Abstract
Background/Objectives: Cardiovascular disease is the leading cause of adult deaths globally and has recently been reported to be on the rise in younger adult women. The present study examined the impact of physical and lifestyle predictors of vascular health in 125 apparently healthy premenopausal East Asian volunteers. Methods: Vascular health outcomes included carotid-femoral pulse wave velocity (cfPWV), central augmentation index (cAIx), and mean arterial pressure (MAP). Body composition/anthropometric predictors included total adiposity, visceral adipose tissue (VAT) and skeletal muscle mass (SMM), as well as body mass index (BMI) and waist circumference (WC). Lifestyle predictors included the International Physical Activity Questionnaire (IPAQ) and dietary recall. Multivariate linear regression was used to identify independent predictors of combined vascular health and individual vascular outcome variables. The analysis for independent vascular outcomes was repeated after age stratification (<35 years versus ≥35 years). Results: VAT showed a significant multivariate effect on combined vascular health outcomes (p = 0.002) and independently contributed to cfPWV (p = 0.013). WC positively predicted cAIx (p = 0.010) while SMM was inversely related to cAIx (p = 0.024). BMI positively predicted MAP (p = 0.039) in the multivariate analysis. After age adjustment however, only BMI emerged as a significant independent predictor of both cfPWV (p = 0.040) and MAP (p = 0.024). Furthermore, WC remained positively associated with cAIx (p = 0.042) while SMM remained inversely related to cAIx (p = 0.038). After age stratification, IPAQ was inversely related to cfPWV while BMI was positively associated with MAP (p = 0.035) in women < 35 years only. However, in older women, total adiposity (p = 0.040) and total cholesterol (p = 0.011) were both positively, while SMM (p = 0.046) was negatively associated with cAIx. Conclusions: With the exception of age, VAT was the single best predictor of general vascular health in East Asian women. Independent of age, however, BMI, WC, and SMM significantly contributed to independent vascular outcome measures and in combination with age, substantially add to the prediction of vascular risk. Furthermore, stratifying younger versus older premenopausal women resulted in different associations with independent vascular outcome measures demonstrating that across a large age range of premenopausal women, it is important to consider age in the evaluation of vascular health.