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Relation of Endothelial Function to Cardiovascular Risk in Women With Sedentary Occupations and Without Known Cardiovascular Disease

      Our purpose was to determine predictors of endothelial function and potential association with cardiovascular risk in women with sedentary occupations, in whom obesity-associated risk factors may contribute to excess morbidity and mortality. Ninety consecutive women (age range 22 to 63 years, 22 overweight (body mass index [BMI] ≥25 to 29.9 kg/m2) and 42 obese (BMI ≥ 30 kg/m2), had vital signs, lipids, insulin, glucose, high-sensitivity C-reactive protein, and sex hormones measured. Endothelial function was determined using brachial artery flow-mediated dilation after 5 minutes of forearm ischemia. Treadmill stress testing was performed with gas exchange analysis at peak exercise (peak oxygen consumption [Vo2]) to assess cardiorespiratory fitness. Brachial artery reactivity was negatively associated with Framingham risk score (r = −0.3542, p = 0.0007). Univariate predictors of endothelial function included peak Vo2 (r = 0.4483, p <0.0001), age (r = −0.3420, p = 0.0010), BMI (r = −0.3065, p = 0.0035), and high-sensitivity C-reactive protein (r = −0.2220, p = 0.0400). Using multiple linear regression analysis with stepwise modeling, peak Vo2 (p = 0.0003) was the best independent predictor of brachial artery reactivity, with age as the only other variable reaching statistical significance (p = 0.0436) in this model. In conclusion, endothelial function was significantly associated with cardiovascular risk in women with sedentary occupations, who were commonly overweight or obese. Even in the absence of routine exercise, cardiorespiratory fitness, rather than conventional risk factors or body mass, is the dominant predictor of endothelial function and suggests a modifiable approach to risk.
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