Vascular structure and function and their relationship with health-related quality of life in the MARK study

Luis García-Ortiz, José I Recio-Rodríguez, Sara Mora-Simón, John Guillaumet, Ruth Martí, Cristina Agudo-Conde, Emiliano Rodriguez-Sanchez, Jose A Maderuelo-Fernandez, Rafel Ramos-Blanes, Manuel A Gómez-Marcos, MARK Group, Luis García-Ortiz, José I Recio-Rodríguez, Sara Mora-Simón, John Guillaumet, Ruth Martí, Cristina Agudo-Conde, Emiliano Rodriguez-Sanchez, Jose A Maderuelo-Fernandez, Rafel Ramos-Blanes, Manuel A Gómez-Marcos, MARK Group

Abstract

Background: There is limited evidence concerning the relationship between vascular disease and health-related quality of life (HRQL). We investigated the relationship between vascular structure and function with health-related quality of life in a population with intermediate cardiovascular risk.

Methods: This study analyzed 303 subjects with ankle-brachial index (ABI) values ranging from 0.9 to 1.4 who were included in the MARK study (age 35 to 74 years; mean:60.5 ± 8.5), of which 50.2 % were women. Measurements included: ABI, brachial-ankle pulse wave velocity (ba-PWV), and cardio-ankle vascular index (CAVI), all measured using the VaSera device. The central augmentation index was adjusted to 75 lpm (AIx_75) using the Mobil-O-Graph device. HRQL was assessed by the Spanish version of the SF-12, version2. The highest obtained CAVI and ba-PWV values and the lowest ABI values were considered for the study.

Results: The cohort was composed of21 % smokers, 76 % hypertensive patients, and 24 % diabetic patients. The ABI mean was 1.09 ± 0.07,the ba-PWV mean was 14.64 ± 2.55 m/s with a 12.9 % of subjects higher than 17.5 m/s, AIx_75 26.46 ± 14.05, and CAVI 8.61 ± 1.08 with a 36.6 % of subjects higher than 9. Men scored higher than women in the HRQL measurements for physical (PSC-12; 49.9 vs. 46.9, p = 0.004) and mental (MSC-12) domains (51.2 vs. 47.7, p = 0.003). Age was positively correlated with CAVI (r = 0.547), ba-PWV (r = 0.469), AIx_75 (r = 0.255, p < 0.01), and the MSC-12 (r = 0.147, p < 0.05), but not the PSC-12. In the adjusted multiple linear regression analysis, the positive association of ABI and CAVI with the PSC-12 was maintained.

Conclusions: The ABI in the normal range has a positive association with the PSC-12 of HRQL evaluated with the SF-12. The CAVI also showed a positive association with the PSC-12 of HRQL.

Trial registration: ClinicalTrials.gov Identifier: NCT01428934 .

Keywords: Ankle-brachial index; Arterial stiffness; Augmentation index; Brachial ankle pulse wave velocity; Cardio-ankle vascular index; Health-related quality of life.

Figures

Fig. 1
Fig. 1
Marginal means of standardized physical (PCS-12) and mental (MCS-12) components by CAVI categories. P < 0.05 by Multivariate General Lineal Model (MANOVA) using LSD post hoc test. Unadjusted: PCS-12: CAVI < 8 with > 9. MCS-12: CAVI 8–9 with > 9. Adjusted: PCS-12: CAVI < 8 with > 9. MCS-12: CAVI < 8 with 8–9 and 8-9 with > 9. Adjusted for age, gender, current smoker, alcohol consumption in gr/week, physical activity (METs-min 14 days), diet quality index, mean blood pressure, atherogenic index (Total Cholesterol/HDL-Cholesterol), HbA1c and antihypertensive and lipid-lowering drugs. CAVI: Cardio Ankle Vascular index, SE: Standard error

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