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Abstract
Cardiovascular disease represents a massive healthcare burden worldwide. Gender differences in the pathophysiology, presentation and prognosis of cardiovascular disease have been described in the literature. Metabolic syndrome, characterized by a cluster of metabolic abnormalities is associated with increased risk for type 2 diabetes mellitus and atherosclerotic cardiovascular disease. With the global obesity epidemic, the prevalence of metabolic syndrome is rising rapidly in the developed as well as developing world. However, there is considerable variation in the prevalence based on geography, age, sex and, definition used for diagnosis. Data on gender related differences in metabolic syndrome is relatively scarce. Here, we aim to review the gender differences in epidemiology and pathophysiology of metabolic syndrome as well as its individual components. Knowledge of gender differences in metabolic syndrome can help design gender specific preventative and therapeutic strategies that will have a positive impact on overall population health.
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Affiliation(s)
- Yogita Rochlani
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA,
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52
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Huang YH, Yang YC, Lu FH, Sun ZJ, Wu JS, Chang CJ. Serum Bilirubin Is Inversely Associated with Increased Arterial Stiffness in Men with Pre-Hypertension but Not Normotension. PLoS One 2016; 11:e0146226. [PMID: 26757267 PMCID: PMC4710537 DOI: 10.1371/journal.pone.0146226] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Accepted: 11/11/2015] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Serum bilirubin level has shown to be inversely associated with coronary atherosclerosis, and may serve as a protective biomarker of coronary artery disease. Serum bilirubin has also been shown to be negatively associated with brachial-ankle pulse wave velocity (baPWV) in men without a history of hypertension, and in men with hypertension. It is unknown whether such associations can be observed in the pre-hypertensive or normotensive population. This study thus aimed to investigate the relationship between serum bilirubin level and increased arterial stiffness in subjects with pre-hypertension and normotension for both genders. METHODS A cross-sectional sample of 3,399 apparently healthy subjects undergoing a medical check-up at National Cheng Kung University Hospital was enrolled between October 2006 and August 2009, after excluding subjects with serum total bilirubin level greater than 20.52 μmol/L. Increased arterial stiffness was defined as baPWV of 1,400 cm/s or higher as the dichotomous variable and bilirubin as the continuous variable. RESULTS Based on multiple linear regression analysis, serum bilirubin level was inversely associated with baPWV in non-hypertensive men (β = -0.066, p < 0.001) but not in non-hypertensive women. In addition, the inverse relationship between bilirubin level and baPWV was found statistically significant only in pre-hypertensive men (β = -0.110, p < 0.001). Multiple logistic regression analysis showed that serum bilirubin was inversely associated with increased arterial stiffness in men with pre-hypertension (odds ratio = 0.955, 95% confidence interval = 0.916-0.996, p < 0.05) but not normotension after adjustment for other confounding factors. However, the relationship between total bilirubin level and increased arterial stiffness did not reach statistical significance for female subjects with pre-hypertension and normotension. CONCLUSION Serum bilirubin is inversely associated with increased arterial stiffness in men with pre-hypertension but not normotension. The association between bilirubin level and arterial stiffness was not found significant in women.
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Affiliation(s)
- Yao-Hsien Huang
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Feng-Hwa Lu
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Zih-Jie Sun
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Family Medicine, National Cheng Kung University Hospital Dou-Liou Branch, Yunlin, Taiwan
| | - Jin-Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Jen Chang
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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53
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Weberruß H, Pirzer R, Böhm B, Dalla Pozza R, Netz H, Oberhoffer R. Intima-media thickness and arterial function in obese and non-obese children. BMC OBESITY 2016; 3:2. [PMID: 26798485 PMCID: PMC4706715 DOI: 10.1186/s40608-016-0081-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 01/06/2016] [Indexed: 12/17/2022]
Abstract
Background Obesity is an independent cardiovascular risk factor that contributes to the development of atherosclerosis. Subclinical forms of the disease can be assessed via sonographic measurement of carotid intima-media thickness (cIMT) and distensibility – both may already be altered in childhood. As childhood obesity increases to an alarming extent, this study compares vascular data of obese with normal weight boys and girls to investigate the influence of obesity on cIMT and distensibility of the carotid arteries. Methods cIMT and distensibility of 46 obese children (27 girls) aged 7–17 years were compared with measures of 46 sex- and age-matched normal weight controls. cIMT and distensibility were measured by B- and M-mode ultrasound and expressed as standard deviation scores (SDS). Arterial distensibility was defined by arterial compliance (AC), elastic modulus (Ep), stiffness index β (β), and local pulse wave velocity β (PWV β). Results Obese girls had significantly stiffer arteries compared with normal weight girls (Ep SDS 0.64 ± 1.24 vs. 0 ± 1.06, β SDS 0.6 ± 1.17 vs. -0.01 ± 1.06 p < .01, PWV β 0.54 ± 1.2 vs. -0.12 ± 1.05 p < .05). No significant differences were observed for boys. In multiregression analysis, BMI significantly influenced Ep, β and PWV β but not cIMT and AC. Conclusions Obese girls seemed to be at higher cardiovascular risk than boys, expressed by stiffer arteries in obese girls compared with normal weight girls. Overall, BMI negatively influenced parameters of arterial stiffness (Ep, β and PWV β) but not compliance or cIMT.
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Affiliation(s)
- Heidi Weberruß
- Institute of Preventive Pediatrics, Technische Universität München, Georg-Brauchle-Ring 60/62, Campus D, 80992 Munich, Germany
| | - Raphael Pirzer
- Department of Pediatric Cardiology, Ludwig-Maximilians-University, Marchioninistraße 15, 81377 Munich, Germany
| | - Birgit Böhm
- Institute of Preventive Pediatrics, Technische Universität München, Georg-Brauchle-Ring 60/62, Campus D, 80992 Munich, Germany
| | - Robert Dalla Pozza
- Department of Pediatric Cardiology, Ludwig-Maximilians-University, Marchioninistraße 15, 81377 Munich, Germany
| | - Heinrich Netz
- Department of Pediatric Cardiology, Ludwig-Maximilians-University, Marchioninistraße 15, 81377 Munich, Germany
| | - Renate Oberhoffer
- Institute of Preventive Pediatrics, Technische Universität München, Georg-Brauchle-Ring 60/62, Campus D, 80992 Munich, Germany
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54
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Kozakova M, Morizzo C, Bianchi V, Marchetti S, Federico G, Palombo C. Hemodynamic overload and intra-abdominal adiposity in obese children: Relationships with cardiovascular structure and function. Nutr Metab Cardiovasc Dis 2016; 26:60-66. [PMID: 26643211 DOI: 10.1016/j.numecd.2015.10.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 09/21/2015] [Accepted: 10/13/2015] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND AIMS Childhood obesity promotes adverse changes in cardiovascular structure and function. This study evaluated whether these changes are related to intra-abdominal adiposity and associated cardiometabolic risk or to body-size induced hemodynamic overload. METHODS AND RESULTS 55 obese children/adolescents and 35 healthy-weight controls underwent carotid, cardiac and abdominal ultrasound to assess carotid artery intima-media thickness (IMT), diameter, distension and stiffness, left ventricular (LV) dimension, mass and function and extent of intra-abdominal adiposity. As compared to controls with healthy BMI, obese children had higher systolic blood pressure (BP), stroke volume and lower total peripheral resistance (P < 0.001-0.0001), higher plasma triglycerides, glycated hemoglobin, insulin and HOMA-IR index (P = 0.01-<0.0001), higher carotid IMT, diameter and distension (P < 0.005-0.0005), higher LV diameter, wall thickness and mass (P < 0.001-0.0001), and impaired LV diastolic function assessed by myocardial longitudinal performance (P < 0.005). In entire population, independent determinants of carotid diameter, LV diameter, wall thickness and mass were fat-free mass (or stroke volume, respectively) and BP. Carotid distension was determined by carotid diameter and BP, and carotid IMT by carotid diameter, BP, HDL-cholesterol and glycated hemoglobin. LV diastolic performance was inversely related to preperitoneal fat thickness and plasma insulin levels. CONCLUSIONS Obese youths present signs of impaired lipid and glucose metabolism, hyperdynamic circulation and cardiovascular changes. Increase in LV dimensions and mass and in carotid diameter and distension seems to reflect adaptation to body-size induced increase in hemodynamic load, changes in LV diastolic performance a negative impact of intra-abdominal adiposity and associated metabolic risk, and increase in IMT both adaptive remodeling and metabolic risk.
