Lifestyle, cardio-metabolic risk and arterial stiffness.

UNLABELLED: HDL-cholesterol plays a key role defining the functional state of the arteries and the relation to cardiovascular risk. AIM: To assess the degree of arterial stiffness in asymptomatic subjects with and without cardiovascular risk, depending on lipidic parameters behavior and on the insulin resistance state. METHODS: Arterial stiffness was assessed using the carotid-radial pulse wave velocity (PWV-CR) measured with Complior; cardiovascular risk was calculated using the SCORE chart; metabolic risk was quantified by assessing fasting lipidic (TC, TG, HDL, LDL) and glycemic parameters (HOMA-IR >1 defines the insulin resistance state). RESULTS: 58 asymptomatic subjects, 57.62 +/- 14.40 years: 46.55% with (SCORE > or = 5%) and 53.45% without (SCORE < 5%) cardiovascular risk. In subjects with SCORE < 5% and low HDL (< 40 mg/dL), PWV-CR is influenced by the TG/HDL ratio (R2=0.27, p=0.04); LDL < 115 mg/dL has a powerful influence on PWV-CR (R2=0.58, p=0.02); the association of lipidic alterations is predictive for increased PWV-CR (> or = 9.5 m/s) (R2=0.85, p=0.008). In subjects with SCORE > or = 5%, protective HDL level (> or = 40 mg/dL) and HOMA-IR > 1, PWV-CR is strongly related to the insulin resistance state (R2=0.74, p=0.02), also to the association with LDL levels (R2=0.92, p=0.01). CONCLUSIONS: The association between low HDL levels and other lipidic alterations in asymptomatic subjects with low cardiovascular risk influences the degree of arterial stiffness. Increased HDL levels and the presence of insulin resistance syndrome in high risk asymptomatic subjects are predictive for arterial stiffness. This prediction is amplified by LDL association to the metabolic state of the insulin resistance syndrome. It is necessary to establish target levels for HDL and TG in the cardiovascular disease prevention guidelines.