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Polo-López A, Calatayud J, Núñez-Cortés R, Andersen LL, Moya-Ramón M, López-Bueno R. Dose-Response Association Between Handgrip Strength and Hypertension: A Longitudinal Study of 76,503 European Older Adults. Curr Probl Cardiol 2023; 48:101813. [PMID: 37209803 DOI: 10.1016/j.cpcardiol.2023.101813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/13/2023] [Indexed: 05/22/2023]
Abstract
To examine the prospective dose-response association between handgrip strength and the incidence of hypertension in a representative sample of older European adults. We retrieved data from the Survey of Health, Ageing and Retirement in Europe (SHARE) waves 1, 2, 4, 5, 6, 7, and 8. Handgrip strength was measured and participants reported whether they had a medical diagnosis of hypertension. We assessed the longitudinal dose-response associations of handgrip strength with hypertension using restricted cubic splines. During the follow-up, 27,149 (35.5%) were diagnosed with incident hypertension. At the fully adjusted model, the minimum and optimal dose of handgrip strength for a significant reduction in the risk of hypertension was 28 Kg (HR: 0.92; 95% CI: 0.89-0.96) and 54 Kg (HR: 0.83; 95% CI: 0.78-0.89), respectively. There exists an association between increased handgrip strength and reduced risk of developing hypertension in older European adults.
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Affiliation(s)
- Ana Polo-López
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain
| | - Joaquín Calatayud
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - Rodrigo Núñez-Cortés
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Department of Physiotherapy, University of Valencia, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Valencia, Spain
| | | | - Manuel Moya-Ramón
- Sports Research Centre (Department of Sport Sciences), Miguel Hernández University of Elche, Alicante, Spain; Department of Sport Sciences, Miguel Hernandez University, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Rubén López-Bueno
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
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Sánchez-Delgado JC, Cohen DD, Camacho-López PA, Carreño-Robayo J, Castañeda-Hernández A, García-González D, Martínez-Bello D, Aroca-Martinez G, Parati G, Lopez-Jaramillo P. Handgrip Strength Is Associated with Specific Aspects of Vascular Function in Individuals with Metabolic Syndrome. Biomedicines 2023; 11:2435. [PMID: 37760876 PMCID: PMC10525985 DOI: 10.3390/biomedicines11092435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a disorder associated with an increased risk for the development of diabetes mellitus and its complications. Lower isometric handgrip strength (HGS) is associated with an increased risk of cardiometabolic diseases. However, the association between HGS and arterial stiffness parameters, which are considered the predictors of morbidity and mortality in individuals with MetS, is not well defined. OBJECTIVE To determine the association between HGS and HGS asymmetry on components of vascular function in adults with MetS. METHODS We measured handgrip strength normalized to bodyweight (HGS/kg), HGS asymmetry, body composition, blood glucose, lipid profile, blood pressure, pulse wave velocity (PWV), reflection coefficient (RC), augmentation index @75 bpm (AIx@75) and peripheral vascular resistance (PVR) in 55 adults with a diagnosis of MetS between 25 and 54 years old. RESULTS Mean age was 43.1 ± 7.0 years, 56.3% were females. HGS/kg was negatively correlated with AIx@75 (r = -0.440), p < 0.05, but these associations were not significant after adjusting for age and sex. However, when interaction effects between sex, HGS/kg and age were examined, we observed an inverse relationship between HGS/kg and AIx@75 in the older adults in the sample, whereas in the younger adults, a weak direct association was found. We also found a significant association between HGS asymmetry and PVR (beta = 30, 95% CI = 7.02; 54.2; p <0.012). CONCLUSIONS Our findings suggest that in people with MetS, maintaining muscle strength may have an increasingly important role in older age in the attenuation of age-related increases in AIx@75-a marker of vascular stiffness-and that a higher HGS asymmetry could be associated with a greater vascular resistance.
