Central and peripheral fat and subclinical vascular damage in older women.

OBJECTIVE: the aim of this study was to evaluate the relationship between fat distribution and arterial compliance in a group of elderly women, in particular to test a possible independent role of abdominal fat mass and peripheral fat mass on subclinical vascular damage, defined by a pulse wave velocity (PWV) >12 m/s. METHODS: in 96 women with age range 60-80 years (68.65 ± 4.98 years) and BMI range from 18.8 to 41.2 kg/m(2) (27.07 ± 4.61 kg/m(2)), we evaluated the body mass index, waist circumference, systolic and diastolic blood pressure, fasting glucose, cholesterol, LDL and HDL cholesterol, triglycerides and body composition by dual energy X-ray absorptiometry (DXA). Arterial stiffness was assessed by carotid-femoral (PWVcf) and carotid-radial pulse wave velocity (PWVcr). RESULTS: significant associations were found between PWVcf, age, waist circumference, BMI and trunk fat assessed by DXA, as well as TG and HDL cholesterol. After adjustment for the total fat mass a negative statistically significant association between PWVcf and leg fat mass was shown. In multiple regression analyses the mean arterial pressure, trunk fat mass and leg fat mass were significant predictors of vascular damage with OR, respectively, of 1.06 (CI: 1.01-1.11), 1.25 (CI: 1.06-1.48) and 0.73 (CI: 0.53-0.99). CONCLUSIONS: the results of this study show, in a sample of apparently healthy elderly women, that central and peripheral adiposity are independent predictors, with an opposite effect on subclinical vascular damage, confirming and strengthening the protective role of the gluteal-femoral fat on cardiovascular risk even in elderly.

Supervised walking groups to increase physical activity in elderly women with and without hypertension: effect on pulse wave velocity.

To date, only a few studies have evaluated the effect of physical activity on PWVcf in the elderly. In the current study, 21 community-dwelling women, with a mean age of 68.19±5.72 years and a mean BMI of 28.63±4.69 kg m(-2), participated in moderate physical activity sessions for 1 h per day and 2 days each week under the supervision of a qualified physical education instructor for a total of 24 weeks. At the beginning of the study, at 3 months and at 6 months, the study participants' body weight, waist circumference, sagittal abdominal diameter (SAD) and body composition by dual energy X-ray absorptiometry (DEXA) were recorded along with the participants' Physical Activity Scale for the Elderly questionnaire. Total low-density-lipoprotein and high-density lipoprotein cholesterol; triglycerides (TGs) and HbA1c; blood pressure (BP); and arterial stiffness, as determined by carotid-femoral and carotid-radial pulse wave velocity (PWVcf, PWVcr), were also assessed. During the follow-up period, the waist and SAD significantly decreased, whereas fat-free mass, BMI and weight did not decrease. A significant decline in TGs was observed. A significant decline in PWVcf, even after adjusting for mean arterial pressure, heart rate triglycerides and waist diameter changes, was observed. In a sub-analysis that examined the effect of physical activity separately in the hypertensive and normotensive subjects, we observed a significant decline in PWVcf in the hypertensive subjects and a nonsignificant tendency in the normotensive subjects. The data showed an association between light aerobic physical activity in the elderly and decreased PWVcf, even after adjusting for changes in systolic BP (SBP), TGs and central adiposity. These results suggest a beneficial effect of moderate physical activity on subclinical vascular damage, particularly in hypertensive subjects.

Abdominal obesity and subclinical vascular damage in the elderly.

OBJECTIVE: The aim of the present study was to assess the relationships between metabolic syndrome, its components and arterial stiffness as well as evaluate the waist measurement that would accurately identify subclinical vascular damage. METHODS: Ninety-one participants (16 men) free of cardiovascular diseases with mean age 68.5 +/- 5.1 (range 60-80 years) and a BMI of 27.73 +/- 3.89 were included in the study. In each participant, we evaluated BMI, waist circumference, SBP and DBP, fasting glucose, cholesterol, low-density lipoprotein and high-density lipoprotein cholesterol, triglycerides and body composition by dual energy X-ray absorptiometry. Arterial stiffness was assessed by carotid-femoral and carotid-radial pulse wave velocity. We defined subclinical vascular damage as pulse wave velocity higher than 12 m/s. Metabolic syndrome was defined using both International Diabetes Federation (IDF) and National Cholesterol Education Program (NCEP) criteria. RESULTS: Significant associations were observed between age, triglycerides, waist circumference, trunk fat, SBP and DBP and carotid-femoral pulse wave velocity. Carotid-femoral pulse wave velocity but not carotid-radial pulse wave velocity was significantly higher in patients with metabolic syndrome than in those without metabolic syndrome, independently of its definition (IDF or NCEP). By using waist circumference cut-off suggested by IDF, it was possible to recognize a higher percentage of patients with subclinical vascular damage than by using those suggested by NCEP (88.5 vs. 50%, P = 0.01 and 0.35, respectively). CONCLUSION: These data show that in apparently healthy elderly, metabolic syndrome is strongly associated with subclinical vascular damage. Abdominal obesity and hypertriglyceridemia are also significant predictors of vascular damage. More conservative values of waist cut-off, as suggested by IDF, seem to be able to identify a larger group of patients with subclinical vascular damage, who should be better taken in consideration for treatment.