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Petre I, Iurciuc S, Buleu F, Petre I, Moleriu RD, Popa D, Turi V, Bordianu A, Tasdemir R, Craciun LM, Marc L, Barna FM, Iurciuc M. The Impact of Medical Physical Training and a Structured Personalized Exercise Training Program on Hemodynamic Parameters and Arterial Stiffness in Pregnant Women. Biomedicines 2024; 12:986. [PMID: 38790947 PMCID: PMC11118944 DOI: 10.3390/biomedicines12050986] [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: 04/08/2024] [Revised: 04/23/2024] [Accepted: 04/29/2024] [Indexed: 05/26/2024] Open
Abstract
INTRODUCTION In developed countries, heart disease is the primary cause of maternal mortality during pregnancy. Arterial stiffness, an independent risk factor for atherosclerosis and a predictor of cardiovascular complications, can be assessed using the augmentation index (AIx) and pulse wave velocity (PWV). In this prospective study, we aimed to evaluate diverse hemodynamic parameters and arterial stiffness in pregnant women before and after participating in a structured, personalized exercise training program. MATERIALS AND METHODS Forty healthy pregnant women, non-smokers, who agreed to participate daily for 12 weeks in a physical exercise training program under the supervision of a team made up of an obstetrician, a cardiologist, and a physiotherapist were included. Anthropometric characteristics, arterial function, and physical activity data were collected from the participants at two different time points: at the beginning of the exercise training program (T0) and at the end, after 12 weeks (T1). RESULTS Upon conducting a statistical analysis, it was discovered that there were noteworthy disparities (p = 0.05) in body mass index, brachial AIx, systolic blood pressure, and pulse pressure values between the two time points. The regression analysis for the AIx brachial values and the PWVao values from Trim II (T0) and Trim III (T1) showed major differences between these two time points; the association between the AIx brachial values in the second and third trimesters of pregnancy revealed a strong direct significant correlation (p < 0.001), and the correlation between the PWVao values in the second (T0) and third trimester (T1) of pregnancy was weak and insignificant (p = 0.12). CONCLUSIONS The findings of our study indicate that a personalized exercise training program positively impacts the physical and psychological well-being of pregnant women, leading to a reduction in PWV.
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Affiliation(s)
- Izabella Petre
- Department XII of Obstetrics and Gynaecology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- County Emergency Clinical Hospital “Pius Brinzeu”, 300732 Timisoara, Romania; (F.B.); (R.T.)
| | - Stela Iurciuc
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.M.C.); (M.I.)
| | - Florina Buleu
- County Emergency Clinical Hospital “Pius Brinzeu”, 300732 Timisoara, Romania; (F.B.); (R.T.)
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.M.C.); (M.I.)
| | - Ion Petre
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.P.); (D.P.)
- Department of Functional Sciences, Medical Informatics and Biostatistics Discipline, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Radu Dumitru Moleriu
- Department of Functional Sciences, Medical Informatics and Biostatistics Discipline, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Daian Popa
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.P.); (D.P.)
- Department of Surgery, Emergency Discipline, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Vladiana Turi
- Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Anca Bordianu
- Department of Plastic Surgery and Reconstructive Microsurgery Bagdasar-Arseni, Emergency Hospital Bucharest, University of Medicine and Pharmacy “Carol Davila”, 010825 Bucharest, Romania;
| | - Rabia Tasdemir
- County Emergency Clinical Hospital “Pius Brinzeu”, 300732 Timisoara, Romania; (F.B.); (R.T.)
| | - Laura Maria Craciun
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.M.C.); (M.I.)
| | - Luciana Marc
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Department of Internal Medicine II, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Flavia Mirela Barna
- Department of Finance, Faculty of Economics and Business Administration, West University of Timisoara, 300115 Timisoara, Romania;
| | - Mircea Iurciuc
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.M.C.); (M.I.)
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Leed A, Sheridan E, Baker B, Bamford S, Emmanouilidis E, Stewart F, Ostafe K, Sarwari M, Lim K, Zheng M, Islam SMS, Bolton KA, Grimes CA. Dietary Intake and Arterial Stiffness in Children and Adolescents: A Systematic Review. Nutrients 2023; 15:2092. [PMID: 37432233 DOI: 10.3390/nu15092092] [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: 03/06/2023] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 07/12/2023] Open
Abstract
Arterial stiffness is a risk factor for cardiovascular disease that is affected by diet. However, research understanding how these dietary risk factors are related to arterial stiffness during childhood is limited. The purpose of this review was to determine whether various dietary factors were associated with arterial stiffness in the pediatric population. Five databases were systematically searched. Intervention studies, cross-sectional and cohort studies were included that investigated nutrient or food intake and outcomes of arterial stiffness, primarily measured by pulse wave velocity (PWV) and augmentation index (AIx), in the pediatric population (aged 0-18 years). A final 19 studies (six intervention and 13 observational) were included. Only two intervention studies, including a vitamin D and omega-3 supplementation trial, found protective effects on PWV and AIx in adolescents. Findings from observational studies were overall inconsistent and varied. There was limited evidence to indicate a protective effect of a healthy dietary pattern on arterial stiffness and an adverse effect of total fat intake, sodium intake and fast-food consumption. Overall, results indicated that some dietary factors may be associated with arterial stiffness in pediatric populations; however, inconsistencies were observed across all study designs. Further longitudinal and intervention studies are warranted to confirm the potential associations found in this review.
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Affiliation(s)
- Allanah Leed
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Emma Sheridan
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Brooke Baker
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Sara Bamford
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Elana Emmanouilidis
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Fletcher Stewart
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Kristen Ostafe
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Mustafa Sarwari
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Karen Lim
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Kristy A Bolton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Carley A Grimes
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
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Kim H, Lichtenstein AH, Ganz P, Du S, Tang O, Yu B, Chatterjee N, Appel LJ, Coresh J, Rebholz CM. Identification of Protein Biomarkers of the Dietary Approaches to Stop Hypertension Diet in Randomized Feeding Studies and Validation in an Observational Study. J Am Heart Assoc 2023; 12:e028821. [PMID: 36974735 PMCID: PMC10122905 DOI: 10.1161/jaha.122.028821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/15/2023] [Indexed: 03/29/2023]
Abstract
Background The Dietary Approaches to Stop Hypertension (DASH) diet is recommended for cardiovascular disease prevention. We aimed to identify protein biomarkers of the DASH diet using data from 2 randomized feeding studies and validate them in an observational study, the ARIC (Atherosclerosis Risk in Communities) study. Methods and Results Large-scale proteomic profiling was conducted in serum specimens (SomaLogic) collected at the end of 8-week and 4-week DASH diet interventions in multicenter, randomized controlled feeding studies of the DASH trial (N=215) and the DASH-Sodium trial (N=396), respectively. Multivariable linear regression models were used to compare the relative abundance of 7241 proteins between the DASH and control diet interventions. Estimates from the 2 trials were meta-analyzed using fixed-effects models. We validated significant proteins in the ARIC study (N=10 490) using the DASH diet score. At a false discovery rate <0.05, there were 71 proteins that were different between the DASH diet and control diet in the DASH and DASH-Sodium trials. Nineteen proteins were validated in the ARIC study. The 19 proteins collectively improved the prediction of the DASH diet intervention in the feeding studies (range of difference in C statistics, 0.267-0.313; P<0.001 for both tests) and the DASH diet score in the ARIC study (difference in C statistics, 0.017; P<0.001) beyond participant characteristics. Conclusions We identified 19 proteins robustly associated with the DASH diet in 3 studies, which may serve as biomarkers of the DASH diet. These results suggest potential pathways that are impacted by consumption of the DASH diet. Registration URL: https://www.clinicaltrials.gov; Unique identifiers: NCT03403166, NCT00000608.
