Effect of BMI on Central Arterial Reflected Wave Augmentation Index, Toe-Brachial Index, Brachial-Ankle Pulse Wave Velocity and Ankle-Brachial Index in Chinese Elderly Hypertensive Patients with Hemorrhagic Stroke

Anthropometric Measurements in Predicting Haemorrhagic Stroke Among Bangladeshi Population: The MAGPIE Study

Background

Anthropometric measurements used to predict cardiovascular disease vary worldwide but are mostly derived from those of Caucasian ancestry. We sought to undertake such measurements in the little studied Bangladeshi population.

Methods

The MAGPIE (Multidimensional Approach of Genotype and Phenotype in Stroke Etiology) study is a Bangladeshi stroke case-control study that recruited nationwide between January 2022 and June 2024. The univariate analysis was utilised to curtail the risk of independent variables, and a receiver operating characteristic (ROC) curve was employed to identify the cut-off values of Body Mass Index (BMI), Waist Circumference (WC), and Hip Circumference (HC). Furthermore, a multivariate logistic regression (LR) model demonstrated the risk of independent predictors of haemorrhagic stroke (HS) among sexes.

Results

Of a total of 1491 age- and sex-matched study population, 918 were haemorrhagic stroke (61.5%) with female predominance (n=489; 53.3%) and significantly older than men (P=0.003). The BMI (22.9 ±3.0 vs 21.3 ±3.0; P<0.001), WC (84.0 ±7.3 vs 80.8 ±7.3; P<0.001) and HC (90.6 ±7.1 vs 85.5 ±7.7; P<0.001) was significantly higher among women compared to men. A ROC curve demonstrated that the cut-off values of BMI, WC, and HC are 20.6kg/m2, 78.8cm, and 84.6cm, respectively, in men and 21.1 kg/m2, 81.5cm, and 88.1cm, respectively, in women haemorrhagic stroke population. Furthermore, an age-adjusted multivariate LR model identified a HC of ≥84.6 cm in men (OR 2.8, 95% CI 1.61-4.97; P <0.001) and a WC of ≥81.5cm in women (OR 1.6, 95% CI 1.01-2.37; P=0.001) as potential independent predictors of haemorrhagic stroke.

Conclusion

Bangladeshi men with a hip circumference of ≥84.6cm have about threefold, and women with a waist circumference of ≥81.1cm have about twofold heightened risk of haemorrhagic stroke.

Pulse signal may be a key bridge connecting cardiology and pulse diagnosis of TCM

Objective

This study extracts atherosclerosis indices from six channels of C u n k o u and discusses the data distribution, aims to explore the connection between cardiology of modern medicine (MM) and traditional Chinese medicine (TCM) pulse diagnosis.

Methods

We use a device capable of simultaneously collecting the pulse signals of the Cun, G u a n and Chi to test the population participating in routine physical examinations. Firstly, we collected pressure pulse waves from six channels of C u n k o u of 1045 healthy subjects (578 men and 467 women, average age=37.99±16.02 years). Secondly, we extracted the two most common arteriosclerosis indices pulse transit time (PTT) and Augmentation index (AIx) from six-channel pulse waves. Lastly, T-test and correlation test were taken to analyze the differences and relevance of the atherosclerosis indices extracted from six channels of C u n k o u .

Results

When analyzing AIx and PTT at different wrist, it was found that AIx of left wrist is significantly higher than that of right wrist (P<0.001), while the PTT of left wrist is significantly lower than that of right wrist (P<0.001), a phenomenon that is common in both men and women. Furthermore, regardless of whether it is left or right wrist, the AIx at Chi channel is higher than that at Cun (P<0.05) and G u a n (P<0.05). At the same time, the PTT at G u a n is bigger than that at Cun in two wrists (P<0.05). However, when the specific channel is not considered, there is no significant difference in AIx and PTT between each channel and the corresponding wrist (P>0.05). In addition, regardless of gender, when the specific channel is not considered, AIx and PTT of each wrist are significantly correlated with age (P<0.001).

Conclusions

The differences of the atherosclerosis indices AIx and PTT in six channels support that the method of six-channel pulse diagnosis is indispensable in TCM. Additionally, the pulse waves obtained from each channel can be utilized as a dependable foundation for diagnosing atherosclerotic conditions. This study is beneficial for promoting the integration of TCM and MM in diagnosing disease.

