Inflammation as a cardiovascular risk factor and pulse wave velocity as a marker of early-stage atherosclerosis in the Japanese population

Abstract

Inflammation and pulse wave velocity (PWV) are a potential risk factor and marker, respectively, for atherosclerosis in the primary prevention setting. Atherosclerosis is now generally accepted to be an inflammatory disorder of the arterial wall, and the high-sensitivity Creactive protein (hs-CRP) level has been reported to be a strong predictor of cardiovascular events. High-sensitivity-CRP is associated with two factors related to inflammation: (1) the local production of CRP by atheromatous tissue or coronary artery smooth muscle cells and (2) adipose tissue as a potent source of inflammatory cytokines. Based on studies in North America and Europe, hs-CRP has been established as a cardiovascular risk factor and a cut-off value has been recommended. However, Japanese have lower hs-CRP values than their Western counterparts, partly because Japanese have a lower body mass index (BMI), which correlates positively to hs-CRP, and partly because lifestyle and genetic factors can affect hs-CRP values. Therefore, a cut-off value needs to be established by cohort studies for the Japanese population. Carotidfemoral PWV is most commonly measured by applanation tonometry, particularly in Europe, but this method is critically dependent upon the accurate placing of transducers over the arteries and is both time-consuming and complex. A novel device has been recently developed in Japan that measures brachial-ankle PWV (baPWV) using a volumerendering method. Brachian-ankle PWV is a suitable screening method because of its technical simplicity and shorter measurement time. It is associated not only with conventional cardiovascular risk factors but also with new risk factors, such as inflammation, c-glutamyltransferase, chronic kidney disease, and psychosocial factors. However, a suitable cut-off value has yet to be established.

Association between Silent Brain Infarct and Arterial Stiffness Indicated by Brachial-ankle Pulse Wave Velocity

“…Model 2 included baPWV categorized by the cutoff value and model 3 included baPWV categorized by quartile distributions with the same adjustment applied. indicates arteriosclerotic change (2)(3)(4)(5)(6)(7)(8)(18)(19)(20)(21)(22)(23)(24)(25)(26). Although hypertension and age were independently associated with WMHs in that cohort (5), these risk factors were not statistically significant in the present study.…”

“…Matsumoto et al demonstrated that baPWV!18 m/s is the best cutoff value to identify increased CCAIMT in hypertensive patients (7). Furthermore, there is an opinion that a baPWV cutoff value should be 18 m/s, because baPWV is roughly 1.5-fold the magnitude of carotid-femoral pulse wave (cfPWV; conventional measurement of arterial stiffness) (8,20). The cutoff value of cfPWV >12 m/s for total cardiovascular risk is recommended in the Guidelines for the Management of Arterial Hypertension of the European Society of Hypertension and the European Society of Cardiology (17,20).…”

“…Furthermore, there is an opinion that a baPWV cutoff value should be 18 m/s, because baPWV is roughly 1.5-fold the magnitude of carotid-femoral pulse wave (cfPWV; conventional measurement of arterial stiffness) (8,20). The cutoff value of cfPWV >12 m/s for total cardiovascular risk is recommended in the Guidelines for the Management of Arterial Hypertension of the European Society of Hypertension and the European Society of Cardiology (17,20). Thus, the baPWV cutoff values of the present studies are consistent with these previous studies, although there are certain differences regarding subjects and outcomes.…”

Association of serum hs-CRP and lipids with obesity in school children in a 12-month follow-up study in Japan

“…Serum LDL-C, TG, and LDL-C/HDL-C have been used as risk indicators for arteriosclerosis. The serum hs-CRP level is increasingly used in healthy adults [33,34] and children [7][8][9][10][11]35] as a biochemical marker of vascular inflammation associated with atherosclerosis. Yoshida et al reported a cross-sectional analysis of the association of serum hs-CRP and other serum parameters with physique in 568 Japanese children (7-10 years old).…”

Effects of Metabolic Syndrome on Cardio-Ankle Vascular Index in Middle-Aged and Elderly Chinese

“…Earlier studies of diabetic vascular responses clearly demonstrated that blood vessels from patients with diabetes mellitus have reduced nitric oxide bioavailability. [30][31][32] In China, there is a significantly higher prevalence of obesity, diabetes mellitus, dyslipidemia, hypertension, and the metabolic syndrome in people in the north or in urban areas compared with the south or rural areas. 33 In northeastern China, the local cuisines are relatively salty and greasy, with wheat as the staple food due to the dry arctic winter.…”