The Glycocalyx as harbinger of vascular RIsk in the general Population (GRIP)

Cardiovascular disease remains the major cause of mortality worldwide. The currently available interventions to interfere with risk factors, such a high blood pressure or elevated cholesterol, and to decrease the burden of cardiovascular disease, at best, achieve a 40% relative risk reduction. Another strategy to curb the epidemic of cardiovascular disease is to understand how blood vessels are protected against harmful stimuli and how these protective mechanisms might be enhanced by preventive and/or therapeutic measures. Over recent years, the focus of research shifted from large to small arteries and capillaries. The glycocalyx is a layer of proteins that lines and protects the inner surface of blood vessels and that can be reproducibly studied in capillaries, for instance under the tongue. Measurement of the glycocalyx is already performed in intensive care units to monitor patients with systemic infections, in whom the circulating bacteria damage and reduce the glycocalyx, thereby damaging the protective barrier between the circulating blood and the vessel wall. In small studies of volunteers, the glycocalyx decreased with ageing and was diminished in diabetic patients. However, nothing is known about the properties of the glycocalyx, as measured in an unbiased sample of the population. In this project, called GRIP (Glycocalyx as harbinger of vascular RIsk in the general Population), we will quantify the glycocalyx in 800 participants randomly recruited from a Flemish population. The goals of GRIP are three pronged: (1) to differentiate ageing of the glycocalyx in healthy people from ageing in people with risk factors or cardiovascular disease; (2) to determine which factors related to the host (e.g., sex, obesity, metabolic factors,…) and environment (e.g., lifestyle factors, fine particulate,…) affect the glycocalyx; (3) to search for association between changes in the glycocalyx in the small capillaries and signs of vascular disease in the larger arteries. The GRIP results will pave the way towards better informed strategies to prevent and treat vascular disease, hopefully making up for at least part of the therapeutic deficit inherent to the current management of cardiovascular risk factors. This project will therefore increase GRIP on cardiovascular risk.