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Affiliation(s)
- Hyunju Kim
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMD
- Welch Center for Prevention, Epidemiology, and Clinical ResearchJohns Hopkins UniversityBaltimoreMD
| | | | - Peter Ganz
- Cardiovascular Division, Zuckerberg San Francisco General HospitalUniversity of California, San FranciscoSan FranciscoCA
| | - Shutong Du
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMD
- Welch Center for Prevention, Epidemiology, and Clinical ResearchJohns Hopkins UniversityBaltimoreMD
| | - Olive Tang
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMD
- Welch Center for Prevention, Epidemiology, and Clinical ResearchJohns Hopkins UniversityBaltimoreMD
| | - Bing Yu
- Department of Epidemiology, Human Genetics & Environmental SciencesUniversity of Texas Health Sciences Center at Houston School of Public HealthHoustonTX
| | - Nilanjan Chatterjee
- Department of BiostatisticsJohns Hopkins Bloomberg School of Public HealthBaltimoreMD
| | - Lawrence J. Appel
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMD
- Welch Center for Prevention, Epidemiology, and Clinical ResearchJohns Hopkins UniversityBaltimoreMD
- Division of Nephrology, Department of MedicineJohns Hopkins School of MedicineBaltimoreMD
| | - Josef Coresh
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMD
- Welch Center for Prevention, Epidemiology, and Clinical ResearchJohns Hopkins UniversityBaltimoreMD
- Division of Nephrology, Department of MedicineJohns Hopkins School of MedicineBaltimoreMD
| | - Casey M. Rebholz
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMD
- Welch Center for Prevention, Epidemiology, and Clinical ResearchJohns Hopkins UniversityBaltimoreMD
- Division of Nephrology, Department of MedicineJohns Hopkins School of MedicineBaltimoreMD
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Abstract
Arterial stiffness is a strong predictor of cardiovascular events and all-cause mortality in middle-aged and old adults. Arterial stiffness has been limited to being an intermediate marker of atherosclerotic cardiovascular events in adolescents and young adult studies. The paucity of normative longitudinal data and repeated gold-standard assessments of arterial stiffness among the young population has occasioned a huge knowledge gap in its clinical utility. This review summarizes recent longitudinal evidence in a large adolescent population, supporting the value of arterial stiffness as a novel risk factor for hypertension, overweight/obesity and insulin resistance. Preventing or decreasing arterial stiffness during adolescence may confer cardiometabolic health benefits in later life, but further pathological and mechanistic research is needed. The review also offers suggestions for incorporating arterial stiffness measures into routine paediatric and young adult clinical practice.
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Basdeki ED, Koumi K, Tsirimiagkou C, Argyris A, Chrysostomou S, Sfikakis PP, Protogerou AD, Karatzi K. Late-Night Overeating or Low-Quality Food Choices Late at Night Are Associated with Subclinical Vascular Damage in Patients at Increased Cardiovascular Risk. Nutrients 2022; 14:nu14030470. [PMID: 35276835 PMCID: PMC8840219 DOI: 10.3390/nu14030470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 02/06/2023] Open
Abstract
Late-night overeating (LNO) is associated with several cardiovascular disease (CVD) risk factors. Limited data exist regarding the association between late-night (LN) systematic food consumption, LNO, and LN poor food quality with subclinical vascular damage (SVD) which precedes the onset of CVD. This study aimed to investigate the above associations with SVD in a large sample of adults, free of established CVD, with one or more CVD risk factors. In total, 901 adults (45.2% males) underwent anthropometric, dietary (through two 24 h dietary recalls) and vascular assessment. LN systematic eating was defined as consumption of food after 19:00 h in both dietary recalls and LNO was defined as systematic consumption of >40% of daily total energy intake (dTEI) after 19:00 h. Systematic LN food consumption was inversely associated with diastolic blood pressure (DBP) (−1.44 95% C.I. (−2.76, −0.12)) after adjusting for age, sex, hypertension, diabetes, dyslipidemia, smoking, BMI and dTEI. LNO was positively associated with existence of carotid plaques (1.70 95% C.I. (1.07, 2.68)), while LN increased consumption of red meat, refined grains and wine and low consumption of whole wheat grains was positively associated with Aix (Augmentation Index) (0.84 95% C.I. (0.09, 1.59)), after adjusting for all the mentioned confounders. Systematic LN eating is associated with lower DBP while systematic LNO and consumption of poor-quality food late at night, is associated with SVD. Further research is needed to define more accurately the impact of LN eating habits on vascular health.
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Affiliation(s)
- Eirini D. Basdeki
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, 15772 Athens, Greece; (E.D.B.); (C.T.); (A.A.); (A.D.P.)
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, 17671 Kallithea, Greece
| | - Konstantina Koumi
- Department of Life Sciences, School of Sciences, European University of Cyprus, Nicosia 2404, Cyprus; (K.K.); (S.C.)
| | - Christiana Tsirimiagkou
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, 15772 Athens, Greece; (E.D.B.); (C.T.); (A.A.); (A.D.P.)
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, 17671 Kallithea, Greece
| | - Antonios Argyris
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, 15772 Athens, Greece; (E.D.B.); (C.T.); (A.A.); (A.D.P.)
| | - Stavri Chrysostomou
- Department of Life Sciences, School of Sciences, European University of Cyprus, Nicosia 2404, Cyprus; (K.K.); (S.C.)
| | - Petros P. Sfikakis
- 1st Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece;
| | - Athanase D. Protogerou
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, 15772 Athens, Greece; (E.D.B.); (C.T.); (A.A.); (A.D.P.)
| | - Kalliopi Karatzi
- Laboratory of Dietetics and Quality of Life, Department of Food Science & Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece
- Correspondence:
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Mason J, Tenenbaum G, Jaime S, Roque N, Maharaj A, Figueroa A. Arterial Stiffness and Cardiorespiratory Fitness Are Associated With Cognitive Function in Older Adults. Behav Med 2022; 48:54-65. [PMID: 33108259 PMCID: PMC8425270 DOI: 10.1080/08964289.2020.1825921] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Age-related cognitive impairment has been associated with arterial stiffening and decreased cardiorespiratory fitness. The aims of this cross-sectional study were to compare cognitive function domains and cardiovascular parameters in older adults (≥ 65 years old) with high and normal aortic stiffness (via carotid-femoral pulse wave velocity, cfPWV) and to explore relationships among cfPWV, carotid intima-media thickness, cardiorespiratory fitness, and cognitive function. Vascular and cognitive function were measured in older adults with either normal or high cfPWV. Cognitive function was measured via an intensive one-time neuropsychological battery, while cfPWV by applanation tonometry, carotid intima-media thickness and function (i.e., distensibility) by ultrasonography, and cardiorespiratory fitness (i.e., VO2peak) by a submaximal exercise test. Correlations among age, VO2peak, carotid intima-media thickness, cfPWV, and cognitive function were performed along with a series of multivariate analyses of variance. Compared with NAS, participants with HAS had greater aortic, carotid, and brachial blood pressures but similar cardiorespiratory fitness and carotid intima-media thickness and distensibility. Participants with NAS exhibited better neuropsychological performance in executive function and attention and overall cognitive function than those with HAS. When controlling for age, visual scanning and perception scores were correlated with cfPWV and VO2peak. Our findings suggest that certain cognitive domains for older adults are associated with their cardiorespiratory fitness and aortic stiffness.
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Affiliation(s)
- Justin Mason
- Department of Occupational Therapy, University of Florida, Gainesville, FL
| | - Gershon Tenenbaum
- Department of Social Psychology, Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC), Herzliya, Israel
| | - Salvador Jaime
- Department of Exercise and Sport Science, University of Wisconsin – La Crosse, WI
| | - Nelson Roque
- Center for Healthy Aging, Pennsylvania State University, University Park, PA
| | - Arun Maharaj
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX
| | - Arturo Figueroa
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX
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Chiang PH, Wong M, Dey S. Using Wearables and Machine Learning to Enable Personalized Lifestyle Recommendations to Improve Blood Pressure. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2021; 9:2700513. [PMID: 34765324 PMCID: PMC8577573 DOI: 10.1109/jtehm.2021.3098173] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/16/2021] [Accepted: 07/06/2021] [Indexed: 12/20/2022]
Abstract
Background: Blood pressure (BP) is an essential indicator for human health and is known to be greatly influenced by lifestyle factors, like activity and sleep factors. However, the degree of impact of each lifestyle factor on BP is unknown and may vary between individuals. Our goal is to investigate the relationships between BP and lifestyle factors and provide personalized and precise recommendations to improve BP, as opposed to the current practice of general lifestyle recommendations. Method: Our proposed system consists of automated data collection using home BP monitors and wearable activity trackers and feature engineering techniques to address time-series data and enhance interpretability. We propose Random Forest with Shapley-Value-based Feature Selection to offer personalized BP modeling and top lifestyle factor identification, and subsequent generation of precise recommendations based on the top factors. Result: In collaboration with UC San Diego Health and Altman Clinical and Translational Research Institute, we performed a clinical study, applying our system to 25 patients with elevated BP or stage I hypertension for three consecutive months. Our study results validate our system's ability to provide accurate personalized BP models and identify the top features which can vary greatly between individuals. We also validate the effectiveness of personalized recommendations in a randomized controlled experiment. After receiving recommendations, the subjects in the experimental group decreased their BPs by 3.8 and 2.3 for systolic and diastolic BP, compared to the decrease of 0.3 and 0.9 for the subjects without recommendations. Conclusion: The study demonstrates the potential of using wearables and machine learning to develop personalized models and precise lifestyle recommendations to improve BP.
