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Evsevieva M, Sergeeva O, Mazurakova A, Koklesova L, Prokhorenko-Kolomoytseva I, Shchetinin E, Birkenbihl C, Costigliola V, Kubatka P, Golubnitschaja O. Pre-pregnancy check-up of maternal vascular status and associated phenotype is crucial for the health of mother and offspring. EPMA J 2022; 13:351-366. [PMID: 36061831 PMCID: PMC9437153 DOI: 10.1007/s13167-022-00294-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 07/04/2022] [Accepted: 08/04/2022] [Indexed: 12/15/2022]
Abstract
Abstract Cardiovascular disease remains the leading cause of disease burden globally with far-reaching consequences including enormous socio-economic burden to healthcare and society at large. Cardiovascular health is decisive for reproductive function, healthy pregnancy and postpartum. During pregnancy, maternal cardiovascular system is exposed to highly increased haemodynamic stress that significantly impacts health status of the mother and offspring. Resulting from sub-optimal maternal health conditions overlooked in pre-pregnancy time, progressive abnormalities can be expected during pregnancy and postpartum. Contextually, there are two main concepts to follow in the framework of predictive, preventive and personalised medicine, namely to develop: 1. advanced screening of sub-optimal health conditions in young populations to predict and prevent individual health risks prior to planned pregnancies 2. in-depth companion diagnostics during pregnancy to predict and prevent long-lasting postpartum health risks of the mother and offspring. Data collected in the current study demonstrate group-specific complications to health of the mother and offspring and clinical relevance of the related phenotyping in pre-pregnant mothers. Diagnostic approach proposed in this study revealed its great clinical utility demonstrating important synergies between cardiovascular maladaptation and connective tissue dysfunction. Co-diagnosed pre-pregnancy low BMI of the mother, connective tissue dysfunction, increased stiffness of peripheral vessels and decreased blood pressure are considered a highly specific maternal phenotype useful for innovative screening programmes in young populations to predict and prevent severe risks to health of the mother and offspring. This crucial discovery brings together systemic effects characteristic, for example, for individuals with Flammer syndrome predisposed to the phenotype-specific primary vascular dysregulation, pregnancy-associated risks, normal tension glaucoma, ischemic stroke at young age, impaired wound healing and associated disorders. Proposed maternal phenotyping is crucial to predict and effectively protect both the mother and offspring against health-to-disease transition. Pre-pregnancy check-up focused on sub-optimal health and utilising here described phenotypes is pivotal for advanced health policy. Plain English abstract Cardiovascular health is decisive for reproductive function and healthy pregnancy. During pregnancy, maternal cardiovascular system may demonstrate health-to-disease transition relevant for the affected mother and offspring. Overlooked in pre-pregnancy time, progressive abnormalities can be expected during pregnancy and lifelong. Here we co-diagnosed maternal pre-pregnancy low bodyweight with systemic effects which may increase risks of pregnancy, eye and heart disorders and ischemic stroke at young age, amongst others. Innovative screening programmes focused on sub-optimal health in young populations to predict and to mitigate individual health risks prior to pregnancy is an essential innovation for health policy proposed.
