136/bmj.320.7236.671

10.1097/00006534-198504000-00018

10.1097/00004872-200018100-00009

Borgos J, 2003, Laser Doppler, 17

10.2337/diacare.20.12.1859

10.1056/NEJM198711263172202

10.1016/S0735-1097(97)00542-1

10.1161/hc3401.095098

10.1097/00004872-200018050-00008

10.1161/01.HYP.33.4.998

10.1172/JCI113088

10.1046/j.1365-201x.2000.00722.x

10.2337/diabetes.51.5.1515

Tooke JE, 1985, The effects of intravenous insulin infusion on skin microcirculatory flow in Type 1 diabetes, Int J Microcirc Clin Exp, 4, 69

10.1097/00004872-200209000-00018

10.1016/S0021-9150(00)00567-0

10.1007/978-1-4615-5399-1_8

10.1016/S0021-9150(00)00397-X

10.1161/01.CIR.101.16.1899

Terry RB, 1992, Waist/hip ratio, body mass index and premature cardiovascular disease mortality in US Army veterans during a twenty‐three year follow‐up study, Int J Obes Relat Metab Disord, 16, 417

10.1172/JCI117936

10.2337/diabetes.49.7.1231

10.1161/01.ATV.19.4.972

10.1016/S0741-5214(98)70095-3

10.1093/gerona/50A.2.M121

10.1172/JCI119354

10.1006/mvre.1993.1001

10.1146/annurev.nutr.17.1.487