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Affiliation(s)
- Po-Han Chiang
- Mobile Systems Design LaboratoryDepartment of Electrical and Computer EngineeringUniversity of California at San DiegoLa JollaCA92092USA
| | - Melissa Wong
- Department of MedicineUniversity of California at San DiegoLa JollaCA92092USA
- Primary Care UnitUC San Diego HealthSan DiegoCA92103USA
| | - Sujit Dey
- Mobile Systems Design LaboratoryDepartment of Electrical and Computer EngineeringUniversity of California at San DiegoLa JollaCA92092USA
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Wang Y, Müller J, Myers J. Association between cardiorespiratory fitness and health care costs in hypertensive men. Atherosclerosis 2021; 331:1-5. [PMID: 34252836 DOI: 10.1016/j.atherosclerosis.2021.06.914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/30/2021] [Accepted: 06/24/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS Hypertension increases healthcare costs, but the impact of cardiorespiratory fitness (CRF) on these costs is unknown. This study explored the association between healthcare costs and CRF among hypertensive and normotensive men. METHODS We studied 9794 male subjects aged 58.5 ± 11.3 years from the Palo Alto Veterans Affairs Medical Center, including 6413 with and 3381 without hypertension. CRF was classified into four age-stratified categories according to metabolic equivalents (METs) derived from exercise testing: low fit (4.6 ± 1.2 METs; n = 2481), moderate fit (6.6 ± 1.2 METs; n = 2412), fit (8.0 ± 1.3 METs; n = 2505), and high fit (10.8 ± 2.1 METs; n = 2396). Annual costs per subject were quantified over eight years. RESULTS Total annual healthcare costs were higher in subjects with hypertension ($34,794, 95% CI, 32,828 to 36,761) in comparison to non-hypertensive subjects ($30,221, 95% CI, 26,104 to 32,450) (p < 0.01). In hypertensive subjects, a graded reduction in annual healthcare costs was observed as CRF was higher; costs were $40,346 for low fit, $35,939 for moderate fit, $32,312 for fit, and $29,277 for high fit subjects (p < 0.001). For each 1-MET increase in CRF, annual costs per subject (USD) were $1752 (95% CI, -2476 to -1,027, p < 0.001) lower among those with hypertension and $1025 (95% CI, -2047 to -2, p < 0.05) lower in those without hypertension. CONCLUSIONS Higher CRF is associated with lower healthcare costs in men with and without hypertension. The impact of CRF on healthcare costs is more striking in those with hypertension.
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Affiliation(s)
- Yi Wang
- Institute of Preventive Pediatrics, Technische Universtaet Muenchen, Germany; Division of Cardiology, Veterans Affairs Palo Alto Health Care System, CA, USA; Stanford University School of Medicine, Stanford, CA, USA.
| | - Jan Müller
- Institute of Preventive Pediatrics, Technische Universtaet Muenchen, Germany
| | - Jonathan Myers
- Division of Cardiology, Veterans Affairs Palo Alto Health Care System, CA, USA; Stanford University School of Medicine, Stanford, CA, USA
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Tuktarov AM, Kazanceva TS, Filippov AE, Obrezan AG. The Relationship of Modifiable Risk Factors with Indicators of Arterial Stiffness and Vascular Age in Patients with Arterial Hypertension. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2021. [DOI: 10.20996/1819-6446-2021-02-12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim. To study the relationship of modifiable risk factors (RF) with indicators of arterial stiffness and vascular age based on the contour analysis of the pulse wave velocity in hypertensive patients.Material and methods. The material of the study was the data from a survey of patients undergoing clinical observation at the polyclinic of MMC SOGAZ. A total of 107 patients were examined, in which 70 were men and 37 were women. The average age was 52.3±18.29. Photoplethysmography was used as a special research method, performed using the AngioScan-01 diagnostic complex. The main indicators used to evaluate the stiffness of large vessels were: stiffness index (SI), reflection index (RI), augmentation index (Alp75), age index (AGI), pulse wave types (PV) and vascular age (VA).Results. The mean values of arterial stiffness indices in patients with essential arterial hypertension (AH) and healthy individuals (control) had significant differences. The mean SI, Alp75, and VA values in the group of patients with AH were 7.8±1.03, 7.0±14.44 and 50.8±15.93 versus 7.2±1.73, 0.5±18.02 and 43.8±16.94, respectively (p< 0.05). In both groups, a strong inverse correlation of passport age with C-type PV was revealed (r=0.74, p< 0.01), which reflected the dynamics of a gradual age-dependent decrease in vascular compliance. The average VA value in the control group was 63.1±16.99 years with an average passport age of 59.5±8.79 years, which significantly differed from VA in hypertensive patients (p< 0,05). Overweight, hypercholesterolemia, elevated low-density lipoprotein levels, lack of adequate antihypertensive control, and left ventricular diastolic dysfunction were significantly associated with early vascular (arterial) aging.Conclusion. Patients with hypertension, in addition to high blood pressure, significantly differ from normotensive control in terms of arterial stiffness. The lack of control over modifiable RF of patients with hypertension is associated with early vascular aging.
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Affiliation(s)
- A. M. Tuktarov
- St. Petersburg State University;
LLC “International Medical Center “SOGAZ”
| | | | - A. E. Filippov
- St. Petersburg State University;
LLC “International Medical Center “SOGAZ”
| | - A. G. Obrezan
- St. Petersburg State University;
LLC “International Medical Center “SOGAZ”
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10
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Pruijssen JT, de Korte CL, Voss I, Hansen HHG. Vascular Shear Wave Elastography in Atherosclerotic Arteries: A Systematic Review. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:2145-2163. [PMID: 32620385 DOI: 10.1016/j.ultrasmedbio.2020.05.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/15/2020] [Accepted: 05/15/2020] [Indexed: 06/11/2023]
Abstract
Ischemic stroke is a leading cause of death and disability worldwide, so adequate prevention strategies are crucial. However, current stroke risk stratification is based on epidemiologic studies and is still suboptimal for individual patients. The aim of this systematic review was to provide a literature overview on the feasibility and diagnostic value of vascular shear wave elastography (SWE) using ultrasound (US) in (mimicked) human and non-human arteries affected by different stages of atherosclerotic diseases or diseases related to atherosclerosis. An online search was conducted on Pubmed, Embase, Web of Science and IEEE databases to identify studies using US SWE for the assessment of vascular elasticity. A quality assessment was performed using Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) checklist, and relevant data were extracted. A total of 19 studies were included: 10 with human patients and 9 with non-human subjects (i.e., [excised] animal arteries and polyvinyl alcohol phantoms). All studies revealed the feasibility of using US SWE to assess individually stiffness of the arterial wall and plaques. Quantitative elasticity values were highly variable between studies. However, within studies, SWE could detect statistically significant elasticity differences in patient/subject characteristics and could distinguish different plaque types with good reproducibility. US SWE, with its unique ability to assess the elasticity of the vessel wall and plaque throughout the cardiac cycle, might be a good candidate to improve stroke risk stratification. However, more clinical studies have to be performed to assess this technique's exact clinical value.
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Affiliation(s)
- Judith T Pruijssen
- Medical Ultrasound Imaging Centre (MUSIC), Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Chris L de Korte
- Medical Ultrasound Imaging Centre (MUSIC), Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; Physics of Fluid Group, MESA+ Institute for Nanotechnology, and MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Iona Voss
- Medical Ultrasound Imaging Centre (MUSIC), Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hendrik H G Hansen
- Medical Ultrasound Imaging Centre (MUSIC), Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
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11
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Zekavat SM, Aragam K, Emdin C, Khera AV, Klarin D, Zhao H, Natarajan P. Genetic Association of Finger Photoplethysmography-Derived Arterial Stiffness Index With Blood Pressure and Coronary Artery Disease. Arterioscler Thromb Vasc Biol 2020; 39:1253-1261. [PMID: 31070453 DOI: 10.1161/atvbaha.119.312626] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective- Arterial stiffness index (ASI) is independently associated with blood pressure (BP) and coronary artery disease (CAD) epidemiologically. However, it is unknown whether these associations represent causal relationships. Here, we assess whether genetic predisposition to increased ASI is associated with elevated BP and CAD risk. Approach and Results- We first performed a large-scale epidemiological association of finger photoplethysmography-derived ASI in the UK Biobank, finding significant associations with systolic BP (β=0.55 mm Hg; [95% CI, 0.45-0.65]; P=5.77×10-24; N=137 858), diastolic BP (β=1.05 mm Hg; [95% CI, 0.99-1.11]; P=7.27×10-272; N=137 862), and incident CAD (hazard ratio, 1.08; [95% CI, 1.04-1.11]; P=1.5×10-6; N=3692 cases, 126 615 controls) in multivariable models. We then performed an ASI genome-wide association study analysis in 131 686 participants from the UK Biobank. Across participants not in the ASI genome-wide association study, a 6-variant ASI polygenic risk score was calculated. Each SD increase in genetic ASI was associated with systolic BP (β=4.63 mm Hg; [95% CI, 2.1-7.2]; P=3.37×10-4; N=208 897), and diastolic BP (β=2.61 mm Hg; [95% CI, 1.2-4.0]; P=2.85×10-4; N=208 897); however, no association was observed with incident CAD (hazard ratio, 1.12; [95% CI, 0.55-2.3]; P=0.75; N=223 061; 7534 cases). The lack of CAD association observed was replicated among 184 305 participants (60 810 cases) from the CARDIOGRAMplusC4D (Coronary Artery Disease Genetics Consortium; odds ratio, 0.56; [95% CI, 0.26-1.24]; P=0.15). Conclusions- Our data support the conclusion that finger photoplethysmography-derived ASI is an independent, genetically causal risk factor for BP, but do not support the notion that ASI is a suitable surrogate for CAD risk.
