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Takase H, Sugiura T, Yamashita S, Kawakatsu N, Hayashi K, Kin F, Isogaki T, Dohi Y. Significance of blood pressure variability in normotensive individuals as a risk factor of developing hypertension. Blood Press 2024; 33:2323967. [PMID: 38465635 DOI: 10.1080/08037051.2024.2323967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/20/2024] [Indexed: 03/12/2024]
Abstract
PURPOSE Visit-to-visit blood pressure variability is a strong predictor of the incidence of cardiovascular events and target organ damage due to hypertension. The present study investigated whether year-to-year blood pressure variability predicts the risk of hypertension in the Japanese general population. MATERIALS AND METHODS This study analysed 2806 normotensive individuals who participated in our physical check-up program for five years in a row from 2008 to 2013. The average, standard deviation, coefficient of variation, average real variability, and highest value of systolic blood pressure in the five consecutive visits were determined and used as baseline data. The participants were followed up for the next 6 years with the development of 'high blood pressure', an average blood pressure level of ≥140/90 mmHg or the use of antihypertensive medications, as the endpoint. RESULT During follow-up, 'high blood pressure' developed in 389 participants (13.9%, 29.5 per 1 000 person-years). The incidence increased across the quartiles of standard deviation and average real variability, while the average and highest systolic blood pressure had the most prominent impact on the development of 'high blood pressure'. Multivariate logistic regression analysis adjusted for possible risk factors indicated that the average, standard deviation, average real variability, and highest blood pressure, but not the coefficient of variation of systolic blood pressure, were significant predictors of 'high blood pressure'. CONCLUSION Increased year-to-year blood pressure variability predicts the risk of hypertension in the general normotensive population. The highest blood pressure in the preceding years may also be a strong predictor of the risk of hypertension.
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Affiliation(s)
- Hiroyuki Takase
- Department of Internal Medicine, Enshu Hospital, Hamamatsu, Japan
| | | | - Sumiyo Yamashita
- Department of Cardiology, Nagoya City University Mirai Kousei Hospital, Nagoya, Japan
| | - Naomi Kawakatsu
- Department of Internal Medicine, Enshu Hospital, Hamamatsu, Japan
| | - Kazusa Hayashi
- Department of Internal Medicine, Enshu Hospital, Hamamatsu, Japan
| | - Fumihiko Kin
- Department of Internal Medicine, Enshu Hospital, Hamamatsu, Japan
| | - Takeru Isogaki
- Department of Internal Medicine, Enshu Hospital, Hamamatsu, Japan
| | - Yasuaki Dohi
- Department of Internal Medicine, Faculty of Rehabilitation Sciences, Nagoya Gakuin University, Nagoya, Japan
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Tian X, Chen S, Xu Q, Zhang Y, Xia X, Wang P, Wu S, Wang A. Temporal relationship between arterial stiffness and blood pressure variability and joint effect on cardiovascular disease. Hypertens Res 2024; 47:1133-1143. [PMID: 38145991 DOI: 10.1038/s41440-023-01541-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/16/2023] [Accepted: 11/18/2023] [Indexed: 12/27/2023]
Abstract
Although arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV) and blood pressure (BP) significantly correlated, the relationship between baPWV and BP variation (BPV) was unclear. This study aimed to examine the temporal relationship between brachial-ankle pulse wave velocity (baPWV) and systolic blood pressure variation (SBPV) and their joint effect on the development of cardiovascular disease (CVD). This study included 6632 participants with repeated assessments of baPWV and BP during 2006 to 2018. The baseline and follow-up SBPV was calculated as absolute SBP difference divided by mean SBP over sequential visits, using data between 2006-2010 and 2014-2018, respectively. Cross-lagged analysis was used to assess the temporal relation between baPWV and SBPV, and logistic analysis was used to assess the joint effect of baPWV and SBPV on CVD. After adjustment for confounder, the path coefficient from baseline baPWV to follow-up SBPV (β1 = 0.040; P = 0.0012) was significantly had greater than the path from baseline SBPV to follow-up baPWV (β2 = 0.009; P = 0.3830), with P = 0.0232 for the difference between β1 and β2. This unidirectional relationship from baseline baPWV to follow-up SBPV was consistent in patients without hypertension, with isolated systolic, high systolic and diastolic, uncontrolled and controlled hypertension. In addition, participants with high levels of baseline baPWV and follow-up SBPV had greater risk of CVD (odds ratio, 5.82; 95% confidence interval, 2.50-12.60) than those with low-low levels. The findings suggested that arterial stiffness appeared to precede the increase in SBPV and their joint effect is predictive of the development of CVD.
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Affiliation(s)
- Xue Tian
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, 57 Xinhua East Rd, Tangshan, 063000, China
| | - Qin Xu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yijun Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xue Xia
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Penglian Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, 57 Xinhua East Rd, Tangshan, 063000, China.
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
- Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China.
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Abstract
Arterial stiffness and hypertension are closely related in pathophysiology. Chronic high blood pressure (BP) can lead to arterial wall damage by mechanical stress, endothelial dysfunction, increased inflammation, oxidative stress, and renin-angiotensin-aldosterone system (RAAS) activation. Hypertension also increases collagen fiber production and accelerates elastin fiber degradation. Stiffened arteries struggle with BP changes, raising systolic BP and pulse pressure. The resulting increased systolic pressure further hardens arteries, creating a harmful cycle of inflammation and calcification. Arterial stiffness data can predict target organ damage and future cardiovascular events in hypertensive patients. Thus, early detection of arterial stiffness aids in initiating preventive measures and treatment plans to protect against progression of vascular damage. While various methods exist for measuring arterial stiffness, pulse wave velocity is a non-invasive, simple measurement method that maximizes effectiveness. Healthy lifestyle changes, RAAS blockers, and statins are known to reduce arterial stiffness. Further research is needed to ascertain if improving arterial stiffness will enhance prognosis in hypertensive patients.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, 5 Boramae-Ro, Dongjak-Gu, Seoul, 07061, Republic of Korea.
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Triantafyllou A, Anyfanti P, Koletsos N, Malliora A, Lamprou S, Dipla K, Gkaliagkousi E. Clinical Significance of Altered Vascular Morphology and Function in Normotension. Curr Hypertens Rep 2023; 25:287-297. [PMID: 37392357 PMCID: PMC10505095 DOI: 10.1007/s11906-023-01251-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 07/03/2023]
Abstract
PURPOSE OF REVIEW To review current literature examining the presence of subclinical micro- and macrovascular alterations in normotensive individuals and their clinical significance in terms of hypertension prediction. Emphasis is placed on alterations that can be detected in peripheral vascular beds using non-invasive, easily applicable methodology, as these are in general easier to capture and evaluate in clinical practice compared to more complex invasive or functional tests. RECENT FINDINGS Arterial stiffness, increased carotid intima-media thickness, and altered retinal microvascular diameters predict the progression from the normotensive to the hypertensive state. By contrast, there is substantial lack of relevant prospective studies for skin microvascular alterations. Although conclusions regarding causality cannot be safely deduced from available studies, detection of morphological and functional vascular alterations in normotensive individuals emerges as a sensitive indicator of progression to hypertension and hence increased CVD risk. An increasing amount of evidence suggests that early detection of subclinical micro- and macrovascular alterations would be clinically useful for the early identification of individuals at high risk for future hypertension onset. Methodological issues and gaps in knowledge need to be addressed before detection of such changes could guide the development of strategies to prevent new-onset hypertension in normotensive individuals.
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Affiliation(s)
- A Triantafyllou
- Third Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 56429, Thessaloniki, Greece.
| | - P Anyfanti
- Second Medical Department, Hippokration Hospital, Aristotle University of Thessaloniki, 54642, Thessaloniki, Greece
| | - N Koletsos
- Third Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 56429, Thessaloniki, Greece
| | - A Malliora
- Third Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 56429, Thessaloniki, Greece
| | - S Lamprou
- Third Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 56429, Thessaloniki, Greece
| | - K Dipla
- Physiology & Biochemistry Laboratory, Department of Sport Sciences at Serres, Aristotle University of Thessaloniki, 62100, Serres, Greece
| | - E Gkaliagkousi
- Third Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 56429, Thessaloniki, Greece
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Kellum CE, Kemp KM, Mrug S, Pollock JS, Seifert ME, Feig DI. Adverse childhood experiences are associated with vascular changes in adolescents that are risk factors for future cardiovascular disease. Pediatr Nephrol 2023; 38:2155-2163. [PMID: 36622441 PMCID: PMC10234926 DOI: 10.1007/s00467-022-05853-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs), such as abuse, neglect, and household dysfunction, are associated with a higher risk of cardiovascular disease (CVD) and indicators of future CVD risk in adulthood, such as greater vascular stiffness. The impact of ACEs in adolescence is unclear, and understanding how ACEs relate to blood pressure (BP) and vascular function during early life is key for the development of prevention strategies to reduce CVD risk. We hypothesized that exposure to ACEs would be associated with changes in central hemodynamics such as increased vascular stiffness and higher BP during adolescence. METHODS This pilot study enrolled 86 adolescents recruited from the Children's of Alabama. A validated ACE questionnaire was employed, and ACEs were modeled both as a continuous variable and a categorical variable (ACE ≥ 1 vs. ACE = 0). The primary outcomes used are considered to be indicators of future cardio-renal disease risk: aortic augmentation index normalized to 75 bpm (Alx75, a surrogate for vascular stiffness), carotid-femoral PWV (m/s), and ambulatory BP patterns. RESULTS Adolescents with ACE ≥ 1 had significantly higher Alx75 (ACE: 5.2% ± 2.2 compared to no ACE: - 1.4% ± 3.0; p = 0.043). PWV only reflected this trend when adjustments were made for the body mass index. Adolescents with ACEs showed no differences in ambulatory BP patterns during the 24-h, wake, or sleep periods compared to adolescents with no ACEs. CONCLUSIONS ACEs were associated with higher AIx75 in adolescence, which is a risk factor for future CVD. Adolescence could present an opportunity for early detections/interventions to mitigate adverse cardiovascular outcomes in adulthood. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Cailin E Kellum
- Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, 35233, USA
| | - Keri M Kemp
- Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, 35233, USA
| | - Sylvie Mrug
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, 35233, USA
| | - Jennifer S Pollock
- Cardio-Renal Physiology & Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, 35233, USA.
| | - Michael E Seifert
- Division of Nephrology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, 35233, USA
| | - Daniel I Feig
- Division of Nephrology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, 35233, USA
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Abstract
BACKGROUND An association between blood pressure and aortic stiffness is well known, but ambiguity remains as to whether one precedes the other. This study aimed to investigate the association of aortic stiffness with contemporaneous versus historic blood pressure and direction of causality between aortic stiffening and hypertension in female twins. METHODS Aortic stiffness, measured by carotid-femoral pulse wave velocity (PWV), and mean arterial pressure (MAP) was recorded in 2037 female TwinsUK participants (mean age: 62.4±9.7 years) at a single time point. A subset of 947 participants had repeat PWV and MAP measures (mean interval 5.5±1.7 years) with additional historic MAP (mean interval 6.6±3.3 years before baseline). RESULTS Cross-sectional multivariable linear regression analysis confirmed PWV significantly associated with age and MAP. In longitudinal analysis, annual progression of PWV was not associated with historic MAP (standardized beta coefficient [β]=-0.02, P=0.698), weakly associated with baseline MAP (β=0.09, P=0.049) but strongly associated with progression (from baseline to most recent measurement) of MAP (β= 0.26, P<0.001). Progression of MAP associated with both baseline and progression of PWV (β=0.13, P=0.003 and β=0.24, P<0.001, respectively). CONCLUSIONS Progression of aortic stiffness associates more strongly with contemporaneous MAP compared with historic MAP. In contrast, progression of MAP is associated with prior arterial stiffness. These findings suggest a bidirectional relationship between arterial stiffness and blood pressure, and that lowering blood pressure may prevent a cycle of arterial stiffening and hypertension.
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Affiliation(s)
- Louise Keehn
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital (L.K., P.C., M.C.)
| | - Massimo Mangino
- NIHR Biomedical Research Centre at Guy’s and St Thomas’ Foundation Trust, London (M.M.)
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas Hospital (M.M., T.S.)
| | - Tim Spector
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas Hospital (M.M., T.S.)
| | - Phil Chowienczyk
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital (L.K., P.C., M.C.)
| | - Marina Cecelja
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital (L.K., P.C., M.C.)