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Affiliation(s)
- Juan Carlos Sánchez-Delgado
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
- Grupo de Investigación Ser Cultura y Movimiento, Universidad Santo Tomás-Bucaramanga, Santander 680001, Colombia;
| | - Daniel D. Cohen
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, V94T9PX Limerick, Ireland
| | | | - Javier Carreño-Robayo
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
| | - Alvaro Castañeda-Hernández
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
| | - Daniel García-González
- Grupo de Investigación Ser Cultura y Movimiento, Universidad Santo Tomás-Bucaramanga, Santander 680001, Colombia;
| | - Daniel Martínez-Bello
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
| | - Gustavo Aroca-Martinez
- Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla 080002, Colombia;
| | - Gianfranco Parati
- Istituto Auxologico Italuano & University of Milano-Bicocca, Department of Medicine and Surgery, Piazza Brescia, 20149 Milan, Italy
| | - Patricio Lopez-Jaramillo
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Bucaramanga 680003, Colombia; (D.D.C.); (J.C.-R.); (A.C.-H.); (D.M.-B.)
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Ulgen C, Ozturk I, Sahin M, Guzel FB, Oguz A, Altunoren O, Gungor O. The amount of skeletal muscle mass is associated with arterial stiffness in hemodialysis patients. Ther Apher Dial 2023; 27:24-30. [PMID: 35426237 DOI: 10.1111/1744-9987.13853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/11/2022] [Accepted: 04/11/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Sarcopenia was determined to be associated with increased arterial stiffness in the nondialysis patient population, but there is no available data on this subject in dialysis patients. METHODS A total of 79 patients were included in the study. Sarcopenia was diagnosed according to the EWSGOP-2 criteria. Arterial stiffness was measured noninvasively with a mobile-O-Graph device. RESULTS Skeletal muscle mass was observed to be positively correlated with weight, body mass index, creatinine, and uric acid, while negatively correlated with augmentation index. There was a correlation between augmentation index and sodium, phosphorus, systolic blood pressure, diastolic blood pressure, cardiac index, muscle percentage, fat percentage, and skeletal muscle mass. When the determinants of augmentation index in the linear regression analysis were viewed, just the systolic blood pressure and skeletal muscle mass were observed to be the determinant. CONCLUSION Decreased skeletal muscle mass contributes to increased arterial stiffness in hemodialysis patients.
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Affiliation(s)
- Cansu Ulgen
- Internal Medicine Department, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey
| | - Ilyas Ozturk
- Nephrology Department, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey
| | - Murat Sahin
- Endocrinology and Metabolism Department, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey
| | - Fatma Betul Guzel
- Nephrology Department, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey
| | - Ayten Oguz
- Endocrinology and Metabolism Department, Biruni University Faculty of Medicine, Istanbul, Turkey
| | - Orcun Altunoren
- Nephrology Department, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey
| | - Ozkan Gungor
- Nephrology Department, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey
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Ou Young T, Wu LW, Hsiu H, Peng TC, Chen WL. Characteristics of sarcopenia subjects in arterial pulse spectrum analysis. Front Public Health 2022; 10:969424. [PMID: 36148365 PMCID: PMC9485458 DOI: 10.3389/fpubh.2022.969424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/15/2022] [Indexed: 01/25/2023] Open
Abstract
Aims Sarcopenia is significantly associated with the number of cardiovascular and metabolic diseases, however, the underlying pathophysiological processes are largely unknown. This study performed harmonic index of finger photoplethysmography (PPG) waveforms with the aims of distinguishing different arterial pulse waveform signals between sarcopenia, presarcopenia, dynapenia, and healthy subjects. Methods Sixty-eight subjects were enrolled and obtained 1-min PPG signals, then were assigned to four age-matched groups: control, dynapenia, presarcopenia, and sarcopenia which definition according to Asian Working Group for Sarcopenia (AWGS): 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. Harmonics 1-10 of the PPG waveform were obtained and calculated each of the amplitude proportions (C n ), standard deviations (SD n ), coefficients of variations (CV n ), and vascular elasticity index (VEI) for to evaluating the blood-pressure harmonic variability. Results The prevalence of sarcopenia in women gender (8 out of 9, 88.9%, p = 0.046) and osteoporosis in dynapenia (7 out of 16, 43.8%, p = 0.005) were significant higher. Among the four groups, compared with control, dynapenia, and presarcopenia, sarcopenia had largest SD n -values for harmonics 1, 2, 3, and 5 (ratio 1, 2, 3, 5 = 0.354, 0.209, 0.137, 0.074); whereas sarcopenia had largest coefficients of variations (CV n ) values for harmonics 1, 2, 3 and 10 (ratio 1, 2, 3, 10 = 0.263, 0.310, 0.402, 0.791). Besides, the Δ odds ratio of ratio 3, 4,and 6 tertile values were significantly increased in sarcopenia and possible sarcopenia group compared with control group. Subjects with sarcopenia had significantly higher VEI in mean, SD, and CV of the PPG waveform (mean = 2.332, SD = 1.479, CV = 0.634, p = 0.007) among the groups and the results of binary logistic regression analysis in the tertiles met statistical significance between the sarcopenia and non-sarcopenia groups whether adjusted or unadjusted (adjusted odds ratio 6.956, p = 0.030, unadjusted odds ratio 3.937, p = 0.039). Conclusions The elasticity of vessels among sarcopenia groups in lower-frequency components of harmonic ratio in which we defined as VEI showed a significantly highest VEI mean, SD, and CV in sarcopenia indicates the poorer elasticity of the arteries. The present findings showed finger PPG waveform measurements may be useful for early detection of vascular diseases with patients with sarcopenia in a non-invasive and easy-to-perform technique which may expand the clinical applicability in the future.