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Affiliation(s)
- Seyedeh M Zekavat
- From the Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA (S.M.Z., K.A., C.E., A.V.K., D.K., P.N.).,Yale School of Medicine, New Haven, CT (S.M.Z.).,Computational Biology and Bioinformatics Program, Yale University, New Haven, CT (S.M.Z., H.Z.).,Center for Genomic Medicine (S.M.Z., K.A., A.V.K., D.K., P.N.), Massachusetts General Hospital, Boston.,Cardiovascular Research Center (S.M.Z., K.A., P.N.), Massachusetts General Hospital, Boston
| | - Krishna Aragam
- From the Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA (S.M.Z., K.A., C.E., A.V.K., D.K., P.N.).,Center for Genomic Medicine (S.M.Z., K.A., A.V.K., D.K., P.N.), Massachusetts General Hospital, Boston.,Cardiovascular Research Center (S.M.Z., K.A., P.N.), Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, MA (K.A., C.E., A.V.K., D.K., P.N.)
| | - Connor Emdin
- From the Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA (S.M.Z., K.A., C.E., A.V.K., D.K., P.N.).,Harvard Medical School, Boston, MA (K.A., C.E., A.V.K., D.K., P.N.)
| | - Amit V Khera
- From the Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA (S.M.Z., K.A., C.E., A.V.K., D.K., P.N.).,Center for Genomic Medicine (S.M.Z., K.A., A.V.K., D.K., P.N.), Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, MA (K.A., C.E., A.V.K., D.K., P.N.)
| | - Derek Klarin
- From the Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA (S.M.Z., K.A., C.E., A.V.K., D.K., P.N.).,Center for Genomic Medicine (S.M.Z., K.A., A.V.K., D.K., P.N.), Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, MA (K.A., C.E., A.V.K., D.K., P.N.)
| | - Hongyu Zhao
- Computational Biology and Bioinformatics Program, Yale University, New Haven, CT (S.M.Z., H.Z.).,Department of Biostatistics, Yale School of Public Health, New Haven, CT (H.Z.)
| | - Pradeep Natarajan
- From the Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA (S.M.Z., K.A., C.E., A.V.K., D.K., P.N.).,Center for Genomic Medicine (S.M.Z., K.A., A.V.K., D.K., P.N.), Massachusetts General Hospital, Boston.,Cardiovascular Research Center (S.M.Z., K.A., P.N.), Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, MA (K.A., C.E., A.V.K., D.K., P.N.)
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12
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Deiseroth A, Streese L, Köchli S, Wüst RS, Infanger D, Schmidt-Trucksäss A, Hanssen H. Exercise and Arterial Stiffness in the Elderly: A Combined Cross-Sectional and Randomized Controlled Trial (EXAMIN AGE). Front Physiol 2019; 10:1119. [PMID: 31551805 PMCID: PMC6738015 DOI: 10.3389/fphys.2019.01119] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 08/13/2019] [Indexed: 01/10/2023] Open
Abstract
Introduction: Arterial stiffness (AST) is a main determinant of cardiovascular (CV) mortality. Long-term physical activity (PA) is considered to decrease age-related progression of AST but effects of short-term exercise interventions on AST remain unclear. Methods: In a combined cross-sectional and interventional study approach, we investigated the effects of long-term PA and short-term high-intensity interval training (HIIT) on AST in an older population. 147 older individuals (mean age 59 ± 7 years) were assigned to three groups according to their PA and CV risk profile and compared: healthy active (HA, n = 35), healthy sedentary (HS, n = 33) and sedentary at risk (SR, n = 79). In addition, SR were randomized to either 12 weeks of HIIT or standard recommendations. Pulse wave velocity (PWV) was measured by applanation tonometry. Cardiorespiratory fitness (CRF) was performed by symptom-limited spiroergometry to determine maximal oxygen uptake (VO2max). Results: Higher CRF was associated with lower PWV (p < 0.001) and VO2max explained 18% of PWV variance. PWV was higher in SR (8.2 ± 1.4 m/s) compared to HS (7.5 ± 1.6 m/s) and HA (7.0 ± 1.1 m/s; p < 0.001). 12 weeks of HIIT did not change PWV in SR. HIIT-induced reduction in systolic BP was associated with a reduction in PWV (p < 0.05). Discussion: SR show higher PWV compared to HS and long-term PA is associated with lower PWV. Reduction of AST following short-term HIIT seems to depend on a concomitant decrease in blood pressure. Our study puts into perspective the effects of long- and short-term exercise on arterial wall integrity as treatment options for CV prevention in an older population. Clinical Trial Registration: ClinicalTrials.gov: NCT02796976 (https://clinicaltrials.gov/ct2/show/NCT02796976).
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Affiliation(s)
- Arne Deiseroth
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Lukas Streese
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Sabrina Köchli
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Romy Sandra Wüst
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Denis Infanger
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
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13
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Climie RE, Boutouyrie P, Perier MC, Guibout C, van Sloten TT, Thomas F, Danchin N, Sharman JE, Laurent S, Jouven X, Empana JP. Individual and Neighborhood Deprivation and Carotid Stiffness. Hypertension 2019; 73:1185-1194. [DOI: 10.1161/hypertensionaha.118.12186] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Rachel E. Climie
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
- Baker Heart and Diabetes Institute; Melbourne, Australia (R.E.C.)
- Menzies Institute for Medical Research, University of Tasmanian, Hobart, Australia (R.E.C., J.E.S.)
| | | | - Marie-Cecile Perier
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
| | - Catherine Guibout
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
| | - Thomas T. van Sloten
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
- Cardiovascular Research Institute Maastricht and Department of Internal Medicine, Maastricht University Medical Centre, the Netherlands (T.T.v.S.)
| | - Frederique Thomas
- Investigations Préventives et cliniques (IPC), Paris, France (F.T., N.D.)
| | - Nicolas Danchin
- Investigations Préventives et cliniques (IPC), Paris, France (F.T., N.D.)
| | - James E. Sharman
- Menzies Institute for Medical Research, University of Tasmanian, Hobart, Australia (R.E.C., J.E.S.)
| | | | - Xavier Jouven
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
| | - Jean-Philippe Empana
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
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14
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DuPont JJ, Kenney RM, Patel AR, Jaffe IZ. Sex differences in mechanisms of arterial stiffness. Br J Pharmacol 2019; 176:4208-4225. [PMID: 30767200 DOI: 10.1111/bph.14624] [Citation(s) in RCA: 142] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 01/08/2019] [Accepted: 01/21/2019] [Indexed: 12/24/2022] Open
Abstract
Arterial stiffness progressively increases with aging and is an independent predictor of cardiovascular disease (CVD) risk. Evidence supports that there are sex differences in the time course of aging-related arterial stiffness and the associated CVD risk, which increases disproportionately in postmenopausal women. The association between arterial stiffness and mortality is almost twofold higher in women versus men. The differential clinical characteristics of the development of arterial stiffness between men and women indicate the involvement of sex-specific mechanisms. This review summarizes the current literature on sex differences in vascular stiffness induced by aging, obesity, hypertension, and sex-specific risk factors as well as the impact of hormonal status, diet, and exercise on vascular stiffness in males and females. An understanding of the mechanisms driving sex differences in vascular stiffness has the potential to identify novel sex-specific therapies to lessen CVD risk, the leading cause of death in males and females. LINKED ARTICLES: This article is part of a themed section on The Importance of Sex Differences in Pharmacology Research. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.21/issuetoc.