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Affiliation(s)
- M Kozakova
- Department of Clinical and Experimental Medicine, University of Pisa, Italy.
| | - C Morizzo
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Italy
| | - V Bianchi
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - S Marchetti
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - G Federico
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - C Palombo
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Italy
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55
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Thurn D, Doyon A, Sözeri B, Bayazit AK, Canpolat N, Duzova A, Querfeld U, Schmidt BMW, Schaefer F, Wühl E, Melk A. Aortic Pulse Wave Velocity in Healthy Children and Adolescents: Reference Values for the Vicorder Device and Modifying Factors. Am J Hypertens 2015; 28:1480-8. [PMID: 25944878 DOI: 10.1093/ajh/hpv048] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 11/30/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Aortic pulse wave velocity (PWV), an indicator of arterial stiffness, independently predicts cardiovascular mortality risk in adults. Arterial stiffening advances with age and seems accelerated in children with certain disease conditions such as chronic kidney disease or diabetes. The Vicorder, an oscillometric device to measure PWV, has been validated in children, but reference values in a large pediatric cohort, association to carotid stiffness and influence of individual and family risk factors have not been determined. METHODS Pulse waves were captured in 1,003 healthy children (aged 6-18 years) in 6 centers and gender-specific reference data normalized to age/height were constructed. In 589 children carotid distensibility and intima media thickness were measured. Gestational and family history was reported. RESULTS PWV correlated with age (r = 0.57, P < 0.0001) with significant gender-related differences starting at age 9. Further significant correlations were seen for height, weight, body mass index, blood pressure, pulse pressure, and heart rate. Independent predictors for PWV in a multivariate regression analysis were gender, age, height, weight, mean arterial pressure, and heart rate. Risk factors for higher PWV included small for gestational age at birth, secondhand smoking, parental hypertension, and obesity. PWV showed weak correlations with 2 of the carotid distensibility measures, but not with intima media thickness. CONCLUSION This study defines reference values for PWV captured by the Vicorder device in children and adolescents and reveals associations with potential cardiovascular risk factors in a healthy population. Gender-specific percentiles for age/height will allow for the assessment of pediatric cohorts using this oscillometric method.
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Affiliation(s)
- Daniela Thurn
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Anke Doyon
- Division of Pediatric Nephrology, Center for Pediatric and Adolescent Medicine, Heidelberg, Germany
| | - Betul Sözeri
- Division of Pediatric Nephrology, Ege University Medical Faculty, Izmir, Turkey
| | - Aysun K Bayazit
- Department of Pediatric Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Nur Canpolat
- Department of Pediatric Nephrology, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey
| | - Ali Duzova
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Uwe Querfeld
- Department of Pediatric Nephrology, Charité Universitätsmedizin Berlin, Germany
| | | | - Franz Schaefer
- Division of Pediatric Nephrology, Center for Pediatric and Adolescent Medicine, Heidelberg, Germany
| | - Elke Wühl
- Division of Pediatric Nephrology, Center for Pediatric and Adolescent Medicine, Heidelberg, Germany
| | - Anette Melk
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
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56
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Abstract
Somatic mutations have been identified in the KCNJ5 gene (encoding the potassium channel GIRK4) in aldosterone-producing adenomas (APA). Most of these mutations are located in or near the selectivity filter of the GIRK4 channel pore and several have been shown to lead to the constitutive overproduction of aldosterone. KCNJ5 mutations in APA are more frequent in women; however, this gender dimorphism is a reported phenomenon of Western but not East Asian populations. In this review we discuss some of the issues that could potentially underlie this observation.
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Affiliation(s)
- T A Williams
- Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Turin, Turin, Italy
| | - J W M Lenders
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J Burrello
- Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Turin, Turin, Italy
| | - F Beuschlein
- Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany
| | - M Reincke
- Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany
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57
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Gómez-Marcos MÁ, Recio-Rodríguez JI, Gómez-Sánchez L, Agudo-Conde C, Rodríguez-Sanchez E, Maderuelo-Fernandez J, Gomez-Sanchez M, García-Ortiz L. Gender differences in the progression of target organ damage in patients with increased insulin resistance: the LOD-DIABETES study. Cardiovasc Diabetol 2015; 14:132. [PMID: 26427534 PMCID: PMC4591592 DOI: 10.1186/s12933-015-0293-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 09/17/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to analyze the evolution of vascular, cardiac and renal target organ damage (TOD) in patients with increased insulin resistance over a 3.5 year follow-up and to investigate gender difference and factors that influence its progression. METHODS We performed a prospective observational study involving 112 patients (71 men, 41 women) who were followed for 3.5 years. Measurements included blood pressure, blood glucose, lipids, smoking, body mass index (BMI) and HOMA-Ir Vascular TOD included carotid intima-media thickness (IMT), pulse wave velocity (PWV) and ankle/brachial index (ABI). Cardiac TOD included Cornell voltage-duration product and Sokolow. Renal TOD included creatinine, glomerular filtration and albumin/creatinine ratio. RESULTS The IMT increased in both genders. Each year, the IMT increased 0.005 mm in men and 0.011 in women and the PWV 0.024 and 0.020 m/sec, respectively. The highest increase was in women with type 2 diabetes mellitus, who had an increase in TOD carotid (40%), PWV (24%) and renal TOD (20 %). Multiple regression analysis, after adjusting for age and gender, showed a negative association between duration since diabetes diagnosis and ABI (β = -0.006; p = 0.017) and between BMI and glomerular filtration (β = -0.813; p = 0.014). HbA1c was positively associated with PWV (β = 0.501; p = 0.014). CONCLUSIONS This study showed that the progression of vascular and renal TOD differs by gender. The increase in vascular and renal TOD was higher in women, especially in diabetic women. The PWV increase showed a positive association with mean HbA1c levels during the follow-up. Glomerular filtration was associated with BMI and the ABI was associated with duration since type 2 diabetes mellitus diagnosis. TRIAL REGISTRATION Clinical Trials.gov Identifier NCT01065155.
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Affiliation(s)
- Manuel Ángel Gómez-Marcos
- Primary Care Research Unit, The Alamedilla Health Center, Avda. Comuneros 27, 37003, Salamanca, Spain. .,Castilla and León Health Service-SACYL. REDIAPP, IBSAL, Salamanca, Spain. .,Medicine Department, University of Salamanca, Salamanca, Spain.
| | | | - Leticia Gómez-Sánchez
- Primary Care Research Unit, The Alamedilla Health Center, Avda. Comuneros 27, 37003, Salamanca, Spain.
| | - Cristina Agudo-Conde
- Primary Care Research Unit, The Alamedilla Health Center, Avda. Comuneros 27, 37003, Salamanca, Spain. .,Castilla and León Health Service-SACYL. REDIAPP, IBSAL, Salamanca, Spain.
| | - Emiliano Rodríguez-Sanchez
- Primary Care Research Unit, The Alamedilla Health Center, Avda. Comuneros 27, 37003, Salamanca, Spain. .,Castilla and León Health Service-SACYL. REDIAPP, IBSAL, Salamanca, Spain. .,Medicine Department, University of Salamanca, Salamanca, Spain.
| | - JoseAngel Maderuelo-Fernandez
- Primary Care Research Unit, The Alamedilla Health Center, Avda. Comuneros 27, 37003, Salamanca, Spain. .,Castilla and León Health Service-SACYL. REDIAPP, IBSAL, Salamanca, Spain.
| | - Marta Gomez-Sanchez
- Primary Care Research Unit, The Alamedilla Health Center, Avda. Comuneros 27, 37003, Salamanca, Spain.
| | - Luís García-Ortiz
- Primary Care Research Unit, The Alamedilla Health Center, Avda. Comuneros 27, 37003, Salamanca, Spain. .,Castilla and León Health Service-SACYL. REDIAPP, IBSAL, Salamanca, Spain. .,Medicine Department, University of Salamanca, Salamanca, Spain.