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Shaulian SY, Makaryus AN, Zeltser R. Role of Vascular Receptors in the Development of Hypertension in the Elderly Population. Int J Angiol 2022; 31:260-266. [PMID: 36588863 PMCID: PMC9803552 DOI: 10.1055/s-0042-1759650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Hypertension is a disease common in adults, with many risk factors and potentially life-threatening outcomes. Blood pressure is controlled by receptors that inform the brain about the amount of pressure inside the arteries, and the amount of oxygen and carbon dioxide in the blood, respectively. Research has revealed that baroreflex sensitivity (BRS) decreases with increasing age and that there is a high correlation between hypertension and low BRS. However, various studies with differing results have indicated that high blood pressure is what causes BRS to decline, and vice versa. Several studies have shown very conflicting results on the correlation between chemoreflex and age; there have been indications of chemoreflex having a positive, negative, and zero correlation with age. In several experiments, the surgical removal of the chemoreceptors of hypertensive rats was followed by a decrease in blood pressure. These animal experiments, and an additional noninvasive human experiment in which the chemoreceptors were temporarily "shut off," are reasons why more attention should be given to chemoreceptors as a route of alleviating hypertension.
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Affiliation(s)
| | - Amgad N. Makaryus
- Department of Cardiology, Nassau University Medical Center, East Meadow, New York
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Roman Zeltser
- Department of Cardiology, Nassau University Medical Center, East Meadow, New York
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
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Liu J, Su X, Nie Y, Zeng Z, Chen H. Nocturnal blood pressure rather than night-to-day blood pressure ratio is related to arterial stiffening in untreated young and middle-aged adults with non-dipper hypertension. J Clin Hypertens (Greenwich) 2022; 24:1044-1050. [PMID: 35894760 PMCID: PMC9380157 DOI: 10.1111/jch.14546] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/18/2022] [Accepted: 06/30/2022] [Indexed: 11/29/2022]
Abstract
Little is known about nocturnal blood pressure (BP) or night-to-day BP ratio, which is a more specific determinant of arterial stiffness in subjects with non-dipper hypertension? This study aims to investigate the correlation of nocturnal BP and brachial-ankle pulse wave velocity (ba PWV), an index of arterial stiffness in untreated young and middle-aged adults with non-dipper hypertension. A cross-sectional analysis of baseline parameters of the NARRAS trial was performed. Twenty-four hour ambulatory BP measurements, ba PWV and routine clinical data collection were performed in all patients. The relationship of 24-h ambulatory BP profiles, biochemical measures as well as demographic parameters and ba PWV were analyzed using Pearson's correlation and multiple stepwise regression analysis. A total of 77 patients (mean age 47.0 ± 11.7 years) with non-dipper hypertension were included. Age, height, weight and nocturnal systolic BP were related to ba PWV in Pearson's correlation analysis. In stepwise regression analysis, age (β = 10.57, 95% confidence interval (CI): 6.099-15.042, p < 0.001) and weight (β = -3.835, 95% CI: -7.658--0.013, p = 0.049) are related to ba PWV. Nocturnal systolic BP (β = 8.662, 95% CI: 2.511-14.814, p = 0.006) was the independent predictors of ba PWV, even after night-to-day systolic BP ratio or 24-h ambulatory BP profile were taken into account. Nocturnal systolic BP rather than night-to-day systolic BP ratio appears to be a more specific determinant for arterial stiffness, as assessed by ba PWV in young and middle-aged adults with non-dipper hypertension. 24-h ambulatory BP measurements are essential for cardiovascular risk evaluation.
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Affiliation(s)
- Jing Liu
- Department of HypertensionPeking University People's HospitalBeijingChina
| | - Xiaofeng Su
- Department of HypertensionPeking University People's HospitalBeijingChina
| | - Ying Nie
- Department of Internal MedicineBeijing Jiaotong University HospitalBeijingChina
| | - Zhihuan Zeng
- Department of CardiologyThe First Affiliated Hospital of Guangdong Pharmaceutical UniversityGuangzhouChina
| | - Hongyan Chen
- Deparment of Internal MedicineNorth China Electric Power University HospitalBeijingChina
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Jin M, Miao C, An L, Guo L, Yang X, Zheng M, Hong J, Wu S, Su Q, Tang M. Association between Perceived Salt Intake and Arterial Stiffness. BioMed Research International 2022; 2022:1-7. [PMID: 35845930 PMCID: PMC9279047 DOI: 10.1155/2022/9072082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/30/2022] [Accepted: 06/15/2022] [Indexed: 11/29/2022]
Abstract
To explore the association of perceived salt intake (SI) level with arterial stiffness in the community population in northern China. We enrolled participants who completed the health questionnaire, physical examination, and brachial-ankle pulse wave velocity (baPWV) test during 2010-2019 and divided them into <6 g (low SI), 6-10 g (medium SI), and >10 g (high SI) groups based on their daily SI. The influence of SI on baPWV was analyzed using the multivariate logistic regression model. A total of 36324 subjects, aged (49.10 ± 12.57) years with a male to female ratio of 25934 : 10390, met the inclusion criteria and were enrolled. The average baPWV was (1527.73 ± 355.61) cm/s. Logistic regression analysis showed that after adjusting for other confounders, daily SI>10 g (high SI) was a risk factor for arterial stiffness (baPWV ≥1400 cm/s), with the odds ratio (95% confidence interval [CI]) of 1.17 (1.04-1.31). High SI is independently associated with arterial stiffness.
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Yang W, Sun L, He Y, Xu X, Gan L, Guo T, Yang L. Association between four-limb blood pressure differences and arterial stiffness: a cross-sectional study. Postgrad Med 2022; 134:309-315. [PMID: 35274579 DOI: 10.1080/00325481.2022.2046415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Although inter-arm blood pressure difference (IAD) and inter-ankle blood pressure difference (IAND) have been shown to be associated with cardiovascular disease, controversy remains. In this study, we investigated the prevalence of IAD and IAND as well as the correlation with arterial stiffness and systolic blood pressure in a large number of the Chinese population. METHODS The four-limb blood pressure, IAD, IAND, brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) of 12,176 participants have been measured. Multivariate logistic regression analysis was used to analyze the relationship of the increase in IAD/IAND with arterial stiffness and blood pressure. Reporting adheres to the STROBE guidelines. RESULTS In 12,176 participants, 1832 (15%) subjects had an IAD≥10 mmHg, 663 (5%) had an IAD≥15 mmHg, and 291 (2%) had an IAD≥20 mmHg. Correspondingly, 4548 (37%) had an IAND≥10 mmHg, 2706 (22%) had an IAND≥15 mmHg, and 1706 (14%) had an IAND≥20 mmHg. baPWV was significantly higher in those with an IAD≥10 mmHg (1881 ± 487 cm/s vs. 1943 ± 508 cm/s, P = 0.036) and IAND≥10 mmHg (1850 ± 476 cm/s vs. 1955 ± 509 cm/s, P = 0.000). Compared to others, those with IAD or IAND≥10 mmHg had higher systolic blood pressure (SBP), higher prevalence of hypertension, larger male gender ratio, bigger body mass index, higher pulse rate and lower ABI (P < 0.001 for all). A significant association with baPWV was observed for IAND≥10 mmHg (OR = 1.117; 95%CI: 1.039-1.201; P = 0.003) not for IAD≥10 mmHg (OR = 0.771; 95%CI: 0.699-0.851; P = 0.000) in multivariate logistic regression analysis. CONCLUSIONS Limb blood pressure differences were closely related to arterial stiffness and systolic blood pressure, allowing for a more comprehensive assessment of cardiovascular risk.
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Affiliation(s)
- Wenhui Yang
- Department of Cardiology, Fuwai Yunnan Cardiovascular Hospital, Cardiovascular Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Lin Sun
- Department of Cardiology, Fuwai Yunnan Cardiovascular Hospital, Cardiovascular Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yan He
- Department of Geriatric Cardiology, Yan'an Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Xiaocui Xu
- Department of Cardiology, Fuwai Yunnan Cardiovascular Hospital, Cardiovascular Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Lulu Gan
- Department of Geriatric Cardiology, Yan'an Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Tao Guo
- Department of Cardiology, Fuwai Yunnan Cardiovascular Hospital, Cardiovascular Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Li Yang
- Department of Geriatric Cardiology, Yan'an Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
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Sun Y, Liu F, Zhang Y, Lu Y, Su Z, Ji H, Cheng Y, Song W, Hidru TH, Yang X, Jiang Y. The relationship of endothelial function and arterial stiffness with subclinical target organ damage in essential hypertension. J Clin Hypertens (Greenwich) 2022; 24:418-429. [PMID: 35238151 PMCID: PMC8989756 DOI: 10.1111/jch.14447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 02/02/2022] [Accepted: 02/06/2022] [Indexed: 12/02/2022]
Abstract
This study aimed to explore whether brachial‐ankle pulse wave velocity (baPWV) and brachial artery flow‐mediated dilation (FMD) or the interaction of both parameters are associated with subclinical target organ damage (STOD) indices in patients with essential hypertension. A total of 4618 patients registered from January 2015 to October 2020 were included. baPWV and FMD were measured to evaluate arterial stiffness and endothelial dysfunction. Whereas left ventricular hypertrophy (LVH), urine albumin‐creatinine ratio (UACR), and carotid intima‐media thickness (CIMT) were obtained as STOD indicators. On multivariable logistic regression analysis with potential confounders, higher quartiles of baPWV and FMD were significantly associated with an increased risk of STOD. In patients <65 years of age, the odds ratio (OR) of LVH, UACR, and CIMT ≥.9 mm for the fourth versus the first quartile of baPWV were 1.765 (1.390–2.240), 2.832 (2.014–3.813), and 3.075 (2.315–4.084), respectively. In interaction analysis, an increase in baPWV shows a progressively higher risk of STOD across the quartiles of FMD. Also, the estimated absolute risks of LVH, UACR, and CIMT ≥.9 mm for the first to fourth quartile of baPWV increased from 1.88 to 2.75, 2.35 to 4.44, and 3.10 to 6.10, respectively, in patients grouped by FMD quartiles. The addition of baPWV to FMD slightly improved risk prediction for STOD. BaPWV and FMD were independently associated with an increased risk of STOD in patients with essential hypertension especially among patients <65 years of age. Patients with elevated baPWV and decreased FMD parameters are at increased risk of STOD.
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Affiliation(s)
- Yancui Sun
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Fei Liu
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Ying Zhang
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Yan Lu
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Zhuolin Su
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Haizhe Ji
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Yunpeng Cheng
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Wei Song
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Tesfaldet H Hidru
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Xiaolei Yang
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Yinong Jiang
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
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12
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Saz-Lara A, Bruno RM, Cavero-Redondo I, Álvarez-Bueno C, Notario-Pacheco B, Martínez-Vizcaíno V. Association Between Arterial Stiffness and Blood Pressure Progression With Incident Hypertension: A Systematic Review and Meta-Analysis. Front Cardiovasc Med 2022; 9:798934. [PMID: 35224042 PMCID: PMC8873377 DOI: 10.3389/fcvm.2022.798934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/19/2022] [Indexed: 12/03/2022] Open
Abstract
Background Arterial stiffness is an independent predictor of cardiovascular and all-cause mortality that is classically regarded as a consequence of arterial hypertension. However, a growing number of studies have shown that arterial stiffness is involved in the pathogenesis and prognosis of arterial hypertension. Thus, in this systematic review and meta-analysis, we aimed to assess whether arterial stiffness, as measured by pulse wave velocity, systolic blood pressure and diastolic blood pressure are associated with incident hypertension. Methods The Scopus, PubMed, Web of Science and Cochrane Library databases were searched from inception to March 30, 2021. The DerSimonian and Laird method was used to compute pooled relative risk estimates and their respective 95% confidence intervals of association between incident hypertension with pulse wave velocity, systolic blood pressure and diastolic blood pressure. Results Our findings provide a synthesis of the evidence supporting that the higher arterial stiffness (RR: 1.09; 95% CIs: 1.05, 1.12), systolic blood pressure (RR: 1.08; 95% CIs: 1.05, 1.10) and diastolic blood pressure (RR: 1.08; 95% CIs: 1.04, 1.12) are associated with incident hypertension in normotensive adult subjects, with similar independent predictive values. However, our results should be interpreted with caution because the meta-analyses performed showed considerable heterogeneity. Conclusions Our results showed that higher pulse wave velocity, systolic blood pressure and diastolic blood pressure are associated with incident hypertension. These findings are of clinical importance, supporting arterial stiffness as an additional tool for the prevention of arterial hypertension and being a fundamental component to reduce cardiovascular morbidity and mortality. Systematic Review Registration This study was registered in PROSPERO https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=236435 (Registration number: CRD42021236435).