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Affiliation(s)
- Jennifer J DuPont
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, Massachusetts, United States of America
| | - Rachel M Kenney
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, Massachusetts, United States of America
| | - Ayan R Patel
- Division of Cardiology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts, United States of America
| | - Iris Z Jaffe
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, Massachusetts, United States of America.,Division of Cardiology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts, United States of America
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15
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Safar ME, Asmar R, Benetos A, Blacher J, Boutouyrie P, Lacolley P, Laurent S, London G, Pannier B, Protogerou A, Regnault V. Interaction Between Hypertension and Arterial Stiffness. Hypertension 2019; 72:796-805. [PMID: 30354723 DOI: 10.1161/hypertensionaha.118.11212] [Citation(s) in RCA: 154] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Michel E Safar
- From the Diagnosis and Therapeutics Center, Hôtel-Dieu Hospital, Paris, France (M.E.S., J.B.)
| | - Roland Asmar
- Foundation-Medical Research Institutes, Geneva, Switzerland/Beirut, Lebanon (R.A.)
| | - Athanase Benetos
- Department of Geriatrics, Nancy University Hospital, Université de Lorraine, Inserm U1116, DCAC, France (A.B.)
| | - Jacques Blacher
- From the Diagnosis and Therapeutics Center, Hôtel-Dieu Hospital, Paris, France (M.E.S., J.B.)
| | - Pierre Boutouyrie
- Department of Pharmacology, Assistance Publique-Hôpitaux de Paris, Georges Pompidou European Hospital; Paris-Descartes University; PARCC-Inserm U970, Paris, France (P.B., S.L.)
| | - Patrick Lacolley
- Université de Lorraine, Inserm U1116, DCAC, Nancy, France (P.L., V.R.)
| | - Stéphane Laurent
- Department of Pharmacology, Assistance Publique-Hôpitaux de Paris, Georges Pompidou European Hospital; Paris-Descartes University; PARCC-Inserm U970, Paris, France (P.B., S.L.)
| | - Gérard London
- PARCC-Inserm U970, Paris, France (G.L., B.P.); Department of Nephrology, Manhès Hospital, Fleury-Mérogis, France (G.L., B.P.)
| | - Bruno Pannier
- PARCC-Inserm U970, Paris, France (G.L., B.P.); Department of Nephrology, Manhès Hospital, Fleury-Mérogis, France (G.L., B.P.)
| | - Athanase Protogerou
- Cardiovascular Prevention and Research Unit, Department of Pathophysiology, Medical School, National and Kapodistrian University of Athens, Greece (A.P.)
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16
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Effect of Tai Chi on Cardiac and Static Pulmonary Function in Older Community-Dwelling Adults at Risk of Ischemic Stroke: A Randomized Controlled Trial. Chin J Integr Med 2018; 25:582-589. [DOI: 10.1007/s11655-018-3056-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2017] [Indexed: 10/27/2022]
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17
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Sarajlic P, Fridén C, Lund LH, Manouras A, Venkateshvaran A, Larsson SC, Nordgren B, Opava CH, Lundberg IE, Bäck M. Enhanced ventricular-arterial coupling during a 2-year physical activity programme in patients with rheumatoid arthritis: a prospective substudy of the physical activity in rheumatoid arthritis 2010 trial. J Intern Med 2018; 284:664-673. [PMID: 29143384 DOI: 10.1111/joim.12715] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To establish how guided physical activity in patients with rheumatoid arthritis (RA) without known cardiovascular disease affected vascular and cardiac function, and how these two entities were prospectively interconnected in this patient group. METHODS Prospective substudy of 29 participants in the Physical Activity in RA (PARA) 2010 trial. All subjects were examined at baseline, at year 1 and 2 with measures of pulse wave velocity and arterial augmentation index, as well as echocardiographic evaluation of diastolic parameters and ventricular-arterial coupling. Muscle strength and aerobic exercise capacity were assessed at baseline and yearly. All participants performed physiotherapist-guided aerobic and muscle strength exercise during 2 years and were reminded through SMS to report physical activity progress. RESULTS This cohort of patients with RA exhibited increased vascular stiffness despite normal blood pressure. At baseline, lower muscle strength was associated with increased vascular stiffness (β = 0.68; P = 0.004), whereas lower aerobic working capacity was associated with left ventricular diastolic dysfunction (β = 0.85; P = 0.03). There was a significant positive correlation between vascular stiffness and diastolic dysfunction at baseline (R2 = 0.64) and for the changes in those parameters observed during 2 years of guided physical activity. Finally, a significant improvement in ventricular-arterial coupling was observed after exercise (P < 0.001). CONCLUSION These results indicate that although differentially associated with physical capacity parameters, improved vascular stiffness and improved diastolic dysfunction are interrelated, and that an optimization of the ventricular-arterial coupling may contribute to the beneficial effects of physical activity in patients with RA.
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Affiliation(s)
- P Sarajlic
- Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - C Fridén
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - L H Lund
- Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Heart and Vascular Theme Division of Heart Failure, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - A Manouras
- Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Heart and Vascular Theme Division of Heart Failure, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - A Venkateshvaran
- Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Heart and Vascular Theme Division of Heart Failure, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - S C Larsson
- Institute of Environmental Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - B Nordgren
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - C H Opava
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - I E Lundberg
- Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Rheumatology Unit, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - M Bäck
- Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Heart and Vascular Theme Division of Valvular and Coronary Disease, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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18
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Kucharska-Newton AM, Stoner L, Meyer ML. Determinants of Vascular Age: An Epidemiological Perspective. Clin Chem 2018; 65:108-118. [PMID: 30459170 DOI: 10.1373/clinchem.2018.287623] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 09/11/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Vascular age is an emerging health indicator and predictor of end-organ damage to the heart, brain, and kidney. Although there have been many review publications concerning risk factors for vascular aging, most include cross-sectional epidemiological studies, limiting inferences about temporality. There is a need for a review of longitudinal epidemiological studies with repeated measures of vascular structure and function to allow for a systematic examination of determinants of vascular age and the association of vascular aging with outcomes. CONTENT Arterial stiffness is the most frequently used measure of vascular aging. We report here results of an extensive literature review of longitudinal cohort studies with repeated measures of arterial stiffness to characterize determinants of vascular age. Additionally, we summarize population-based studies that have focused on the association of arterial stiffness with end-organ damage and adverse cardiovascular outcomes. SUMMARY Changes in arterial stiffness are evident in early childhood. In adults, arterial stiffness has been observed to progress at the average rate of 0.2 to 0.7 m/s for every 5 years of life. The state of the science is limited by the small number of studies with repeated measures of arterial stiffness and determinants of arterial stiffness progression, as well as limited studies in children and diverse race/ethnic groups. Several extant studies suggest that beyond age, cardiometabolic risk factors and adverse lifestyle behaviors contribute to arterial stiffening. Therefore, arterial stiffness is important in the assessment of healthy vascular aging and a possible target for the prevention of subclinical and clinical disease.
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Affiliation(s)
- Anna M Kucharska-Newton
- Department of Epidemiology, The Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC;
| | - Lee Stoner
- Department of Exercise Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Michelle L Meyer
- Department of Emergency Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
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19
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Kohn JC, Azar J, Seta F, Reinhart-King CA. High-Fat, High-Sugar Diet-Induced Subendothelial Matrix Stiffening is Mitigated by Exercise. Cardiovasc Eng Technol 2018; 9:84-93. [PMID: 29159794 PMCID: PMC5797500 DOI: 10.1007/s13239-017-0335-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 11/09/2017] [Indexed: 10/18/2022]
Abstract
Consumption of a high-fat, high-sugar diet and sedentary lifestyle are correlated with bulk arterial stiffening. While measurements of bulk arterial stiffening are used to assess cardiovascular health clinically, they cannot account for changes to the tissue occurring on the cellular scale. The compliance of the subendothelial matrix in the intima mediates vascular permeability, an initiating step in atherosclerosis. High-fat, high-sugar diet consumption and a sedentary lifestyle both cause micro-scale subendothelial matrix stiffening, but the impact of these factors in concert remains unknown. In this study, mice on a high-fat, high-sugar diet were treated with aerobic exercise or returned to a normal diet. We measured bulk arterial stiffness through pulse wave velocity and subendothelial matrix stiffness ex vivo through atomic force microscopy. Our data indicate that while diet reversal mitigates high-fat, high-sugar diet-induced macro- and micro-scale stiffening, exercise only significantly decreases micro-scale stiffness and not macro-scale stiffness, during the time-scale studied. These data underscore the need for both healthy diet and exercise to maintain vascular health. These data also indicate that exercise may serve as a key lifestyle modification to partially reverse the deleterious impacts of high-fat, high-sugar diet consumption, even while macro-scale stiffness indicators do not change.
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Affiliation(s)
- Julie C Kohn
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, 14853, USA
| | - Julian Azar
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, 14853, USA
| | - Francesca Seta
- Vascular Biology Section, Boston University School of Medicine, Boston, MA, USA
| | - Cynthia A Reinhart-King
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, 14853, USA.
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 351631, USA.
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20
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Oxidative and inflammatory signals in obesity-associated vascular abnormalities. Clin Sci (Lond) 2017; 131:1689-1700. [DOI: 10.1042/cs20170219] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 05/19/2017] [Accepted: 05/22/2017] [Indexed: 02/07/2023]
Abstract
Obesity is associated with increased cardiovascular morbidity and mortality in part due to vascular abnormalities such as endothelial dysfunction and arterial stiffening. The hypertension and other health complications that arise from these vascular defects increase the risk of heart diseases and stroke. Prooxidant and proinflammatory signaling pathways as well as adipocyte-derived factors have emerged as critical mediators of obesity-associated vascular abnormalities. Designing treatments aimed specifically at improving the vascular dysfunction caused by obesity may provide an effective therapeutic approach to prevent the cardiovascular sequelae associated with excessive adiposity. In this review, we discuss the recent evidence supporting the role of oxidative stress and cytokines and inflammatory signals within the vasculature as well as the impact of the surrounding perivascular adipose tissue (PVAT) on the regulation of vascular function and arterial stiffening in obesity. In particular, we focus on the highly plastic nature of the vasculature in response to altered oxidant and inflammatory signaling and highlight how weight management can be an effective therapeutic approach to reduce the oxidative stress and inflammatory signaling and improve vascular function.