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58
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Kim CW, Chang Y, Zhao D, Cainzos-Achirica M, Ryu S, Jung HS, Yun KE, Choi Y, Ahn J, Zhang Y, Rampal S, Baek Y, Lima JA, Shin H, Guallar E, Cho J, Sung E. Sleep Duration, Sleep Quality, and Markers of Subclinical Arterial Disease in Healthy Men and Women. Arterioscler Thromb Vasc Biol 2015; 35:2238-45. [DOI: 10.1161/atvbaha.115.306110] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 07/24/2015] [Indexed: 01/26/2023]
Affiliation(s)
- Chan-Won Kim
- From the Center for Cohort Studies, Total Healthcare Center (C.-W.K., Y. Chang, S. Ryu, H.-S.J., K.E.Y., Y. Choi, J.A., Y.B., J.C.) and Department of Occupational and Environmental Medicine (Y.C., S. Ryu), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Departments of Epidemiology (D.Z., M.C.-A., Y.Z., S. Rampal, E.G., J.C.) and Medicine (E.G.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of
| | - Yoosoo Chang
- From the Center for Cohort Studies, Total Healthcare Center (C.-W.K., Y. Chang, S. Ryu, H.-S.J., K.E.Y., Y. Choi, J.A., Y.B., J.C.) and Department of Occupational and Environmental Medicine (Y.C., S. Ryu), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Departments of Epidemiology (D.Z., M.C.-A., Y.Z., S. Rampal, E.G., J.C.) and Medicine (E.G.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of
| | - Di Zhao
- From the Center for Cohort Studies, Total Healthcare Center (C.-W.K., Y. Chang, S. Ryu, H.-S.J., K.E.Y., Y. Choi, J.A., Y.B., J.C.) and Department of Occupational and Environmental Medicine (Y.C., S. Ryu), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Departments of Epidemiology (D.Z., M.C.-A., Y.Z., S. Rampal, E.G., J.C.) and Medicine (E.G.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of
| | - Miguel Cainzos-Achirica
- From the Center for Cohort Studies, Total Healthcare Center (C.-W.K., Y. Chang, S. Ryu, H.-S.J., K.E.Y., Y. Choi, J.A., Y.B., J.C.) and Department of Occupational and Environmental Medicine (Y.C., S. Ryu), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Departments of Epidemiology (D.Z., M.C.-A., Y.Z., S. Rampal, E.G., J.C.) and Medicine (E.G.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of
| | - Seungho Ryu
- From the Center for Cohort Studies, Total Healthcare Center (C.-W.K., Y. Chang, S. Ryu, H.-S.J., K.E.Y., Y. Choi, J.A., Y.B., J.C.) and Department of Occupational and Environmental Medicine (Y.C., S. Ryu), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Departments of Epidemiology (D.Z., M.C.-A., Y.Z., S. Rampal, E.G., J.C.) and Medicine (E.G.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of
| | - Hyun-Suk Jung
- From the Center for Cohort Studies, Total Healthcare Center (C.-W.K., Y. Chang, S. Ryu, H.-S.J., K.E.Y., Y. Choi, J.A., Y.B., J.C.) and Department of Occupational and Environmental Medicine (Y.C., S. Ryu), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Departments of Epidemiology (D.Z., M.C.-A., Y.Z., S. Rampal, E.G., J.C.) and Medicine (E.G.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of
| | - Kyung Eun Yun
- From the Center for Cohort Studies, Total Healthcare Center (C.-W.K., Y. Chang, S. Ryu, H.-S.J., K.E.Y., Y. Choi, J.A., Y.B., J.C.) and Department of Occupational and Environmental Medicine (Y.C., S. Ryu), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Departments of Epidemiology (D.Z., M.C.-A., Y.Z., S. Rampal, E.G., J.C.) and Medicine (E.G.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of
| | - Yuni Choi
- From the Center for Cohort Studies, Total Healthcare Center (C.-W.K., Y. Chang, S. Ryu, H.-S.J., K.E.Y., Y. Choi, J.A., Y.B., J.C.) and Department of Occupational and Environmental Medicine (Y.C., S. Ryu), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Departments of Epidemiology (D.Z., M.C.-A., Y.Z., S. Rampal, E.G., J.C.) and Medicine (E.G.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of
| | - Jiin Ahn
- From the Center for Cohort Studies, Total Healthcare Center (C.-W.K., Y. Chang, S. Ryu, H.-S.J., K.E.Y., Y. Choi, J.A., Y.B., J.C.) and Department of Occupational and Environmental Medicine (Y.C., S. Ryu), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Departments of Epidemiology (D.Z., M.C.-A., Y.Z., S. Rampal, E.G., J.C.) and Medicine (E.G.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of
| | - Yiyi Zhang
- From the Center for Cohort Studies, Total Healthcare Center (C.-W.K., Y. Chang, S. Ryu, H.-S.J., K.E.Y., Y. Choi, J.A., Y.B., J.C.) and Department of Occupational and Environmental Medicine (Y.C., S. Ryu), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Departments of Epidemiology (D.Z., M.C.-A., Y.Z., S. Rampal, E.G., J.C.) and Medicine (E.G.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of
| | - Sanjay Rampal
- From the Center for Cohort Studies, Total Healthcare Center (C.-W.K., Y. Chang, S. Ryu, H.-S.J., K.E.Y., Y. Choi, J.A., Y.B., J.C.) and Department of Occupational and Environmental Medicine (Y.C., S. Ryu), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Departments of Epidemiology (D.Z., M.C.-A., Y.Z., S. Rampal, E.G., J.C.) and Medicine (E.G.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of
| | - Youngji Baek
- From the Center for Cohort Studies, Total Healthcare Center (C.-W.K., Y. Chang, S. Ryu, H.-S.J., K.E.Y., Y. Choi, J.A., Y.B., J.C.) and Department of Occupational and Environmental Medicine (Y.C., S. Ryu), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Departments of Epidemiology (D.Z., M.C.-A., Y.Z., S. Rampal, E.G., J.C.) and Medicine (E.G.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of
| | - Joao A. Lima
- From the Center for Cohort Studies, Total Healthcare Center (C.-W.K., Y. Chang, S. Ryu, H.-S.J., K.E.Y., Y. Choi, J.A., Y.B., J.C.) and Department of Occupational and Environmental Medicine (Y.C., S. Ryu), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Departments of Epidemiology (D.Z., M.C.-A., Y.Z., S. Rampal, E.G., J.C.) and Medicine (E.G.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of
| | - Hocheol Shin
- From the Center for Cohort Studies, Total Healthcare Center (C.-W.K., Y. Chang, S. Ryu, H.-S.J., K.E.Y., Y. Choi, J.A., Y.B., J.C.) and Department of Occupational and Environmental Medicine (Y.C., S. Ryu), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Departments of Epidemiology (D.Z., M.C.-A., Y.Z., S. Rampal, E.G., J.C.) and Medicine (E.G.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of
| | - Eliseo Guallar
- From the Center for Cohort Studies, Total Healthcare Center (C.-W.K., Y. Chang, S. Ryu, H.-S.J., K.E.Y., Y. Choi, J.A., Y.B., J.C.) and Department of Occupational and Environmental Medicine (Y.C., S. Ryu), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Departments of Epidemiology (D.Z., M.C.-A., Y.Z., S. Rampal, E.G., J.C.) and Medicine (E.G.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of
| | - Juhee Cho
- From the Center for Cohort Studies, Total Healthcare Center (C.-W.K., Y. Chang, S. Ryu, H.-S.J., K.E.Y., Y. Choi, J.A., Y.B., J.C.) and Department of Occupational and Environmental Medicine (Y.C., S. Ryu), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Departments of Epidemiology (D.Z., M.C.-A., Y.Z., S. Rampal, E.G., J.C.) and Medicine (E.G.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of
| | - Eunju Sung
- From the Center for Cohort Studies, Total Healthcare Center (C.-W.K., Y. Chang, S. Ryu, H.-S.J., K.E.Y., Y. Choi, J.A., Y.B., J.C.) and Department of Occupational and Environmental Medicine (Y.C., S. Ryu), Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Departments of Epidemiology (D.Z., M.C.-A., Y.Z., S. Rampal, E.G., J.C.) and Medicine (E.G.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of
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Simova I, Katova T, Santoro C, Galderisi M. Comparison between Regional and Local Pulse-Wave Velocity Data. Echocardiography 2015; 33:77-81. [DOI: 10.1111/echo.12985] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Iana Simova
- Department of Noninvasive Cardiovascular Imaging and Functional Diagnostics; National Cardiology Hospital; Sofia Bulgaria
| | - Tzvetana Katova
- Department of Noninvasive Cardiovascular Imaging and Functional Diagnostics; National Cardiology Hospital; Sofia Bulgaria
| | - Ciro Santoro
- Department of Advanced Biomedical Sciences; Federico University Hospital; Naples Italy
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences; Federico University Hospital; Naples Italy
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Salerni S, Di Francescomarino S, Cadeddu C, Acquistapace F, Maffei S, Gallina S. The different role of sex hormones on female cardiovascular physiology and function: not only oestrogens. Eur J Clin Invest 2015; 45:634-45. [PMID: 25845675 DOI: 10.1111/eci.12447] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 03/31/2015] [Indexed: 12/18/2022]
Abstract
Human response to different physiologic stimuli and cardiovascular (CV) adaptation to various pathologies seem to be gender specific. Sex-steroid hormones have been postulated as the major contributors towards these sex-related differences. This review will discuss current evidence on gender differences in CV function and remodelling, and will present the different role of the principal sex-steroid hormones on female heart. Starting from a review of sex hormones synthesis, receptors and CV signalling, we will summarize the current knowledge concerning the role of sex hormones on the regulation of our daily activities throughout the life, via the modulation of autonomic nervous system, excitation-contraction coupling pathway and ion channels activity. Many unresolved questions remain even if oestrogen effects on myocardial remodelling and function have been extensively studied. So this work will focus attention also on the controversial and complex relationship existing between androgens, progesterone and female heart.