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Affiliation(s)
- Te Ou Young
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan,School of Medicine, National Defense Medical Center, Taipei, Taiwan,Health Management Center, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Li-Wei Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan,School of Medicine, National Defense Medical Center, Taipei, Taiwan,Health Management Center, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,*Correspondence: Li-Wei Wu
| | - Hsin Hsiu
- Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan,Hsin Hsiu
| | - Tao-Chun Peng
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan,School of Medicine, National Defense Medical Center, Taipei, Taiwan,Health Management Center, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan,School of Medicine, National Defense Medical Center, Taipei, Taiwan,Health Management Center, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Pulse Wave Velocity and Sarcopenia in Older Persons-A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116477. [PMID: 35682063 PMCID: PMC9180900 DOI: 10.3390/ijerph19116477] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/21/2022] [Accepted: 05/23/2022] [Indexed: 01/27/2023]
Abstract
Sarcopenia and cardiovascular disease share some of the pathophysiologic mechanisms. Sarcopenia is likewise an important feature of frailty and the one potentially related to cardiovascular pathology. Previously, the relationship between arterial stiffness and frailty has been established. In this study, we conducted a systematic review and a meta-analysis of studies where the relationship between pulse wave velocity (PWV) and sarcopenia has been addressed. We included six cross-sectional studies that enrolled 5476 participants. Using the WebPlotDigitizer, RevMan5, and SAS 9.4, we extracted or calculated the summary statistics. We then calculated standardized mean differences (SMD) of PWV in the sarcopenic and non-sarcopenic participants. The pooled SMD was 0.73 (95% CI 0.39−1.08, p < 0.0001, I2 = 90%) indicating higher value in the sarcopenic subjects. The three studies that presented odds ratios for sarcopenia as a function of PWV homogenously indicated a greater probability of concomitant sarcopenia with higher values of PWV. Greater stiffness of the aorta is associated with sarcopenia. It is impossible to establish the causation. However, the plausible explanation is that increased stiffness may translate into or be an intermediary phenotype of common vascular and muscle damage. On the other hand, sarcopenia, which shares some of the inflammatory mechanisms with cardiovascular disease, may wind up the age-related large arterial remodeling.
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Lower Lean Mass Is Associated with Greater Arterial Stiffness in Patients with Lower Extremity Artery Disease. J Pers Med 2021; 11:jpm11090911. [PMID: 34575687 PMCID: PMC8470700 DOI: 10.3390/jpm11090911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Arterial stiffness is independently associated with lower extremity artery disease (LEAD). Although obesity is already known as an independent cardiovascular risk factor, it was found that, paradoxically, in patients diagnosed with cardiovascular disease, an increase in body mass index (BMI) was associated with a decrease in mortality. However, the underlying mechanism of this paradoxical association remain uncertain. In this study, we firstly hypothesize that arterial stiffness correlates with body mass; secondly, the underlying mechanism of the association for patients with LEAD is individual body composition, in particular, lean mass. Methods: The present study was performed as a single-center, prospective, observational analysis. A total of 412 patients with current or previously diagnosed LEAD (Rutherford Classification 2–4) were included, the cfPWV and AIx were measured as indices of arterial stiffness, and a body composition assessment was performed. Results: In male patients, there was a significantly negative correlation between the AIx and lean mass coefficient (p = 0.004, 95% CI: −0.28 (−0.48–0.09)). Conclusion: For patients with peripheral arterial disease, our data show that lower lean mass in male patients is associated with increased arterial stiffness as measured by the AIx. Therefore, progressive resistance training may be beneficial for the reduction in arterial stiffness in PAD patients in secondary prevention.