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Affiliation(s)
- Alicia Saz-Lara
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Rosa María Bruno
- INSERM U970, Paris Cardiovascular Research Centre-PARCC, Université de Paris, Paris, France
- Pharmacology Unit, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Rehabilitation in Health Research Center (CIRES), Universidad de las Américas, Santiago, Chile
- *Correspondence: Iván Cavero-Redondo
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | | | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
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13
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Abstract
OBJECTIVE The aim of this study was to examine effect of parental arterial stiffness in offspring. METHODS The individuals who participated in the second or subsequent follow-up and had parent-offspring relationship and completed measurements of brachial-ankle pulse wave velocity (baPWV) from the Kailuan study were recruited. The individuals were divided into groups by the 10-year intervals and sex. Arterial stiffness was defined as the 75th percentiles in each age category. Multivariable generalized estimating equations was used to analyse the effect of parental baPWV and blood pressure in offspring. Multivariable logistic regression using generalized estimating equations was used to analyse the effect of parental arterial stiffness in offspring. RESULTS A total of 4514 parents and offspring who met the inclusion criteria, including 1785 paternal offspring and 625 maternal offspring was recruited. Mean age of paternal offspring and maternal offspring were 36.26 (SD 7.86) and 36.42 (SD 7.57) years, while their mean baPWV were 1294.40 (SD 225.32) and 1270.74 (SD 241.42) cm/s, respectively. In multivariate linear regression analyses, after adjusted for the covariate risk factors, an increase of 1 cm/s in the paternal and maternal baPWV of resulted in an increase of 0.05 and 0.30 cm/s in offspring, respectively. In multivariate logistic regression analyses, the risk of arterial stiffness in the offspring of paternal and maternal arterial stiffness increased by 50 and 77%, respectively. CONCLUSION Paternal and maternal baPWV are linear positively correlated with baPWV in offspring. Parental arterial stiffness is a risk factor for arterial stiffness of offspring and is independent of traditional risk factors of offspring arterial stiffness.
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Affiliation(s)
- Yuntao Wu
- Department of Cardiology, Kailuan General Hospital
| | - Qian Liu
- Graduate School North China University of Science and Technology, Tangshan
| | - Yihan Ma
- Graduate School North China University of Science and Technology, Tangshan
| | - Xu Han
- Graduate School North China University of Science and Technology, Tangshan
| | | | - Haiyan Zhao
- Department of Cardiology, Kailuan General Hospital
| | - Mingzhu Song
- Department of Cardiology, Kailuan General Hospital
| | - Junyan Sun
- Department of Cardiology, Kailuan General Hospital
| | - Xingyu Wang
- Beijing Hypertension League Institute, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital
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14
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Abstract
OBJECTIVE As a risk indicator of hypertension, arterial stiffness is difficult to measure. Thus, we aimed to evaluate the association between estimated pulse wave velocity (ePWV) as a convenient indicator and the incidence of hypertension. METHODS The Kailuan cohort was selected for statistical analysis and 54 849 individuals were included in the final cohort. Multiple linear regression was used to analyse the correlation between ePWV and mean SBP (SBP_m) measured at five time points over a 10-year period and between ePWV and mean DBP (DBP_m) measured at five time points over a 10-year period. Logistic regression was used to analyse the effect of estimated arterial stiffness on hypertension. RESULTS The mean age of individuals was 48.44 ± 9.32 years, and 41 419 individuals (75.51%) were male. A multiple linear regression analysis showed that ePWV was positively correlated with both SBP_m and DBP_m. For every 1 cm/s increase in ePWV, SBP_m and DBP_m increased by 5.60 and 2.12 mmHg, respectively. A logistic regression analysis showed that in the total cohort, the incidence of hypertension in populations with moderate, moderate-high and high ePWV values was 3.03, 5.44 and 7.87-times higher, respectively, compared with individuals with low ePWV values. ePWV had a higher predictive value in female and middle age population compared with male and the eldly population grouped by sex and age respectively. CONCLUSION ePWV positively correlates with both SBP_m and DBP_m, and an increase in ePWV is associated with an increase in the incidence of hypertension.
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Affiliation(s)
- Haojia Chen
- Shantou University Medical College
- Department of Cardiology, First Hospital of Medical College of Shantou University
| | - Weiqiang Wu
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong
| | - Wei Fang
- Shantou University Medical College
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong
| | - Zhichao Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong
| | - Xiuzhu Yan
- School of Foreign Language, Guangdong Polytechnic Normal University, Guangzhou, Guangdong, China
| | - Youren Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan
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15
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Rotar OP, Boiarinova MA, Tolkunova KM, Moguchaia EV, Alievа AS, Orlov AV, Kolesova EP, Erina AM, Usoltsev DA, Solntsev VN, Baranova EI, Konradi AO, Shlyakhto EV. Vascular aging phenotypes in Russian population — biological, social, and behavioral determinants. Cardiovasc Ther Prev 2021. [DOI: 10.15829/1728-8800-2021-2970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To assess the association of cardiovascular risk factors with various vascular aging phenotypes using the St. Petersburg population sample as part of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study.Material and methods. The current analysis, performed within the ESSE-RF multicenter observational study, included 1600 St. Petersburg residents. The participants filled out a questionnaire to assess risk factors. In addition, blood biochemical parameters, anthropometric characteristics, and blood pressure were evaluated. Pulse wave velocity (PWV) was assessed by applanation tonometry using the SphygmoCor device (AtCor, Australia) in 524 people. For analysis, 485 participants without prior cardiovascular events were selected. PWV ≤10 percentile of PWV for healthy individuals in each age group was considered as the criterion for supernormal vascular aging (SUPERNOVA) phenotype, the PWV ≥90 percentile — early vascular aging (EVA), the PWV of 10-90 percentile — normal vascular aging (NVA).Results. The prevalence of SUPERNOVA phenotype was 9,7%, EVA — 18,8%, NVA — 71,5%. Patients with EVA phenotype were more likely to have HTN (60,4%) in comparison with those with SUPERNOVA phenotype (17%) and, less likely — high physical activity (39,6 vs 53,2%). Obesity, hyperglycemia, insulin resistance, hypercholesterolemia, dyslipoproteinemia, and excessive alcohol consumption were significantly less common in participants with SUPERNOVA phenotype compared with those with EVA phenotype.Conclusion. In addition to HTN and dyslipoproteinemia, a significant predictor of premature aging was the cumulative effect of obesity, insulin resistance and hypertriglyceridemia. Among behavioral risk factors, higher physical activity and adequate alcohol consumption were factors associated with supernormal aging.
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Affiliation(s)
| | | | | | | | | | | | | | | | - D. A. Usoltsev
- Almazov National Medical Research Center; Saint Petersburg National Research University of Information Technologies, Mechanics and Optics
| | | | - E. I. Baranova
- Almazov National Medical Research Center; First Pavlov State Medical University
| | - A. O. Konradi
- Almazov National Medical Research Center; Saint Petersburg National Research University of Information Technologies, Mechanics and Optics
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16
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Liu X, Liu L, Wang R, Jia X, Liu B, Ma N, Lu Q. Early arteriosclerosis and its risk factors in subjects with prediabetes and new-onset diabetes. Endocr Connect 2021; 10:599-606. [PMID: 33971618 PMCID: PMC8240705 DOI: 10.1530/ec-21-0202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/06/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND We aimed to investigate early arteriosclerosis and its risk factors in populations with prediabetes and new-onset diabetes. MATERIALS AND METHODS A total of 148 participants who did not have diabetes mellitus were assigned to three groups through an oral glucose tolerance test: the normal glucose tolerance (NGT) group; the impaired glucose regulation, also known as prediabetes group and the new-onset type 2 diabetes mellitus group. The insulin resistance index was assessed using the homeostatic model assessment of insulin resistance (HOMA-IR). An ELISA was used to determine the level of fibroblast growth factor 21 (FGF21). An arteriosclerosis detector was used to measure the brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI). The baPWV, ABI, and FGF21 were used to assess early arteriosclerosis. RESULTS Significant differences in age, systolic blood pressure (SBP), fasting plasma glucose (FPG), 2-h plasma glucose (2hPG), 2-h insulin (2hINS), and HOMA-IR were found between the NGT group and the prediabetes and new-onset diabetes groups. All of the above, except 2hINS, showed an increasing trend. Moreover, the FGF21 was higher in the new-onset diabetes group than in the NGT group. The baPWV was higher in the new-onset diabetes group than in the other two groups, but no significant difference was noted in the ABI. Age, SBP, diastolic blood pressure, FPG, 2hPG, and FGF21 were positively correlated with the baPWV. In addition, FPG, SBP, FGF21, and HOMA-IR were independent risk factors for the baPWV. CONCLUSIONS Patients with prediabetes and new-onset diabetes may have more significant early arteriosclerosis. The blood glucose level and insulin resistance index may be independent risk factors for early arteriosclerosis.
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Affiliation(s)
- Xiaoli Liu
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Lanxiang Liu
- Department of Medical Imaging, The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Rui Wang
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Xiaojiao Jia
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Binbin Liu
- Department of Functional Examination, The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Ning Ma
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Qiang Lu
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China
- Correspondence should be addressed to Q Lu:
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17
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Ajamu SO, Fenner RC, Grigorova YN, Cezayirli D, Morrell CH, Lakatta EG, Bouhrara M, Spencer RG, Fedorova OV, Fishbein KW. Association of central arterial stiffness with hippocampal blood flow and N-acetyl aspartate concentration in hypertensive adult Dahl salt sensitive rats. J Hypertens 2021; 39:2113-21. [PMID: 34001812 DOI: 10.1097/HJH.0000000000002899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Central arterial stiffness (CAS) is associated with elevated arterial blood pressure (BP) and is likely associated with stiffening of cerebral artery walls, with attendant cerebral hypoperfusion, neuronal density loss and cognitive decline. Dahl salt-sensitive (Dahl-S) rats exhibit age-associated hypertension and memory loss, even on a normal salt intake. METHOD We sought to explore whether central arterial pulse wave velocity (PWV), a marker of CAS, is associated with hippocampal cerebral blood flow (CBF) and neuronal density in hypertensive Dahl-S rats. We measured systolic BP (by tail-cuff plethysmography), aortic PWV (by echocardiography) and CBF and N-acetyl aspartate (NAA) (by magnetic resonance imaging) in 6 month-old male Dahl-S rats (n = 12). RESULTS Greater PWV was significantly associated with lower CBF and lower NAA concentration in the hippocampus, supporting a role of CAS in cerebrovascular dysfunction and decline in cognitive performance with aging. CONCLUSION These findings implicate increased CAS in cerebral hypoperfusion and loss of neuronal density and function in the Dahl-S model of age-associated cardiovascular dysfunction.
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18
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Heidari Pahlavian S, Cen SY, Bi X, Wang DJJ, Chui HC, Yan L. Assessment of carotid stiffness by measuring carotid pulse wave velocity using a single-slice oblique-sagittal phase-contrast MRI. Magn Reson Med 2021; 86:442-455. [PMID: 33543788 DOI: 10.1002/mrm.28677] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/14/2020] [Accepted: 12/18/2020] [Indexed: 11/06/2022]
Abstract
PURPOSE Increased arterial stiffness has been shown to be one of the earliest markers of cerebrovascular dysfunction. As a surrogate marker of arterial stiffness, pulse wave velocity (PWV) quantifications are generally carried out on central and peripheral arteries. The purpose of this study was to develop and evaluate an MRI approach to assess carotid stiffness by measuring carotid PWV (cPWV) using a fast oblique-sagittal phase-contrast MRI sequence. METHODS In 29 volunteers, a single-slice oblique-sagittal phase-contrast MRI sequence with retrospective cardiac gating was used to quantify blood velocity waveforms along a vessel segment covering the common carotid artery (CCA) and the internal carotid artery (ICA). The CCA-ICA segment length was measured from a region of interest selected on the magnitude image. Phase-contrast MRI-measured velocities were also used to quantify the ICA pulsatility index along with cPWV quantification. RESULTS The mean value of cPWV calculated using the middle upslope area algorithm was 2.86 ± 0.71 and 3.97 ± 1.14 m/s in young and elderly subjects, respectively. Oblique-sagittal phase-contrast MRI-derived cPWV measurements showed excellent intrascan and interscan repeatability. cPWV and ICA pulsatility index were significantly greater in older subjects compared to those in the young subjects (P < .01 and P = .01, respectively). Also, increased cPWV values were associated with elevated systolic blood pressure (β = 0.05, P = .03). CONCLUSION This study demonstrated that oblique-sagittal phase-contrast MRI is a feasible technique for the quantification of both cPWV and ICA pulsatility index and showed their potential utility in evaluating cerebroarterial aging and age-related neurovascular disorders.