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Affiliation(s)
- Sara Salerni
- Department of Neuroimaging, University of Chieti, Chieti, Italy
| | | | - Christian Cadeddu
- Department of Cardiovascular and Neurological Sciences, University of Cagliari, Cagliari, Italy
| | - Flavio Acquistapace
- Helvetic Confederation IIHM International institute, Cardiologic Medical Center Manno, Lugano, Helvetia
| | - Silvia Maffei
- Fondazione G. Monasterio CNR-Regione Toscana and Institute of Clinical Physiology-CNR, Pisa, Italy
| | - Sabina Gallina
- Department of Neuroimaging, University of Chieti, Chieti, Italy
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Xiao X, Zhu Y, Zhen D, Chen XM, Yue W, Liu L, Li T. Beneficial and side effects of arginine vasopressin and terlipressin for septic shock. J Surg Res 2015; 195:568-79. [DOI: 10.1016/j.jss.2015.02.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 01/22/2015] [Accepted: 02/12/2015] [Indexed: 10/24/2022]
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Gomez-Sanchez L, García-Ortiz L, Recio-Rodríguez JI, Patino-Alonso MC, Agudo-Conde C, Rigo F, Ramos R, Martí R, Gomez-Marcos MA. Leukocyte subtype counts and its association with vascular structure and function in adults with intermediate cardiovascular risk. MARK study. PLoS One 2015; 10:e0119963. [PMID: 25885665 PMCID: PMC4401724 DOI: 10.1371/journal.pone.0119963] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Accepted: 12/17/2014] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES We investigated the relationship between leukocyte subtype counts and vascular structure and function based on carotid intima-media thickness, pulse wave velocity, central augmentation index and cardio-ankle vascular index by gender in intermediate cardiovascular risk patients. METHODS This study analyzed 500 subjects who were included in the MARK study, aged 35 to 74 years (mean: 60.3±8.4), 45.6% women. MEASUREMENT Brachial ankle Pulse Wave Velocity (ba-PWV) estimate by equation, Cardio-AnkleVascular Index (CAVI) using the VaSera device and Carotid ultrasound was used to measure carotid Intima Media Thickness (IMT). The Mobil-O-Graph was used to measure the Central Augmentation Index (CAIx). RESULTS Total leukocyte, neutrophil and monocyte counts were positively correlated with IMT (p < 0.01) in men. Monocyte count was positively correlated with CAIx in women (p < 0.01). In a multiple linear regression analysis, the IMT mean maintained a positive association with the neutrophil count (β = 1.500, p = 0.007) in men. CAIx maintained a positive association with the monocyte count (β = 2.445, p = 0.022) in women. CONCLUSION The results of this study suggest that the relationship between subtype circulating leukocyte counts and vascular structure and function, although small, may be different by gender. In men, the neutrophil count was positively correlated with IMT and in women, the monocyte count with CAIx, in a large sample of intermediate-risk patients. These association were maintained after adjusting for age and other confounders. TRIAL REGISTRATION ClinicalTrials.gov NCT01428934.
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Affiliation(s)
| | - Luis García-Ortiz
- Primary Care Research Unit, The Alamedilla Health Center, Salamanca, Spain
- Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
- Medicine Department, University of Salamanca, Salamanca, Spain
| | - José I. Recio-Rodríguez
- Primary Care Research Unit, The Alamedilla Health Center, Salamanca, Spain
- Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Maria C. Patino-Alonso
- Primary Care Research Unit, The Alamedilla Health Center, Salamanca, Spain
- Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
- Statistics Department, University of Salamanca, Salamanca, Spain
| | - Cristina Agudo-Conde
- Primary Care Research Unit, The Alamedilla Health Center, Salamanca, Spain
- Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Fernando Rigo
- San Agustín Health Center, Isles Baleares Health Service (IBSALUT), Palma de Mallorca, Spain
| | - Rafel Ramos
- Research Unit Family Medicine, Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), Girona, Spain
- Translab Research Group, Department of Medical Sciences, School of Medicine, University of Girona, Girona, Spain
- Girona Biomedical Research Institute (IDIBGI), Dr. Trueta University Hospital, Girona, Spain
| | - Ruth Martí
- Research Unit Family Medicine, Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), Girona, Spain
- Girona Biomedical Research Institute (IDIBGI), Dr. Trueta University Hospital, Girona, Spain
| | - Manuel A. Gomez-Marcos
- Primary Care Research Unit, The Alamedilla Health Center, Salamanca, Spain
- Castilla and León Health Service (SACyL), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
- Medicine Department, University of Salamanca, Salamanca, Spain
- * E-mail:
| | - for the MARK Group
- MARK Group, Research Network on Preventive Activities and Health Promotion (redIAPP), Girona, Spain
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Cote AT, Phillips AA, Harris KC, Sandor GG, Panagiotopoulos C, Devlin AM. Obesity and Arterial Stiffness in Children. Arterioscler Thromb Vasc Biol 2015; 35:1038-44. [DOI: 10.1161/atvbaha.114.305062] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective—
Childhood obesity is associated with risk factors for cardiovascular disease. Arterial stiffness is considered one of the earliest detectable measures of vascular damage. There is controversy in the literature regarding the effects of childhood obesity on arterial stiffness. The objective of this study is to systematically review the literature and to conduct a meta-analysis comparing measures of central arterial stiffness in children and adolescents with obesity to healthy body mass index controls.
Approach and Results—
Literature searches were conducted using databases (eg, MEDLINE, EMBASE) and citations cross-referenced. Studies assessing central pulse wave velocity or β-stiffness index were included. A random effects meta-analysis of the standardized mean difference and 95% confidence intervals in arterial stiffness between children with obesity and control children was performed for each arterial stiffness measure. A total of 523 studies were identified. Fifteen case–control studies were included, with 2237 children/adolescents (1281 with obesity, 956 healthy body mass index controls) between 5 and 24 years of age. All studies measuring carotid and aortic β-stiffness index and 10/12 studies measuring central pulse wave velocity reported greater arterial stiffness in children/adolescents with obesity compared with controls. A random effects meta-analysis was performed revealing a significant effect of obesity on pulse wave velocity (standardized mean difference=0.718; 95% confidence interval=0.291–1.415), carotid β-stiffness index (0.862; 0.323–1.402), and aortic β stiffness index (1.017; 0.419–1.615).
Conclusion—
These findings indicate that child/adolescent obesity is associated with greater arterial stiffness. However, further research is needed to address confounders, such as pubertal status, that may affect this relationship in children. In the future, these techniques may be useful in risk stratification and guiding clinical management of obese children to optimize cardiovascular outcomes.
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Affiliation(s)
- Anita T. Cote
- From the Department of Pediatrics, University of British Columbia, and Child & Family Research Institute, Vancouver, Canada (A.T.C., K.C.H., G.G.S.S., C.P., A.M.D.); and Centre for Heart, Lung, and Vascular Health, Faculty of Health and Social Development, University of British Columbia, Kelowna, Canada (A.A.P.)
| | - Aaron A. Phillips
- From the Department of Pediatrics, University of British Columbia, and Child & Family Research Institute, Vancouver, Canada (A.T.C., K.C.H., G.G.S.S., C.P., A.M.D.); and Centre for Heart, Lung, and Vascular Health, Faculty of Health and Social Development, University of British Columbia, Kelowna, Canada (A.A.P.)
| | - Kevin C. Harris
- From the Department of Pediatrics, University of British Columbia, and Child & Family Research Institute, Vancouver, Canada (A.T.C., K.C.H., G.G.S.S., C.P., A.M.D.); and Centre for Heart, Lung, and Vascular Health, Faculty of Health and Social Development, University of British Columbia, Kelowna, Canada (A.A.P.)
| | - George G.S. Sandor
- From the Department of Pediatrics, University of British Columbia, and Child & Family Research Institute, Vancouver, Canada (A.T.C., K.C.H., G.G.S.S., C.P., A.M.D.); and Centre for Heart, Lung, and Vascular Health, Faculty of Health and Social Development, University of British Columbia, Kelowna, Canada (A.A.P.)
| | - Constadina Panagiotopoulos
- From the Department of Pediatrics, University of British Columbia, and Child & Family Research Institute, Vancouver, Canada (A.T.C., K.C.H., G.G.S.S., C.P., A.M.D.); and Centre for Heart, Lung, and Vascular Health, Faculty of Health and Social Development, University of British Columbia, Kelowna, Canada (A.A.P.)
| | - Angela M. Devlin
- From the Department of Pediatrics, University of British Columbia, and Child & Family Research Institute, Vancouver, Canada (A.T.C., K.C.H., G.G.S.S., C.P., A.M.D.); and Centre for Heart, Lung, and Vascular Health, Faculty of Health and Social Development, University of British Columbia, Kelowna, Canada (A.A.P.)