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Piotrowicz K, Gryglewska B, Grodzicki T, Gąsowski J. Arterial stiffness and frailty - A systematic review and metaanalysis. Exp Gerontol 2021; 153:111480. [PMID: 34265411 DOI: 10.1016/j.exger.2021.111480] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 12/24/2022]
Abstract
Frailty and cardiovascular disease share some of the pathophysiologic features. Our objective was to review and metaanalyse the available published evidence on the topic. We performed a comprehensive literature search for studies where pulse wave velocity (PWV) or carotid-ankle vascular index (CAVI) has been linked with frailty in older persons. Of the initial 362 abstracts, after the application of the PRISMA approach, 5 were analysed in detail. We calculated within-study and pooled standardised mean differences of aortic stiffness measures between frail and non-frail (0.62 [0.31-0.92], p < 0.0001, I2 = 88%), and pre-frail and non-frail (0.32 [0.14-0.51], p = 0.0006, I2 = 72%) groups. In two studies it was possible to extract directly or calculate based on published data the odds ratios for the concomitant frailty, associated in one case with CAVI greater by 1 m/s and in another with cfPWV >13 m/s, indicating greater probability of concomitant frailty given greater aortic stiffness. Across the studies, the prevalence of hypertension, diabetes mellitus, hyperlipidaemia, and smoking tended to increase from non-frail, to pre-frail, and frail groups, presenting a possibility of important confounding, but also a common pathophysiology. In conclusion, the pooled analysis of the published cross-sectional study results indicates a relation between aortic stiffness and frailty in older subjects. However, well designed prospective studies are needed to answer the questions of causality.
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Affiliation(s)
- Karolina Piotrowicz
- Jagiellonian University Medical College, Department of Internal Medicine and Gerontology, Kraków, Poland
| | - Barbara Gryglewska
- Jagiellonian University Medical College, Department of Internal Medicine and Gerontology, Kraków, Poland
| | - Tomasz Grodzicki
- Jagiellonian University Medical College, Department of Internal Medicine and Gerontology, Kraków, Poland
| | - Jerzy Gąsowski
- Jagiellonian University Medical College, Department of Internal Medicine and Gerontology, Kraków, Poland.
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Sivaharan A, Boylan L, Witham MD, Nandhra S. Sarcopenia in Patients Undergoing Lower Limb Bypass Surgery is Associated with Higher Mortality and Major Amputation Rates. Ann Vasc Surg 2021; 75:227-236. [PMID: 33819585 DOI: 10.1016/j.avsg.2021.02.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 02/14/2021] [Accepted: 02/22/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Sarcopenia is adversely associated with survival in several diseases. Vasculopathy is often associated with multimorbidity and consequent deconditioning with poor long-term outcomes. This study examined the impact of sarcopenia on clinical outcome in patients with and without critical limb-threatening ischaemia who underwent infrainguinal bypass surgery. METHODS All patients undergoing infra-inguinal surgical revascularisation in 2016-2018 were retrospectively reviewed. Sarcopenia was defined as a skeletal muscle area at the L3 vertebral level (defined as L3 muscle area < 114cm2 for men or <89.8cm2 for women) on CT angiography. The primary outcome was overall survival by analysed by time to event analysis. Secondary outcomes included ipsilateral major lower-limb amputation, length of hospital stay, myocardial infarction and surgical-site infection. RESULTS A total of 116 patients with a mean age of 66.9 years were included, with a mean follow-up of 21 months. 14 (12%) of patients were sarcopenic; there were more patients with diabetes (40% vs 7%) in the sarcopenic group, p=0.018. Age, gender, Rutherford grade at presentation, other co-morbidities, other laboratory tests, conduit material and Rutherford grade at presentation were similar in those with and without sarcopenia and were statistically insignificant upon testing. Overall survival was worse for sarcopenic patients (Log Rank P=0.001) and Hazard Ratio for death 5.8; 95%CI 1.8-19.1; P=0.001. Major lower-limb amputation occurred more frequently in patients with sarcopenia (7/14 [50%] vs 23/102 [23%]; P=0.046). There was no difference in other secondary outcomes including rates of graft occlusion, myocardial infarction, surgical site infection and length of stay. Adding SMA measurement to a multivariate generalised linear model including age, sex, diabetes, and haemoglobin improved the AUROC from 0.75-0.85. CONCLUSION In this cohort of patients undergoing vascular surgery, sarcopenia defined using L3 muscle area was significantly associated with overall mortality and major lower-limb amputation.
