Abstract
OBJECTIVE—To test the hypothesis that abnormalities of endothelial function are present in Indian Asians and may contribute to their increased coronary heart disease risk. SETTING—Single centre in west London. PATIENTS—26 Indian Asian and 18 European white healthy male subjects, aged 35 to 61 years recruited from general practice lists. DESIGN—Brachial artery diameter responses to reactive hyperaemia and sublingual glyceryl trinitrate were compared using high resolution ultrasound. RESULTS—Mean (SEM) flow mediated, endothelium dependent dilatation was reduced in Indian Asians compared with European whites, at 3.2 (0.8)% v 5.9 (1.0)%, p = 0.03. In contrast, there were no significant differences in baseline brachial arterial diameter (4.6 (0.1) v 4.6 (0.1) mm, p = 0.65) or glyceryl trinitrate induced dilatation (18.8 (1.5)% v 18.5 (1.7)%, p = 0.90) between Indian Asians and European whites, respectively. Univariate analysis showed that Indian Asian race was significantly associated with impaired flow mediated dilatation (regression coefficient = −2.8 (1.3)%, p = 0.03), and in multivariate analysis, this relation was independent of both conventional coronary heart disease risk factors and markers of insulin resistance. CONCLUSIONS—Endothelial function is impaired in healthy UK Indian Asians compared with European whites, and the defect is not accounted for by major coronary heart disease risk factors. Endothelial function may be modulated by novel risk factors in Indian Asians. Keywords: endothelial function; Indian Asians; coronary heart disease; risk factors
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- Anderson T. J., Uehata A., Gerhard M. D., Meredith I. T., Knab S., Delagrange D., Lieberman E. H., Ganz P., Creager M. A., Yeung A. C. Close relation of endothelial function in the human coronary and peripheral circulations. J Am Coll Cardiol. 1995 Nov 1;26(5):1235–1241. doi: 10.1016/0735-1097(95)00327-4. [DOI] [PubMed] [Google Scholar]
- Benzuly K. H., Padgett R. C., Kaul S., Piegors D. J., Armstrong M. L., Heistad D. D. Functional improvement precedes structural regression of atherosclerosis. Circulation. 1994 Apr;89(4):1810–1818. doi: 10.1161/01.cir.89.4.1810. [DOI] [PubMed] [Google Scholar]
- Celermajer D. S., Adams M. R., Clarkson P., Robinson J., McCredie R., Donald A., Deanfield J. E. Passive smoking and impaired endothelium-dependent arterial dilatation in healthy young adults. N Engl J Med. 1996 Jan 18;334(3):150–154. doi: 10.1056/NEJM199601183340303. [DOI] [PubMed] [Google Scholar]
- Celermajer D. S., Sorensen K. E., Spiegelhalter D. J., Georgakopoulos D., Robinson J., Deanfield J. E. Aging is associated with endothelial dysfunction in healthy men years before the age-related decline in women. J Am Coll Cardiol. 1994 Aug;24(2):471–476. doi: 10.1016/0735-1097(94)90305-0. [DOI] [PubMed] [Google Scholar]
- Clarkson P., Adams M. R., Powe A. J., Donald A. E., McCredie R., Robinson J., McCarthy S. N., Keech A., Celermajer D. S., Deanfield J. E. Oral L-arginine improves endothelium-dependent dilation in hypercholesterolemic young adults. J Clin Invest. 1996 Apr 15;97(8):1989–1994. doi: 10.1172/JCI118632. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Harrison D. G., Armstrong M. L., Freiman P. C., Heistad D. D. Restoration of endothelium-dependent relaxation by dietary treatment of atherosclerosis. J Clin Invest. 1987 Dec;80(6):1808–1811. doi: 10.1172/JCI113276. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Joannides R., Haefeli W. E., Linder L., Richard V., Bakkali E. H., Thuillez C., Lüscher T. F. Nitric oxide is responsible for flow-dependent dilatation of human peripheral conduit arteries in vivo. Circulation. 1995 Mar 1;91(5):1314–1319. doi: 10.1161/01.cir.91.5.1314. [DOI] [PubMed] [Google Scholar]