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Affiliation(s)
- Soroush Heidari Pahlavian
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Steven Yong Cen
- Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Xiaoming Bi
- Siemens Medical Solutions USA, Inc., Los Angeles, California, USA
| | - Danny J J Wang
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Helena Chang Chui
- Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Lirong Yan
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Department of Neurology, University of Southern California, Los Angeles, California, USA
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19
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Benny M, Hernandez DR, Sharma M, Yousefi K, Kulandavelu S, Batlahally S, Zambrano R, Chen P, Martinez EC, Schmidt AF, Shehadeh LA, Vasquez-Padron RI, Wu S, Velazquez OC, Young KC. Neonatal hyperoxia exposure induces aortic biomechanical alterations and cardiac dysfunction in juvenile rats. Physiol Rep 2020; 8:e14334. [PMID: 31925922 PMCID: PMC6954121 DOI: 10.14814/phy2.14334] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Supplemental oxygen (O2) therapy in preterm infants impairs lung development, but the impact of O2 on long‐term systemic vascular structure and function has not been well‐explored. The present study tested the hypothesis that neonatal O2 therapy induces long‐term structural and functional alterations in the systemic vasculature, resulting in vascular stiffness observed in children and young adults born preterm. Newborn Sprague‐Dawley rats were exposed to normoxia (21% O2) or hyperoxia (85% O2) for 1 and 3 weeks. A subgroup exposed to 3 weeks hyperoxia was recovered in normoxia for an additional 3 weeks. Aortic stiffness was assessed by pulse wave velocity (PWV) using Doppler ultrasound and pressure myography. Aorta remodeling was assessed by collagen deposition and expression. Left ventricular (LV) function was assessed by echocardiography. We found that neonatal hyperoxia exposure increased vascular stiffness at 3 weeks, which persisted after normoxic recovery at 6 weeks of age. These findings were accompanied by increased PWV, aortic remodeling, and altered LV function as evidenced by decreased ejection fraction, cardiac output, and stroke volume. Importantly, these functional changes were associated with increased collagen deposition in the aorta. Together, these findings demonstrate that neonatal hyperoxia induces early and sustained biomechanical alterations in the systemic vasculature and impairs LV function. Early identification of preterm infants who are at risk of developing systemic vascular dysfunction will be crucial in developing targeted prevention strategies that may improve the long‐term cardiovascular outcomes in this vulnerable population.
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Affiliation(s)
- Merline Benny
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida.,Batchelor Children's Research Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Diana R Hernandez
- Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Mayank Sharma
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida.,Batchelor Children's Research Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Keyvan Yousefi
- The Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, Florida.,Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, Florida.,Division of Cardiology, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida
| | - Shathiyah Kulandavelu
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida.,The Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Sunil Batlahally
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida.,Batchelor Children's Research Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Ronald Zambrano
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida.,Batchelor Children's Research Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Pingping Chen
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida.,Batchelor Children's Research Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Eliana C Martinez
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida.,The Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Augusto F Schmidt
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida.,Batchelor Children's Research Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Lina A Shehadeh
- The Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, Florida.,Division of Cardiology, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida
| | | | - Shu Wu
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida.,Batchelor Children's Research Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Omaida C Velazquez
- Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Karen C Young
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida.,Batchelor Children's Research Institute, University of Miami Miller School of Medicine, Miami, Florida
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20
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Fan Y, Gao W, Li J, Fan F, Qin X, Liu L, Cheng X, Xu X, Wang X, Wang B, Huo Y. Effect of the baseline pulse wave velocity on short term and long term blood pressure control in primary hypertension. Int J Cardiol 2020; 317:193-199. [PMID: 32505371 DOI: 10.1016/j.ijcard.2020.02.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/30/2020] [Accepted: 02/23/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Arterial stiffness may affect antihypertensive response to antihypertensive treatment. However, sufficient clinical evidence is lacking. This longitudinal study aimed to evaluate the effect of baseline arterial stiffness measured by the brachial-ankle pulse wave velocity (baPWV) on response to short-term and long-term enalapril-based treatment in 3310 hypertensive adults from the China Stroke Primary Prevention Trial (CSPPT). METHODS AND RESULTS Blood pressure (BP) measured at three months (short-term) in 2780 subjects, and the time-average on-treatment BP in 3310 subjects during a median of 4.5-year follow-ups (long-term) were analyzed in the study. After short-term antihypertensive treatment, every 1 m/s increase in baPWV denoted a 7% and 6% decreased chance of achieving systolic BP (SBP) control (odds ratio (OR), 0.93; 95% CI 0.90, 0.96; P < 0.001) and BP control (OR, 0.94; 95% CI 0.91, 0.97; P < 0.001), respectively, after adjustment for age, gender and other variables. After long-term treatment, every 1 m/s increase in baPWV posed an 7% and 6% greater risk of failing to attain SBP control (OR, 0.93; 95% CI 0.90, 0.95; P < 0.001) and BP control (OR, 0.94; 95% CI, 0.92, 0.96; P < 0.001), respectively, not regarding for DBP control after both short- and long-term treatment. Higher baseline baPWV significantly decreased SBP reduction both after three months and the median 4.5-year treatment, while increased DBP reduction after the median 4.5-year treatment. CONCLUSIONS Elevated baseline baPWV significantly decreased BP response to short-and long-term treatment in adults with primary hypertensive. Arterial stiffness improvement may be an essential target to achieve adequate BP control.
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Affiliation(s)
- Y Fan
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China
| | - W Gao
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China
| | - J Li
- Cardiology Department, Peking University First Hospital, Beijing, China
| | - F Fan
- Cardiology Department, Peking University First Hospital, Beijing, China
| | - X Qin
- National Center for Clinical Research in Kidney Disease, Guangdong Institute of Nephrology, Southern Medical University, Guangzhou, China
| | - L Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - X Cheng
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Jiangxi, China
| | - X Xu
- National Center for Clinical Research in Kidney Disease, Guangdong Institute of Nephrology, Southern Medical University, Guangzhou, China
| | - X Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - B Wang
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Y Huo
- Cardiology Department, Peking University First Hospital, Beijing, China.
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21
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Cooper LL, Musani SK, Moore JA, Clarke VA, Yano Y, Cobbs K, Tsao CW, Butler J, Hall ME, Hamburg NM, Benjamin EJ, Vasan RS, Mitchell GF, Fox ER. Clinical Associations of Vascular Stiffness, Microvascular Dysfunction, and Prevalent Cardiovascular Disease in a Black Cohort: The Jackson Heart Study. J Am Heart Assoc 2020; 9:e017018. [PMID: 32873113 PMCID: PMC7726980 DOI: 10.1161/jaha.120.017018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background Measures of vascular dysfunction are related to adverse cardiovascular disease (CVD) outcomes in non‐Hispanic, White populations; however, data from Black individuals are limited. We aimed to investigate the associations between novel hemodynamic measures and prevalent CVD in a sample of Black individuals. Methods and Results Among older Black participants of the Jackson Heart Study, we assessed noninvasive vascular hemodynamic measures using arterial tonometry and Doppler ultrasound. We assessed 5 measures of aortic stiffness and wave reflection (carotid‐femoral pulse wave velocity, pulse wave velocity ratio, forward pressure wave amplitude, central pulse pressure, and augmentation index), and 2 measures of microvascular function (baseline and hyperemic brachial flow velocity). Using multivariable logistic regression models, we examined the relations between vascular hemodynamic measures and prevalent CVD. In models adjusted for traditional CVD risk factors, higher carotid‐femoral pulse wave velocity (odds ratio [OR],1.25; 95% CI, 1.01–1.55; P=0.04), lower augmentation index (OR, 0.84; 95% CI, 0.70–0.99; P=0.05), and lower hyperemic brachial flow velocity (OR, 0.77; 95% CI, 0.65–0.90; P=0.001) were associated with higher odds of CVD. After further adjustment for hypertension treatment, lower augmentation index (OR, 0.84; 95% CI, 0.70–0.99; P=0.04) and hyperemic brachial flow velocity (OR, 0.79; 95% CI, 0.67–0.94; P=0.006), but not carotid‐femoral pulse wave velocity (OR, 1.23; 95% CI, 0.99–1.051; P=0.06), were associated with higher odds of CVD. Conclusions In a sample of older Black individuals, more severe microvascular damage and aortic stiffness were associated with prevalent CVD. Further research on hemodynamic mechanisms that contribute to cardiovascular risk among older Black individuals is merited.
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Affiliation(s)
| | - Solomon K Musani
- Department of Medicine Division of Cardiovascular Diseases University of Mississippi Medical Center Jackson MS
| | - Josiah A Moore
- Department of Medicine Division of Cardiovascular Diseases University of Mississippi Medical Center Jackson MS.,Tougaloo College Jackson MS
| | | | - Yuichiro Yano
- Department of Family Medicine and Community Health Duke University Durham NC
| | - Keith Cobbs
- Department of Medicine Division of Cardiovascular Diseases University of Mississippi Medical Center Jackson MS
| | - Connie W Tsao
- Boston University and NHLBI's Framingham Heart Study Framingham MA.,Department of Medicine Cardiovascular Division Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA
| | - Javed Butler
- Department of Medicine Division of Cardiovascular Diseases University of Mississippi Medical Center Jackson MS
| | - Michael E Hall
- Department of Medicine Division of Cardiovascular Diseases University of Mississippi Medical Center Jackson MS
| | - Naomi M Hamburg
- Evans Department of Medicine Boston University School of Medicine Boston MA.,Whitaker Cardiovascular Institute Boston University School of Medicine Boston MA
| | - Emelia J Benjamin
- Boston University and NHLBI's Framingham Heart Study Framingham MA.,Sections of Cardiology, Preventive Medicine and Epidemiology Department of Medicine Boston University School of Medicine Boston MA
| | - Ramachandran S Vasan
- Evans Department of Medicine Boston University School of Medicine Boston MA.,Whitaker Cardiovascular Institute Boston University School of Medicine Boston MA.,Sections of Cardiology, Preventive Medicine and Epidemiology Department of Medicine Boston University School of Medicine Boston MA.,Department of Epidemiology Boston University School of Public Health Boston MA
| | | | - Ervin R Fox
- Department of Medicine Division of Cardiovascular Diseases University of Mississippi Medical Center Jackson MS
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22
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Pamuk N, Akkan T, Dağdeviren M, Koca AO, Beyan E, Ertuğrul DT, Altay M. Central and peripheral blood pressures and arterial stiffness increase in hypoparathyroidism. Arch Endocrinol Metab 2020; 64:374-382. [PMID: 32267362 PMCID: PMC10522079 DOI: 10.20945/2359-3997000000234] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 12/26/2019] [Indexed: 11/23/2022]
Abstract
Objective The aim of the present study was to evaluate whether arterial stiffness is affected in the patients with hypoparathyroidism through pulse wave analysis (PWA). Subjects and methods Sixty-three patients diagnosed with hypoparathyroidism and sixty volunteers were evaluated for the study. When 21 patients were excluded in the hypoparathyroidism group due to exclusion criteria, the research continued with 42 patients and 60 volunteers who are similar to the patients in terms of age, gender and body mass index (BMI). Fasting plasma glucose after 10 hours of fasting, creatinine, thyroid stimulating hormone (TSH), free thyroxine (fT4), albumin, calcium, phosphorus, magnesium, 25-OH vitamin D, parathormone (PTH) and urine calcium results in 24-hour urine for the patients in the hypoparathyroidism group were recorded. Evaluation of arterial stiffness was performed by Mobil-O-Graph 24h PWA device. Results Systolic blood pressure (SBP) (p = 0.01), diastolic blood pressure (DBP) (p = 0.005), mean blood pressure (p = 0.009), central SBP (p = 0.004), central DBP (p = 0.01) and pulse wave velocity (PWV) (p = 0.02) were found higher in the hypoparathyroidism group. A positive correlation was detected between phosphorus level and SBP [(p = 0.03. r = 0.327)], central SBP [(p = 0.04, r = 0.324)] and PWV [(p = 0.003, r = 0.449)]. We detected that age and serum phosphorus levels were independent predictor variables for PWV (B = 0.014, p < 0.001 and B = 0.035, p < 0.001, respectively). Conclusion We detected that hypoparathyroidism causes an increase in blood pressure and arterial stiffness. The most significant determinant factors were detected as advanced age and hyperphosphatemia. The patients diagnosed with hypoparathyroidism should be closely monitored and treatment planning should include to prevent the patients from hyperphosphatemia.