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Affiliation(s)
- Maria Evsevieva
- Stavropol State Medical University, Stavropol, Russian Federation
| | - Oksana Sergeeva
- Stavropol State Medical University, Stavropol, Russian Federation
| | - Alena Mazurakova
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 036 01 Martin, Slovakia
| | - Lenka Koklesova
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 036 01 Martin, Slovakia
| | | | | | | | | | - Peter Kubatka
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 036 01 Martin, Slovakia
| | - Olga Golubnitschaja
- Predictive, Preventive and Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, Germany
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Omboni S, Campolo L, Panzeri E. Telehealth in chronic disease management and the role of the Internet-of-Medical-Things: the Tholomeus® experience. Expert Rev Med Devices 2020; 17:659-670. [DOI: 10.1080/17434440.2020.1782734] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Stefano Omboni
- Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy
- Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine, Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Luca Campolo
- Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy
| | - Edoardo Panzeri
- Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy
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Omboni S, Panzeri E, Campolo L. E-Health in Hypertension Management: an Insight into the Current and Future Role of Blood Pressure Telemonitoring. Curr Hypertens Rep 2020; 22:42. [PMID: 32506273 DOI: 10.1007/s11906-020-01056-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
PURPOSE OF REVIEW Out-of-office blood pressure (BP) monitoring techniques, including home and ambulatory BP monitoring, are currently recommended by hypertension guidelines worldwide to confirm the diagnosis of hypertension and to monitor the appropriateness of treatment. However, such techniques are not always effectively implemented or timely available in the routine clinical practice. In recent years, the widespread availability of e-health solutions has stimulated the development of blood pressure telemonitoring (BPT) systems, which allow remote BP tracking and tighter and more efficient monitoring of patients' health status. RECENT FINDINGS There is currently strong evidence that BPT may be of benefit for hypertension screening and diagnosis and for improving hypertension management. The advantage is more significant when BPT is coupled with multimodal interventions involving a physician, a nurse or pharmacist, and including education on lifestyle and risk factors and drug management. Several randomized controlled studies documented enhanced hypertension management and improved BP control of hypertensive patients through BPT. Potential additional effects of BPT are represented by improved compliance to treatment, intensification, and optimization of drug use, improved quality of life, reduction in risk of developing cardiovascular complications, and cost-saving. Applications based on m-health and making use of wearables or smartwatches integrated with machine learning models are particularly promising for the future development of efficient BPT solutions, and they will provide remarkable support decision tools for doctors. BPT and telehealth will soon disrupt hypertension management. However, which approach will be the most effective and whether it will be sustainable in the long-term still need to be elucidated.
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Omboni S, Posokhov I, Parati G, Arystan A, Tan I, Barkan V, Bulanova N, Derevyanchenko M, Grigoricheva E, Minyukhina I, Mulè G, Orlova I, Paini A, Peixoto Maldonado JM, Pereira T, Ramos-Becerra CG, Tilea I, Waisman G. Variable association of 24-h peripheral and central hemodynamics and stiffness with hypertension-mediated organ damage: the VASOTENS Registry. J Hypertens 2020; 38:701-715. [DOI: 10.1097/hjh.0000000000002312] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Omboni S, Posokhov I, Parati G, Rogoza A, Kotovskaya Y, Arystan A, Avolio A, Barkan V, Bulanova N, Cardona Muñoz E, Grigoricheva E, Konradi A, Minyukhina I, Muiesan ML, Mulè G, Orlova I, Pereira T, Peixoto Maldonado JM, Statsenko ME, Tilea I, Waisman G, Rogoza A, Forcada P, Zelveian P, Butlin M, Barin E, Tan I, Ghiadoni L, Bruno RM, Sarzani R, Espinosa E, Volpe M, Savoia C, Tocci G, Borghi C, Schillaci G, Pucci G, Paini A, Rizzoni D, Ramos C, Alanis A, Varga A, Volkov D, Kurlykina N, Rotar O, Orlov A, Gorbunov V, Boytsov S, Fedorova E, Korneva V, Kuznetsova T, Kulikova N, Evdokimov VV, Kuznetsova A, Zheleznyak E, Kobalava Z, Borisova I, Svetozarsky T, Gubanova M, Lazareva V, Derevyanchenko MV, Kopylov P, Sirenko Y, Recovets O. Ambulatory blood pressure and arterial stiffness web‐based telemonitoring in patients at cardiovascular risk. First results of the VASOTENS (Vascular health ASsessment Of The hypertENSive patients) Registry. J Clin Hypertens (Greenwich) 2019; 21:1155-1168. [DOI: 10.1111/jch.13623] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/18/2019] [Accepted: 05/28/2019] [Indexed: 02/02/2023]
