Рациональная фармакотерапия в кардиологии (Mar 2022)
Preventive Screening of Young People from the Perspective of Vascular Aging Phenotypes: the Role of Body Weight
Abstract
Aim. To study the cardiovascular stiffness index CAVI in relation to main risk factors (RF) in young people from the point of their vascular aging phenotype and gender.Material and methods. 264 young people (93 boys and 171 girls) at age of 18 to 25 years were examined. Vascular screening was performed with evaluating of CAVI. All subjects were divided into tertile groups for this indicator, taking into account gender. Such interval analysis of gender- and age- homogeneous sample allows to identify carriers of the phenotypes of premature (upper CAVI-tercile), normal (middle CAVI-tercile), and favorable or healthy (low CAVI-tercile) vascular aging. The first of them is also called EVA (early vascular aging) syndrome. In these groups, the incidence of carriers of insufficient, normal body mass (BM) and overweight were estimated. In three groups formed by BM indicator, the parameters of CAVI, hemodynamic and metabolic status in response to changes in BM were determined.Results. Among of the presented RF, the correlation was significant for CAVI with a weight -0.428 (p<0.001) for R-CAVI, -0.453 (p<0.001) for L- CAVI, and even more significant with the BM index - at the level of -0.410 (p<0.001) for R-CAVI and -0.462 (p<0.001) for L-CAVI. This connection is found in boys. Among boys and girls with excessive BM, the most favorable vascular aging phenotype is observed 2.7 and 2.2 times more often than the EVA syndrome. In contrast, among girls with insufficient BM, a favorable vascular phenotype is detected almost twice rarely as compared with EVA syndrome. In similar group of boys, a healthy vascular phenotype is not observed at all. Among normal-weight boys and girls, the occurrence of the two extreme vascular phenotypes is almost identical. The arterial rigidity decrease on the background of BM increase occurs despite the сhanges of hemo- dynamic and metabolic indicators. This changes are especially pronounced in girls. The difference between the extreme weight categories in terms of R- CAVI and L-CAVI for boys was 1.4, while for girls it was only 0.3 for R-CAVI and 0.4 for L-CAVI.Conclusion. When carrying out preventive measures among young people, one should not limit oneself to evaluating only traditional RF. Based on the concept of vascular aging, angiological screening should be more widely implemented. It will allow for more individualized preventive interventions among young people in the future.
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