The Association between Inflammation and Pulse Wave Velocity in Dyslipidemia: An Evidence-Based Review
Amilia Aminuddin, Md Rizman Md Lazin Md Lazim, Adila A. Hamid, Chua K. Hui, Mohd Heikal Mohd Yunus, Jaya Kumar, Azizah Ugusman
Abstract
Dyslipidemia is associated with increased arterial stiffness (AS) which may lead to hypertension. Among the methods to assess AS are carotid-femoral and brachial-ankle pulse wave velocity. Dyslipidemia is also known to trigger inflammation. C-reactive protein (CRP) is one of the commonest inflammatory markers measured in the clinical setting. However, the association between inflammation and pulse wave velocity (PWV) in people with dyslipidemia is less studied. Therefore, this review investigated the association between inflammation (as measured by CRP) and PWV in dyslipidemia patients. The search of the literature was conducted via PubMed and Scopus database. The keywords used were “aortic stiffness” OR “arterial stiffness” OR “pulse wave velocity” OR “vascular stiffness” OR “carotid femoral pulse wave velocity” OR “pulse wave analysis” AND “inflammation” OR “c reactive protein” OR “c-reactive protein” OR “high sensitivity c reactive protein” AND “dyslipidemia” OR “hyperlipidemia” OR “hypercholesterolemia” OR “hyperlipoproteinemia” OR “hypertriglyceridemia”. The following criteria were used: (1) only full-length original articles published in English language, (2) articles that reported the association between arterial stiffness measured as carotid-femoral PWV (cfPWV) or brachial-ankle PWV (baPWV) and CRP or high-sensitivity CRP, and (3) study involving human subjects. The search identified 957 articles published between 1980 and February 2020. Only eight articles fulfilled the inclusion criteria and were used for data extraction. Five of the studies were cross-sectional studies while another three studies were interventional studies. Seven out of eight papers found a significant positive association between AS and CRP, and the correlation ranged from mild to moderate association (Pearson <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mi>r</mml:mi><mml:mo>=</mml:mo><mml:mn>0.33</mml:mn></mml:math> to <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mi>r</mml:mi><mml:mo>=</mml:mo><mml:mn>0.624</mml:mn></mml:math>). In conclusion, inflammation is associated with increased PWV in patients with dyslipidemia. This supports the involvement of inflammation in the development of AS in dyslipidemia.