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Affiliation(s)
- Ashwin Sivaharan
- Northern Vascular Centre, Freeman Hospital, Newcastle-upon-Tyne Hospitals, Newcastle, UK
| | - Luke Boylan
- Northern Vascular Centre, Freeman Hospital, Newcastle-upon-Tyne Hospitals, Newcastle, UK
| | - Miles D Witham
- AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, 3(rd) Floor Biomedical Research Building, Campus for Ageing and Vitality, Newcastle NE4 5PL
| | - Sandip Nandhra
- Northern Vascular Centre, Freeman Hospital, Newcastle-upon-Tyne Hospitals, Newcastle, UK; Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK.
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Tap L, Kirkham FA, Mattace-Raso F, Joly L, Rajkumar C, Benetos A. Unraveling the Links Underlying Arterial Stiffness, Bone Demineralization, and Muscle Loss. Hypertension 2020; 76:629-639. [DOI: 10.1161/hypertensionaha.120.15184] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The effects of elevated arterial stiffness on cardiovascular outcomes are widely studied, whereas the relation to noncardiovascular outcomes relevant to older persons, such as the effect on bones and muscles, is less well established. Arterial stiffness, bone demineralization, and muscle loss are all age-related processes with common risk factors, however, whether these are just parallel age-related alterations or whether these processes share common pathways is not yet understood. In this review, we outline previous literature using different assessments of arterial stiffness in various populations across the world to produce a comprehensive overview. Although there are many studies showing an association between arterial stiffness and loss of bone and muscle, the majority are cross-sectional and there is limited longitudinal evidence to justify causal conclusions. We also give an in-depth review of hypotheses and possible mechanisms which may underlie these associations including hormone dysregulation, impaired glucose metabolism, and inflammation. This narrative review highlights the associations between vessels, bones, and muscles with aging, offering insights into possible shared pathways.
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Affiliation(s)
- Lisanne Tap
- From the Department of Internal Medicine, Section of Geriatric Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands (L.T., F.M.-R.)
| | - Frances A. Kirkham
- Brighton and Sussex Medical School, University of Sussex, United Kingdom (F.A.K., C.R.)
| | - Francesco Mattace-Raso
- From the Department of Internal Medicine, Section of Geriatric Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands (L.T., F.M.-R.)
| | - Laure Joly
- Department of Geriatrics, FHU-CARTAGE, CHRU de Nancy, and INSERM DCAC, Université de Lorraine, France (L.J., A.B.)
| | - Chakravarthi Rajkumar
- Brighton and Sussex Medical School, University of Sussex, United Kingdom (F.A.K., C.R.)
| | - Athanase Benetos
- Department of Geriatrics, FHU-CARTAGE, CHRU de Nancy, and INSERM DCAC, Université de Lorraine, France (L.J., A.B.)
