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Correlation of carotid artery reactivity with cardiovascular risk factors and coronary artery vasodilator responses in asymptomatic, healthy volunteers

van Mil, Anke C.C.M.a,b; Hartman, Yvonnea; van Oorschot, Frederiekea; Heemels, Annemiekea; Bax, Nikkia; Dawson, Ellen A.b; Hopkins, Nicolab; Hopman, Maria T.E.a,c; Green, Daniel J.b,d; Oxborough, David L.b; Thijssen, Dick H.J.a,b

doi: 10.1097/HJH.0000000000001274
ORIGINAL PAPERS: Blood vessels

Objectives: Carotid artery reactivity (CAR%), involving carotid artery diameter responses to a cold pressor test (CPT), is a noninvasive measure of conduit artery function in humans. This study examined the impact of age and cardiovascular risk factors on the CAR% and the relationship between CAR% and coronary artery vasodilator responses to the CPT.

Methods: Ultrasound was used to measure resting and peak carotid artery diameters during the CPT, with CAR% being calculated as the relative change from baseline (%). We compared CAR% between young (n = 50, 24 ± 3 years) and older participants (n = 44, 61 ± 8 years), and subsequently assessed relationships between CAR% and traditional cardiovascular risk factors in 50 participants (44 ± 21 years). Subsequently, we compared left anterior descending (LAD) artery velocity (using transthoracic Doppler) with carotid artery diameter (i.e. CAR%) during the CPT (n = 33, 37 ± 17 years).

Results: A significantly larger CAR% was found in young versus older healthy participants (4.1 ± 3.7 versus 1.8 ± 2.6, P < 0.001). Participants without cardiovascular risk factors demonstrated a higher CAR% than those with at least two risk factors (2.9 ± 2.9 versus 0.5 ± 2.9, P = 0.019). Carotid artery diameter and LAD velocity increased during CPT (P < 0.001). Carotid diameter and change in velocity correlated with LAD velocity (r = 0.486 and 0.402, P < 0.004 and 0.02, respectively).

Conclusion: Older age and cardiovascular risk factors are related to lower CAR%, while CAR% shows good correlation with coronary artery responses to the CPT. Therefore, CAR% may represent a valuable technique to assess cardiovascular risk, while CAR% seems to reflect coronary artery vasodilator function.

aRadboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands

bResearch institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK

cDivision of Human Nutrition, Wageningen University, Wageningen, The Netherlands

dSchool of Sports Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia, Australia

Correspondence to Prof. Dr Dick H.J. Thijssen, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street L3 3AF, Liverpool, UK. Tel: +441519046264; e-mail:

Abbreviations: CAR%, carotid artery reactivity; CPT, cold pressor test; IMT, intima–media thickness; LAD, left anterior descending; VTI, velocity time integral

Received 22 August, 2016

Revised 11 November, 2016

Accepted 4 January, 2017

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