학술논문
Occupational class differences in ankle-brachial index and pulse wave velocity measurements to detect subclinical vascular disease.
Document Type
Academic Journal
Author
Ferrario MM; EPIMED Research Centre, Department of Medicine and Surgery, School of Medicine, University of Insubria, Varese, Italy; and Occupational Medicine Unit, University Hospital of Varese, Varese, Italy . marco.ferrario@uninsubria.it.; Martire G; School of Specialization in Occupational Medicine, University of Insubria, Varese, Italy. g.martire@studenti.uninsubria.it.; Gianfagna F; EPIMED Research Centre, Department of Medicine and Surgery, School of Medicine, University of Insubria, Varese, Italy; and Mediterranea Cardiocentro, Napoli, Italy. francesco.gianfagna@uninsubria.it.; Lasalvia P; EPIMED Research Centre, Department of Medicine and Surgery, School of Medicine, University . p.lasalvia@uninsubria.it.; Cremonesi F; School of Specialization in Occupational Medicine, University of Insubria, Varese, Italy; . f.cremonesi@studenti.uninsubria.it.; Tozzi M; Vascular Surgery Unit, Department of Medicine and Surgery, School of Medicine, University of Insubria, Varese, Italy. matteo.tozzi@uninsubria.it.; Franchin M; Vascular Surgery Unit, Department of Medicine and Surgery, School of Medicine, University of Insubria, Varese, Italy. marco.franchin@asst-settelaghi.it.; Campana F; School of Specialization in Occupational Medicine, University of Insubria, Varese, Italy; . f.campana@studenti.uninsubria.it.; Roncaioli M; School of Specialization in Occupational Medicine, University of Insubria, Varese, Italy; . mroncaioli@uninsubria.it.; Cavicchiolo M; School of Specialization in Occupational Medicine, University of Insubria, Varese, Italy; . m.cavicchiolo@studenti.uninsubria.it.; Borchini R; ASST Lariana, Como, Italy. rossana.borchini@asst-lariana.it.; Iacoviello L; EPIMED Research Centre, Department of Medicine and Surgery, School of Medicine, University of Insubria, Varese, Italy; and Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy. licia.iacoviello@uninsubria.it.; Veronesi G; EPIMED Research Centre, Department of Medicine and Surgery, School of Medicine, University of Insubria, Varese, Italy; . giovanni.veronesi@uninsubria.it.
Source
Publisher: Mattioli 1885 Country of Publication: Italy NLM ID: 0401176 Publication Model: Electronic Cited Medium: Print ISSN: 0025-7818 (Print) Linking ISSN: 00257818 NLM ISO Abbreviation: Med Lav Subsets: MEDLINE
Subject
Language
English
ISSN
0025-7818
Abstract
Background: High pulse wave velocity (PWV) and low ankle brachial index (ABI) have been proposed as surrogate end-points for cardiovascular disease (CVD).
Objectives: In a cross-sectional setting, we aimed at assessing the distributions of PWV and ABI among occupational classes (OC) in a population-based ever-employed salaried sample.
Methods: We enrolled 1388 salaried CVD-free workers attending a CVD population-based survey, the RoCAV study, and classified them into four OC, based on current or last job title: manager/director (MD), non-manual (NMW), skilled-manual (SMW) and (UMW) unskilled-manual workers. We derived brachial-ankle PWV and ABI from four-limb blood pressures measurements, then carotid-femoral PWV (cfPWV) was estimated. We estimated the OC gradients in cfPWV and ABI using linear and logistic regression models.
Results: Compared to MD (reference category), UMW had higher age- and BMI-adjusted cfPWV mean values both in men (0.63 m/s; 95%CI:0.11-1.16) and women (1.60 m/s; 0.43-2.77), only marginally reduced when adjusting for CVD risk factors. Decreased ABI mean values were also detected in lower OC. The overall detection rate of abnormal cfPWV (≥12 m/s) or ABI (≤0.9) values was 28%. Compared to MD, the prevalence of abnormal cfPWV or ABI was higher in NMW (OR=1.77; 95%CI:1.12-2.79), SMW (1.71; 1.05-2.78) and UMW (2.72; 1.65-4.50). Adjustment for CVD risk factors used in risk score equations did not change the results.
Discussion: We found a higher prevalence of abnormal values of arterial stiffness measures in lower OC, and these differences were not explained by traditional CVD risk factors. These may be presumably determined by additional work- and environmental-related risk factors.
Objectives: In a cross-sectional setting, we aimed at assessing the distributions of PWV and ABI among occupational classes (OC) in a population-based ever-employed salaried sample.
Methods: We enrolled 1388 salaried CVD-free workers attending a CVD population-based survey, the RoCAV study, and classified them into four OC, based on current or last job title: manager/director (MD), non-manual (NMW), skilled-manual (SMW) and (UMW) unskilled-manual workers. We derived brachial-ankle PWV and ABI from four-limb blood pressures measurements, then carotid-femoral PWV (cfPWV) was estimated. We estimated the OC gradients in cfPWV and ABI using linear and logistic regression models.
Results: Compared to MD (reference category), UMW had higher age- and BMI-adjusted cfPWV mean values both in men (0.63 m/s; 95%CI:0.11-1.16) and women (1.60 m/s; 0.43-2.77), only marginally reduced when adjusting for CVD risk factors. Decreased ABI mean values were also detected in lower OC. The overall detection rate of abnormal cfPWV (≥12 m/s) or ABI (≤0.9) values was 28%. Compared to MD, the prevalence of abnormal cfPWV or ABI was higher in NMW (OR=1.77; 95%CI:1.12-2.79), SMW (1.71; 1.05-2.78) and UMW (2.72; 1.65-4.50). Adjustment for CVD risk factors used in risk score equations did not change the results.
Discussion: We found a higher prevalence of abnormal values of arterial stiffness measures in lower OC, and these differences were not explained by traditional CVD risk factors. These may be presumably determined by additional work- and environmental-related risk factors.