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21
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Mahaney MC, Karere GM, Rainwater DL, Voruganti VS, Dick EJ, Owston MA, Rice KS, Cox LA, Comuzzie AG, VandeBerg JL. Diet-induced early-stage atherosclerosis in baboons: Lipoproteins, atherogenesis, and arterial compliance. J Med Primatol 2017. [PMID: 28620920 DOI: 10.1111/jmp.12283] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The purpose of this study was to determine whether dietary manipulation can reliably induce early-stage atherosclerosis and clinically relevant changes in vascular function in an established, well-characterized non-human primate model. METHODS We fed 112 baboons a high-cholesterol, high-fat challenge diet for two years. We assayed circulating biomarkers of cardiovascular disease (CVD) risk, at 0, 7, and 104 weeks into the challenge; assessed arterial compliance noninvasively at 104 weeks; and measured atherosclerotic lesions in three major arteries at necropsy. RESULTS We observed evidence of atherosclerosis in all but one baboon fed the two-year challenge diet. CVD risk biomarkers, the prevalence, size, and complexity of arterial lesions, plus consequent arterial stiffness, were increased in comparison with dietary control animals. CONCLUSIONS Feeding baboons a high-cholesterol, high-fat diet for two years reliably induces atherosclerosis, with risk factor profiles, arterial lesions, and changes in vascular function also seen in humans.
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Affiliation(s)
- Michael C Mahaney
- South Texas Diabetes and Obesity Institute, School of Medicine, The University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - Genesio M Karere
- Department of Genetics, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - David L Rainwater
- Department of Genetics, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Venkata S Voruganti
- Department of Nutrition and UNC Nutrition Research Institute, University of North Carolina, Kannapolis, NC, USA
| | - Edward J Dick
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Michael A Owston
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Karen S Rice
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Laura A Cox
- Department of Genetics, Texas Biomedical Research Institute, San Antonio, TX, USA.,Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Anthony G Comuzzie
- Department of Genetics, Texas Biomedical Research Institute, San Antonio, TX, USA.,Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - John L VandeBerg
- South Texas Diabetes and Obesity Institute, School of Medicine, The University of Texas Rio Grande Valley, Brownsville, TX, USA
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22
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Meyer ML, Palta P, Tanaka H, Deal JA, Wright J, Knopman DS, Griswold ME, Mosley TH, Heiss G. Association of Central Arterial Stiffness and Pressure Pulsatility with Mild Cognitive Impairment and Dementia: The Atherosclerosis Risk in Communities Study-Neurocognitive Study (ARIC-NCS). J Alzheimers Dis 2017; 57:195-204. [PMID: 28222517 PMCID: PMC5450915 DOI: 10.3233/jad-161041] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND The association of central arterial stiffness and pressure pulsatility with mild cognitive impairment (MCI) and dementia is not well characterized in the population-based setting. OBJECTIVE The aim of this study was to quantify the cross-sectional association of arterial stiffness and pressure pulsatility with MCI and dementia among 4,461 older white and black adults from the population-based Atherosclerosis Risk in Communities Study-Neurocognitive Study. METHODS We used race-stratified multinomial logistic regression to evaluate associations of percentile cut points of carotid-femoral pulse wave velocity, central systolic blood pressure, central pulse pressure, and pulse pressure amplification with MCI and dementia versus no cognitive impairment. RESULTS Among whites, those with carotid-femoral pulse wave velocity or central systolic blood pressure ≥75th percentile had a higher prevalence of MCI compared to participants <75th percentile (conditional odds ratio (OR); 95% confidence interval (CI): 1.27 (1.02, 1.56) and 1.28 (1.04, 1.57), respectively) and those with central pulse pressure ≥75th percentile had a higher prevalence of MCI (OR 1.27 (95% CI: 1.03, 1.58)) and dementia (OR 1.76 (95% CI: 1.06, 2.92) compared to participants <75th percentile. Also among whites, those with pulse pressure amplification ≤25th percentile had a higher prevalence of dementia compared to participants >25th percentile (OR 1.65; (95% CI: 1.01, 2.70). Weaker associations were seen among black participants. CONCLUSION Higher arterial stiffness and pulsatility were associated with MCI and dementia in white participants. Longitudinal characterization of the observed associations is warranted to assess whether arterial stiffness and pressure pulsatility predict MCI and dementia among older adults.
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Affiliation(s)
- Michelle L Meyer
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Priya Palta
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD
| | | | | | - Michael E Griswold
- Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS
| | - Thomas H Mosley
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS
| | - Gerardo Heiss
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
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23
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Kirwan JP, Malin SK, Scelsi AR, Kullman EL, Navaneethan SD, Pagadala MR, Haus JM, Filion J, Godin JP, Kochhar S, Ross AB. A Whole-Grain Diet Reduces Cardiovascular Risk Factors in Overweight and Obese Adults: A Randomized Controlled Trial. J Nutr 2016; 146:2244-2251. [PMID: 27798329 PMCID: PMC5086786 DOI: 10.3945/jn.116.230508] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 03/03/2016] [Accepted: 08/29/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Increased dietary whole-grain intake may protect against cardiovascular disease (CVD). OBJECTIVE The objective was to evaluate the efficacy of whole grains compared with refined grains on body composition, hypertension, and related mediators of CVD in overweight and obese adults. METHODS We conducted a double-blind, randomized, controlled crossover trial in 40 overweight or obese men and women aged <50 y with no known history of CVD. Complete whole-grain and refined-grain diets were provided for two 8-wk periods, with a 10-wk washout between diets. Macronutrient composition was matched, except for the inclusion of either whole grains or refined grains (50 g/1000 kcal in each diet). Measurements included blood pressure, body composition, blood lipids and adiponectin, and markers of inflammation and glycemia. RESULTS Thirty-three participants (6 men and 27 women) completed the trial [mean ± SD age: 39 ± 7 y; mean ± SD body mass index (in kg/m2): 33.1 ± 4.3]. Decreases in diastolic blood pressure were -5.8 mm Hg (95% CI: -7.7, -4.0 mm Hg) after the whole-grain diet and -1.6 mm Hg (95% CI: -4.4, 1.3 mm Hg) after the control diet (between effect, P = 0.01). Decreases in plasma adiponectin were -0.1 (95% CI: -0.9, 0.7) after the whole-grain diet and -1.4 (95% CI: -2.6, -0.3) after the control diet (between effect, P = 0.05). Decreases in diastolic blood pressure correlated with the circulating adiponectin concentration (r = 0.35, P = 0.04). Substantial reductions in body weight, fat loss, systolic blood pressure, total cholesterol, and LDL cholesterol were observed during both diet periods, with no relevant difference between them. CONCLUSIONS The improvement in diastolic blood pressure was >3-fold greater in overweight and obese adults when they consumed a whole-grain compared with a refined-grain diet. Because diastolic blood pressure predicts mortality in adults aged <50 y, increased whole-grain intake may provide a functional approach to control hypertension. This may benefit patients at risk of vascular-related morbidity and mortality. This trial was registered at clinicaltrials.gov as NCT01411540.
