1. METHODS INTRODUCTION I Webster, C Westcott, C Marincowitz, N Mashele, P De Boever, N Goswami, H Strijdom Division of Medical Physiology, Faculty of Medicine & Health Sciences, University of Stellenbosch, Cape Town, South Africa. iwebster@sun.ac.za CONCLUSIONS AIM OF STUDY Functional recovery Non recirculate RESULTS Endothelial Dysfunction is an early, detectable marker & predictor of heart disease Non-invasive methods to assess endothelial function are % Flow Mediated Dilation (FMD) during reactive hyperaemia measured by Brachial Artery Ultrasound Imaging & analysis of micro vessel diameter in the retina. There is a shortage of cardiovascular health profile data for the Western Cape province of South Africa. Therefore, in view of developing future research and intervention strategies, cardiovascular health profile data generation is invaluable. To assess whether traditional cardiovascular risk factors influence % FMD and retinal artery and venule equivalents in a female mixed race cohort in Cape Town. FUTURE PROJECTS Brachial artery measurements: baseline diameter, max diameter, % FMD. Retinal image analysis: central retinal artery equivalent (CRAE), - venule equivalent (CRVE) Use of flow mediated dilatation to assess endothelial function in a female cohort of mixed race ancestry in Cape Town, South Africa in Cape Town, South Africa 66% of South African women are obese. South Africa has the world’s highest rate of hypertension among people over the age of 50 years old (Int J Epidemiol 2014;43:116–128) This research is preliminary data from the larger EndoAfrica parent project which is assessing HIV infection & the use of antiretroviral therapy (ART) drugs in South Africa, & their effect on the endothelial function. Data from control HIV negative subjects will be used to compare to patients with HIV and on ART. Descriptive Statistics Variables (n = 36)Mean ± SDev smoking status = 75% versus non smokers 25% age (years)34 ± 11 BMI *23.40 (17.4-50.3) Waist-hip ratio0.81 ± 0.06 Biochemical measurements Total Cholesterol4.1 ± 1.0 HDL cholesterol (mmol/l)1.4 ± 0.4 LDL cholesterol (mmol/l)2.3 ± 0.7 Triglycerides (mmol/l) *0.8 (0.4-3.1) Fasting glucose4.5 ± 0.62 HbA1c5.4 ± 0.5 CVD measurements Systolic BP (mmHg)128 ± 16 Diastolic BP (mmHg)78 ± 14 Baseline diameter of brachial artery3.13 ± 0.49 Max diameter of brachial artery3.39 ± 0.58 % FMD *7.97 (-1.5-35.6) Average CRAE152.69 ±12.53 Average CRVE248.24 ± 16.90 * values are median (IQR) Forward stepwise regression analysis demonstrating associations between endothelial function & various cardiovascular factors FMD (%)* CRVE*CRAE* Adjusted R 2 0.2090.4740.228 Independent variablesβ (95% CI)p p p Fasting glucose HbA1c Total cholesterol ------ ------ - -15.98 (-3.07; -28.89) - 0.024 - 10.03 (0.97; 19.08) - 0.038 - LDL-cholesterol HDL-cholesterol Triglycerides ------ ------ ------ ------ - 10.07 (-0.48; 20.61) - 0.076 Systolic BP Diastolic BP Waist to hip ratio BMI smoking 0.177 (0.003;0.35) - 0.05 - -0.66 (-0.19; -1.13) - 71.86 ( -6.56; 150.28) -1.22 (-0.14; -2.29) -14.78 (-7.0; -22.56) 0.01 - 0.08 0.03 0.001 - -101.32 (-3.39; -199.24) - -6.99 (0.434; -14.41) - 0.05 - 0.076 β: beta coefficient (5 th to 95 th percentile interval). *Data in bold is regarded as statistically significant, p ≤ 0.05 & a trend level significance when 0.05 < p ≤ 0.08. FMD% adjusted for baseline FMD. *Models adjusted for: age, BMI, smoking status, alcohol use. Systolic BP is a predictor of %FMD, Smoking, Systolic BP, BMI and HbA1c all predictors of average CRVE Fasting glucose levels and waist to hip ratio are predictors of average CRAE Thus traditional and social cardiovascular risk factors are predictors of endothelial function in this population. Flow Mediated Dilation (FMD): Esaote MyLab TM Five Mobile Ultrasound System Retinal Image Analysis Software developed by DCI Labs, Belgium Retinal Image Analysis Software developed by DCI Labs, Belgium Identified study participants Fasted blood for analysis Lipid Profile: Cholesterol HDL, LDL Triglycerides Blood Profile: Fasting Glucose HBA1c Participant recruitment Patient Consent & Questionnaire: Demographics, Lifestyle, Anthropometry, Medical background