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Grygiel-Górniak B, Kaczmarek E, Mosor M, Przysławski J, Nowak J. Association of PPAR-γ2 and β3-AR Polymorphisms With Postmenopausal Hypertension. J Clin Hypertens (Greenwich) 2015; 17:549-56. [PMID: 25827163 DOI: 10.1111/jch.12537] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 12/18/2014] [Accepted: 12/19/2014] [Indexed: 11/27/2022]
Abstract
The aim of this study was to test the association of peroxisome proliferator-activated receptor (PPAR-γ2) (Pro12Ala, C1431T) and β3-AR (Trp64Arg) polymorphisms with metabolic, nutritional, and blood pressure parameters in 271 postmenopausal women (151 hypertensive and 120 normotensive controls). The TaqMan genotyping assay and restriction fragment length polymorphism methods were used to determine the distributions of selected alleles and genotype frequencies. Nutritional status was determined by a bioimpedance method and dietary habits were assessed via 7-day dietary recall. The distribution of selected genotypes and allele frequencies did not differ between hypertensive women and normal controls after analysis by chi-square test. The postmenopausal hypertensive women were older and had higher body fat mass, serum glucose, and triglyceride levels. The cluster analysis showed that the hypertensive group with Pro12Pro genotype had highest pulse pressure and mean arterial pressure values when compared with Pro12Ala patients. In the logistic regression analysis, blood glucose (Pro12Ala polymorphism) and energy intake (C1431Tand T1431T polymorphisms) determined hypertension.
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Affiliation(s)
- Bogna Grygiel-Górniak
- Department of Bromatology and Human Nutrition, Poznan University of Medical Sciences, Poznan, Poland
| | - Elżbieta Kaczmarek
- Department of Bioinformatics and Computational Biology, Poznan University of Medical Sciences, Poznan, Poland
| | - Maria Mosor
- Department of Molecular Pathology, Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - Juliusz Przysławski
- Department of Bromatology and Human Nutrition, Poznan University of Medical Sciences, Poznan, Poland
| | - Jerzy Nowak
- Department of Molecular Pathology, Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
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Vaidya D, Golden SH, Haq N, Heckbert SR, Liu K, Ouyang P. Association of sex hormones with carotid artery distensibility in men and postmenopausal women: multi-ethnic study of atherosclerosis. Hypertension 2015; 65:1020-5. [PMID: 25753974 DOI: 10.1161/hypertensionaha.114.04826] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 02/16/2015] [Indexed: 11/16/2022]
Abstract
The decline in carotid distensibility with age is steeper in women than in men, however, the correlates of this sex difference are not known. We examined the association of bioavailable testosterone, estradiol, dehydroepiandrosterone, and sex hormone-binding globulin, in 2783 postmenopausal women and 2987 men aged 45 to 84 years at the Multi-Ethnic Study of Atherosclerosis baseline examination. Carotid artery lumen diameters by ultrasound and brachial artery blood pressures were measured at systole and diastole. Regression models to determine the association of carotid distensibility coefficient and lumen diameter with sex-specific quartiles of sex hormones were adjusted for age, race, height, weight, diabetes mellitus, current smoking, antihypertensive medication use, total and high-density lipoprotein cholesterol levels, and hormone replacement therapy in women. A higher DC indicates a more distensible vessel. In women, higher dehydroepiandrosterone (P=0.008) and lower sex hormone-binding globulin (P=0.039) were associated with lower distensibility; higher dehydroepiandrosterone and lower estradiol were associated with smaller carotid diameters. In men, higher Bio-T (P=0.009) and lower estradiol (P=0.007) were associated with greater distensibility and also with smaller diameters (P=0.012 and 0.002, respectively). An androgenic internal milieu is associated with lesser carotid distensibility and diameter remodeling in women, but the opposite is true for men. Higher levels of estradiol are associated with smaller carotid diameters in both the sexes. Future longitudinal and experimental studies are needed to reveal the mechanism and clinical consequences of these associations.
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Affiliation(s)
- Dhananjay Vaidya
- From the Johns Hopkins University School of Medicine, Baltimore, MD (D.V., S.H.G., N.H., P.O.); Department of Epidemiology, University of Washington, Seattle (S.R.H.); and Northwestern University School of Medicine, Chicago, IL (K.L.).
| | - Sherita H Golden
- From the Johns Hopkins University School of Medicine, Baltimore, MD (D.V., S.H.G., N.H., P.O.); Department of Epidemiology, University of Washington, Seattle (S.R.H.); and Northwestern University School of Medicine, Chicago, IL (K.L.)
| | - Nowreen Haq
- From the Johns Hopkins University School of Medicine, Baltimore, MD (D.V., S.H.G., N.H., P.O.); Department of Epidemiology, University of Washington, Seattle (S.R.H.); and Northwestern University School of Medicine, Chicago, IL (K.L.)
| | - Susan R Heckbert
- From the Johns Hopkins University School of Medicine, Baltimore, MD (D.V., S.H.G., N.H., P.O.); Department of Epidemiology, University of Washington, Seattle (S.R.H.); and Northwestern University School of Medicine, Chicago, IL (K.L.)
| | - Kiang Liu
- From the Johns Hopkins University School of Medicine, Baltimore, MD (D.V., S.H.G., N.H., P.O.); Department of Epidemiology, University of Washington, Seattle (S.R.H.); and Northwestern University School of Medicine, Chicago, IL (K.L.)
| | - Pamela Ouyang
- From the Johns Hopkins University School of Medicine, Baltimore, MD (D.V., S.H.G., N.H., P.O.); Department of Epidemiology, University of Washington, Seattle (S.R.H.); and Northwestern University School of Medicine, Chicago, IL (K.L.)
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Pedrotty DM, Jessup M. "Frailty, thy name is woman": syndrome of women with heart failure with preserved ejection fraction. Circ Cardiovasc Qual Outcomes 2015; 8:S48-51. [PMID: 25714824 PMCID: PMC5835973 DOI: 10.1161/circoutcomes.115.001700] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Dawn M Pedrotty
- From the Cardiovascular Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Mariell Jessup
- From the Cardiovascular Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
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Roush GC, Fagard RH, Salles GF, Pierdomenico SD, Reboldi G, Verdecchia P, Eguchi K, Kario K, Hoshide S, Polonia J, de la Sierra A, Hermida RC, Dolan E, Fapohunda J. Prognostic impact of sex–ambulatory blood pressure interactions in 10 cohorts of 17 312 patients diagnosed with hypertension. J Hypertens 2015; 33:212-20. [DOI: 10.1097/hjh.0000000000000435] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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68
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Brant LCC, Hamburg NM, Barreto SM, Benjamin EJ, Ribeiro ALP. Relations of digital vascular function, cardiovascular risk factors, and arterial stiffness: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort study. J Am Heart Assoc 2014; 3:e001279. [PMID: 25510401 PMCID: PMC4338719 DOI: 10.1161/jaha.114.001279] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background Vascular dysfunction is an early expression of atherosclerosis and predicts cardiovascular (CV) events. Peripheral arterial tonometry (PAT) evaluates basal pulse amplitude (BPA), endothelial function (PAT ratio), and wave reflection (PAT‐AIx) in the digital microvessels. In Brazilian adults, we investigated the correlations of PAT responses to CV risk factors and to carotid‐femoral pulse wave velocity (PWV), a measure of arterial stiffness. Methods and Results In a cross‐sectional study, 1535 participants of the ELSA‐Brasil cohort underwent PAT testing (52±9 years; 44% women). In multivariable analyses, more‐impaired BPA and PAT ratios were associated with male sex, higher body mass index (BMI), and total cholesterol/high‐density lipoprotein. Higher age and triglycerides were related to higher BPA, whereas lower systolic blood pressure, hypertension (HTN) treatment, and prevalent CV disease (CVD) were associated with lower PAT ratio. PAT‐AIx correlated positively with female sex, advancing age, systolic and diastolic blood pressures, and smoking and inversely to heart rate, height, BMI, and prevalent CVD. Black race was associated with lower BPA, higher PAT ratio, and PAT‐AIx. Microvessel vasodilator function was not associated with PWV. Higher PAT‐AIx was modestly correlated to higher PWV and PAT ratio and inversely correlated to BPA. Conclusion Metabolic risk factors are related to impaired microvessel vasodilator function in Brazil. However, in contrast to studies from the United States, black race was not associated with an impaired microvessel vasodilator response, implying that vascular function may vary by race across populations. PAT‐AIx relates to HTN, may be a valid measure of wave reflection, and provides distinct information from arterial stiffness.