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Elliot CA, Hamlin MJ, Lizamore CA. Inter-operator Reliability for Measuring Pulse Wave Velocity and Augmentation Index. Front Cardiovasc Med 2020; 7:72. [PMID: 32411729 PMCID: PMC7198861 DOI: 10.3389/fcvm.2020.00072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 04/14/2020] [Indexed: 11/25/2022] Open
Abstract
Background: Arterial stiffness is a reversible precursor to hypertension. However, research is needed to determine the minimum amount of training required before acceptable arterial stiffness measurements are collected by novice operators. Objective: To compare novice vs. experienced operator measurements over a 2-week training period to assess when expert-like measures are achieved by the novice operator. Method: Forty-one participants (18 males, 23 females, age: 46.6 ± 14.9 years; BMI: 25.2 ± 3.8; systolic blood pressure: 122.8 ± 14.7 mmHg) received alternating novice and experienced operator arterial stiffness assessments. Measurements included: pulse wave velocity (PWV; using the automatic-capture time-periods of 5-, 10-, and 20-s) and augmentation index (AIx75) measurements using the SphygmoCor XCEL System v1 (AtCor Medical Pty Ltd., Sydney, Australia). Data were chronologically arranged into quintiles. Results: The intraclass correlation coefficient for PWV substantially improved from quintile 1 (r < 0.8) to quintile 2 and beyond (typically r > 0.8) while AIx75 improved consistently (r = 0.7 in quintile 1 and r = 0.97 in quintile 5). The coefficient of variation was lowest in quintile 4 (PWV: 4.7-6% across the three measurement time-periods; and 15% for AIx75) but increased in quintile 5 (PWV: 6.2-10.5%; and 25% for AIx75). All measurements demonstrated acceptable to excellent reliability after quintile 2. Conclusion: To achieve expert-like PWV measurements in this study, the novice operator underwent a familiarization session including guided practice measurements on 5 different people, for 10-15 min per person on two occasions (~2.5 h). The novice operator then required ≥14 practice measurements, with accuracy continuing to improve up to 30 participants. At least 30 training measurements are recommended for novices to take acceptable AIx75 measurements after a familiarization training.
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Affiliation(s)
- Catherine A. Elliot
- Department of Tourism, Sport and Society, Lincoln University, Christchurch, New Zealand
| | - Michael J. Hamlin
- Department of Tourism, Sport and Society, Lincoln University, Christchurch, New Zealand
| | - Catherine A. Lizamore
- Department of Tourism, Sport and Society, Lincoln University, Christchurch, New Zealand
- Department of Nursing, Midwifery and Allied Health, Ara Institute of Canterbury, Christchurch, New Zealand
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Dvoretskiy S, Lieblein-Boff JC, Jonnalagadda S, Atherton PJ, Phillips BE, Pereira SL. Exploring the Association between Vascular Dysfunction and Skeletal Muscle Mass, Strength and Function in Healthy Adults: A Systematic Review. Nutrients 2020; 12:E715. [PMID: 32156061 PMCID: PMC7146456 DOI: 10.3390/nu12030715] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/27/2020] [Accepted: 03/04/2020] [Indexed: 02/02/2023] Open
Abstract
Background: The prevalence of vascular dysfunction increases with advancing age, as does the loss of muscle mass, strength and function. This systematic review explores the association between vascular dysfunction and skeletal muscle health in healthy adults. Methods: EMBASE and MEDLINE were searched for cross-sectional and randomized controlled studies between January 2009 and April 2019, with 33 out of 1246 studies included based on predefined criteria. Assessments of muscular health included muscle mass, strength and function. Macrovascular function assessment included arterial stiffness (pulse wave velocity or augmentation index), carotid intima-media thickness, and flow-mediated dilation. Microvascular health assessment included capillary density or microvascular flow (contrast enhanced ultrasound). Results: All 33 studies demonstrated a significant association between vascular function and skeletal muscle health. Significant negative associations were reported between vascular dysfunction and -muscle strength (10 studies); -mass (9 studies); and -function (5 studies). Nine studies reported positive correlations between muscle mass and microvascular health. Conclusions: Multiple studies have revealed an association between vascular status and skeletal muscle health in healthy adults. This review points to the importance of screening for muscle health in adults with vascular dysfunction with a view to initiating early nutrition and exercise interventions to ameliorate functional decline over time.
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Affiliation(s)
- Svyatoslav Dvoretskiy
- Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, IL 61801, USA;
- Abbott Nutrition, Columbus, OH 43219, USA; (J.C.L.-B.); (S.J.)
| | | | | | - Philip J. Atherton
- MRC-ARUK Centre of Excellence for Musculoskeletal Ageing Research, School of Medicine, University of Nottingham, Derby DE22 3DT, UK; (P.J.A.); (B.E.P.)
| | - Bethan E. Phillips
- MRC-ARUK Centre of Excellence for Musculoskeletal Ageing Research, School of Medicine, University of Nottingham, Derby DE22 3DT, UK; (P.J.A.); (B.E.P.)