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Affiliation(s)
- Naim Pamuk
- University of Health Sciences TurkeyKeçiören Education and Research HospitalDepartment of Internal MedicineAnkaraTurkeyUniversity of Health Sciences Turkey, Keçiören Education and Research Hospital, Department of Internal Medicine, Ankara, Turkey
| | - Tolga Akkan
- University of Health Sciences TurkeyKeçiören Education and Research HospitalDepartment of Endocrinology and MetabolismAnkaraTurkeyUniversity of Health Sciences Turkey, Keçiören Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Murat Dağdeviren
- University of Health Sciences TurkeyKeçiören Education and Research HospitalDepartment of Endocrinology and MetabolismAnkaraTurkeyUniversity of Health Sciences Turkey, Keçiören Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Arzu Or Koca
- University of Health Sciences TurkeyKeçiören Education and Research HospitalDepartment of Endocrinology and MetabolismAnkaraTurkeyUniversity of Health Sciences Turkey, Keçiören Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Esin Beyan
- University of Health Sciences TurkeyKeçiören Education and Research HospitalDepartment of Internal MedicineAnkaraTurkeyUniversity of Health Sciences Turkey, Keçiören Education and Research Hospital, Department of Internal Medicine, Ankara, Turkey
| | - Derun Taner Ertuğrul
- University of Health Sciences TurkeyKeçiören Education and Research HospitalDepartment of Endocrinology and MetabolismAnkaraTurkeyUniversity of Health Sciences Turkey, Keçiören Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Mustafa Altay
- University of Health Sciences TurkeyKeçiören Education and Research HospitalDepartment of Endocrinology and MetabolismAnkaraTurkeyUniversity of Health Sciences Turkey, Keçiören Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
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23
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Kähönen E, Lyytikäinen LP, Aatola H, Koivistoinen T, Haarala A, Sipilä K, Juonala M, Lehtimäki T, Raitakari OT, Kähönen M, Hutri-Kähönen N. Systemic vascular resistance predicts the development of hypertension: the cardiovascular risk in young Finns study. Blood Press 2020; 29:362-369. [PMID: 32597238 DOI: 10.1080/08037051.2020.1783992] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE To study whether systemic hemodynamics, especially systemic vascular resistance, predicts the development of hypertension and improves the risk prediction of incident hypertension beyond common risk factors in the risk models in young adults. MATERIALS AND METHODS Typical risk factors for hypertension in the risk prediction models (systolic and diastolic blood pressure, parental history of hypertension, age, sex, body-mass index, smoking), laboratory values (high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, glucose, insulin, C-reactive protein), heart rate (HR), stroke index (SI), and systemic vascular resistance index (SVRI) calculated by whole-body impedance cardiography were evaluated in 2007 and blood pressure in 2011 in 1293 Finnish adults (aged 30-45 years; females 56%; n = 1058 normotensive in 2007). RESULTS Of hemodynamic variables, SVRI and HR evaluated in 2007 were independently associated with systolic blood pressure (p < 0.001 and p = 0.047, respectively) and SVRI with diastolic blood pressure measured in 2011 (p = 0.014), and SVRI and HR were independent predictors of incident hypertension (p < 0.001 and p = 0.024, respectively). SVRI was the most significant predictor of incident hypertension independently of other risk factors (odds ratio 2.73 per 1 standard deviation increase, 95% confidence interval 1.93-3.94, p < 0.001). The extended prediction model (including SVRI) improved the incident hypertension risk prediction beyond other risk factors, with an area under the receiver operating characteristic curve of 0.846 versus 0.817 (p = 0.042) and a continuous net reclassification improvement of 0.734 (p < 0.001). CONCLUSIONS These findings suggest that systemic vascular resistance index predicts the incidence of hypertension in young adults and that the evaluation of systemic hemodynamics could provide an additional tool for hypertension risk prediction.
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Affiliation(s)
- Emilia Kähönen
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland.,Faculty of Medicine, University of Latvia, Riga, Latvia
| | - Leo-Pekka Lyytikäinen
- Fimlab Laboratories, Tampere, Finland.,Department of Clinical Chemistry, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland.,Finnish Cardiovascular Research Center-Tampere, Tampere, Finland
| | - Heikki Aatola
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Teemu Koivistoinen
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland.,Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland
| | - Atte Haarala
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Kalle Sipilä
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku, and the Division of Medicine, Turku University Hospital, Turku, Finland
| | - Terho Lehtimäki
- Fimlab Laboratories, Tampere, Finland.,Department of Clinical Chemistry, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland.,Finnish Cardiovascular Research Center-Tampere, Tampere, Finland
| | - Olli T Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Mika Kähönen
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland.,Finnish Cardiovascular Research Center-Tampere, Tampere, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
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24
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Qi Z, Zhao ZY, Xu JT, Zhu LP, Zhang Y, Bao YM, Zhang ZF. Radial Pulse Wave Signals Combined with Ba-PWV for the Risk Prediction of Hypertension and the Monitoring of Its Accompanying Metabolic Risk Factors. Evid Based Complement Alternat Med 2020; 2020:3926851. [PMID: 32419802 DOI: 10.1155/2020/3926851] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 03/13/2020] [Accepted: 04/15/2020] [Indexed: 12/21/2022]
Abstract
Our aim was to study whether radial pulse wave signals can improve the risk prediction of incident hypertension and are associated with its concomitant metabolic risk factors beyond the traditional cardiovascular risk factor Ba-PWV. By enrolling 523 Chinese subjects in this study, linear and stepwise regression analysis was performed to assess the association of radial artery pulse wave signals and Ba-PWV with blood pressure and its related metabolic risk factors such as fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and uric acid (UA). The area under the receiver-operating characteristic curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were calculated by risk assessment plot to compare the discriminative ability among models with and without radial artery pulse wave signals. After adjusting related confounding factors, radial artery pulse wave variable h3/h1 was selected as the sensitive influential factor for blood pressure. Moreover, a new model with h3/h1 had a higher AUC than the reference model without it (0.86 vs 0.84; P=0.030). And the NRI and IDI for the new model was 50.0% (P=0.017) and 3.16% (P=0.044), respectively. In addition to Ba-PWV, we found that the decrease of t4, t5, and h5 might be associated with higher FPG, TC, LDL-C, and UA and lower HDL-C. This research might provide a valuable additional tool for remote wearable monitoring of radial artery pulse wave signals in hypertension risk evaluation and management.
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25
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Jiang Y, Fan F, Jia J, Li J, Xia Y, Zhou J, Huo Y, Zhang Y. Brachial-Ankle Pulse Wave Velocity Predicts New-Onset Hypertension and the Modifying Effect of Blood Pressure in a Chinese Community-Based Population. Int J Hypertens 2020; 2020:9075636. [PMID: 32328303 DOI: 10.1155/2020/9075636] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 11/17/2022] Open
Abstract
Brachial-ankle pulse wave velocity (baPWV) was proven to be a prognostic indicator of cardiovascular events. However, the modifying effect of blood pressure (BP) on the longitudinal association between baPWV and new-onset hypertension is not well established. This study included 1849 non-hypertensive Chinese subjects from Shougang cohort study during December 2011 to July 2014. BaPWV was obtained using an Omron Colin BP-203RPE III device. Multivariate logistic regression models were used to evaluate associations of baPWV and outcomes. During a mean follow-up time of 2.36 years, 248 (13.41%) developed hypertension. BaPWV independently and gradably predicted the risk of incident hypertension and the SBP level at revisit (odds ratio or β (95% confidence interval) for participants with baPWV in quartile 4 vs. quartile 1: 2.72 (1.54, 4.78) for incident hypertension and 5.92 (4.26, 7.58) for SBP, P for trend: <0.001) after adjusting demonstrated risk factors. Besides, the effects of baseline baPWV on either incident hypertension or SBP at revisit were interactively modified by the level of baseline SBP; the effect size increased as the SBP level decreased. baPWV independently predicted the risk of hypertension and BP progression, modified by the level of SBP at baseline in this Chinese community-based population. The combination of baPWV and SBP can help differentiate the potential high-risk candidates who will develop hypertension quickly and benefit from early diagnosis and treatment.
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26
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Luo F, Zhuo C. Association between uric acid and brachial-ankle pulse wave velocity: secondary analysis of data from a cross-sectional study. Sci Rep 2020; 10:2282. [PMID: 32042084 PMCID: PMC7010787 DOI: 10.1038/s41598-020-59391-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 01/14/2020] [Indexed: 11/09/2022] Open
Abstract
At present, the association between uric acid (UA) and brachial-ankle pulse wave velocity (baPWV) has not been well clarified. This study is the second analysis based on a cross-sectional study. 912 participants (average age is 51.5 ± 9.6 years) who underwent medical health examinations were included in this study, UA levels and baPWV were measured. Participants were divided into four groups according to UA levels (Quantile 1: 2.00-4.10 mg/dL; Quantile 2: 4.20-5.20 mg/dL; Quantile 3: 5.30-6.00 mg/dL and Quantile 4: 6.10-9.80 mg/dL), and the differences of baPWV between the four groups were compared. Univariate analysis showed a positive correlation between UA and baPWV [(Quantile 2 vs Quantile 1: 8.85 (-36.05, 53.75); Quantile 3 vs Quantile 1: 60.32 (13.22, 107.42) and Quantile 4 vs Quantile 1: 80.34 (36.19, 124.49)]. After adjusting for confounding factors, the positive correlation between UA and baPWV still exists [(Quantile 2 vs Quantile 1: -9.92 (-60.16, 40.32); Quantile 3 vs Quantile 1: 82.34 (4.00, 160.68) and Quantile 4 vs Quantile 1: 143.13 (0.75, 285.51)]. Furthermore, curve fitting showed that UA and baPWV had a non-linear positive correlation. In conclusion, elevated UA were associated with baPWV, suggesting that UA could be used as a predictor of atherosclerosis.
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Affiliation(s)
- Faxin Luo
- Emergency Department, The People's Hospital of Longhua, Shenzhen, China.
| | - Chaozhou Zhuo
- Emergency Department, The People's Hospital of Longhua, Shenzhen, China
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27
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Kanegae H, Suzuki K, Fukatani K, Ito T, Harada N, Kario K. Highly precise risk prediction model for new-onset hypertension using artificial intelligence techniques. J Clin Hypertens (Greenwich) 2019; 22:445-450. [PMID: 31816148 DOI: 10.1111/jch.13759] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 10/31/2019] [Indexed: 12/22/2022]
Abstract
Hypertension is a significant public health issue. The ability to predict the risk of developing hypertension could contribute to disease prevention strategies. This study used machine learning techniques to develop and validate a new risk prediction model for new-onset hypertension. In Japan, Industrial Safety and Health Law requires employers to provide annual health checkups to their employees. We used 2005-2016 health checkup data from 18 258 individuals, at the time of hypertension diagnosis [Year (0)] and in the two previous annual visits [Year (-1) and Year (-2)]. Data were entered into models based on machine learning methods (XGBoost and ensemble) or traditional statistical methods (logistic regression). Data were randomly split into a derivation set (75%, n = 13 694) used for model construction and development, and a validation set (25%, n = 4564) used to test performance of the derived models. The best predictor in the XGBoost model was systolic blood pressure during cardio-ankle vascular index measurement at Year (-1). Area under the receiver operator characteristic curve values in the validation cohort were 0.877, 0.881, and 0.859 for the XGBoost, ensemble, and logistic regression models, respectively. We have developed a highly precise prediction model for future hypertension using machine learning methods in a general normotensive population. This could be used to identify at-risk individuals and facilitate earlier non-pharmacological intervention to prevent the future development of hypertension.
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Affiliation(s)
- Hiroshi Kanegae
- Department of Medicine, Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.,Genki Plaza Medical Center for Health Care, Tokyo, Japan
| | - Kenji Suzuki
- The Japan Health Promotion Foundation, Tokyo, Japan
| | | | | | | | - Kazuomi Kario
- Department of Medicine, Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
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Abstract
Arterial stiffness and blood pressure (BP) both increase with aging synchronously. Whether elevated BP results from thickening of arterial wall or vice versa is controversial in previous studies. This study included 17 862 participants without history of myocardial infarction, stroke, atrial fibrillation or flutter, or cancer and with brachial-ankle pulse wave velocity (baPWV) and BP measurements during 2010 to 2016. Age was calculated from the self-reported birthdate to the first date of baPWV examination. Mediation analyses were applied to assess the mediation effect by baPWV in the association between age and BP. Temporal relation between baPWV and BP was assessed by cross-lagged analyses among 1508 participants with repeated assessment of baPWV. We found that systolic BP increased 0.47 (95% CI, 0.45-0.49) mm Hg per 1 year older by the mediation effect of baPWV and that the direct effect of aging on systolic BP was -0.07 (95% CI, -0.09 to -0.05) mm Hg per 1 year older. The standard regression coefficient from baseline baPWV to follow-up systolic BP was 0.09 (95% CI, 0.04-0.15), which was greater than the standard regression coefficient from baseline systolic BP to follow-up baPWV (0.01; 95% CI, -0.04 to 0.06). Arterial stiffness mediated the positive association between aging and BP, and arterial stiffness might precede elevated BP. Clinical Trial Registration- URL: http://www.chictr.org.cn . Unique identifier: ChiCTR-TNRC-11001489.
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Affiliation(s)
- Shouling Wu
- From the Department of Cardiology (S.W., C.J., X. Zheng, X. Zhang), Kailuan General Hospital, Tangshan, People's Republic of China
| | - Cheng Jin
- From the Department of Cardiology (S.W., C.J., X. Zheng, X. Zhang), Kailuan General Hospital, Tangshan, People's Republic of China
| | - Shanshan Li
- Clinical Epidemiology Unit, Boston University School of Medicine, MA (S.L.)
| | - Xiaoming Zheng
- From the Department of Cardiology (S.W., C.J., X. Zheng, X. Zhang), Kailuan General Hospital, Tangshan, People's Republic of China
| | - Xinyuan Zhang
- From the Department of Cardiology (S.W., C.J., X. Zheng, X. Zhang), Kailuan General Hospital, Tangshan, People's Republic of China.,Department of Nutritional Sciences, Pennsylvania State University, State College (X. Zhang, X.G.)
| | - Liufu Cui
- Department of Rheumatic Disease (L.C.), Kailuan General Hospital, Tangshan, People's Republic of China
| | - Xiang Gao
- Department of Nutritional Sciences, Pennsylvania State University, State College (X. Zhang, X.G.)
