Can arterial wave augmentation in young adults help account for variability of cardiovascular risk in different British ethnic groups?

Abstract

Objective:Traditional cardiovascular risk factors do not fully account for ethnic differences in cardiovascular disease. We tested if arterial function indices, particularly augmentation index (AIx), and their determinants from childhood could underlie such ethnic variability among young British adults in the ‘DASH’ longitudinal study.Methods:DASH, at http://dash.sphsu.mrc.ac.uk/, includes representative samples of six main British ethnic groups. Pulse wave velocity (PWV) and AIx were recorded using the Arteriograph device at ages 21–23 years in a subsample (n = 666); psychosocial, anthropometric, and blood pressure (BP) measures were collected then and in two previous surveys at ages 11–13 years and 14–16 years. For n = 334, physical activity was measured over 5 days (ActivPal).Results:Unadjusted values and regression models for PWVs were similar or lower in ethnic minority than in White UK young adults, whereas AIx was higher – Caribbean (14.9, 95% confidence interval 12.3–17.0%), West African (15.3, 12.9–17.7%), Indian (15.1, 13.0–17.2%), and Pakistani/Bangladeshi (15.7, 13.7–17.7%), compared with White UK (11.9, 10.2–13.6%). In multivariate models, adjusted for sex, central SBP, height, and heart rate, Indian and Pakistani/Bangladeshi young adults had higher AIx (β = 3.35, 4.20, respectively, P < 0.01) than White UK with a similar trend for West Africans and Caribbeans but not statistically significant. Unlike PWV, physical activity, psychosocial or deprivation measures were not associated with AIx, with borderline associations from brachial BP but no other childhood variables.Conclusion:Early adult AIx, but not arterial stiffness, may be a useful tool for testing components of excess cardiovascular risk in some ethnic minority groups.

Ethnic differences in subclinical vascular function in South Asians, Whites, and African Americans in the United States

“…The “DASH study” assessed differences in PWV in a multi-ethnic cohort of young adults aged 21–23 years and found that PWV was slightly lower in South Asians compared to Whites and Black Caribbean young adults [27] . The results of this study also reported higher AIX in South Asians compared to Whites, differences that persisted after adjustment for confounding variables [28] . Our results confirm the findings of lower PWV, a measure of arterial stiffness, and higher AIX, a measure of pulse wave reflection, in a middle-aged population of South Asian adults living in the United States compared to their White and African American counterparts.…”

Association of Endothelial Function with Parental Hypertension in Normotensive-Obese African-American Women: A Pilot Study

“…These pressure waves result from various causes including stiffness of the medium-sized and smaller peripheral arteries, only indirectly associated with adverse cardiovascular events [38]. AI is also a measure of arterial stiffness that is affected by various confounding factors such as shorter stature, lower heart rate and older age, which tend to increase it [39]. We confirmed the apparent physiological relationship between body stature and AI by virtue of our finding that body height and the baseline pre-exercise AI were negatively correlated.…”

Longitudinal study of the influence of lung function on vascular health from adolescence to early adulthood in a British multiethnic cohort

“…The mean of second and third readings was analysed, as previously reported [ 14 ]. At 21–23 years, central SBP (cSBP), pulse, PWV, central AIx (AIxao), and brachial BP were also measured using the Arteriograph 24-h device (TensioMed, Budapest, Hungary), previously calibrated and standardized [ 23 ].…”