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Affiliation(s)
- John P Kirwan
- Department of Pathobiology, Lerner Research Institute,
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH
| | | | | | | | - Sankar D Navaneethan
- Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, and
| | - Mangesh R Pagadala
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH
| | - Jacob M Haus
- Department of Pathobiology, Lerner Research Institute
| | | | - Jean-Philippe Godin
- Analytical Sciences Department, Nestlé Research Center, Lausanne, Switzerland; and
| | - Sunil Kochhar
- Analytical Sciences Department, Nestlé Research Center, Lausanne, Switzerland; and
| | - Alastair B Ross
- Analytical Sciences Department, Nestlé Research Center, Lausanne, Switzerland; and
- Division of Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenberg, Sweden
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24
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Padilla J, Ramirez-Perez FI, Habibi J, Bostick B, Aroor AR, Hayden MR, Jia G, Garro M, DeMarco VG, Manrique C, Booth FW, Martinez-Lemus LA, Sowers JR. Regular Exercise Reduces Endothelial Cortical Stiffness in Western Diet-Fed Female Mice. Hypertension 2016; 68:1236-1244. [PMID: 27572153 DOI: 10.1161/hypertensionaha.116.07954] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 08/04/2016] [Indexed: 12/18/2022]
Abstract
We recently showed that Western diet-induced obesity and insulin resistance promotes endothelial cortical stiffness in young female mice. Herein, we tested the hypothesis that regular aerobic exercise would attenuate the development of endothelial and whole artery stiffness in female Western diet-fed mice. Four-week-old C57BL/6 mice were randomized into sedentary (ie, caged confined, n=6) or regular exercise (ie, access to running wheels, n=7) conditions for 16 weeks. Exercise training improved glucose tolerance in the absence of changes in body weight and body composition. Compared with sedentary mice, exercise-trained mice exhibited reduced endothelial cortical stiffness in aortic explants (sedentary 11.9±1.7 kPa versus exercise 5.5±1.0 kPa; P<0.05), as assessed by atomic force microscopy. This effect of exercise was not accompanied by changes in aortic pulse wave velocity (P>0.05), an in vivo measure of aortic stiffness. In comparison, exercise reduced femoral artery stiffness in isolated pressurized arteries and led to an increase in femoral internal artery diameter and wall cross-sectional area (P<0.05), indicative of outward hypertrophic remodeling. These effects of exercise were associated with an increase in femoral artery elastin content and increased number of fenestrae in the internal elastic lamina (P<0.05). Collectively, these data demonstrate for the first time that the aortic endothelium is highly plastic and, thus, amenable to reductions in stiffness with regular aerobic exercise in the absence of changes in in vivo whole aortic stiffness. Comparatively, the same level of exercise caused destiffening effects in peripheral muscular arteries, such as the femoral artery, that perfuse the working limbs.
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Affiliation(s)
- Jaume Padilla
- From the Department of Nutrition and Exercise Physiology (J.P., F.W.B.), Dalton Cardiovascular Research Center (J.P., F.I.R.-P., L.A.M.-L., J.R.S.), Department of Child Health (J.P.), Department of Biological Engineering (F.I.R.-P., L.A.M.-L.); Division of Cardiovascular Medicine, Department of Medicine (B.B.), Diabetes and Cardiovascular Research Center (J.H., A.R.A., M.R.H., G.J., M.G., V.G.D., C.M., J.R.S.), Department of Medical Pharmacology and Physiology (L.A.M.-L., J.R.S.), and Biomedical Sciences (F.W.B.), University of Missouri; and Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO (J.R.S.)
| | - Francisco I Ramirez-Perez
- From the Department of Nutrition and Exercise Physiology (J.P., F.W.B.), Dalton Cardiovascular Research Center (J.P., F.I.R.-P., L.A.M.-L., J.R.S.), Department of Child Health (J.P.), Department of Biological Engineering (F.I.R.-P., L.A.M.-L.); Division of Cardiovascular Medicine, Department of Medicine (B.B.), Diabetes and Cardiovascular Research Center (J.H., A.R.A., M.R.H., G.J., M.G., V.G.D., C.M., J.R.S.), Department of Medical Pharmacology and Physiology (L.A.M.-L., J.R.S.), and Biomedical Sciences (F.W.B.), University of Missouri; and Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO (J.R.S.)
| | - Javad Habibi
- From the Department of Nutrition and Exercise Physiology (J.P., F.W.B.), Dalton Cardiovascular Research Center (J.P., F.I.R.-P., L.A.M.-L., J.R.S.), Department of Child Health (J.P.), Department of Biological Engineering (F.I.R.-P., L.A.M.-L.); Division of Cardiovascular Medicine, Department of Medicine (B.B.), Diabetes and Cardiovascular Research Center (J.H., A.R.A., M.R.H., G.J., M.G., V.G.D., C.M., J.R.S.), Department of Medical Pharmacology and Physiology (L.A.M.-L., J.R.S.), and Biomedical Sciences (F.W.B.), University of Missouri; and Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO (J.R.S.)
| | - Brian Bostick
- From the Department of Nutrition and Exercise Physiology (J.P., F.W.B.), Dalton Cardiovascular Research Center (J.P., F.I.R.-P., L.A.M.-L., J.R.S.), Department of Child Health (J.P.), Department of Biological Engineering (F.I.R.-P., L.A.M.-L.); Division of Cardiovascular Medicine, Department of Medicine (B.B.), Diabetes and Cardiovascular Research Center (J.H., A.R.A., M.R.H., G.J., M.G., V.G.D., C.M., J.R.S.), Department of Medical Pharmacology and Physiology (L.A.M.-L., J.R.S.), and Biomedical Sciences (F.W.B.), University of Missouri; and Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO (J.R.S.)
| | - Annayya R Aroor
- From the Department of Nutrition and Exercise Physiology (J.P., F.W.B.), Dalton Cardiovascular Research Center (J.P., F.I.R.-P., L.A.M.-L., J.R.S.), Department of Child Health (J.P.), Department of Biological Engineering (F.I.R.-P., L.A.M.-L.); Division of Cardiovascular Medicine, Department of Medicine (B.B.), Diabetes and Cardiovascular Research Center (J.H., A.R.A., M.R.H., G.J., M.G., V.G.D., C.M., J.R.S.), Department of Medical Pharmacology and Physiology (L.A.M.-L., J.R.S.), and Biomedical Sciences (F.W.B.), University of Missouri; and Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO (J.R.S.)
| | - Melvin R Hayden
- From the Department of Nutrition and Exercise Physiology (J.P., F.W.B.), Dalton Cardiovascular Research Center (J.P., F.I.R.-P., L.A.M.-L., J.R.S.), Department of Child Health (J.P.), Department of Biological Engineering (F.I.R.-P., L.A.M.-L.); Division of Cardiovascular Medicine, Department of Medicine (B.B.), Diabetes and Cardiovascular Research Center (J.H., A.R.A., M.R.H., G.J., M.G., V.G.D., C.M., J.R.S.), Department of Medical Pharmacology and Physiology (L.A.M.-L., J.R.S.), and Biomedical Sciences (F.W.B.), University of Missouri; and Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO (J.R.S.)
| | - Guanghong Jia
- From the Department of Nutrition and Exercise Physiology (J.P., F.W.B.), Dalton Cardiovascular Research Center (J.P., F.I.R.-P., L.A.M.-L., J.R.S.), Department of Child Health (J.P.), Department of Biological Engineering (F.I.R.-P., L.A.M.-L.); Division of Cardiovascular Medicine, Department of Medicine (B.B.), Diabetes and Cardiovascular Research Center (J.H., A.R.A., M.R.H., G.J., M.G., V.G.D., C.M., J.R.S.), Department of Medical Pharmacology and Physiology (L.A.M.-L., J.R.S.), and Biomedical Sciences (F.W.B.), University of Missouri; and Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO (J.R.S.)
| | - Mona Garro
- From the Department of Nutrition and Exercise Physiology (J.P., F.W.B.), Dalton Cardiovascular Research Center (J.P., F.I.R.-P., L.A.M.-L., J.R.S.), Department of Child Health (J.P.), Department of Biological Engineering (F.I.R.-P., L.A.M.-L.); Division of Cardiovascular Medicine, Department of Medicine (B.B.), Diabetes and Cardiovascular Research Center (J.H., A.R.A., M.R.H., G.J., M.G., V.G.D., C.M., J.R.S.), Department of Medical Pharmacology and Physiology (L.A.M.-L., J.R.S.), and Biomedical Sciences (F.W.B.), University of Missouri; and Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO (J.R.S.)
| | - Vincent G DeMarco
- From the Department of Nutrition and Exercise Physiology (J.P., F.W.B.), Dalton Cardiovascular Research Center (J.P., F.I.R.-P., L.A.M.-L., J.R.S.), Department of Child Health (J.P.), Department of Biological Engineering (F.I.R.-P., L.A.M.-L.); Division of Cardiovascular Medicine, Department of Medicine (B.B.), Diabetes and Cardiovascular Research Center (J.H., A.R.A., M.R.H., G.J., M.G., V.G.D., C.M., J.R.S.), Department of Medical Pharmacology and Physiology (L.A.M.-L., J.R.S.), and Biomedical Sciences (F.W.B.), University of Missouri; and Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO (J.R.S.)
| | - Camila Manrique
- From the Department of Nutrition and Exercise Physiology (J.P., F.W.B.), Dalton Cardiovascular Research Center (J.P., F.I.R.-P., L.A.M.-L., J.R.S.), Department of Child Health (J.P.), Department of Biological Engineering (F.I.R.-P., L.A.M.-L.); Division of Cardiovascular Medicine, Department of Medicine (B.B.), Diabetes and Cardiovascular Research Center (J.H., A.R.A., M.R.H., G.J., M.G., V.G.D., C.M., J.R.S.), Department of Medical Pharmacology and Physiology (L.A.M.-L., J.R.S.), and Biomedical Sciences (F.W.B.), University of Missouri; and Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO (J.R.S.)