Affiliation(s)
- Stefano Omboni
- Clinical Research Unit Italian Institute of Telemedicine Varese Italy
- Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine Sechenov First Moscow State Medical University Moscow Russian Federation
| | - Igor Posokhov
- Hemodynamic Laboratory Ltd Nizhniy Novgorod Russian Federation
| | - Gianfranco Parati
- Department of Cardiology Istituto Auxologico Italiano Milan Italy
- Department of Medicine and Surgery University of Milano‐Bicocca Milan Italy
| | - Anatoly Rogoza
- Department of New Diagnostic Methods Russian Cardiology Research and Production Complex Moscow Russian Federation
| | - Yulia Kotovskaya
- Russian Clinical and Research Center of Gerontology Pirogov Russian National Research Medical Moscow Russian Federation
| | - Ayana Arystan
- Department of Functional Diagnostics Medical Center Hospital of President’s Affairs Administration of The Republic of Kazakhstan Astana Kazakhstan
| | - Alberto Avolio
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences Macquarie University Sydney New South Wales Australia
| | - Vitaliy Barkan
- Diagnostics Department The Hospital within the Russian Railroad Network Chita Russian Federation
| | - Natalia Bulanova
- Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine Sechenov First Moscow State Medical University Moscow Russian Federation
| | | | | | - Alexandra Konradi
- Department of Epidemiology North‐West Federal Medical Research Center St. Petersburg Russian Federation
| | - Irina Minyukhina
- Lomonosov Moscow State University Clinic Moscow Russian Federation
| | - Maria Lorenza Muiesan
- Dipartimento di Scienze Mediche e Chirurgiche Università di Brescia, Medicina 2 Brescia Italy
| | - Giuseppe Mulè
- Unità Operativa di Nefrologia ed Ipertensione, Centro di Riferimento Regionale per l'Ipertensione Arteriosa Policlinico Paolo Giaccone Palermo Italy
| | - Iana Orlova
- Volga District Medical Center Nizhniy Novgorod Russian Federation
| | - Telmo Pereira
- Escola Superior de Tecnologia da Saúde de Coimbra Instituto Politécnico de Coimbra Coimbra Portugal
| | | | | | - Ioan Tilea
- Cardiac Rehabilitation Clinic Tirgu Mures Emergency Clinical County Hospital Tirgu Mures Romania
| | - Gabriel Waisman
- Servicio de Clínica Médica y Sección Hipertensión Arterial Hospital Italiano de Buenos Aires Buenos Aires Argentina
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Kilic A, Baydar O. The relationship between diurnal blood pressure abnormalities and target organ damage in normotensive subjects. Which is more important? Increased blood pressure levels or circadian blood pressure abnormalities. Clin Exp Hypertens 2019; 42:244-249. [PMID: 31122073 DOI: 10.1080/10641963.2019.1619757] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 10/26/2022]
Abstract
Objective: Circadian blood pressure (CBP) abnormalities are well-known risk factors for many diseases such as cardiovascular, cerebrovascular, and chronic kidney disease. The object of this study was to evaluate the relationship between abnormalities in CBP rhythm and target organ damage (TOD) in normotensive non-dipper (non-DP) subjects.Methods: The 24-h ambulatory BP monitoring (ABPM) and echocardiography were performed and urinary albumin excretion (UAE) was measured in 127 normotensive dipper (DP) (42 males, 85 females) and 337 (89 males, 248 females) normotensive non-DP subjects.Results: When we compared DP and non-DP subjects; Pulse wave velocity (PWV) (7.12 ± 1.72 vs 7.57 ± 1.87 m/s, p = 0.02), the percentile of corrected PWV (cPWV) (7.1 vs. 20.2, p= 0.001) and the percentile of corrected augmentation index (cAIx) (23.5 vs. 33.9, p = 0.03), left ventricle mass index (LVMI) (78.00 ± 23.27 vs. 95.59 ± 18.29 g/m2, p = 0.01), relative wall thickness (RWT)(0.36 ± 0.13 vs 0.46 ± 0.09, p = 0.01), percentile of proteinuria (8.6 vs 29.2%, p = 0.00) were higher in non-DP group. In the correlation analyses, the PWV, LVMI, RWT were negatively correlated with the rate of systolic fall in nighttime (%)(-0.15, p = 0.01 vs. -0.23, p = 0.02 vs. -0.27, p = 0.00). It was observed that cPWV, cAIx, and UAE were independently associated with age and non-DP status (NDS), in logistic regression analysis.Conclusions: Our results suggested that normotensive persons with CBP abnormalities had TOD. In light of the data of this article, non-dipper status is detected in the early period and if the provision of diurnal blood pressure rhythm may reduce the incidence of future adverse events in nondipper normotensive subjects.
