Age, Gender, and Number of Atherosclerotic Risk Factors are the Independent Factor of Endothelial Dysfunction in Patients with Coronary Atherosclerosis

ABSTRACT

BACKGROUND AND OBJECTIVES: The endothelial function is impaired in patients with atherosclerosis risk factors as well as in those with atherosclerotic disease, such as coronary artery disease. This study was performed to evaluate the impact of individual risk factors and their number in patients with coronary atherosclerosis, who already had an impaired endothelial function. SUBJECTS AND METHODS: The endothelial function was measured in 884 consecutive patients (mean age; 59 years old, 486 male) undergoing coronary angiography, using high-resolution ultrasound. The flow-mediated brachial artery dilation (FMD, %) was used to measure the endothelial function. The risk factors were classified according to the hypertension, diabetes mellitus, smoking and dyslipidemia, and their number classified from 0 to 4. RESULTS: The FMD was lower (3.85+/-2.1% vs. 4.27+/-2.1%, p<0.005) in patients with hypertension (n=431) than in those without (n=453); however, no significant difference was shown according to the presence of other risk factors. A multivariate analysis showed age (beta=-0.204, p<0.001), gender (beta=0.118, p<0.01) and the number of risk factors (beta=-0.150, p<0.01) were independent risk factors of the FMD in patients with coronary atherosclerosis. Furthermore, the FMD was significantly associated with the number of risk factors in our study subjects (r=-0.083, p<0.05, n=884). CONCLUSION: This study suggests that the increased number of risk factors, old age and male are independent factors for endothelial dysfunction, even in patients with coronary atherosclerosis, who already had an impaired endothelial function.