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Increased arterial stiffness in healthy young South Asian men

Journal of Human Hypertension volume 20, pages 163–165 (2006)Cite this article

South Asians have a higher mortality from coronary heart disease (CHD) compared with European Caucasians.1 They experience myocardial infarction at a younger age and are likely to suffer from earlier and more severe coronary disease.2, 3 This increased risk is not accounted for by differences in traditional cardiovascular risk factors such as smoking, hypertension or hypercholesterolaemia.4 While greater insulin resistance in South Asians is thought to be a contributory factor, the exact pathophysiological mechanisms responsible for their increased CHD risk remain only partly understood.

Arterial stiffness and wave reflection can be assessed noninvasively through analysis of pulse waveforms. The central arterial pressure wave consists of a forward travelling wave resulting from left ventricular ejection and a later arriving reflected wave from the periphery. Greater arterial stiffness leads to increased transmission velocities of both the forward and reflected waves. This results in earlier arrival of the reflected wave at the aortic root, where it augments central systolic pressure and increases left ventricular afterload. The degree of augmentation is a measure of early wave reflection and systemic arterial stiffness. It can be expressed in absolute terms (augmented pressure) or as a percentage of pulse pressure (augmentation index) and is associated with increased cardiovascular risk as well as being a strong risk marker for premature CHD.5, 6

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References

  1. Chaturvedi N . Ethnic differences in cardiovascular disease. Heart 2003; 89: 681–686.

    Article  Google Scholar 

  2. Hughes LO, Raval U, Raftery EB . First myocardial infarctions in Asian and white men. BMJ 1989; 298: 1345–1350.

    Article  CAS  Google Scholar 

  3. Vallapuri S, Gupta D, Talwar KK, Billie M, Mehta MC, Morise AP et al. Comparison of atherosclerotic risk factors in Asian Indian and American Caucasian patients with angiographic coronary artery disease. Am J Cardiol 2002; 90: 1147–1150.

    Article  Google Scholar 

  4. McKeigue PM, Shah B, Marmot MG . Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet 1991; 337: 382–386.

    Article  CAS  Google Scholar 

  5. Nurnberger J, Keflioglu-Scheiber A, Opazo Saez AM, Wenzel RR, Philipp T, Schafers RF . Augmentation index is associated with cardiovascular risk. J Hypertens 2002; 20: 2407–2414.

    Article  Google Scholar 

  6. Weber T, Auer J, O'Rourke MF, Kvas E, Lassnig E, Berent R et al. Arterial stiffness, wave reflections, and the risk of coronary artery disease. Circulation 2004; 109: 184–189.

    Article  Google Scholar 

  7. Wilkinson IB, MacCallum H, Flint L, Cockcroft JR, Newby DE, Webb DJ . The influence of heart rate on augmentation index and central arterial pressure in humans. J Physiol 2000; 525: 263–270.

    Article  CAS  Google Scholar 

  8. Wilkinson IB, Fuchs SA, Jansen IM, Spratt JC, Murray GD, Cockcroft JR et al. Reproducibility of pulse wave velocity and augmentation index measured by pulse wave analysis. J Hypertens 1998; 16(12 Part 2): 2079–2084.

    Article  CAS  Google Scholar 

  9. Anand SS, Yusuf S, Vuksan V, Devanesen S, Teo KK, Montague PA et al. Differences in risk factors, atherosclerosis, and cardiovascular disease between ethnic groups in Canada: the Study of Health Assessment and Risk in Ethnic groups (SHARE). Lancet 2000; 356: 279–284.

    Article  CAS  Google Scholar 

  10. Nurnberger J, Dammer S, Opazo Saez A, Philipp T, Schafers RF . Diastolic blood pressure is an important determinant of augmentation index and pulse wave velocity in young, healthy males. J Hum Hypertens 2003; 17: 153–158.

    Article  CAS  Google Scholar 

  11. Chambers JC, Eda S, Bassett P, Karim Y, Thompson SG, Gallimore JR et al. C-reactive protein, insulin resistance, central obesity, and coronary heart disease risk in Indian Asians from the United Kingdom compared with European whites. Circulation 2001; 104: 145–150.

    Article  CAS  Google Scholar 

  12. Westerbacka J, Seppala-Lindroos A, Yki-Jarvinen H . Resistance to acute insulin induced decreases in large artery stiffness accompanies the insulin resistance syndrome. J Clin Endocrinol Metab 2001; 86: 5262–5268.

    Article  CAS  Google Scholar 

  13. Hope SA, Meredith IT, Cameron JD . Effect of non-invasive calibration of radial waveforms on error in transfer-function-derived central aortic waveform characteristics. Clin Sci (London) 2004; 107: 205–211.

    Article  Google Scholar 

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Authors and Affiliations

  1. Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK

    J N Din, O A Ashman, S M Aftab, A W Jubb & D E Newby

  2. Department of Cardiology, Royal Infirmary of Edinburgh, Edinburgh, UK

    A D Flapan

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  1. J N Din
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  2. O A Ashman
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  3. S M Aftab
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  4. A W Jubb
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  5. D E Newby
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Correspondence to J N Din.

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Din, J., Ashman, O., Aftab, S. et al. Increased arterial stiffness in healthy young South Asian men. J Hum Hypertens 20, 163–165 (2006). https://doi.org/10.1038/sj.jhh.1001961

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