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29
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Liu Y, Yan Y, Yang X, Li S, Bazzano L, He J, Chen W. Long-Term Burden of Higher Body Mass Index and Adult Arterial Stiffness Are Linked Predominantly Through Elevated Blood Pressure. Hypertension 2019; 73:229-234. [PMID: 30571556 DOI: 10.1161/hypertensionaha.118.12106] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Obesity and hypertension are important risk factors of arterial stiffness. However, the complex relationship between increased body mass index (BMI), elevated blood pressure (BP), and arterial stiffness is largely unknown. We aim to examine the mediation effect of elevated BP on the association of early life BMI, long-term burden, and trend of BMI with arterial stiffness in midlife. The longitudinal study cohort consisted of 1190 participants (829 whites and 361 blacks, 518 males, mean age=40.0 years at follow-up) who had been examined for BMI and BP 4 to 15 times from childhood and aortic-femoral pulse wave velocity (afPWV) in adulthood, with a mean follow-up period of 30.3 years. Total area under the curve (AUCt) and incremental AUC (AUCi) were calculated in random-effects models and used as long-term measures of BMI and BP. Total effects of BMI measures on adult afPWV, adjusted for covariates were all significant without adult BMI and systolic BP (SBP) measures included in the models. The mediation effects of adult SBP (20.2%) and SBP AUCi (16.9%) were significant on the childhood BMI-afPWV association. Adult SBP showed significant mediation effects of 36.7% on the BMI AUCi-afPWV association and 36.4% on the BMI AUCt-afPWV association. The mediation effect of SBP AUCi was estimated at 63.3% ( P<0.01) on the BMI AUCi-afPWV association. Diastolic BP had similar total and mediation effects. These findings suggest that the association of increased childhood BMI and its cumulative burden with adult arterial stiffness measured as afPWV is predominantly mediated through the long-term and increasing trend of BP.
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Affiliation(s)
- Yang Liu
- From the Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (Y.L., X.Y.).,Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (Y.L., Y.Y., L.B., J.H., W.C.)
| | - Yinkun Yan
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (Y.L., Y.Y., L.B., J.H., W.C.).,Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China (Y.Y.)
| | - Xiangjun Yang
- From the Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China (Y.L., X.Y.)
| | - Shengxu Li
- Children's Minnesota Research Institute, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN (S.L.)
| | - Lydia Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (Y.L., Y.Y., L.B., J.H., W.C.)
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (Y.L., Y.Y., L.B., J.H., W.C.)
| | - Wei Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (Y.L., Y.Y., L.B., J.H., W.C.)
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Abstract
Both small and large artery disease might precede the development of hypertension. However, no prospective trial has yet determined the role of small and large artery disease on the rate of new-onset hypertension in a normotensive general population. This study investigated associations between both arterial stiffness and small artery retinopathy and the development of hypertension in adults from Japan. Normotensive individuals who underwent a baseline health checkup from 2005 to 2015 and at least 1 annual follow-up were eligible. The cardio-ankle vascular index (CAVI) was measured, and retinal fundus photography was performed at baseline. Follow-up visits included measurement of clinic blood pressure. The primary end point was new-onset hypertension (blood pressure ≥140/90 mm Hg or initiation of antihypertensive medication with self-reported hypertension). The analysis included 34 649 subjects (mean age, 44.2 years; 46.4% male). Mean follow-up duration was 3.18±2.50 years. The cumulative incidence of new-onset hypertension during the 10-year follow-up period was 40% of patients overall, with rates increasing in parallel with baseline CAVI (quartile [Q]1, 23%; Q2, 33%; Q3, 42%; Q4, 58%; P<0.001), and as the severity of retinopathy increased ( P<0.001). CAVI showed good discriminative ability for detecting new-onset hypertension. In multivariate analysis, both CAVI and small artery retinopathy were independent predictors of hypertension development. There was no interaction between CAVI and small artery retinopathy with respect to incident hypertension. In conclusion, we showed that both large and small artery disease predict future hypertension independently of each other and confounding risk factors in a general normotensive population.
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Affiliation(s)
- Kazuomi Kario
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K., H.K.)
| | - Hiroshi Kanegae
- From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K., H.K.).,Genki Plaza Medical Center for Health Care, Tokyo, Japan (H.K., T.O.)
| | - Takamitsu Oikawa
- Genki Plaza Medical Center for Health Care, Tokyo, Japan (H.K., T.O.)
| | - Kenji Suzuki
- Japan Health Promotion Foundation, Tokyo, Japan (K.S.)
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Lee SJ, Avolio A, Seo DC, Kim BS, Kang JH, Lee MY, Sung KC. Relationship Between Brachial-Ankle Pulse Wave Velocity and Incident Hypertension According to 2017 ACC/AHA High Blood Pressure Guidelines. J Am Heart Assoc 2019; 8:e013019. [PMID: 31412746 PMCID: PMC6759909 DOI: 10.1161/jaha.119.013019] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background Arterial stiffness predicts both cardiovascular events and incident hypertension. However, whether brachial‐ankle pulse wave velocity (baPWV) is predictive of incident hypertension based on the 2017 American College of Cardiology/American Heart Association (ACC/AHA) High Blood Pressure Guidelines has not been established. We performed a large cohort study to investigate whether incident hypertension could be predicted from baPWV measurements as a measure of arterial stiffness, even when applying updated hypertension criteria. Methods and Results A total of 10 360 Korean adults who underwent baPWV examination during a health‐screening program between 2010 and 2016 were enrolled. Hypertension was defined according to the 2017 ACC/AHA Guidelines as 130/80 mm Hg. Cox proportional hazard analysis was used to assess the risk of incident hypertension according to baPWV quartiles. The mean age of the study subjects was 40.2 years and 75.6% were men. During the follow‐up period (median 2.17 years), 2000 subjects (19.3%) developed hypertension. The subjects in the highest baPWV quartile group showed an increased risk of hypertension compared with the lowest baPWV quartile group as confirmed by multivariate adjusted hazard ratios of 1.64 (95% CI 1.41–1.89; P<0.001) in men and 12.36 (95% CI 4.41–34.62; P=0.005) in women. The increased risk of developing hypertension was consistent after adjusting for several confounding factors. Conclusions Arterial stiffness measured by baPWV is associated with incident hypertension according to the updated 2017 ACC/AHA Guidelines and is a useful independent predictor of incident hypertension among relatively healthy people.
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Affiliation(s)
- Seung Jae Lee
- Division of Cardiology Department of Internal Medicine Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Seoul Republic of Korea
| | - Alberto Avolio
- Department of Biomedical Sciences Faculty of Medicine and Health Sciences Macquarie University Sydney New South Wales Australia
| | - Dae Chul Seo
- Division of Cardiology Department of Internal Medicine Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Seoul Republic of Korea
| | - Bum Soo Kim
- Division of Cardiology Department of Internal Medicine Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Seoul Republic of Korea
| | - Jin Ho Kang
- Division of Cardiology Department of Internal Medicine Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Seoul Republic of Korea
| | - Mi Yeon Lee
- Division of Biostatistics Department of R&D Management Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Seoul Republic of Korea
| | - Ki-Chul Sung
- Division of Cardiology Department of Internal Medicine Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Seoul Republic of Korea
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Rojek M, Rajzer MW, Wojciechowska W, Drożdż T, Skalski P, Pizoń T, Januszewicz A, Czarnecka D. Relationship among long-term aircraft noise exposure, blood pressure profile, and arterial stiffness. J Hypertens 2019; 37:1350-8. [DOI: 10.1097/hjh.0000000000002060] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Hu L, Zhang Y, Huang X, Song Y, Qin X, Wang B, Zhang Y, Tang G, Li J, Li P, Bao H, Huo Y, Cheng X. Associations between Blood Pressure Indices and Brachial-ankle Pulse Wave Velocity in Treated Hypertensive Adults: results from the China Stroke Primary Prevention Trial (CSPPT). Sci Rep 2019; 9:8178. [PMID: 31160658 PMCID: PMC6547652 DOI: 10.1038/s41598-019-44740-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 05/22/2019] [Indexed: 01/27/2023] Open
Abstract
Brachial–ankle pulse wave velocity (baPWV), as a marker of arterial stiffness, has been demonstrated to be associated with blood pressure (BP) and onset of hypertension. However, little information is available on the associations between baPWV and BP indices [systolic BP (SBP), diastolic BP (DBP), pulse pressure (PP), mean arterial pressure (MAP)] in treated hypertensive patients. We aimed to assess the associations between BP indices and baPWV. In this cross-sectional study, 14,598 hypertensive patients from China Stroke Primary Prevention Trial (CSPPT) at the exit visit of the trial were analyzed. Elevated baPWV was defined as ≥18.3 m/s. Multivariate linear and logistic regression analyses were performed to evaluate the associations of BP indices with baPWV and elevated baPWV. Moreover, the smooth curve fitting (penalized spline method) was conducted. Multivariate linear regression analyses showed that continuous SBP, DBP, PP and MAP were independently and positively associated with baPWV (β = 0.081, 0.084, 0.078 and 0.115, respectively, all P < 0.001). Compared with controlled SBP group (<140 mm Hg), uncontrolled SBP (≥140 mm Hg) was significantly associated with higher baPWV [β = 2.234, 95% confidence interval (CI): 2.137–2.332]. Similarly, compared with controlled DBP group (<90 mm Hg), uncontrolled DBP (≥90 mm Hg) was significantly associated with higher baPWV (β = 1.466, 95%CI: 1.341–1.590). Multiple logistic analyses also showed that SBP, DBP, PP and MAP were significantly and positively associated with elevated baPWV (OR = 1.056, 1.049, 1.052, and 1.075, respectively, all P < 0.001). The fully-adjusted smooth curve fitting presented a linear association between BP indices with baPWV. In conclusion, among treated hypertensive patients, SBP, DBP, PP and MAP levels were independently and positively associated with baPWV and elevated baPWV, suggesting that baPWV might be a way to predict uncontrolled BP.
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Affiliation(s)
- Lihua Hu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Yuanyuan Zhang
- National Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiao Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Yun Song
- National Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xianhui Qin
- National Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Binyan Wang
- National Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Yan Zhang
- Department of Cardiology and Heart Center, Peking University First Hospital, Beijing, China
| | - Genfu Tang
- School of Health Administration, Anhui University, Hefei, China
| | - Jianping Li
- Department of Cardiology and Heart Center, Peking University First Hospital, Beijing, China
| | - Ping Li
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China.
| | - Yong Huo
- Department of Cardiology and Heart Center, Peking University First Hospital, Beijing, China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China.
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Climie RE, van Sloten TT, Bruno RM, Taddei S, Empana JP, Stehouwer CD, Sharman JE, Boutouyrie P, Laurent S. Macrovasculature and Microvasculature at the Crossroads Between Type 2 Diabetes Mellitus and Hypertension. Hypertension 2019; 73:1138-1149. [DOI: 10.1161/hypertensionaha.118.11769] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Rachel E. Climie
- From the INSERM, U970, Paris Cardiovascular Research Center (PARCC), France (R.E.C., T.T.v.S., R.-M.B., J.-P.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.)
| | - Thomas T. van Sloten
- From the INSERM, U970, Paris Cardiovascular Research Center (PARCC), France (R.E.C., T.T.v.S., R.-M.B., J.-P.E.)
- Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, the Netherlands (T.T.v.S., C.D.A.S.)
| | - Rosa-Maria Bruno
- From the INSERM, U970, Paris Cardiovascular Research Center (PARCC), France (R.E.C., T.T.v.S., R.-M.B., J.-P.E.)
- Department of Clinical and Experimental Medicine, University of Pisa, Italy (R.-M.B., S.T.)
| | - Stefano Taddei
- Department of Clinical and Experimental Medicine, University of Pisa, Italy (R.-M.B., S.T.)
| | - Jean-Philippe Empana
- From the INSERM, U970, Paris Cardiovascular Research Center (PARCC), France (R.E.C., T.T.v.S., R.-M.B., J.-P.E.)
| | - Coen D.A. Stehouwer
- Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, the Netherlands (T.T.v.S., C.D.A.S.)
| | - James E. Sharman
- Menzies Institute for Medical Research, University of Tasmanian, Hobart, Australia (R.E.C., J.E.S.)
| | - Pierre Boutouyrie
- INSERM, U970, APHP. Paris Descartes University, Paris, France (P.B., S.L.)
| | - Stéphane Laurent
- INSERM, U970, APHP. Paris Descartes University, Paris, France (P.B., S.L.)
