Factors Associated with Endothelial Cell Functions and Arterial Stiffness in Elderly


  • Titiporn Mekrungruangwong Faculty of Allied Health Sciences, Naresuan University
  • Chomphunit Salee Faculty of Allied Health Sciences, Naresuan University
  • Sakonrat Rungruang Faculty of Allied Health Sciences, Naresuan University
  • Jitlada Charonelap Faculty of Allied Health Sciences, Naresuan University
  • Sunsanee Mekrungrongwong Faculty of Public Health, Naresuan University
  • Sitthichai Vachirasrisirikul Department of Surgery, Buddhachinaraj Phitsanulok Hospital




Elderly, Arterial stiffness, Endothelial function


This study aimed to investigate the factors associated with endothelial cell functions and arterial stiffness in elderly. Sixty-eight subjects aged 60-80 years were voluntarily enrolled. Data were collected for factors such as age, gender, waist circumference, body mass index, mean blood pressure, heart rate, underlying disease, family history of cardiovascular disease, smoking history, drinking history, and physical activity by using a validated questionnaire and arterial stiffness was evaluated by using cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI) and endothelial function was determined by using flow-mediated vasodilation (FMD). Data were analyzed using descriptive statistics and multiple linear regression. The results showed that age, underlying disease, and body mass index (BMI) significantly predict CAVI at approximately 21% (R2=0.210, F = 6.954, p < 0.05); family history of cardiovascular disease, drinking history, and mean arterial blood pressure significantly predict ABI at approximately 23.9% (R2=0.239, F = 8.005, p < 0.05), and heart rate, physical activity with high metabolic equivalent of task (MET) significantly predict FMD at approximately 22.7% (R2=0.227, F = 9.819, p < 0.05). Interestingly, the positive correlation between high MET and FMD may imply that exercise in aging prevented age-induced endothelial dysfunction.


Download data is not yet available.


Zieman S, Kass D. Advanced glycation end product cross-linking: pathophysiologic role and therapeutic target in cardiovascular disease. Congestive Heart Failure. 2004; 10(3): 144-9; quiz 50-51.

Hashimoto M, Ishinaga Y, Honda M, Ohoka M, Morioka S, Moriyama K. Age-related increase in the uptake of acetylated low density lipoprotein into cultured endothelial cells from rat aorta. Experimental gerontology. 1991; 26(4): 397-406.

London GM, Guerin AP, Pannier BM, Marchais SJ, Metivier F. Body height as a determinant of carotid pulse contour in humans. Journal Hypertension Supplement. 1992; 10(6): S93-595.

Costa-Hong VA, Muela HCS. Gender differences of aortic wave reflection and influence of menopause on central blood pressure in patients with arterial hypertension. BMC cardiovascular disorders. 2018; 18(1): 123.

Zaydun G, Tomiyama H, Hashimoto H, Arai T, Koji Y, Yambe M, et al. Menopause is an independent factor augmenting the age-related increase in arterial stiffness in the early postmenopausal phase. Atherosclerosis. 2006; 184(1): 137-142.

Núñez-Córdoba JM, Martínez-González MA, Bes-Rastrollo M, Toledo E, Beunza JJ, Alonso A. Alcohol consumption and the incidence of hypertension in a Mediterranean cohort: the SUN study. Revista Espanola Cardiologia. 2009; 62(6): 633-641.

Tison GH, Ndumele CE, Gerstenblith G, Allison MA, Polak JF, Szklo M. Usefulness of baseline obesity to predict development of a high ankle brachial index (from the Multi-Ethnic Study of Atherosclerosis). The American journal of cardiology. 2011; 107(9): 1386-1391.

McLeod JC, Stokes T, Phillips SM. Resistance Exercise Training as a Primary Countermeasure to Age- Related Chronic Disease. Frontiers in Physiology 2019; 10: 645.

Bauersachs R, Zeymer U, Brière J-B, Marre C, Bowrin K, Huelsebeck M. Burden of Coronary Artery Disease and Peripheral Artery Disease: A Literature Review. Cardiovascular Therapeutics. 2019; 2019: 8295054.

Kobayashi R, Sato K, Takahashi T, Asaki K, Iwanuma S, Ohashi N, Hashiguchi T. Arterial stiffness during hyperglycemia in older adults with high physical activity vs low physical activity. Journal of clinical biochemistry and nutrition. 2019; 65(2): 146-152.

Hair JF, Black B, Black WC, Babin BJ, Anderson RE. Multivariate data analysis: A global perspective. (Seventh Edition). Pearson Education, Upper Saddle River.; 2010.

Nagayama D, Imamura H, Sato Y, Yamaguchi T, Ban N, Kawana H, Ohira M, Saiki A, Shirai K, Tatsuno I. Inverse relationship of cardioankle vascular index with BMI in healthy Japanese subjects: a cross-sectional study. Vascular health and risk management. 2016; 13: 1-9.

