Cardiovascular Risk Factors Have Larger Impact on Endothelial Function in Self-Reported Healthy Women than Men in the HUNT3 Fitness Study

Abstract

BackgroundSeveral studies suggest that cardiovascular risk factors comprising the metabolic syndrome have larger effects on the development of cardiovascular disease in women than in men. A recent study in self-reported healthy subjects demonstrated a marked gender difference in endothelial dysfunction that may be an important precursor of manifest cardiovascular disease. The aim of the present study was to determine whether the association between endothelial function and cardiovascular risk factors is different in self-reported healthy women compared to self-reported healthy men.Methods and ResultsAssociations between endothelial function (flow mediated dilation, FMD, of the brachial artery measured by ultrasound), anthropometric variables, peak oxygen uptake (VO2peak), blood pressure, serum lipids, blood glucose and a questionnaire on general health and lifestyle including smoking status were studied by logistic and linear regression in 2 528 women and 2 211 men aged 20–89 years, free from self-reported cardiovascular disease. In women with hyperglycemia, endothelial dysfunction (FMD ≤0%) occurred twice as frequently as in male counterparts. The presence of the metabolic syndrome, high blood pressure and low VO2peak increased the prevalence of endothelial dysfunction more in women than in men.ConclusionEndothelial dysfunction is more strongly associated with cardiovascular risk factors in self-reported healthy women than in self-reported healthy men. This finding could explain why the metabolic syndrome, and especially hyperglycemia, is associated with higher cardiovascular risk and a worse prognosis in women.

Comparison of Endothelial Function in Healthy Patients and Patients With Chronic Periodontitis and Myocardial Infarction

“…Their results showed that patients who had mean FMD of 4.4% ± 2.8% developed cardiovascular events like MI, unstable angina, stroke, and death, whereas those without an event had FMD of 7.0% ± 4.9%. Studies by Yu et al, 25 Skaug et al, 26 and Jadhav et al 27 are in agreement with the results of this study. Other studies by Halcox et al 41 and Schächinger et al 42 have also highlighted the significance of endothelial dysfunction in causing predisposition toward acute cardiovascular events like MI by using invasive methods to assess endothelial function.…”

“…Based on this concept, FMD can be assessed as an indicator for endothelial dysfunction to gauge the same in the present study. Gokce et al, 24 Yu et al, 25 Skaug et al, 26 and Jadhav et al 27 have observed decreased endothelial function in patients with CVD and in controls. Higashi et al 28 evaluated endothelial function using invasive methods of injecting ACh and nitroglycerin, respectively, to assess vasodilation observed in healthy patients and those with CP and hypertension, whereas endothelial dysfunction was observed in patients with CP and hypertension compared with the control group.…”

Atherosclerosis in rheumatoid arthritis: is it all about inflammation?

“…10 In vitro and animal studies have shown that inflamma tory cytokines such as TNF are associated with impaired endothelialdependent vasodilatation. 11 Atherosclerotic plaque development On entering the subendothelial layer, LDL undergoes modification in the subendothelial layer, often becom ing oxidized.…”

Associations between lung and endothelial function in early middle age

“…Endothelial function is regulated differently in men and women, with a strong influence of sex hormones. Although women generally have better endothelial function than men, cardiovascular risk factors (blood pressure, poor fitness and metabolic syndrome) are more strongly associated with endothelial function in healthy women without respiratory disease than men . Endothelial function was more strongly associated with High‐Density Lipoprotein (HDL) cholesterol among women in the Framingham Heart study, although it was more strongly correlated with BMI in men .…”