Age and gender differences of endothelial function in 4739 healthy adults: the HUNT3 Fitness Study

Skaug, Eli-Anne
Aspenes, Stian Thoresen
Oldervoll, Line
Mørkedal, Bjørn
Vatten, Lars
Wisløff, Ulrik
Ellingsen, Øyvind

¹Norwegian University of Science and Technology, Trondheim, Norway ²St Olavs Hospital, Trondheim, Norway

Corresponding author:

Øyvind Ellingsen, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, PO Box 8905, Medical Technology Research Centre, NO-7491 Trondheim, Norway

Email: [email protected]

Received 17 November 2011; accepted 1 March 2012

European Journal of Preventive Cardiology 20(4):p 531-540, August 2013. | DOI: 10.1177/2047487312444234

Abstract

Aims:

Endothelial dysfunction is an important marker for prognosis in patients with coronary heart disease. However, there are no reference values for endothelial function in a healthy population. Our aim was to determine the distribution of flow-mediated dilation (FMD) values by gender and age in healthy adults.

Methods:

FMD was measured by ultrasound during reactive hyperaemia in the brachial artery of 4739 adults aged 20-89 years, who were free from self-reported cardiovascular or pulmonary disease. Differences in FMD across age and gender were analysed by multiple linear regression.

Results:

Total mean ± SD FMD was 4.8 ± 4.2%, with corresponding estimates of 4.3 ± 3.9% for men and 5.3 ± 4.5% for women (p < 0.001). In total, 17% had FMD ≤0%, indicating endothelial dysfunction. FMD decreased with increasing age in both genders up to 70 years for men and 80 for women (p < 0.001). In women, age-related decline in FMD was steepest after age 45; in men, a steady decline after age 30. In men 80 years and older, FMD was higher than in men aged 50-79 years.

Conclusions:

The distribution of FMD in this study is representative of the respective age and gender groups of a healthy population and may be a useful reference for future studies. The high proportion of endothelial dysfunction came as a surprise. Its age and gender distribution suggest that FMD ≤0% precedes cardiovascular disease and that it may be a powerful non-invasive biomarker for identifying high-risk individuals.