Measurement of arterial stiffness and vascular aging in community pharmacies-The ASINPHAR@2action project

J Clin Hypertens (Greenwich). 2019 Jun;21(6):813-821. doi: 10.1111/jch.13554. Epub 2019 May 16.

Abstract

The ASINPHAR@2action project aims at raising awareness to arterial stiffness (AS) and early vascular aging (EVA) through a community pharmacy-based intervention. This preliminary analysis is focused on the analysis of the proportion of participants with increased AS and the identification of its main determinants. We performed an observational cross-sectional study of participants enrolled in 11 community pharmacies in Portugal, between April and November 2017. Blood pressure (BP) and arterial function parameters were measured with a validated device. Clinical and demographic information was gathered, as well as the estimation of global cardiovascular risk, health-related quality of life, and dietary profile. Cholesterol and glycaemia were taken from a recent laboratory bulletin. The cohort includes 658 participants with a mean age of 57.3 ± 16.3 years, 66% women. Brachial BP was 126.6 ± 16.4 mm Hg and 79.9 ± 11.5 mm Hg, and central BP was 115.8 ± 15.4 mm Hg and 81.2 ± 11.6 mm Hg, respectively, for systolic and diastolic BP. Mean pulse wave velocity (PWV) was 8.5 ± 2.3 m/s, and the augmentation index was 23.6 ± 15.6%. The proportion of participants with increased AS was 19.8%. The overall best-fitting model for AS included age, gender, aortic PP, visceral fat, HDL cholesterol, AIx@75, total vascular resistance, hypertension, and diabetes, corresponding to an AUC of 0.910 (CI: 0.883, 0.937; P < 0.001) in the ROC curve analysis. The preliminary results of this pioneering large-scale study measuring arterial function in community pharmacies provide the grounds for the operationalization of subclinical target organ damage screening in pharmacies, as a strategy to improve cardiovascular risk monitoring and to promote adherence to treatment.

Keywords: arterial stiffness; cardiovascular risk; early vascular aging.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aging / physiology*
  • Arteries / physiopathology*
  • Awareness / physiology
  • Blood Pressure / physiology
  • Blood Pressure Determination / methods
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / prevention & control
  • Cross-Sectional Studies
  • Diabetes Mellitus / epidemiology
  • Female
  • Humans
  • Hypertension / physiopathology
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / methods
  • Pharmacies / statistics & numerical data*
  • Portugal / epidemiology
  • Prospective Studies
  • Pulse Wave Analysis / methods
  • Quality of Life
  • Vascular Resistance / physiology
  • Vascular Stiffness / physiology*