Cardiovascular disease increases with age and menopause. Atherosclerosis directly contributes to cardiovascular disease and subclinical markers of atherosclerosis are noninvasive methods that help to detect early vascular changes. Thus, risk factors associated with markers of subclinical atherosclerosis may be targeted for interventions in individuals at high risk of developing cardiovascular disease. C-Reactive Protein (CRP), a marker of inflammation, has been found to be associated with cardiovascular events in a large number of populations. However, studies examining the association between CRP and markers of subclinical atherosclerosis have been limited.
The cross-sectional association between CRP and central arterial stiffness, assessed by carotid-femoral pulse wave velocity (PWV), was tested in a biracial (Caucasian and Black) cohort of 154 women transitioning through menopause within the Study of Womens Health Across the Nation (mean age 50.8 ± 2.6; 44.2% Black). After adjustment for age, systolic blood pressure, ethnicity, study site, waist circumference, diastolic blood pressure, and physical activity, the mean pulse wave velocity increased with increasing CRP tertiles (758.5 cm/s, 784.5 cm/s, 861.7 cm/s; p for trend = .01). Furthermore, the association was stronger in women later in their transition compared to women earlier in their transition (p for interaction = .02).
The cross-sectional association between CRP and systemic arterial stiffness, assessed by brachial artery distensibility, was tested in 1069 women of the same cohort (mean age 53.6 ± 2.6 years). After adjustment for confounders, the mean distensibility decreased with increasing tertiles of CRP (p for trend = .001). This pattern was similar in women of different ethnic groups and stages of the menopausal transition.
The association between CRP and three year incident peripheral arterial disease (PAD), assessed by the ankle-brachial index (ABI), was tested in a biracial (Caucasian and Black) cohort of 1918 older adults within the Health, Aging, Body, and Composition Study (mean age 73.6±2.9; 40.3% Black). Participants in the top tertile of CRP had an increased odds of developing PAD compared to those in the bottom tertile (OR=1.87, 95% CI= 1.22 to 2.88).
Given the high prevalence of cardiovascular disease, finding risk factors associated with early vascular changes in high risk populations is of public health importance.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-04102006-202522 |
| Date | 02 June 2006 |
| Creators | Mehta, Vinay Gautam |
| Contributors | Jen Brach, PhD, PT, Howard Rockette, PhD, Sheryl Kelsey, PhD, Anne B. Newman, MD, MPH, Kim Sutton-Tyrrell, DrPH, MPH |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-04102006-202522/ |
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