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Affiliation(s)
- Luisa C C Brant
- Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil) Hospital das Clínicas and School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (L.C.B., S.M.B., A.P.R.)
| | - Naomi M Hamburg
- Whitaker Cardiovascular Institute, School of Medicine, Boston University, Boston, MA (N.M.H., E.J.B.)
| | - Sandhi M Barreto
- Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil) Hospital das Clínicas and School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (L.C.B., S.M.B., A.P.R.)
| | - Emelia J Benjamin
- Whitaker Cardiovascular Institute, School of Medicine, Boston University, Boston, MA (N.M.H., E.J.B.)
| | - Antonio L P Ribeiro
- Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil) Hospital das Clínicas and School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (L.C.B., S.M.B., A.P.R.)
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Dennis M, Laarkson M, Padang R, Tanous DJ, Robinson P, Pressley L, O'Meagher S, Celermajer D, Puranik R. Long term followup of aortic root size after repair of tetralogy of Fallot. Int J Cardiol 2014; 177:136-8. [PMID: 25499358 DOI: 10.1016/j.ijcard.2014.09.113] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 09/20/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Mark Dennis
- Sydney Medical School, University of Sydney, Sydney, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia.
| | - Maarit Laarkson
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Ratnasari Padang
- Sydney Medical School, University of Sydney, Sydney, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
| | - David J Tanous
- Department of Cardiology, Westmead Hospital, Sydney, Australia
| | - Peter Robinson
- Department of Cardiology, Westmead Hospital, Sydney, Australia
| | - Lynne Pressley
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Shamus O'Meagher
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
| | - David Celermajer
- Sydney Medical School, University of Sydney, Sydney, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Rajesh Puranik
- Sydney Medical School, University of Sydney, Sydney, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia; SMRI Imaging, RPAH Medical Centre, Sydney, Australia
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Hemodynamic and metabolic effects of estrogen plus progestin therapy in hypertensive postmenopausal women treated with an ACE-inhibitor or a diuretic. Clin Res Cardiol 2014; 104:38-50. [PMID: 25216597 PMCID: PMC4300408 DOI: 10.1007/s00392-014-0755-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 08/11/2014] [Indexed: 01/01/2023]
Abstract
Objectives The aim of the study was to assess the hemodynamic and metabolic actions of estrogen plus progestin therapy (EPT) in hypertensive, postmenopausal women treated with perindopril (ACEI) or hydrochlorothiazide (HCTZ). A group of normotensive postmenopausal women was also studied. Methods 100 hypertensive and 40 normotensive postmenopausal women were recruited for the study. The hypertensive females were randomly assigned to receive ACEI or HCTZ for 12 months. The patients of the ACEI group and the patients of the HCTZ group, as well as normotensives, were further subdivided into two subgroups each. One subgroup received estrogen plus progestin therapy (EPT+), the other subgroup received no hormone replacement (EPT−). Combined hormone replacement with transdermal patches releasing 17β-estradiol and norethisterone was used. Office and 24-hour ambulatory blood pressure was measured at baseline and during follow-up. Renal plasma flow (RPF) was measured using the clearance of [125I]-iodohippuran. Pulse wave velocity (PWV) was determined with an automatic device. Results In normotensive postmenopausal women, transdermal estrogen plus progestin therapy increases RPF and insulin sensitivity, decreases PWV, decreases total and LDL cholesterol, and decreases uric acid serum levels. Perindopril (4 mg/day) and hydrochlorothiazide (25 mg/day) were equally effective in reducing blood pressure in postmenopausal, hypertensive subjects. In these females, perindopril increased RPF and decreased PWV and plasma insulin levels. These effects of the ACEI were not altered by estrogen plus progestin therapy. Hydrochlorothiazide decreased RPF and increased plasma insulin and uric acid concentrations in hypertensive subjects whom were not receiving estrogen plus progestin therapy. Conclusions The unfavorable metabolic and hemodynamic actions of the diuretic were counteracted by estrogen plus progestin therapy. Concomitant estrogen plus progestin therapy may be a method to avoid unfavorable hemodynamic and metabolic effects of thiazide diuretics in hypertensive, postmenopausal women.
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Kim JY, Park JB, Kim DS, Kim KS, Jeong JW, Park JC, Oh BH, Chung N. Gender Difference in Arterial Stiffness in a Multicenter Cross-Sectional Study: The Korean Arterial Aging Study (KAAS). Pulse (Basel) 2014; 2:11-7. [PMID: 26587439 DOI: 10.1159/000365267] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Elevated arterial stiffness has emerged as an important risk factor for future cardiovascular (CV) events in men and women. However, gender-related differences in arterial stiffness have not been clearly demonstrated. We thus determine whether gender affects arterial stiffness in subjects with and without CV risk factors. We consecutively enrolled 1,588 subjects aged 17-87 years (mean age: 46.5; 51% women) from the Korean Arterial Aging Study (KAAS), which is a multicenter registry from 13 university hospitals in Korea for the evaluation of arterial stiffness. We compared markers of arterial stiffness - central augmentation index (AIx), aortic pulse wave velocity (PWV), and pulse pressure (PP) amplification - in apparently healthy men and women without risk factors with those in high-risk subjects with a smoking habit, hypertension, diabetes, and dyslipidemia but without drug treatment. Aortic PWV and PP amplification were significantly higher in men than in women (7.78 ± 1.16 vs. 7.64 ± 1.15 m/s, p = 0.015, and 1.39 ± 0.22 vs. 1.30 ± 0.18, p < 0.001, respectively). However, women had a significantly higher central AIx than men (23.5 ± 11.9 vs. 16.1 ± 12.6%, p < 0.001). The central AIx and aortic PWV values were significantly higher in the high-risk group than in the healthy group for both men and women. In men, central AIx and aortic PWV were associated positively with age and blood pressure, and negatively with body mass index. In women, central AIx was positively related to age, diastolic blood pressure, and serum cholesterol levels. Aortic PWV was positively related to age, systolic blood pressure, fasting glucose, and heart rate. PP amplification was associated negatively with age and blood pressure and positively with heart rate in both men and women. In conclusion, arterial stiffness is mainly determined by sex, age, and blood pressure. Markers of arterial stiffness differ between men and women. Dyslipidemia and glucose contribute to a modest increase in arterial stiffness only in women. Therefore, the arteries of women may be more vulnerable to CV risk factors than those of men.
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Affiliation(s)
- Jang-Young Kim
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju Christian Hospital, Wonju, Korea
| | - Jeong Bae Park
- Department of Internal Medicine, Cheil General Hospital, Kwandong University College of Medicine, Seoul, Korea
| | - Dong Soo Kim
- Department of Internal Medicine, Busan Paik Hospital, University of Inje College of Medicine, Busan, Korea
| | - Kee Sik Kim
- Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Korea
| | - Jin Won Jeong
- Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea
| | - Jong Chun Park
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Byung Hee Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seongnam, Korea
| | - Namsik Chung
- Cardiology Division, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
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72
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Li T, Xiao X, Zhang J, Zhu Y, Hu Y, Zang J, Lu K, Yang T, Ge H, Peng X, Lan D, Liu L. Age and sex differences in vascular responsiveness in healthy and trauma patients: contribution of estrogen receptor-mediated Rho kinase and PKC pathways. Am J Physiol Heart Circ Physiol 2014; 306:H1105-15. [PMID: 24531808 DOI: 10.1152/ajpheart.00645.2013] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Several medical conditions exhibit age- and sex-based differences. Whether or not traumatic shock exhibits such differences with regard to vascular responsiveness is not clear. In a cohort of 177 healthy subjects and 842 trauma patients (21–82 years) as well as different ages (4, 8, 10, 14, 18, and 24 wk; 1 and 1.5 years) and sexes of Sprague-Dawley normal and traumatic shock rats, the age- and sex-based differences of vascular responsiveness and the underlying mechanisms were investigated. Middle-aged and young women as well as female rats of reproductive age had higher vascular responsiveness in the normal condition and a lower decrease in vascular responsiveness after traumatic shock than older men and male rats of identical age. Exogenous supplementation of 17β-estrdiol increased vascular reactivity in both male and femal rats of 8–24 wk and preserved vascular responsiveness in rats following traumatic shock. No effect was observed in rats 1 to 1.5 years. These protective effects of estrogen were closely related to G protein-coupled receptor (GPR)30, estrogen receptor-mediated Rho kinase, and PKC pathway activation. Vascular responsiveness exhibits age- and sex-based differences in healthy subjects and trauma patients. Estrogen and its receptor (GPR30) mediated activation of Rho kinase and PKC using genomic and nongenomic mechanisms to elicit protective effects in vascular responsiveness. This finding is important for the personalized treatment for several age- and sex-related diseases involving estrogen.