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Ishida A, Kinjo K, Maeda T, Ohya Y. Association between high-normal ankle–brachial index and hypertension incidence: the Okinawa Peripheral Arterial Disease Study. J Hypertens 2019; 37:935-41. [DOI: 10.1097/hjh.0000000000001995] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Zhu H, Gao Y, Cheng H, Lu Y, Cheang I, Xu D, Yao W, Xu T, Zhou F, Zhou Y, Xu F, Kong X, Li X, Zhang H. Comparison of arterial stiffness indices measured by pulse wave velocity and pulse wave analysis. Blood Press 2019; 28:206-213. [PMID: 30924384 DOI: 10.1080/08037051.2019.1598254] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Hongyan Zhu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yuan Gao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huiling Cheng
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yichao Lu
- Department of Cardiology, The Affiliated Jiangyin People’s Hospital of Southeast University Medical College, Jiangyin, China
| | - IokFai Cheang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Dongxu Xu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wenming Yao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Tianbao Xu
- Department of Cardiology, The People’s Hospital of Kizilsu Kirghiz Autonomous Prefecture, Xinjiang, China
| | - Fang Zhou
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yanli Zhou
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Fang Xu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiangqing Kong
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xinli Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Haifeng Zhang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Cardiology, The People’s Hospital of Kizilsu Kirghiz Autonomous Prefecture, Xinjiang, China
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Zhang JQ, Yang GH, Zhou X, Liu JX, Shi R, Dong Y, Chen SB, Li YM. Effects of allisartan isoproxil on blood pressure and target organ injury in patients with mild to moderate essential hypertension. Medicine (Baltimore) 2019; 98:e14907. [PMID: 30896643 PMCID: PMC6708765 DOI: 10.1097/md.0000000000014907] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Evidence has shown that angiotensin II type 1 receptor antagonists have lower blood pressure and have target organ protective effects, but this is not the case for the drug allisartan isoproxil. The aim of this study was to evaluate the effects of allisartan isoproxil on blood pressure and target organ injury in patients with mild to moderate essential hypertension.In total, 80 essential hypertensive participants were randomly divided into an allisartan group and a nifedipine group (n = 40 per group), and their blood pressure was measured once per month for 6 months. A 2-dimensional echocardiogram was performed at baseline and at the end of the study. The serum levels of renal injury indexes, endothelial function markers, inflammatory factors, blood biochemical assays and urinary measurements were determined at baseline and at 6 months.At the end of the study, both systolic and diastolic blood pressure were significantly decreased in the allisartan group compared with baseline and showed the same antihypertensive effect as the nifedipine group. Meanwhile, the left ventricular remodeling, 24-hours levels of urinary microalbumin, endothelial dysfunction, and arterial stiffness were all significantly improved compared with that of the baseline and the nifedipine group (all P < .05).The present study showed that allisartan isoproxil had favorable blood pressure lowering and heart, renal, and endothelial protective effects in patients with mild to moderate essential hypertension.
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Affiliation(s)
- Jian-Qi Zhang
- Graduate School of Tianjin Medical University
- Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, Tianjin, China
| | | | - Xin Zhou
- Graduate School of Tianjin Medical University
| | | | - Rui Shi
- Graduate School of Tianjin Medical University
| | - Yan Dong
- Graduate School of Tianjin Medical University
| | | | - Yu-Ming Li
- Graduate School of Tianjin Medical University
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Abstract
PURPOSE OF REVIEW The review discusses evidence from the Framingham Heart Study that supports the assessment and utility of novel vascular and blood pressure measures to inform clinical management of blood pressure-related cardiovascular disease. RECENT FINDINGS Recent Framingham Heart Study investigations provide new insights into the associations of novel and traditional vascular and blood pressure measures, such as measures of aortic stiffness, components of blood pressure waves, and orthostatic change in blood pressure, with cardiovascular disease events and brain structure and function. Novel vascular measures provide opportunities for additional investigation and potential development of new interventions that are more precisely targeted at underlying pathophysiology. Inclusion of novel vascular measures should be considered in clinical practice to screen for early, subclinical disease and to stratify high-risk individuals for targeted therapies.
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Affiliation(s)
- Leroy L Cooper
- Biology Department, Vassar College, 124 Raymond Ave., Box 70, Poughkeepsie, NY, 12604, USA.
| | - Gary F Mitchell
- Cardiovascular Engineering, Inc., 1 Edgewater Drive, Suite 201A, Norwood, MA, 02062, USA.
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Abstract
The mortality rates of age-related diseases (ARDs) increase exponentially with age. Processes described by the exponential growth function typically involve a branching chain reaction or, more generally, a positive feedback loop. Here I propose that each ARD is mediated by one or several positive feedback loops (vicious cycles). I then identify critical vicious cycles in five major ARDs: atherosclerosis, hypertension, diabetes, Alzheimer's and Parkinson's. I also propose that the progression of ARDs can be halted by selectively interrupting the vicious cycles and suggest the most promising targets.
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Affiliation(s)
- Aleksey V Belikov
- Laboratory of Innovative Medicine, School of Biological and Medical Physics, Moscow Institute of Physics and Technology, Institutsky per., 9, 141701 Dolgoprudny, Moscow Region, Russia.
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Tarlovskaya EI, Merezhanova AA. Daily variability of arterial stiffness of patients with arterial hypertension depending on the category of cardiovascular risk. ACTA ACUST UNITED AC 2018; 58:47-57. [PMID: 30625089 DOI: 10.18087/cardio.2489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 12/14/2018] [Indexed: 11/18/2022]
Abstract
PURPOSE The study of the daily variability of arterial stiffness indicators, depending on the category of cardiovascular risk. Materials and methods. The study consistently included patients with essential hypertension who were admitted to the cardiology department of the Volga district medical center from November 1, 2015 to October 1, 2017. The study involved 134 patients with an average age of 52±1 years. Depending on the category of total cardiovascular risk, the patients were divided into 3 groups from I (lowest risk) to III (highest risk). The analysis was carried out on ABPM for 12-14 days (BPLab system of "Peter Telegin" firm). Determined: glomerular filtration rate (GFR), the thickness of the intima-media of the common carotid arteries, analysis of the lipid spectrum. For statistical analysis of clinical and instrumental data, a T-criterion for independent samples was used and an ANOVA analysis was performed. A correlation analysis was performed. Results. Patients of group III had the highest level of av. SBP (рI-III =0.010; pII-III =0.020) and mean pulse BP (PBP) (рI-III =0.002; pII-III =0.002), also more unfavorable the indicators cALALx (pI-II=0.025; рI-III =0.004), varAlx (рI-III =0.004) and av. ASI (рI-III =0.034). When comparing the data of patients of groups II and III, adjusted for gender and age, it was found that statistically significant differences between the groups of varPAD (pII-III =0.008), AASI (рI-III =0.043), varAlx (pII-III=0.049), as well as a pronounced tendency for varASI (pII-III=0.050). Markers of target organ damage (TIM, LVML, GFR) were more pronounced in the high-risk group. As the risk group increased, the level of HDL decreased (рI-III =0.002; pII-III I=0.0001), the level of TG increased (рI-III =0.007; pII-III =0.009) and the CA (рI-III =0.015). The total cholesterol level was lower in patients of group III compared to group II (pII-III=0.004). Statistically signifi nt relationships of arterial wall stiffness indicators with age were found: crAlx (0.467, p<0.001), varAlx (0.272, p<0.01), cpASI (0.227, p<0.01), varASI (0.407, p<0.001). In addition, women showed significant correlations of medium and high strength between age and mean values of mean SPD (r = 0.490, p<0.05), varPAD (r=0.540, p<0.05), avAS (r=0.460, p<0.05) and varASI (r=0.620, p<0.05). VarASI and WedSASI were most closely associated with the level of SRSAD and SRPAD. Only cASI was associated with GFR, and only varASI was associated with the parameters of the lipid spectrum (HSLPVP, TG, KA and LVMI. Conclusion. The most statistically significant dynamics was observed when evaluating varASI, which varied in the sequence I gr. <II gr. < III gr. Corrected by sex and age, the analysis showed a greater variability in arterial stiffness in high-risk patients.
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Siriopol D, Covic A, Iliescu R, Kanbay M, Tautu O, Radulescu L, Mitu O, Salaru D, Dorobantu M. Arterial stiffness mediates the effect of salt intake on systolic blood pressure. J Clin Hypertens (Greenwich) 2018; 20:1587-1594. [DOI: 10.1111/jch.13399] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 08/29/2018] [Indexed: 01/01/2023]
Affiliation(s)
- Dimitrie Siriopol
- Nephrology Department; “Grigore T. Popa” University of Medicine and Pharmacy; Iasi Romania
| | - Adrian Covic
- Nephrology Department; “Grigore T. Popa” University of Medicine and Pharmacy; Iasi Romania
| | - Radu Iliescu
- Pharmacology Department; “Grigore T. Popa” University of Medicine and Pharmacy; Iasi Romania
| | - Mehmet Kanbay
- Division of Nephrology, Department of Medicine; Koc University School of Medicine; Istanbul Turkey
| | - Oana Tautu
- Cardiology Department; “Carol Davila” University of Medicine and Pharmacy; Bucharest Romania
| | - Luminita Radulescu
- Nephrology Department; “Carol Davila” University of Medicine and Pharmacy; Bucharest Romania
| | - Ovidiu Mitu
- Cardiology Department; “Grigore T. Popa” University of Medicine and Pharmacy; Iasi Romania
| | - Delia Salaru
- Cardiology Department; “Grigore T. Popa” University of Medicine and Pharmacy; Iasi Romania
| | - Maria Dorobantu
- Cardiology Department; “Carol Davila” University of Medicine and Pharmacy; Bucharest Romania
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Walter LM, Tamanyan K, Limawan AP, Biggs SN, Weichard AJ, Davey MJ, Nixon GM, Horne RS. Overweight and obese children with sleep disordered breathing have elevated arterial stiffness. Sleep Med 2018; 48:187-93. [DOI: 10.1016/j.sleep.2018.05.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 05/09/2018] [Accepted: 05/14/2018] [Indexed: 11/23/2022]
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de Mendonça GS, de Souza DF, de Alvarenga Cunha Brunelli AC, de Oliveira Peres CI, Freitas EGB, Lacerda GN, Dorneles MC, Peixoto AJ, Ferreira-Filho SR. Arterial stiffness in elderly patients with normotension and hypertension in Brazil. J Clin Hypertens (Greenwich) 2018; 20:1285-1293. [PMID: 30039916 DOI: 10.1111/jch.13358] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 05/21/2018] [Indexed: 02/03/2023]
Abstract
Data on arterial stiffness in older populations, according to blood pressure (BP) levels, are scarce in Brazil. The objective of this study was to establish reference values for core measures of arterial stiffness, including carotid-femoral pulse wave velocity (cf-PWV) and aortic augmentation index (AIx), in a cohort of older individuals with normotension (NT) and hypertension. Cross-sectional analysis was performed with applanation tonometry data from 1192 patients aged 60 years or older. The authors classified patients according to their BP levels as having NT, controlled hypertension (CH), and uncontrolled hypertension (UH). The cf-PWV values were 9.11 ± 0.16 m/s (NT), 9.12 ± 0.18 m/s (CH), and 9.42 ± 2.2 m/s (UH) (P < 0.005; UH vs NT and CH). The AIx was 33.3% for the entire cohort and similar across all groups. The cf-PWV increased with age but reached a ceiling at 75 years. Compared with men, women had a higher AIx but similar cf-PWV levels. In conclusion, the markers of arterial stiffness were similar among individuals with NT/CH and higher among individuals with UH.
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Affiliation(s)
| | | | | | | | | | | | | | - Aldo José Peixoto
- Section of Nephrology, Yale University School of Medicine, New Haven, Connecticut
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Youssef G, El Tebi I, Osama D, Shehahta A, Baligh E, Ashour Z, Gamal H. Familial history of hypertension as a predictor of increased arterial stiffness in normotensive offspring. Egypt Heart J 2018; 69:37-44. [PMID: 29622953 PMCID: PMC5839363 DOI: 10.1016/j.ehj.2016.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 07/26/2016] [Accepted: 07/30/2016] [Indexed: 11/29/2022] Open
Abstract
Background Increased arterial stiffness can be used as a prognostic marker of arterial hypertension. The relationship between arterial stiffness and arterial hypertension seems to be reciprocal. Objective Evaluation of changes of the arterial elastic prosperities in normotensive subjects, with and without parental history of hypertension. Subjects and Methods One hundred and ten normotensive individuals, aged 20–30 years, were divided into two groups: group-A (n = 57) and group-B (n = 53) subjects with positive and negative parental history of hypertension, respectively. Systolic, diastolic and pulse pressures were measured using mercury sphygmomanometer. The elastic properties of the ascending aorta and the common carotid arteries were assessed using M-mode echo and B-mode imaging, respectively. Stiffness index of the digital volume pulse (SIDVP) was measured in the right index finger using photoplethysmography. Results Group A subjects showed higher aortic stiffness index (p = 0.002), carotid stiffness index (p = 0.001), carotid pulse wave velocity (p ⩽ 0.001) and stiffness index of digital volume pulse (p = 0.001). Group A subjects showed lower aortic distensibility (p = 0.001), aortic strain (p = 0.004), changes in aortic diameter (p = 0.022), carotid distension (p = 0.026), carotid distensibility coefficient (p ⩽ 0.001) and carotid compliance coefficient (p = 0.002). Conclusion The aortic and carotid stiffness parameters and SIDVP were higher in normotensive offspring of hypertensive parents. This finding could direct the attention towards the increased cardiovascular risk in this group and thus prompt earlier and tighter prevention of cardiovascular risk factors.