Interaction between body mass index and blood pressure on the risk of vascular stiffness : A community-based cross-sectional study and implications for nursing

Objective

This study aimed to analyze associations between body mass index (BMI) and vascular measurements (brachial ankle pulse wave velocity [baPWV] and ankle-brachial index [ABI]), whether blood pressure (BP) was involved in the relationship, and implications for nursing.

Methods

A cross-sectional study was conducted, including 1,894 middle-aged and older adults who underwent routine health screening at a community medical center in the Zhangjiang community in Shanghai, China. Participants were divided into three groups based on BMI: normal weight (n = 1,202), overweight (n = 480), and obese (n = 212). Multivariate linear regression models and smooth curve fittings were used to evaluate the associations between BMI and indices of vascular stiffness. Mediation analysis examined whether blood pressure mediate the association between BMI and vascular stiffness.

Results

Multiple linear regression analysis showed that BMI to be significantly and negatively associated with baPWV (β = -0.06 [-0.10, -0.03]) and ABI (β = -0.004 [-0.005, -0.003]), respectively. The interaction test results of systolic blood pressure (SBP) in the relationship between BMI and baPWV were significant (P for interaction = 0.01). After adjusting for age and sex, mediation analyses showed that BMI and baPWV were correlated (β = 0.090, P < 0.001) and mediated by SBP (β = 0.533, P < 0.001) and diastolic blood pressure (DBP) (β = 0.338, P < 0.001). A negative association was found between BMI and ABI (β = -0.135, P < 0.001), which appeared to be partially mediated by SBP (β = 0.124, P < 0.001) and DBP (β = 0.053, P < 0.001). Additional subgroup analysis based on blood pressure levels did not revealed statistically significant mediating effects.

Conclusions

Our findings showed conflicting associations between BMI and non-invasive vascular measurements of arterial stiffness. BP may have a biological interaction in the relationship between BMI and baPWV. Managing blood pressure and weight through comprehensive clinical care is crucial for preventing stiffness or blockage of vessels in middle-aged and older adults.

Vascular Age, Metabolic Panel, Cardiovascular Risk and Inflammaging in Patients With Rheumatoid Arthritis Compared With Patients With Osteoarthritis

Introduction

The risk of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) is 1.5–2 times higher than the general population. The fundamental risk factor for CVD is age, related to alterations at the arterial level. The aim of the study was to compare vascular age (VA) in RA patients under a strict treat-to-target (T2T) strategy with Osteoarthritis (OA) patients without strict follow up and to assess the influence of inflammaging (chronic, sterile, low-grade inflammation related to aging) and metabolic markers on VA.

Materials and Methods

This was an analytical cross-sectional study. Patients with RA (under a strict a T2T strategy) and OA patients without strict clinical follow-up were included. Patients with a history of uncontrolled hypertension, CVD, and/or current smoking were excluded. Sociodemographic, physical activity, and toxic exposure data were obtained. Waist-hip ratio and body mass index (BMI) were measured. DAS-28 (RA) and inflammatory markers, lipid profile, and glycaemia were analyzed. Pulse wave velocity (PWV) was measured (oscillometric method, Arteriograph-TensioMed®). VA was calculated based on PWV. Eleven components of inflammaging [six interleukins, three metalloproteinases (MMP), and two tissue inhibitors of metalloproteinases (TIMP)] were evaluated (Luminex® system). Univariate and bivariate analyzes (Mann Whitney U and chi-square) and correlations (Spearmans Rho) were done to compare the two groups.

Results

A total of 106 patients (74% women) were included, 52/RA and 54/OA. The mean age was 57 (Interquartile range - IQR 9 years). The BMI, waist circumference, and weight were higher in patients with OA (p &lt; 0.001). RA patients had low disease activity (DAS-28-CRP). There were no differences in VA, inflammaging nor in PWV between the two groups. VA had a positive, but weak correlation, with age and LDL. In group of RA, VA was higher in those who did not receive methotrexate (p = 0.013). LDL levels correlated with MMP1, TIMP1, and TIMP2.

Conclusions

When comparing RA patients with low levels of disease activity with OA patients with poor metabolic control, there are no differences in VA. Furthermore, methotrexate also influences VA in RA patients. This shows that implemented therapies may have an impact on not only the inflammatory state of the joint but also CVD risk.