Association of vascular health measures and physical function: a prospective analysis in the Framingham Heart Study

Authors: SAHNI, SHIVANI - Marcus Institute For Aging Research; DUFOUR, ALYSSA - Marcus Institute For Aging Research; WANG, NA - Boston University; KIEL, DOUGLAS - Marcus Institute For Aging Research; HANNAN, MARIAN - Marcus Institute For Aging Research; JACQUES, PAUL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; BENJAMIN, EMELIA - Boston University; VASAN, RAMACHANDRAN - Boston University; MURABITO, JOANNE - Boston University; NEWMAN, ANNE - University Of Pittsburgh; FIELDING, ROGER - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; MITCHELL, GARY - Cardiovascular Engineering Inc; HAMBURG, NAOMI - Boston University

Submitted to: Journal of Gerontology Medical Science
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/8/2023
Publication Date: 7/15/2023
Citation: Sahni, S., Dufour, A., Wang, N., Kiel, D.P., Hannan, M., Jacques, P.F., Benjamin, E., Vasan, R.S., Murabito, J.M., Newman, A.B., Fielding, R.A., Mitchell, G.F., Hamburg, N. 2023. Association of vascular health measures and physical function: a prospective analysis in the Framingham Heart Study. Journal of Gerontology Medical Science. https://doi.org/10.1093/gerona/glad097.
DOI: https://doi.org/10.1093/gerona/glad097

Interpretive Summary: Changes in blood vessel function with aging may influence muscle strength and walking speed. We examined the relationships between blood vessel function and muscle strength and walking speed in the Framingham Heart Study. In over 2,400 participants we found significant associations between measures of blood vessel size and pressure and higher grip strength. In addition, higher blood vessel pressure was associated with a greater decline in walking speed over time. These results highlight that blood vessel function may influence muscle strength and walking speed with aging.

Technical Abstract: Background: Dysfunction in blood vessel dynamics may contribute to changes in muscle measures. Therefore, we examined associations of vascular health measures with grip strength and gait speed in adults from the Framingham Heart Study. Methods: The cross-sectional study (1998-2001) included participants with one measure of grip strength (kg, dynamometer) or gait speed (4-m walk, m/s) and at least one vascular function measure assessed by brachial artery ultrasound (resting flow velocity, resting brachial artery diameter, flow-mediated dilation %, hyperemic brachial blood flow velocity, and brachial flow pulsatility index) and tonometry (mean arterial pressure [MAP], carotid-femoral pulse wave velocity [CFPWV], and brachial pulse pressure). The longitudinal study included participants with =1 follow-up measurement of gait speed or grip strength. Multivariable linear regression estimated the association of 1 standard deviation (SD) higher level of each vascular measure with annualized percent change in grip strength and gait speed, adjusting for covariates. Results: In cross-sectional analyses (n=2,498, age 61>10 years; 56% women), higher resting brachial artery diameter (BASE per 1 SD: 0.59>0.24, P=0.01) and MAP (BASE: 0.39>0.17, P=0.02) were associated with higher grip strength. Higher brachial pulse pressure (BASE: -0.02>0.01, P=0.07) was marginally associated with slower gait speed. In longitudinal analyses (n=2,157), higher brachial pulse pressure (BASE: -0.19>0.07, P=0.005), was associated with slowing of gait speed but not with grip strength. Conclusions: Higher brachial artery pulse pressure (measure of aortic stiffness) was associated with loss of physical function over ~11 years, although we found no evidence that microvascular function contributed to the relation.