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Affiliation(s)
- Alparslan Kilic
- Department of Cardiology, Koc University Hospital, Istanbul, Turkey
| | - Onur Baydar
- Department of Cardiology, Koc University Hospital, Istanbul, Turkey
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Berukstis A, Jarasunas J, Daskeviciute A, Ryliskyte L, Baranauskas A, Steponeniene R, Laucevicius A. How to interpret 24-h arterial stiffness markers: comparison of 24-h ambulatory Mobil-O-Graph with SphygmoCor office values. Blood Press Monit 2019; 24:93-8. [DOI: 10.1097/mbp.0000000000000369] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Affiliation(s)
- Giuseppe Mulè
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Marco Guarneri
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Clarissa Pugliares
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Giulio Geraci
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
| | - Santina Cottone
- Unit of Nephrology and Hypertension, Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy
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Abstract
The predictive value of vascular biomarkers such as pulse wave velocity (PWV), central arterial pressure (CAP), and augmentation index (AIx), obtained through pulse wave analysis (PWA) in resting conditions, has been documented in a variety of patient groups and populations. There are appropriate recommendations on their clinical use in clinical practice guidelines of various scientific societies. Operator-independent methods are currently available for estimating vascular biomarkers also in ambulatory conditions. The acceptable accuracy and reproducibility of ambulatory PWA makes it be a promising tool for evaluating vascular biomarkers in daily-life conditions. This approach may provide an opportunity to further improve the early cardiovascular screening in subjects at risk. However, there is no sufficient evidence to support the routine clinical use of PWA in ambulatory conditions at the moment. In particular, long-term outcome studies are needed to show the predictive value of ambulatory PWV, CAP and AIx values.
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Affiliation(s)
- Yu. V. Kotovskaya
- Russian Gerontology Clinical Research Center of the Ministry of Health
| | - A. N. Rogoza
- Scientific Medical Research Center of Cardiology of the Ministry of Health
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Lithovius R, Gordin D, Forsblom C, Saraheimo M, Harjutsalo V, Groop PH. Ambulatory blood pressure and arterial stiffness in individuals with type 1 diabetes. Diabetologia 2018; 61:1935-1945. [PMID: 29797021 DOI: 10.1007/s00125-018-4648-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 01/31/2018] [Accepted: 04/23/2018] [Indexed: 12/31/2022]
Abstract
AIMS/HYPOTHESIS This study aimed to assess the use of ambulatory BP monitoring (ABPM) to identify the presence of masked, nocturnal and white-coat hypertension in individuals with type 1 diabetes, patterns that could not be detected by regular office-based BP monitoring alone. We also analysed associations between BP patterns and arterial stiffness in order to identify individuals at cardiovascular risk. METHODS This substudy included 140 individuals with type 1 diabetes from the Helsinki metropolitan area, who attended the Finnish Diabetic Nephropathy Study (FinnDiane) Centre in Helsinki between January 2013 and August 2017. Twenty-four hour ABPM and pulse wave analysis were performed simultaneously using a validated non-invasive brachial oscillometric device (Mobil-O-Graph). Definitions of hypertension were based on the European Society of Hypertension guidelines. Masked hypertension was defined as normal office BP (BP obtained using a standardised automated BP device) but elevated 24 h ABPM, and white-coat hypertension as elevated office BP but normal 24 h ABPM. RESULTS A total of 38% of individuals were normotensive and 33% had sustained hypertension, while 23% had masked and 6% had white-coat hypertension. About half of the cohort had increased absolute levels of night-time BP, half of whom were untreated. In the ambulatory setting, central BP and pulse wave velocity (PWV) were higher in participants with masked hypertension than in those with normotension (p ≤ 0.001). In a multivariable linear regression model adjusted for age, sex, BMI, antihypertensive treatment and eGFR, masked hypertension was independently associated with higher 24 h PWV (β 0.50 [95% CI 0.34, 0.66]), but not with PWV obtained during resting conditions (adjusted β 0.28 [95% CI -0.53, 1.10]), using normotension as the reference group. CONCLUSIONS/INTERPRETATION ABPM analysis revealed that one-quarter of the participants with type 1 diabetes had masked hypertension; these individuals would not have been detected by office BP alone. Moreover, arterial stiffness was increased in individuals with masked hypertension. These findings support the use of ABPM to identify individuals at risk of cardiovascular disease.