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Affiliation(s)
- Tao Li
- State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Xudong Xiao
- State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Jie Zhang
- State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Yu Zhu
- State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Yi Hu
- Department of Anesthesiology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Jiatao Zang
- State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Kaizhi Lu
- Department of Anesthesiology, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Tiande Yang
- Department of Anesthesiology, South Western Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Hengjiang Ge
- Department of Anesthesiology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Xiaoyong Peng
- State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Dan Lan
- State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Liangming Liu
- State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China
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73
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Doumas M, Papademetriou V, Faselis C, Kokkinos P. Gender differences in hypertension: myths and reality. Curr Hypertens Rep 2014; 15:321-30. [PMID: 23749317 DOI: 10.1007/s11906-013-0359-y] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Life expectancy is longer in women compared to men, and cardiovascular events occur at a lower rate and at a later age in females than males. The impact of gender on the prevalence, the presentation, and the long-term outcome of cardiovascular disease has long been a topic of active research. Gender differences have been found in several studies but opposite findings also exist. The impact of gender in hypertension and antihypertensive therapy remains poorly clarified. The prevalence, awareness, treatment, and control rates of hypertension exhibit some differences between the two sexes, which are age-dependent. The female advantage in the cardiovascular risk of hypertensive patients might be attenuated by comorbidities and target organ damage. Another aspect of major clinical importance is whether gender differences exist on the effects of antihypertensive agents in blood pressure reduction and cardiovascular morbidity and mortality. The aim of this review is to critically evaluate recent data regarding gender differences in hypertension and incorporate new data into the body of existing knowledge.
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Affiliation(s)
- Michael Doumas
- Veteran Affairs Medical Center and George Washington University, 50 Irwing Street NW, Washington, DC 20422, USA.
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74
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Magalhães P, Capingana DP, Silva ABT, Ferreira AVL, de Sá Cunha R, Rodrigues SL, Mill JG. Age- and gender-specific reference values of pulse wave velocity for African adults: preliminary results. AGE (DORDRECHT, NETHERLANDS) 2013; 35:2345-2355. [PMID: 23319362 PMCID: PMC3824996 DOI: 10.1007/s11357-012-9504-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 12/27/2012] [Indexed: 06/01/2023]
Abstract
Pulse wave velocity (PWV) is an independent predictor of cardiovascular (CV) risk. Higher PWV values have been observed in Africans; however, there are no established age- and gender-adjusted reference values for this population. Therefore, PWV was measured using a validated device (Complior SP) in 544 subjects recruited from an occupational cohort of employees of a public university in Angola. Since high blood pressure (BP) is an important factor influencing PWV, a subsample of 301 normotensive subjects (aged 22-72 years) was selected for this study. A subset of 131 individuals without CV risk factors was considered the healthy group (HG), while the entire group (n = 301) comprised the less healthy group (LHG). Predictors of PWV were evaluated using multiple regression analyses and age- and gender-specific percentile tables and curves were constructed. Age and PWV means were 36 ± 9.7 years and 6.6 ± 1.0 m/s in the HG, respectively, and 39.9 ± 10.2 years and 7.3 ± 1.3 m/s in the LHG. Age and plasma uric acid (UA) were the only significant PWV predictors in the HG, while age, mean BP (MBP), and gender showed significant prediction of PWV in the multiple regression analysis in the LHG. Age- and gender-adjusted reference values of PWV were provided for healthy and less healthy normotensive Africans. Considering the small sample size of our cohort, these preliminary results should be used cautiously until data on robust sample of the general population can be obtained.
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75
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Cherney DZI, Montanari A. Gender, clamped hyperglycemia and arterial stiffness in patients with uncomplicated type 1 diabetes mellitus. Clin Exp Hypertens 2013; 36:187-93. [PMID: 24164216 DOI: 10.3109/10641963.2013.804543] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Diabetes mellitus (DM) reduces female gender-mediated protection against the development of renal disease possibly through effects on hyperglycemia. Women with DM also exhibit increased arterial stiffness, which may promote renal disease progression. The mechanisms responsible for increased arterial stiffness in women and the possible role of acute changes in ambient glycemia remain unknown. METHODS Blood pressure, augmentation index (AIx), pulse wave velocity (PWV) and circulating mediators of the renin angiotensin system and nitric oxide (cGMP) were measured in men (n = 22) and women (n = 19) with uncomplicated type 1 DM under clamped euglycemic and hyperglycemic conditions. RESULTS At baseline, men exhibited higher levels of angiotensin II (p = 0.030) and lower cGMP levels (p = 0.004), higher systolic blood pressure (124 ± 2 versus 109 ± 2 mmHg, p < 0.0001) and pulse pressure (42 ± 2 versus 58 ± 2 beats per minute, p < 0.0001). For arterial stiffness, radial (-8.0 ± 2.6% versus +5.4 ± 3.7%, p < 0.0001) and carotid AIx (-4.7 ± 2.9 versus +12.5 ± 3.0, p < 0.0001) were lower in men versus women. In contrast, carotid-femoral PWV was similar in men and women (5.20 ± 0.30 versus 5.13 ± 0.17, respectively, p = 0.853). In response to clamped hyperglycemia, systolic blood pressure increased in women (109 ± 2 to 112 ± 2 mmHg, p = 0.005) but not men. Serum aldosterone increased and cGMP declined in women but not in men. Clamped hyperglycemia did not influence arterial stiffness in either group and radial and carotid AIx remained higher in women. CONCLUSIONS Arterial stiffness is higher in women with type 1 DM. This effect is not dependent on the effects of clamped hyperglycemia or neurohormonal activation.
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Affiliation(s)
- David Z I Cherney
- Department of Medicine, Division of Nephrology, Toronto General Hospital, University of Toronto , Canada and
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76
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Li T, Zhu Y, Tian K, Xue M, Peng X, Lan D, Liu L. Ideal resuscitation pressure for uncontrolled hemorrhagic shock in different ages and sexes of rats. Crit Care 2013; 17:R194. [PMID: 24020401 PMCID: PMC4264615 DOI: 10.1186/cc12888] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2012] [Revised: 05/24/2013] [Accepted: 09/10/2013] [Indexed: 11/11/2023] Open
Abstract
INTRODUCTION Our previous studies demonstrated that 50-60 mmHg mean arterial blood pressure was the ideal target hypotension for uncontrolled hemorrhagic shock during the active hemorrhage in sexually mature rats. The ideal target resuscitation pressure for immature and older rats has not been determined. METHODS To elucidate this issue, using uncontrolled hemorrhagic-shock rats of different ages and sexes (6 weeks, 14 weeks and 1.5 years representing pre-adult, adult and older rats, respectively), the resuscitation effects of different target pressures (40, 50, 60, 70 and 80 mmHg) on uncontrolled hemorrhagic shock during active hemorrhage and the age and sex differences were observed. RESULTS Different target resuscitation pressures had different resuscitation outcomes for the same age and sex of rats. The optimal target resuscitation pressures for 6-week-old, 14-week-old and 1.5-year-old rats were 40 to 50 mmHg, 50 to 60 mmHg and 70 mmHg respectively. Ideal target resuscitation pressures were significantly superior to other resuscitation pressures in improving the hemodynamics, blood perfusion, organ function and animal survival of uncontrolled hemorrhagic-shock rats (P < 0.01). For same target resuscitation pressures, the beneficial effect on hemorrhagic shock had a significant age difference (P < 0.01) but no sex difference (P > 0.05). Different resuscitation pressures had no effect on coagulation function. CONCLUSION Hemorrhagic-shock rats at different ages have different target resuscitation pressures during active hemorrhage. The ideal target resuscitation hypotension for 6-week-old, 14-week-old and 1.5-year-old rats was 40 to 50 mmHg, 50 to 60 mmHg and 70 mmHg, respectively. Their resuscitation effects have significant age difference but had no sex difference.