| | - Frank W Booth
- From the Department of Nutrition and Exercise Physiology (J.P., F.W.B.), Dalton Cardiovascular Research Center (J.P., F.I.R.-P., L.A.M.-L., J.R.S.), Department of Child Health (J.P.), Department of Biological Engineering (F.I.R.-P., L.A.M.-L.); Division of Cardiovascular Medicine, Department of Medicine (B.B.), Diabetes and Cardiovascular Research Center (J.H., A.R.A., M.R.H., G.J., M.G., V.G.D., C.M., J.R.S.), Department of Medical Pharmacology and Physiology (L.A.M.-L., J.R.S.), and Biomedical Sciences (F.W.B.), University of Missouri; and Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO (J.R.S.)
| | - Luis A Martinez-Lemus
- From the Department of Nutrition and Exercise Physiology (J.P., F.W.B.), Dalton Cardiovascular Research Center (J.P., F.I.R.-P., L.A.M.-L., J.R.S.), Department of Child Health (J.P.), Department of Biological Engineering (F.I.R.-P., L.A.M.-L.); Division of Cardiovascular Medicine, Department of Medicine (B.B.), Diabetes and Cardiovascular Research Center (J.H., A.R.A., M.R.H., G.J., M.G., V.G.D., C.M., J.R.S.), Department of Medical Pharmacology and Physiology (L.A.M.-L., J.R.S.), and Biomedical Sciences (F.W.B.), University of Missouri; and Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO (J.R.S.)
| | - James R Sowers
- From the Department of Nutrition and Exercise Physiology (J.P., F.W.B.), Dalton Cardiovascular Research Center (J.P., F.I.R.-P., L.A.M.-L., J.R.S.), Department of Child Health (J.P.), Department of Biological Engineering (F.I.R.-P., L.A.M.-L.); Division of Cardiovascular Medicine, Department of Medicine (B.B.), Diabetes and Cardiovascular Research Center (J.H., A.R.A., M.R.H., G.J., M.G., V.G.D., C.M., J.R.S.), Department of Medical Pharmacology and Physiology (L.A.M.-L., J.R.S.), and Biomedical Sciences (F.W.B.), University of Missouri; and Research Service, Harry S. Truman Memorial Veterans' Hospital, Columbia, MO (J.R.S.).
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25
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Hughes TM, Craft S, Lopez OL. Review of 'the potential role of arterial stiffness in the pathogenesis of Alzheimer's disease'. Neurodegener Dis Manag 2016; 5:121-35. [PMID: 25894876 DOI: 10.2217/nmt.14.53] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Arterial stiffness is emerging as an important risk marker for poor brain aging and dementia through its associations with cerebral small vessel disease, stroke, β-amyloid deposition, brain atrophy and cognitive impairment. Arterial stiffness directly relates the detrimental effects of hypertension on peripheral organs with dire consequences for the extensive microvasculature structure of the kidneys and brain. In this review, we discuss the evidence linking arterial stiffness, hypertension and brain structural abnormalities in older adults. In particular, we discuss the potential mechanisms linking arterial stiffness to brain β-amyloid deposition and dementia and potential therapeutic strategies to prevent hypertension's adverse effects on the brain.
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Affiliation(s)
- Timothy M Hughes
- Department of Internal Medicine, Division of Gerontology & Geriatric Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1207, USA
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26
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Anujuo K, Stronks K, Snijder MB, Jean-Louis G, van den Born BJ, Peters RJ, Agyemang C. Relationship between sleep duration and arterial stiffness in a multi-ethnic population: The HELIUS study. Chronobiol Int 2016; 33:543-52. [PMID: 27058653 PMCID: PMC5357559 DOI: 10.3109/07420528.2016.1158721] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
We examined the relationship between sleep duration and arterial stiffness among a multi-ethnic cohort, and whether the associations differed among ethnic minority groups in the Netherlands. Data were derived from 10 994 participants (aged 18-71 years) of the Healthy Life in an Urban Setting (HELIUS) study. Self-reported sleep duration was categorized into: short (<7 h/night), healthy (7-8 h/night) and long (≥9 h/night). Arterial stiffness was assessed by duplicate pulse-wave velocity (PWV in m/s) measurements using the Arteriograph system. The association of sleep duration with PWV was analysed using linear regression (β) with 95% confidence interval (CI). Results showed that neither short nor long sleep was related to PWV in all ethnic groups, except for long sleep in Dutch men which was associated with higher PWV (indicating stiffer arteries) after adjustment for potential confounders (β = 0.67, 95%CI, 0.23-1.11). Our study showed no convincing evidence that sleep duration was related to arterial stiffness among various ethnic groups. The link between sleep duration and cardiovascular outcomes does not seem to operate through arterial stiffness. Further research is needed to consolidate these findings.
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Affiliation(s)
- Kenneth Anujuo
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Karien Stronks
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Marieke B. Snijder
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Girardin Jean-Louis
- Department of Medicine, Center for Healthful Behavior Change, New York University School of Medicine, New York, NY, USA,Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Bert-Jan van den Born
- Department of Internal and Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Ron J. Peters
- Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Charles Agyemang
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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27
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Chen Q, Chiheb S, Fysekidis M, Jaber Y, Brahimi M, Nguyen MT, Millasseau S, Cosson E, Valensi P. Arterial stiffness is elevated in normotensive type 2 diabetic patients with peripheral neuropathy. Nutr Metab Cardiovasc Dis 2015; 25:1041-1049. [PMID: 26474725 DOI: 10.1016/j.numecd.2015.08.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 06/19/2015] [Accepted: 08/02/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Arterial stiffness, a measure of macrovascular damage predictive of poor cardio-vascular outcomes, is strongly related to age and hypertension (HT). In diabetic patients peripheral neuropathy (PN) has been found to be associated with increased arterial stiffness, which might be due to the concomitant presence of HT. The aim of this study was to examine in type-2 diabetic patients, the relationship between arterial stiffness and presence or absence of PN and HT separately. METHODS AND RESULTS Arterial stiffness was measured with the gold standard carotid-femoral pulse wave velocity (PWV) in 447 type-2 diabetic subjects of whom 66% were hypertensive, 53% had PN, and 40% had both. Patients with PN were older, more often hypertensive and had higher PWV than those free of PN. Patients were separated according to the presence or absence of PN and HT. PWV values above the 90th percentile age- and blood pressure-adjusted reference range (PWV+) were different across these groups (p < 0.005) with the following respective prevalences: 27.2%, 53.4%, 33.3% and 30.6%. Only PWV+ was significantly associated with PN and hypertension in the interaction analysis. CONCLUSION Well controlled hypertensive patients did not have elevated arterial stiffness compared to normotensive patients. This might be due to anti-hypertensive treatment although our study design does not allow us to confirm it. A strong association between PN and arterial stiffness was only present in normotensive patients, suggesting that normotensive type 2 diabetic patients with PN and elevated arterial stiffness should be carefully managed to prevent future macrovascular complications.
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Affiliation(s)
- Q Chen
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France; Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shangai, China
| | - S Chiheb
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France
| | - M Fysekidis
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France
| | - Y Jaber
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France
| | - M Brahimi
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France
| | - M T Nguyen
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France
| | - S Millasseau
- Pulse Wave Consulting, Saint Leu la Foret, France
| | - E Cosson
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France; UMR U1153 Inserm/U1125 Inra/Cnam/Univ Paris 13, Research Center in Epidemiology and Biostatistic Sorbonne-Paris-Cité, Bobigny, France
| | - P Valensi
- Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Paris-Nord University, CRNH-IdF, CINFO, Bondy, France.
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28
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Doumas M, Faselis C, Kokkinos P. Exaggerated Blood Pressure Response to Exercise: Will It Ever Be Ready for Prime Time? J Clin Hypertens (Greenwich) 2015; 17:845-7. [PMID: 26234157 DOI: 10.1111/jch.12630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Michael Doumas
- Department of Veterans Affairs and George Washington University, Washington, DC
| | - Charles Faselis
- Department of Veterans Affairs and George Washington University, Washington, DC
| | - Peter Kokkinos
- Department of Veterans Affairs and George Washington University, Washington, DC
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29
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Townsend RR, Wilkinson IB, Schiffrin EL, Avolio AP, Chirinos JA, Cockcroft JR, Heffernan KS, Lakatta EG, McEniery CM, Mitchell GF, Najjar SS, Nichols WW, Urbina EM, Weber T. Recommendations for Improving and Standardizing Vascular Research on Arterial Stiffness: A Scientific Statement From the American Heart Association. Hypertension 2015; 66:698-722. [PMID: 26160955 DOI: 10.1161/hyp.0000000000000033] [Citation(s) in RCA: 919] [Impact Index Per Article: 102.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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30
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Affiliation(s)
- Peter Kokkinos
- From the Cardiology Department, Veterans Affairs Medical Center, Washington, DC; Department of Cardiology, Georgetown University School of Medicine, Washington, DC; George Washington University School of Medicine and Health Sciences, Washington, DC; and Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia.
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