Endothelial dysfunction determined by pulse wave velocity in overweight and obese rural Filipino subjects

PURPOSE: To show by Pulse Wave Velocity (PWV) determination that pathological arterial wall changes occur in both obese and overweight individuals. METHOD: PWV was determined indirectly with the BPULS apparatus using the left external carotid and left dorsalis pedis arteries as the “central” and “peripheral” points respectively. Pulses of said arteries were picked up by sensors and recorded on a computer simultaneously with a single lead ECG. The time delay between the two pulses is measured. A shorter time delay indicates decreased arterial wall elasticity. Waist circumference (WC) was measured in the standard manner. Weight and height were taken for BMI computation.
MATERIALS: A total of 950 asymptomatic Filipinos living in rural areas were studied. Females - 553, Males -397; Age range - 17–84 years. Of the females, 145 had WC of80 cm. and 408 had WCof80 cm.; and, Males -226 had WC of90 cm. and 171 had WC of90 cm. Based on BMI: Underweight - 102; Normal - 481; Overweight - 283, and Obese - 84
RESULTS:PWV Time in sec. (corrected for height): Females with WC80 cm. -0.1456; with80cm. - 0.1290; Males with WC90 cm. - 0.1506 and with90 cm. - 0.1331, p0.03.PWV Time in sec. (corrected for height): Underweight - 0.1544; Normal -0.1404;Overweight - 0.1289; and, Obese - 0.1257. p0.03 DISCUSSION: Decreased arterial wall elasticity is associated with endothelial dysfunction which is the initial change leading to atherosclerosis Our study shows decreased arterial wall elasticity determined by PWV in both males and females with increased WC and also cases whose BMI correspond to both overweight and obesity. This implies that these subjects are at high risk to develop cardiovascular disease (CVD). Weight loss even just in cases of overweight should be emphasized not only because they are at high risk to develop CVD but it is also much easier for these individuals to lose weight before they become definitely obese.
CONCLUSION: Subjects with abnormally increased waist circumference and elevated BMI have decreased arterial wall elasticity as shown by abnormal PWV indicating endothelial dysfunction. Therefore all these cases should reduce weight before they progress to atherosclerosis.