- Kooner J. S., Baliga R. R., Wilding J., Crook D., Packard C. J., Banks L. M., Peart S., Aitman T. J., Scott J. Abdominal obesity, impaired nonesterified fatty acid suppression, and insulin-mediated glucose disposal are early metabolic abnormalities in families with premature myocardial infarction. Arterioscler Thromb Vasc Biol. 1998 Jul;18(7):1021–1026. doi: 10.1161/01.atv.18.7.1021. [DOI] [PubMed] [Google Scholar]
- Leeson P., Thorne S., Donald A., Mullen M., Clarkson P., Deanfield J. Non-invasive measurement of endothelial function: effect on brachial artery dilatation of graded endothelial dependent and independent stimuli. Heart. 1997 Jul;78(1):22–27. doi: 10.1136/hrt.78.1.22. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mather H. M., Keen H. The Southall Diabetes Survey: prevalence of known diabetes in Asians and Europeans. Br Med J (Clin Res Ed) 1985 Oct 19;291(6502):1081–1084. doi: 10.1136/bmj.291.6502.1081. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Matthews D. R., Hosker J. P., Rudenski A. S., Naylor B. A., Treacher D. F., Turner R. C. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985 Jul;28(7):412–419. doi: 10.1007/BF00280883. [DOI] [PubMed] [Google Scholar]
- McKeigue P. M., Ferrie J. E., Pierpoint T., Marmot M. G. Association of early-onset coronary heart disease in South Asian men with glucose intolerance and hyperinsulinemia. Circulation. 1993 Jan;87(1):152–161. doi: 10.1161/01.cir.87.1.152. [DOI] [PubMed] [Google Scholar]
- McKeigue P. M., Shah B., Marmot M. G. Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet. 1991 Feb 16;337(8738):382–386. doi: 10.1016/0140-6736(91)91164-p. [DOI] [PubMed] [Google Scholar]
- Nagasaka S., Iwamoto Y., Ishikawa S., Kuzuya T., Saito T. Efficacy of troglitazone measured by insulin resistance index. Lancet. 1997 Jul 19;350(9072):184–184. doi: 10.1016/s0140-6736(05)62350-1. [DOI] [PubMed] [Google Scholar]
- Panza J. A., Casino P. R., Kilcoyne C. M., Quyyumi A. A. Impaired endothelium-dependent vasodilation in patients with essential hypertension: evidence that the abnormality is not at the muscarinic receptor level. J Am Coll Cardiol. 1994 Jun;23(7):1610–1616. doi: 10.1016/0735-1097(94)90664-5. [DOI] [PubMed] [Google Scholar]
- Sorensen K. E., Celermajer D. S., Georgakopoulos D., Hatcher G., Betteridge D. J., Deanfield J. E. Impairment of endothelium-dependent dilation is an early event in children with familial hypercholesterolemia and is related to the lipoprotein(a) level. J Clin Invest. 1994 Jan;93(1):50–55. doi: 10.1172/JCI116983. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Vane J. R., Anggård E. E., Botting R. M. Regulatory functions of the vascular endothelium. N Engl J Med. 1990 Jul 5;323(1):27–36. doi: 10.1056/NEJM199007053230106. [DOI] [PubMed] [Google Scholar]
- Woo K. S., McCrohon J. A., Chook P., Adams M. R., Robinson J. T., McCredie R. J., Lam C. W., Feng J. Z., Celermajer D. S. Chinese adults are less susceptible than whites to age-related endothelial dysfunction. J Am Coll Cardiol. 1997 Jul;30(1):113–118. doi: 10.1016/s0735-1097(97)00111-3. [DOI] [PubMed] [Google Scholar]
- Woo K. S., Robinson J. T., Chook P., Adams M. R., Yip G., Mai Z. J., Lam C. W., Sorensen K. E., Deanfield J. E., Celermajer D. S. Differences in the effect of cigarette smoking on endothelial function in chinese and white adults. Ann Intern Med. 1997 Sep 1;127(5):372–375. doi: 10.7326/0003-4819-127-5-199709010-00006. [DOI] [PubMed] [Google Scholar]