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12
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Zhang Y, He P, Li Y, Zhang Y, Li J, Liang M, Wang G, Tang G, Song Y, Wang B, Liu C, Liu L, Cui Y, Wang X, Huo Y, Xu X, Qin X. Positive association between baseline brachial-ankle pulse wave velocity and the risk of new-onset diabetes in hypertensive patients. Cardiovasc Diabetol 2019; 18:111. [PMID: 31462258 PMCID: PMC6714437 DOI: 10.1186/s12933-019-0915-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 08/19/2019] [Indexed: 12/14/2022] Open
Abstract
Background There is no clearly defined temporal relationship between arterial stiffness and diabetes. We aimed to investigate the prospective association between baseline brachial–ankle pulse wave velocity (baPWV) and the risk of new-onset diabetes during follow-up, and examined whether there were effect modifiers, in hypertensive patients. Methods We included 2429 hypertensive patients with all the pertinent data but without diabetes at the baseline, who were part of the China Stroke Primary Prevention Trial (CSPPT), a randomized, double-blind, actively controlled trial conducted in 32 communities in Anhui and Jiangsu provinces in China. The primary outcome was new-onset diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during follow-up, or fasting glucose (FG) ≥ 126.0 mg/dL at the exit visit. Results During a median follow-up duration of 4.5 years, 287 (11.8%) participants developed diabetes. There was a significant positive association between baseline baPWV and the risk of new-onset diabetes (per SD increment; OR, 1.33; 95% CI 1.13, 1.56). Consistently, when baPWV was assessed as quartiles, a significantly higher risk of new-onset diabetes was found in participants in quartiles 2–4 (≥ 15.9 m/s; OR, 1.80; 95% CI 1.22, 2.65) compared with those in quartile 1 (< 15.9 m/s). The positive association was consistent in participants with (per SD increment; OR, 1.29; 95% CI 1.06, 1.56) or without (per SD increment; OR, 1.40; 95% CI 1.15, 1.71) impaired fasting glucose (IFG, FG ≥ 100.8 and < 126.0 mg/dL, P-interaction = 0.486). Conclusions In this sample of hypertensive patients, we found a significant positive association between baseline baPWV and the risk of new-onset diabetes. Clinical trial registration Trial registration: NCT00794885 (clinicaltrials.gov). Retrospectively registered November 20, 2008
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Affiliation(s)
- Yuanyuan Zhang
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Panpan He
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Youbao Li
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Min Liang
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Guobao Wang
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Genfu Tang
- Health Management College, Anhui Medical University, Hefei, 230032, China
| | - Yun Song
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, China.,Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
| | - Binyan Wang
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
| | - Chengzhang Liu
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
| | - Lishun Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, China
| | - Yimin Cui
- Department of Pharmacy, Peking University First Hospital, Beijing, 100034, China
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, E4132, Baltimore, MD, 21205-2179, USA
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Xiping Xu
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China. .,Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, China.
| | - Xianhui Qin
- National Clinical Research Center for Kidney Disease; The State Key Laboratory for Organ Failure Research; Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
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Influence of Body Composition on Arterial Stiffness in Middle-Aged Adults: Healthy UAL Cross-Sectional Study. ACTA ACUST UNITED AC 2019; 55:medicina55070334. [PMID: 31277306 PMCID: PMC6681323 DOI: 10.3390/medicina55070334] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/28/2019] [Accepted: 07/01/2019] [Indexed: 12/31/2022]
Abstract
Background and objectives: Several anthropometric and body composition parameters have been linked to arterial stiffness (AS) as a biomarker of cardiovascular disease. However, little is known about which of these closely related factors is more strongly associated with AS. The aim of the present study was to analyze the relationship of different anthropometric and body composition parameters with AS in middle-aged adults. Materials and Methods: This cross-sectional study included 186 middle-aged participants (85 women, 101 men; age = 42.8 ± 12.6 years) evaluated as part of the Healthy UAL study, a population study conducted at the University of Almería with the main purpose of analyzing the etiology and risk factors associated with cardio-metabolic diseases. Anthropometric measures included neck, waist, and hip circumferences, as well as the waist-to-height ratio (WHtr). Bioimpedance-derived parameters included fat-free mass index (FFMI), fat mass index (FMI), and percent of body fat (%BF). AS was measured by pulse wave velocity (PWV). The relationships of interest were examined through stepwise regression analyses in which age and sex were also introduced as potential confounders. Results: Neck circumference (in the anthropometric model; R2: 0.889; β: age = 0.855, neck = 0.204) and FFMI (in the bio-impedance model; R2: 0.891; β: age = 0.906, FFMI = 0.199) emerged as significant cross-sectional predictors of AS. When all parameters were included together (both anthropometry and bio-impedance), both neck circumference and FFMI appeared again as being significantly associated with AS (R2: 0.894; β: age = 0.882, FFMI = 0.126, neck = 0.093). Conclusion: It was concluded that FFMI and neck circumference are correlated with AS regardless of potential confounders and other anthropometric and bioimpedance-derived parameters in middle-aged adults.
