The integrated flow-mediated vasodilation (FMD) response has been associated with cardiovascular (CV) risk factors, but the association between the integrated FMD response and subsequent CV events has been unclear. We enrolled 555 patients who had at least one CV risk factor (hypertension, dyslipidemia, diabetes, or smoking). We measured the peak percentage change in diameter (ΔFMD), and integrated FMD response calculated as the area under the dilation curve over a 120-second dilation period (FMD-AUC₁₂₀). Elderly patients (age ≥ 65 years, N = 270) in the lowest tertile of FMD-AUC₁₂₀ (FMD-AUC₁₂₀ < 5.6) had a higher rate of CV events compared with those in the two higher tertiles (FMD-AUC₁₂₀ ≥ 5.6) (log rank 4.15, P = .041). The association remained significant after adjusting for covariates (hazard ratio 3.84, P = .007). In the 285 middle-aged patients (age < 65 years), the CV event rates were similar between patients in the lowest tertile and those in the two higher tertiles of FMD-AUC₁₂₀ (log rank 0.39, P = .53). The CV event rates were similar between patients in the lowest tertile and those in the two higher tertiles of ΔFMD in elderly and middle-aged patient groups. In conclusion, integrated flow-mediated vasodilation response, but not ΔFMD, predicted CV events in elderly patients with CV risk factors.

整合的血流介导的血管舒张（FMD）反应已与心血管（CV）危险因素相关，但整合的FMD反应与随后的CV事件之间的关联尚不清楚。我们招募了555名患有至少一种CV危险因素（高血压，血脂异常，糖尿病或吸烟）的患者。我们测量了直径的峰值百分比变化（ΔFMD），并计算了FMD响应的积分值，该响应值是在120秒的扩张周期（FMD-AUC ₁₂₀）下的扩张曲线下的面积计算的。老年患者在FMD-AUC的最低组（年龄≥65岁，N = 270）₁₂₀（FMD-AUC ₁₂₀ <5.6）具有与那些在两个较高三分位数（FMD-AUC相比心血管事件的更高速率₁₂₀ ≥ 5.6）（对数等级4.15，P = .041）。调整协变量后，关联仍然很显着（风险比3.84，P  = .007）。在285名中年患者（年龄<65岁）中，FMD-AUC ₁₂₀最低三分位数患者与两个较高三分位数患者之间的CV事件发生率相似（对数等级0.39，P  = .53）。在老年和中年患者组中，最低三分位数患者和两个较高三分位数患者的CV事件发生率相似。总之，在具有CV危险因素的老年患者中，综合的血流介导的血管舒张反应而非ΔFMD可以预测CV事件。