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Affiliation(s)
- Raija Lithovius
- Folkhälsan Institute of Genetics, Folkhälsan Research Centre, Biomedicum Helsinki, Haartmaninkatu 8, FIN-00290, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - Daniel Gordin
- Folkhälsan Institute of Genetics, Folkhälsan Research Centre, Biomedicum Helsinki, Haartmaninkatu 8, FIN-00290, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
- Dianne Nunnally Hoppes Laboratory Section of Vascular Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
| | - Carol Forsblom
- Folkhälsan Institute of Genetics, Folkhälsan Research Centre, Biomedicum Helsinki, Haartmaninkatu 8, FIN-00290, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - Markku Saraheimo
- Folkhälsan Institute of Genetics, Folkhälsan Research Centre, Biomedicum Helsinki, Haartmaninkatu 8, FIN-00290, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - Valma Harjutsalo
- Folkhälsan Institute of Genetics, Folkhälsan Research Centre, Biomedicum Helsinki, Haartmaninkatu 8, FIN-00290, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
- The Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Per-Henrik Groop
- Folkhälsan Institute of Genetics, Folkhälsan Research Centre, Biomedicum Helsinki, Haartmaninkatu 8, FIN-00290, Helsinki, Finland.
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia.
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Omboni S, Posokhov IN, Kotovskaya YV, Protogerou AD, Blacher J. Twenty-Four-Hour Ambulatory Pulse Wave Analysis in Hypertension Management: Current Evidence and Perspectives. Curr Hypertens Rep 2016; 18:72. [PMID: 27659178 DOI: 10.1007/s11906-016-0681-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The predictive value of vascular biomarkers such as pulse wave velocity (PWV), central arterial pressure (CAP), and augmentation index (AIx), obtained through pulse wave analysis (PWA) in resting conditions, has been documented in a variety of patient groups and populations. This allowed to make appropriate recommendations in clinical practice guidelines of several scientific societies. Due to advances in technologies, largely operator-independent methods are currently available for estimating vascular biomarkers also in ambulatory conditions, over the 24 h. According to the acceptable accuracy and reproducibility of 24-h ambulatory PWA, it appears to be a promising tool for evaluating vascular biomarkers in daily life conditions. This approach may provide an opportunity to further improve the early cardiovascular screening in subjects at risk. However, concerning the clinical use of PWA over the 24 h in ambulatory conditions at the moment, there is no sufficient evidence to support its routine clinical use. In particular, long-term outcome studies are needed to show the predictive value of 24-h PWV, CAP, and AIx values, provided by these devices, over and beyond peripheral blood pressure, and to answer the many technical and clinical questions still open. To this regard, the VASOTENS Registry, an international observational prospective study recently started, will help providing answers on a large sample of hypertensive patients recruited worldwide.