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Di Iorio A, Di Blasio A, Napolitano G, Ripari P, Paganelli R, Cipollone F. High fat mass, low muscle mass, and arterial stiffness in a population of free-living healthy subjects: The "al passo con la tua salute" project. Medicine (Baltimore) 2019; 98:e16172. [PMID: 31261548 PMCID: PMC6616375 DOI: 10.1097/md.0000000000016172] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION A progressive decline in lean body mass and increase in fat mass occur with aging, and result in progressive weakness and impaired mobility; these features are altogether landmarks of the ageing frailty syndrome. High-fat mass and low muscle mass are both associated with an increased risk of cardiovascular events and are supposed to be risk factors for arterial stiffness. Little data analyzing the relationship between body composition and cardio-ankle vascular index (CAVI) are currently available. The main objective of this study was to verify whether low muscle mass and/or high fat mass could be associated with arterial stiffness measured by CAVI. METHODS Data are from the cross-sectional assessment of the "Al passo con la tua salute", a clinical study aimed to promote physical function among free-living elderly subjects.After a screening interview and a clinical visit aimed to exclude ineligible persons, 52 volunteers were enrolled in the study. All underwent: clinical examination, physical performance assessment, an interview on lifestyle and dietary habits, and lastly, a blood sample collection after at least 8 hours of fasting. RESULTS CAVI was statistically significantly higher in those participants in the highest tertile of distribution for fat mass compared to all other subjects (P = .03). In those participants in the lowest tertile of distribution of muscle mass, compared to all other, CAVI was also statistically significant higher (P = .01) independently of age, sex, body mass index, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and systolic blood pressure. CONCLUSIONS Low muscle mass and high fat mass were landmarks in the frailty model of aging; therefore, it is not inconsistent that both clinical conditions might share with the "aging vessel" a common pathway, probably mediated through signaling network deregulation and/or through alteration of the balance between energy availability and energy demand.
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Affiliation(s)
- Angelo Di Iorio
- Department of Medicine and Science of Aging, Laboratory of Clinical Epidemiology and Aging, University Centre of Sports Medicine
| | - Andrea Di Blasio
- Department of Medicine and Sciences of Aging, Unit of Endocrinology
| | | | - Patrizio Ripari
- Department of Medical and Oral Sciences and Biotechnologies, Laboratory of Medicine and Sports Cardiology, University Centre of Sports Medicine
| | - Roberto Paganelli
- Department of Medicine and Science of Aging, Immunology and Allergy Unit
| | - Francesco Cipollone
- Internal Medicine and Geriatric Unit; Department of Medicine and Science of Aging; University "G. d'Annunzio" Chieti, Italy
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Lima-Junior DD, Farah BQ, Germano-Soares AH, Andrade-Lima A, Silva GO, Rodrigues SLC, Ritti-Dias R. Association between handgrip strength and vascular function in patients with hypertension. Clin Exp Hypertens 2018; 41:692-695. [DOI: 10.1080/10641963.2018.1539096] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Dalton de Lima-Junior
- Department of Physical Education, Federal University of Pernambuco, Recife, PE, Brazil
| | - Breno Quintella Farah
- Department of Physical Education, Rural Federal University of Pernambuco, Recife, PE, Brazil
| | | | - Aluísio Andrade-Lima
- Department of Physical Education, Federal University of Sergipe, Aracaju, SE, Brazil
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