Cross-sectional relations of multiple biomarkers from distinct biological pathways to brachial artery endothelial function

Sekar Kathiresan, Philimon Gona, Martin G. Larson, Joseph A. Vita, Gary F. Mitchell, Geoffrey H. Tofler, Daniel Levy, Christopher Newton-Cheh, Thomas J. Wang, Emelia J. Benjamin, Ramachandran S. Vasan

Research output: Contribution to journalArticlepeer-review

82 Scopus citations


BACKGROUND - Endothelial dysfunction is a critical intermediate phenotype in the pathogenesis of cardiovascular disease. We evaluated the relative contributions of distinct biological pathways to interindividual variation in endothelial function by relating prototype biomarkers (representing these pathways) to brachial artery vasodilator function. METHODS AND RESULTS - We investigated the cross-sectional relations of a panel of 7 biomarkers measured at a routine examination to brachial artery vasodilator function (flow-mediated dilation [FMD] and reactive hyperemia) assessed at a subsequent examination (mean interval, 2.9 years) in 2113 Framingham Heart Study participants (mean age, 61 years; 54% women). We selected biomarkers from 4 biological domains: neurohormonal (N-terminal pro-atrial natriuretic peptide [N-ANP], B-type natriuretic peptide [BNP], renin, aldosterone), hemostatic factors (plasminogen activator inhibitor-1 [PAI-1]), inflammation (C-reactive protein [CRP]), and target organ damage (urine albumin-creatinine ratio). In age- and sex-adjusted models, several biomarkers were related to baseline brachial artery diameter (PAI-1, CRP, urine albumin-creatinine ratio), baseline mean flow (N-ANP, BNP, PAI-1, CRP, aldosterone), FMD (N-ANP, PAI-1, CRP, renin), and reactive hyperemia (BNP, PAI-1, CRP, renin, urine albumin-creatinine ratio). In multivariable analyses relating the 7 biomarkers conjointly to each vascular function measure (adjusting for known risk factors), N-ANP and renin were positively related to FMD (P=0.001 and P=0.04, respectively), and N-ANP was inversely related to baseline mean flow velocity (P=0.01). None of the other biomarkers was significantly related to the vascular function measures studied. CONCLUSIONS - In our large community-based sample, a conservative strategy relating several biomarkers to vascular endothelial function identified plasma N-ANP as a key correlate of mean flow under basal conditions and of FMD in response to forearm cuff occlusion.

Original languageEnglish (US)
Pages (from-to)938-945
Number of pages8
Issue number7
StatePublished - Feb 2006
Externally publishedYes


  • Atrial natriuretic factor
  • Endothelium
  • Inflammation
  • Natriuretic peptides
  • Renin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


Dive into the research topics of 'Cross-sectional relations of multiple biomarkers from distinct biological pathways to brachial artery endothelial function'. Together they form a unique fingerprint.

Cite this