Davis AE, Lewandowski AJ, Holloway CJ, Ntusi NAB, Banerjee R, Nethononda R, Pitcher A, Francis JM, Myerson SG, Leeson P, Donovan T, Neubauer S, Rider OJ. Observational study of regional aortic size referenced to body size: production of a cardiovascular magnetic resonance nomogram. Journal of Cardiovascular Magnetic Resonance. 2014; 16(1): 9. doi: 10.1186/1532-429X-16-19.

Buschmann EE, Li L, Brix M, Zietzer A, Hillmeister P, Busjahn A, Bramlage P, Buschmann I. A novel computer-aided diagnostic approach for detecting peripheral arterial disease in patients with diabetes. PLOS ONE. 2018; 13(6): e0199374. doi: 10.1371/journal.pone.0199374.

Thapanee R, Ruchada S-a, Nawiya H. High systolic blood pressure is associated with increased Cardio-ankle Vascular Index in the elderly. Artery Research. 2020; 27(1): 25-31.

Davies PF. Hemodynamic shear stress and the endothelium in cardiovascular pathophysiology. Nature clinical practice Cardiovascular medicine. 2009; 6(1): 16-26.

Nagayama D, Watanabe Y, Saiki A, Shirai K, Tatsuno I. Lipid parameters are independently associated with Cardio-Ankle Vascular Index (CAVI) in healthy Japanese subjects. Journal of atherosclerosis and thrombosis. 2018; 25(7): 621-633.

Satoh N, Shimatsu A, Kato Y, Araki R, Koyama K, Okajima T, Tanabe M, Ooishi M, Kotani K, Ogawa Y. Evaluation of the cardio-ankle vascular index, a new indicator of arterial stiffness independent of blood pressure, in obesity and metabolic syndrome. Hypertension research: official journal of the Japanese Society of Hypertension. 2008; 31(10): 1921-1930.

Ko SH, Cha BY. Diabetic peripheral neuropathy in type 2 diabetes mellitus in Korea. Diabetes & metabolism journal. 2012; 36(1): 6-12.

Wassel CL, Loomba R, Ix JH, Allison MA, Denenberg JO, Criqui MH. Family history of peripheral artery disease is associated with prevalence and severity of peripheral artery disease: the San Diego population study. Journal of the American College of Cardiology. 2011; 58(13): 1386-1392.

Xie X, Ma Y-T, Yang Y-N, Li X-M, Liu F, Huang D, Fu ZY, Ma X, Chen BD, Huang Y. Alcohol consumption and Ankle-to-Brachial Index: results from the cardiovascular risk survey. PLOS ONE. 2010; 5(12): e15181. doi: 10.1371/journal.pone.0015181.

Kalla A, Figueredo VM. Alcohol and cardiovascular disease in the geriatric population. Clinical Cardiology. 2017; 40(7): 444-449.

Li YH, Sheu WH, Lee IT. Use of the ankle-brachial index combined with the percentage of mean arterial pressure at the ankle to improve prediction of all-cause mortality in type 2 diabetes mellitus: an observational study. 2020; 19(1): 173.

Luo YY, Li J, Xin Y, Zheng LQ, Yu JM, Hu DY. Risk factors of peripheral arterial disease and relationship between low ankle brachial index and mortality from all-cause and cardiovascular disease in Chinese patients with hypertension. Journal of human hypertension. 2007; 21(6): 461-466.

Benjamin EJ, Larson MG, Keyes MJ, Mitchell GF, Vasan RS, Keaney JF, Jr., Lehman BT, Fan S, Osypiuk E, Vita JA. Clinical correlates and heritability of flow-mediated dilation in the community: the Framingham Heart Study. Circulation. 2004; 109(5): 613-619.

Pinter A, Horvath T, Sarkozi A, Kollai M. Relationship between heart rate variability and endothelial function in healthy subjects. Autonomic Neuroscience: Basic and Clinical. 2012; 169(2): 107-112.

Beck DT, Casey DP, Martin JS, Emerson BD, Braith RW. Exercise training improves endothelial function in young prehypertensives. Experimental biology and medicine (Maywood, NJ). 2013; 238(4): 433-441.

Fox BM, Brantley L, White C, Seigler N, Harris RA. Association beween resting heart rate, shear and flow-mediated dilation in healthy adults. Experimental Physiology. 2014; 99(10): 1439-1448.

Custodis F, Reil JC, Laufs U, Böhm M. Heart rate: a global target for cardiovascular disease and therapy along the cardiovascular disease continuum. Journal of cardiology. 2013; 62(3): 183-187.




How to Cite

Mekrungruangwong T, Salee C, Rungruang S, Charonelap J, Mekrungrongwong S, Vachirasrisirikul S. Factors Associated with Endothelial Cell Functions and Arterial Stiffness in Elderly. Health Sci J Thai [Internet]. 2022 Sep. 27 [cited 2023 Dec. 3];4(4):1-9. Available from: https://he02.tci-thaijo.org/index.php/HSJT/article/view/255183



Original articles