Augmentation index is a better marker for cardiovascular risk in young Malaysian males. A comparison of involvement of pulse wave velocity, augmentation index, and C-reactive protein

To determine the association between carotid femoral pulse wave velocity PWV[CF] and augmentation index [AI] with future cardiovascular disease [CVD] risk, and to assess whether high sensitivity C-reactive protein [hs-CRP] is an important mediator towards these vascular changes, among young men. This cross-sectional study was conducted at Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia from July 2011 to December 2012. Two hundred and eleven young men were recruited. The PWV[CF] and AI were measured using Vicorder. High sensitivity C-reactive protein was measured by using immunological methods. The future CVD risk was assessed by Framingham risk score [FRS] and age adjusted FRS [A-FRS]. Data for analysis was conducted using the Statistical Package for Social Sciences Version 15 [SPSS Inc., Chicago, IL, USA]. The mean age of the subjects was 27.09 [95% confidence intervals [CI] 26.39-27.79] years old. Those with >/-2 risk factors had significantly higher AI [10.09 [95% CI: 9.06-11.12] versus 6.56 [95% CI: 5.54-7.57] [p=0.001], but not PWV[CF] 7.45 [95% CI: 7.29-7.61] m/s versus 7.29 [95% CI: 7.06-7.51] m/s, [p=0.90] when compared to the healthy subjects. High sensitivity C-reactive protein was not an independent determinant for PWVCF and AI. Only AI was significantly associated with FRS and A-FRS [p=0.0001]. To assess the impact of risk factors on vascular damage and for future assessment of CVD risk among the young men, AI may be a better marker than PWVCF. The increase in AI among these subjects was not related to hs-CRP

High C reactive protein associated with increased pulse wave velocity among urban men with metabolic syndrome in Malaysia

To determine the association between carotid femoral pulse wave velocity [PWV[CF]]; augmentation index [AI]; and high-sensitivity C reactive protein [hs-CRP] with metabolic syndrome [MetS], and to determine the influence of ethnicity on PWV[CF] and AI, and the association between high hs-CRP and increased PWV, and AI in MetS. A cross-sectional study was conducted at Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia from September 2009 to September 2011. Three hundred and eighty men [Chinese and Malays] were recruited from the study. The PWV[CF] and AI were measured by Vicorder [SMT Medical, Wuerzburg, Germany]. The hs-CRP level was also determined. We defined MetS using the International Diabetes Federation [IDF] and harmonized criteria. Malays had higher AI compared to the Malaysian Chinese. Patients with MetS had higher PWV[CF] [IDF criteria: 8.5 [8.3-8.7] versus 8.2 [8.0-8.4] m/s, p=0.03; harmonized criteria: 8.5 [8.4-8.7] versus 8.2 [8.0-8.4] m/s, p=0.007] and hs-CRP [IDF criteria: 0.9 +/- 2.0 versus 0.4 +/- 1.1 mg/L, p=0.0007; harmonized criteria: 0.8 +/- 1.9 versus 0.4 +/- 1.1 mg/L, p=0.002] compared to non-MetS. In subjects with MetS, those with high hs-CRP [>3mg/L] had higher PWV[CF]. Augmentation index values were significantly higher in Malays compared with Malaysian Chinese. Metabolic syndrome was associated with increased PWV[CF] and hs-CRP. Patients with MetS and high hs-CRP were associated with higher PWV[CF]. The measurement of hs-CRP reflects the degree of subclinical vascular damage in MetS

Two months aerobic exercise improves endothelial function and reduces oxidative DNA damage in women with elevated blood pressure

Regular aerobic exercise has been shown to improve endothelial function and reduce oxidative stress in hypertensive patients. However, the information regarding the amount of exercise that is needed to produce this adaptation is scarce. Thirteen women [35 to 60 years of age] with elevated systolic blood pressure [SBP] were recruited. Six women underwent four weeks aerobic exercise [EG] three times per week at 50% heart rate reserve [HRR] for 30 minutes per session, which was then increased to 70% HRR for 45 minutes per session for another four weeks. Seven women served as control group [CG]. Flow mediated dilation [FMD] and plasma von Willebrand Factor [vWF] were measured of oxidative DNA damage. Baseline measurements were repeated at four and eight weeks. ANOVA repeated measures via SPSS version 15 was used for data analysis and the level of P<0.05 was considered as statistically significant. At baseline, there were insignificant differences in all parameters between the groups: age [EG=48.17 +/- 6.21 vs. CG= 50.00 +/- 8.29 years, P=0.84], resting SBP [EG=136.00 +/- 7.69 vs. GC=133.57 +/- 9.81 mmHg, P=0.73], FMD [EG=2.10 +/- 3.11 vs. CG-2.01 +/- 5.50%, P=0.73], plasma vWF [EG=51.72 +/- 28.60 vs. CG= 49.68 +/- 30.48%, P=0.84] and urine 8- OHdG [EG=6.58 +/- 2.26 vs. CG= 7.85 +/- 2.50 ng/mg creatinine, P=0.34]. After intervention, significant reduction was found for plasma vWF [EG=41.12 +/- 22.65 vs. CG=56.70 +/- 22.35%, P<0.05] and urine 8-OHdG [EG=4.33 +/- 0.79 vs. CG=7.02 +/- 1.73 ng/mg creatinine, P< 0.05]. Two months aerobic training using the prescribed exercise regime increased endothelial function and reduced oxidative DNA damage in women with elevated SBP