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Mulè G, Nardi E, Geraci G, Schillaci MK, Cottone S. The relationships between lipid ratios and arterial stiffness. J Clin Hypertens (Greenwich) 2017; 19:777-779. [DOI: 10.1111/jch.13030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Giuseppe Mulè
- Dipartimento Biomedico did Medicina Interna e Specialistica (DIBIMIS); Unit of Nephrology and Hypertension; European Society of Hypertension Excellence Centre; Università di Palermo; Palermo Italy
| | - Emilio Nardi
- Dipartimento Biomedico did Medicina Interna e Specialistica (DIBIMIS); Unit of Nephrology and Hypertension; European Society of Hypertension Excellence Centre; Università di Palermo; Palermo Italy
| | - Giulio Geraci
- Dipartimento Biomedico did Medicina Interna e Specialistica (DIBIMIS); Unit of Nephrology and Hypertension; European Society of Hypertension Excellence Centre; Università di Palermo; Palermo Italy
| | - Margherita Ketty Schillaci
- Dipartimento Biomedico did Medicina Interna e Specialistica (DIBIMIS); Unit of Nephrology and Hypertension; European Society of Hypertension Excellence Centre; Università di Palermo; Palermo Italy
| | - Santina Cottone
- Dipartimento Biomedico did Medicina Interna e Specialistica (DIBIMIS); Unit of Nephrology and Hypertension; European Society of Hypertension Excellence Centre; Università di Palermo; Palermo Italy
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Singh RB, Hristova K, Bjørklund G, Fedacko J, Chirumbolo S, Pella D. Extended consensus on blood pressure variability beyond blood pressure for management of hypertension. ACTA ACUST UNITED AC 2017; 11:6-9. [PMID: 28040405 DOI: 10.1016/j.jash.2016.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 11/10/2016] [Accepted: 11/16/2016] [Indexed: 11/24/2022]
Affiliation(s)
- Ram B Singh
- Halberg Hospital and Research Institute, Moradabad, India
| | - Krasimira Hristova
- Division of Echocardiography Imaging, National Heart Hospital, Sofia, Bulgaria
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway.
| | - Jan Fedacko
- Faculty of Medicine, Pavol Jozef Šafárik University, Kosice, Slovakia
| | - Salvatore Chirumbolo
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | - Daniel Pella
- Faculty of Medicine, Pavol Jozef Šafárik University, Kosice, Slovakia
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Omboni S, Posokhov IN, Rogoza AN. Relationships between 24-h blood pressure variability and 24-h central arterial pressure, pulse wave velocity and augmentation index in hypertensive patients. Hypertens Res 2016; 40:385-391. [PMID: 27881851 DOI: 10.1038/hr.2016.156] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 09/14/2016] [Accepted: 10/06/2016] [Indexed: 11/09/2022]
Abstract
Twenty-four-h blood pressure variability (BPV) predicts cardiovascular complications in hypertension, but its association with pulse wave indices (central arterial pressure, pulse wave velocity (PWV) and augmentation index (AIx)) is poorly understood. In the present study, we assessed the degree of the effect of 24-h BPV on 24-h pulse wave indices. Brachial blood pressure was measured non-invasively over the 24 h with an electronic, oscillometric, automated device (BPLab) in 661 uncomplicated treated or untreated hypertensive patients. Digitalized oscillometric waveforms were analyzed with a validated algorithm to obtain pulse wave indices. Twenty-four-h BPV was calculated as the unweighted (SDu) or weighted s.d. (SDw) of the mean blood pressure or as the average real variability (ARV). Twenty-four-h systolic BPV showed a direct and significant relationship with the central arterial systolic pressure (r=0.28 SDu, r=0.40 SDw, r=0.34 ARV), PWV (r=0.10 SDu, r=0.21 SDw, r=0.19 ARV) and AIx (r=0.17 SDu, r=0.27 SDw, r=0.23 ARV). After adjustment for age, sex, body mass index, antihypertensive treatment and 24-h systolic blood pressure, the relationship lost some power but was still significant for all measures, except for the AIx. Pulse wave indices were higher in patients with high BPV than in those with low BPV: after adjustment, these differences were abolished for the AIx. The diastolic BPV showed a weak association with the pulse wave indices. In conclusion, in hypertensive patients, 24-h systolic BPV is moderately and independently associated with 24-h central arterial pressure and stiffness.
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Affiliation(s)
- Stefano Omboni
- Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy
| | | | - Anatoly N Rogoza
- Department of New Methods of Diagnostics, Russian Cardiology Research and Production Complex, Moscow, Russia
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