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Affiliation(s)
- Ghada Youssef
- Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ibrahim El Tebi
- Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dina Osama
- Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Shehahta
- Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Essam Baligh
- Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Zeinab Ashour
- Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hany Gamal
- Department of Physiology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Koivistoinen T, Lyytikäinen LP, Aatola H, Luukkaala T, Juonala M, Viikari J, Lehtimäki T, Raitakari OT, Kähönen M, Hutri-Kähönen N. Pulse Wave Velocity Predicts the Progression of Blood Pressure and Development of Hypertension in Young Adults. Hypertension 2018; 71:451-456. [DOI: 10.1161/hypertensionaha.117.10368] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 10/04/2017] [Accepted: 12/14/2017] [Indexed: 12/25/2022]
Affiliation(s)
- Teemu Koivistoinen
- From the Departments of Clinical Physiology (T.K., H.A., M.K.), Clinical Chemistry, Fimlab Laboratories (L.-P.L., T. Lehtimäki), and Pediatrics (N.H-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Research and Innovation Center, Tampere University Hospital, Finland (T. Luukkaala); Health Sciences, Faculty of Social Sciences, University of Tampere,
| | - Leo-Pekka Lyytikäinen
- From the Departments of Clinical Physiology (T.K., H.A., M.K.), Clinical Chemistry, Fimlab Laboratories (L.-P.L., T. Lehtimäki), and Pediatrics (N.H-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Research and Innovation Center, Tampere University Hospital, Finland (T. Luukkaala); Health Sciences, Faculty of Social Sciences, University of Tampere,
| | - Heikki Aatola
- From the Departments of Clinical Physiology (T.K., H.A., M.K.), Clinical Chemistry, Fimlab Laboratories (L.-P.L., T. Lehtimäki), and Pediatrics (N.H-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Research and Innovation Center, Tampere University Hospital, Finland (T. Luukkaala); Health Sciences, Faculty of Social Sciences, University of Tampere,
| | - Tiina Luukkaala
- From the Departments of Clinical Physiology (T.K., H.A., M.K.), Clinical Chemistry, Fimlab Laboratories (L.-P.L., T. Lehtimäki), and Pediatrics (N.H-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Research and Innovation Center, Tampere University Hospital, Finland (T. Luukkaala); Health Sciences, Faculty of Social Sciences, University of Tampere,
| | - Markus Juonala
- From the Departments of Clinical Physiology (T.K., H.A., M.K.), Clinical Chemistry, Fimlab Laboratories (L.-P.L., T. Lehtimäki), and Pediatrics (N.H-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Research and Innovation Center, Tampere University Hospital, Finland (T. Luukkaala); Health Sciences, Faculty of Social Sciences, University of Tampere,
| | - Jorma Viikari
- From the Departments of Clinical Physiology (T.K., H.A., M.K.), Clinical Chemistry, Fimlab Laboratories (L.-P.L., T. Lehtimäki), and Pediatrics (N.H-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Research and Innovation Center, Tampere University Hospital, Finland (T. Luukkaala); Health Sciences, Faculty of Social Sciences, University of Tampere,
| | - Terho Lehtimäki
- From the Departments of Clinical Physiology (T.K., H.A., M.K.), Clinical Chemistry, Fimlab Laboratories (L.-P.L., T. Lehtimäki), and Pediatrics (N.H-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Research and Innovation Center, Tampere University Hospital, Finland (T. Luukkaala); Health Sciences, Faculty of Social Sciences, University of Tampere,
| | - Olli T. Raitakari
- From the Departments of Clinical Physiology (T.K., H.A., M.K.), Clinical Chemistry, Fimlab Laboratories (L.-P.L., T. Lehtimäki), and Pediatrics (N.H-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Research and Innovation Center, Tampere University Hospital, Finland (T. Luukkaala); Health Sciences, Faculty of Social Sciences, University of Tampere,
| | - Mika Kähönen
- From the Departments of Clinical Physiology (T.K., H.A., M.K.), Clinical Chemistry, Fimlab Laboratories (L.-P.L., T. Lehtimäki), and Pediatrics (N.H-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Research and Innovation Center, Tampere University Hospital, Finland (T. Luukkaala); Health Sciences, Faculty of Social Sciences, University of Tampere,
| | - Nina Hutri-Kähönen
- From the Departments of Clinical Physiology (T.K., H.A., M.K.), Clinical Chemistry, Fimlab Laboratories (L.-P.L., T. Lehtimäki), and Pediatrics (N.H-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Research and Innovation Center, Tampere University Hospital, Finland (T. Luukkaala); Health Sciences, Faculty of Social Sciences, University of Tampere,
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Lonardo A, Nascimbeni F, Mantovani A, Targher G. Hypertension, diabetes, atherosclerosis and NASH: Cause or consequence? J Hepatol 2018; 68:335-352. [PMID: 29122390 DOI: 10.1016/j.jhep.2017.09.021] [Citation(s) in RCA: 432] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 09/13/2017] [Accepted: 09/23/2017] [Indexed: 02/06/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) has become one of the most common forms of chronic liver disease worldwide and its prevalence is expected to continue rising. NAFLD has traditionally been considered a consequence of metabolic syndrome (MetS). However, the link between NAFLD and MetS components, especially type 2 diabetes mellitus (T2DM), hypertension (HTN), and cardiovascular disease (CVD) is more complex than previously thought. Indeed, the adverse effects of NAFLD extend far beyond the liver, with a large body of clinical evidence now suggesting that NAFLD may precede and/or promote the development of T2DM, HTN and atherosclerosis/CVD. The risk of developing these cardiometabolic diseases parallels the underlying severity of NAFLD. Accumulating evidence suggests that the presence and severity of NAFLD is associated with an increased risk of incident T2DM and HTN. Moreover, long-term prospective studies indicate that the presence and severity of NAFLD independently predicts fatal and nonfatal CVD events. In this review, we critically discuss the rapidly expanding body of clinical evidence that supports the existence of a bi-directional relationship between NAFLD and various components of MetS, particularly T2DM and HTN, as well as the current knowledge regarding a strong association between NAFLD and CVD morbidity and mortality. Finally, we discuss the most updated putative biological mechanisms through which NAFLD may contribute to the development of HTN, T2DM and CVD.
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Affiliation(s)
- Amedeo Lonardo
- Division of Internal Medicine, Department of Biomedical, Metabolic and Neural Sciences, Azienda Ospedaliero-Universitaria, Ospedale Civile di Baggiovara, Modena, Italy
| | - Fabio Nascimbeni
- Division of Internal Medicine, Department of Biomedical, Metabolic and Neural Sciences, Azienda Ospedaliero-Universitaria, Ospedale Civile di Baggiovara, Modena, Italy
| | - Alessandro Mantovani
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Giovanni Targher
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
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47
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Ato D, Sawayama T. Factors associated with high brachial-ankle pulse wave velocity in non-hypertensive and appropriately treated hypertensive patients with atherosclerotic risk factors. Vasc Health Risk Manag 2017; 13:383-392. [PMID: 29066906 PMCID: PMC5644576 DOI: 10.2147/vhrm.s144923] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
While pulse wave velocity (PWV) correlates with blood pressure (BP), its extent differs between patients, and some cases of high PWV in normotensives are present. Moreover, PWV frequently remains high in hypertensive patients despite adequate BP control. The factors associated with such phenomena are yet to be elucidated. Here, we investigated the factors associated with brachial–ankle PWV (baPWV) in 107 patients whose systolic BP was under 140 mmHg at their latest baPWV measurement. There were 64 controlled hypertensives and 43 normotensives. Multivariate regression analysis identified age, hypertension, body mass index (BMI), systolic BP, and heart rate (HR) as independent factors for baPWV. Next, we divided the subjects into groups according to their age (in 5-year increments) and calculated the mean and standard deviation (SD) of the baPWV for each group. For each age group, we defined patients with a baPWV above the mean + SD baPWV for the group as the high-baPWV cohort. Multivariate logistic regression analysis revealed that BMI, hypertension, and smoking were independent determinants of a high-baPWV subject. This represents the first study to report the existence of the hypertensive state itself as one of the independent predictors of high baPWV in normotensive and well-treated hypertensive patients. This finding implies that the hypertensive state itself possibly worsens arterial stiffness independently from aging in spite of adequate BP maintenance. To prevent the early progression of arterial stiffness, the application of an appropriate intervention during the early stages of hypertension is important and the continuation of an appropriate BP treatment is suggested.
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Affiliation(s)
- Dai Ato
- Gakujutsu Shien (Academic Support) Co., Ltd. Tokyo
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48
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Lefferts WK, Sperry SD, Jorgensen RS, Kasprowicz AG, Skilton MR, Figueroa A, Heffernan KS. Carotid stiffness, extra-media thickness and visceral adiposity in young adults. Atherosclerosis 2017; 265:140-146. [DOI: 10.1016/j.atherosclerosis.2017.08.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 07/14/2017] [Accepted: 08/30/2017] [Indexed: 10/18/2022]
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49
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Guo J, Sekikawa A. Reply. J Hypertens 2017; 35:1326-1327. [DOI: 10.1097/hjh.0000000000001342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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50
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Brandão AA, Amodeo C, Alcântara C, Barbosa E, Nobre F, Pinto F, Vilela-Martin JF, Bastos JM, Yugar-Toledo JC, Mota-Gomes MA, Neves MFT, Malachias MVB, Rodrigues MDC, Passarelli O, Jardim PCBV, Cunha PG, Póvoa R, Fonseca T, Dias VP, Barroso WS, Oigman W. I Luso-Brazilian Positioning on Central Arterial Pressure. Arq Bras Cardiol 2017; 108:100-108. [PMID: 28327876 PMCID: PMC5344653 DOI: 10.5935/abc.20170011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 11/10/2016] [Indexed: 01/30/2023] Open
Affiliation(s)
- Andréa A Brandão
- Departamento de Hipertensão Arterial da Sociedade Brasileira de Cardiologia, Rio de Janeiro, RJ - Brazil
| | - Celso Amodeo
- Departamento de Hipertensão Arterial da Sociedade Brasileira de Cardiologia, Rio de Janeiro, RJ - Brazil
| | | | - Eduardo Barbosa
- Departamento de Hipertensão Arterial da Sociedade Brasileira de Cardiologia, Rio de Janeiro, RJ - Brazil
| | - Fernando Nobre
- Departamento de Hipertensão Arterial da Sociedade Brasileira de Cardiologia, Rio de Janeiro, RJ - Brazil
| | | | | | | | - Juan Carlos Yugar-Toledo
- Departamento de Hipertensão Arterial da Sociedade Brasileira de Cardiologia, Rio de Janeiro, RJ - Brazil
| | - Marco Antônio Mota-Gomes
- Departamento de Hipertensão Arterial da Sociedade Brasileira de Cardiologia, Rio de Janeiro, RJ - Brazil
| | - Mario Fritsch Toros Neves
- Departamento de Hipertensão Arterial da Sociedade Brasileira de Cardiologia, Rio de Janeiro, RJ - Brazil
| | | | | | - Oswaldo Passarelli
- Departamento de Hipertensão Arterial da Sociedade Brasileira de Cardiologia, Rio de Janeiro, RJ - Brazil
| | - Paulo César B Veiga Jardim
- Departamento de Hipertensão Arterial da Sociedade Brasileira de Cardiologia, Rio de Janeiro, RJ - Brazil
| | | | - Rui Póvoa
- Departamento de Hipertensão Arterial da Sociedade Brasileira de Cardiologia, Rio de Janeiro, RJ - Brazil
| | | | | | - Weimar Sebba Barroso
- Departamento de Hipertensão Arterial da Sociedade Brasileira de Cardiologia, Rio de Janeiro, RJ - Brazil
| | - Wille Oigman
- Departamento de Hipertensão Arterial da Sociedade Brasileira de Cardiologia, Rio de Janeiro, RJ - Brazil
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