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Affiliation(s)
- Tao Li
- State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of
Research Institute of Surgery, Daping Hospital, Third Military Medical University,
Chongqing 400042, P.R. China
| | - Yu Zhu
- State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of
Research Institute of Surgery, Daping Hospital, Third Military Medical University,
Chongqing 400042, P.R. China
| | - Kunlun Tian
- State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of
Research Institute of Surgery, Daping Hospital, Third Military Medical University,
Chongqing 400042, P.R. China
| | - Mingying Xue
- State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of
Research Institute of Surgery, Daping Hospital, Third Military Medical University,
Chongqing 400042, P.R. China
| | - Xiaoyong Peng
- State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of
Research Institute of Surgery, Daping Hospital, Third Military Medical University,
Chongqing 400042, P.R. China
| | - Dan Lan
- State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of
Research Institute of Surgery, Daping Hospital, Third Military Medical University,
Chongqing 400042, P.R. China
| | - Liangming Liu
- State Key Laboratory of Trauma, Burns and Combined Injury, Second Department of
Research Institute of Surgery, Daping Hospital, Third Military Medical University,
Chongqing 400042, P.R. China
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77
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Randby A, Namtvedt SK, Hrubos-Strøm H, Einvik G, Somers VK, Omland T. Sex-Dependent Impact of OSA on Digital Vascular Function. Chest 2013; 144:915-922. [DOI: 10.1378/chest.12-2283] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Denton KM, Hilliard LM, Tare M. Sex-related differences in hypertension: seek and ye shall find. Hypertension 2013; 62:674-7. [PMID: 23980069 DOI: 10.1161/hypertensionaha.113.00922] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Kate M Denton
- Department of Physiology, Monash University, Melbourne, VIC 3800, Australia.
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79
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Cote AT, Harris KC, Panagiotopoulos C, Sandor GGS, Devlin AM. Childhood obesity and cardiovascular dysfunction. J Am Coll Cardiol 2013; 62:1309-19. [PMID: 23954339 DOI: 10.1016/j.jacc.2013.07.042] [Citation(s) in RCA: 311] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 07/19/2013] [Accepted: 07/22/2013] [Indexed: 12/17/2022]
Abstract
Obesity-related cardiovascular disease in children is becoming more prevalent in conjunction with the rise in childhood obesity. Children with obesity are predisposed to an increased risk of cardiovascular morbidity and mortality in adulthood. Importantly, research in children with obesity over the last decade has demonstrated that children may exhibit early signs of cardiovascular dysfunction as a result of their excess adiposity, often independent of other obesity-related comorbidities such as dyslipidemia and insulin resistance. The clinical evidence is accumulating to suggest that the cardiovascular damage, once observed only in adults, is also occurring in obese children. The objective of this review is to provide a synopsis of the current research on cardiovascular abnormalities in children with obesity and highlight the importance and need for early detection and prevention programs to mitigate this potentially serious health problem.
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Affiliation(s)
- Anita T Cote
- Department of Pediatrics, University of British Columbia, Child and Family Research Institute, Vancouver, British Columbia, Canada
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80
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Mahendru AA, Morris E. Cardiovascular disease in menopause: Does the obstetric history have any bearing? ACTA ACUST UNITED AC 2013; 19:115-20. [DOI: 10.1177/1754045313495675] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cardiovascular disease remains a leading cause of morbidity and mortality in menopausal women in spite of the overall reduction in age-adjusted mortality from the disease in the last few years. It is now clear that mechanisms of cardiovascular disease in menopausal women are similar to men and rather than midlife acceleration of cardiovascular disease in women, the final impact of cardiovascular disease in later life may be a reflection of cardiovascular changes during reproductive years as a result of woman’s obstetric history. A decade after the Women’s Health Initiative trial, there is upcoming evidence to suggest that hormone replacement therapy in young recently menopausal women has a cardioprotective effect. Cardiovascular changes during normal pregnancy or pregnancy complications such as preeclampsia may affect a woman’s long-term cardiovascular health. Therefore, it is plausible that the cardioprotective benefit of hormone replacement therapy depends on occult pre-existing cardiovascular risks in women in relation to their previous obstetric history. In this review, we describe the cardiovascular changes during and after pregnancy in obstetric complications such as recurrent miscarriage, preeclampsia, intrauterine growth restriction, preterm labour and gestational diabetes; existing evidence regarding their association with cardiovascular disease later in life, and hypothesize possible mechanisms. Our aim is to improve the understanding and highlight the importance of including obstetric history in risk assessment in menopausal women and individualizing their risks before prescribing hormone replacement therapy. Future research in risk benefit assessment of hormone replacement therapy should also account for a woman’s background cardiovascular risk in the light of her obstetric history.
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Affiliation(s)
- Amita A Mahendru
- Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Edward Morris
- Norfolk and Norwich University Hospital, Norwich, UK
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81
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Marlatt KL, Kelly AS, Steinberger J, Dengel DR. The influence of gender on carotid artery compliance and distensibility in children and adults. JOURNAL OF CLINICAL ULTRASOUND : JCU 2013; 41:340-6. [PMID: 23233368 PMCID: PMC3736987 DOI: 10.1002/jcu.22015] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Accepted: 10/22/2012] [Indexed: 05/24/2023]
Abstract
PURPOSE Given the role of arterial wall elasticity in the development of cardiovascular disease, carotid artery compliance and distensibility have been used commonly over the last decade as predictors of cardiovascular risk, although their gender differences remain unknown. The purpose of our study was to evaluate the impact of gender on carotid arterial elasticity in a large sample of children and adults. METHODS Carotid artery compliance and distensibility were measured with ultrasonography in 294 children (157 boys, 137 girls; ages 6-18 years) and 604 adults (291 men, 311 women; ages 18-49 years) previously recruited for a study investigating cardiovascular risk factors. An independent sample t test was used to compare demographic and carotid artery elasticity values by age and gender. RESULTS No significant gender difference in carotid arterial compliance and distensibility was observed in children. Women had significantly greater cross-sectional compliance than men (0.004 ± 0.000 versus 0.003 ± 0.000 1/mmHg, p = 0.041). CONCLUSIONS We found significant gender difference in carotid compliance in adults, but not in children, suggesting that gender differences in arterial stiffness are not present early in life but emerge later in adulthood.
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Affiliation(s)
- Kara L Marlatt
- Laboratory of Integrative Human Physiology, School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
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82
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Nieman D, Dew D, Krasen P. Gender difference in the acute influence of a 2-hour run on arterial stiffness in trained runners. Res Sports Med 2013; 21:66-77. [PMID: 23286423 DOI: 10.1080/15438627.2012.738445] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Arterial stiffness scores over a 5-h period following a 2-h run were measured in trained males (N = 8, age 39.3 ± 2.3 y) and females (N = 8, 35.8 ± 2.8 y). Subjects reported for two lab sessions (randomized, crossover design) from 7:30 am to 4:15 pm, separated by 1-2 weeks, and either rested or ran for 2 h on a treadmill at 75% VO(2 max) from 9:15 to 11:15 am. Augmentation index standardized to a heart rate of 75 bpm (AIx75), and carotid to femoral pulse wave velocity (PWV), were measured by applanation tonometry. Significant interaction effects were measured for AIx75 (P = 0.039) and PWV (P = 0.020), and compared with the rest condition, female runners experienced decreased AIx75 from 11:45 am to 3:15 pm, and in PWV at 11:45 am and 12:15 pm, in contrast to no change in the male runners. These data support a notable gender difference in arterial stiffness following a 2-h bout of running.
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Affiliation(s)
- David Nieman
- Appalachian State University, Boone, North Carolina 28608, USA.
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83
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Yuan LJ, Xue D, Duan YY, Cao TS, Zhou N. Maternal carotid remodeling and increased carotid arterial stiffness in normal late-gestational pregnancy as assessed by radio-frequency ultrasound technique. BMC Pregnancy Childbirth 2013; 13:122. [PMID: 23710816 PMCID: PMC3669620 DOI: 10.1186/1471-2393-13-122] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Accepted: 05/21/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The adaption of elastic arteries to transient increase in hemodynamic load in normal pregnancy (NP) remains controversial. The purpose of this study was to investigate the NP carotid remodeling and regional arterial stiffness before and after parturition. METHODS Fifty-one NP women and 30 age-matched non-pregnant women were included. All women underwent right common carotid artery (RCCA) measurements with MylabTwice ultrasound instrument (Esaote, Italy). Carotid intima-medial thickness (IMT), pulse wave velocity (PWV, m/s), distensibility coefficient (DC, 1/KPa), α, β, augmentation index (AIx, %) and carotid arterial pressure were obtained by the newly developed ultrasound vascular wall tracking methods: automatic QAS (Quality Arterial Stiffness) and QIMT (Quality Intima-Medial Thickness) Follow up study was performed. RESULTS Compared to the non-pregnant controls, the arterial pressures were significantly increased and RCCA diameter was significantly enlarged in late gestational NP women. Twenty months after parturition, carotid diameter, DC, AIx, PWV and arterial wall tension were significantly decreased and had no significant difference with those in non-pregnant controls. CONCLUSIONS Carotid arterial remodeling and stiffening could be seen in the normal pregnant women, which seems to be a physiological adaption and could be recovered post partum. QIMT and QAS together could provide a comprehensive assessment of the maternal carotid arterial changes during pregnancy.
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Affiliation(s)
- Li-Jun Yuan
- Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
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84
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Increased night heart rate is associated with worse large artery elasticity in chronic kidney disease patients. Int Urol Nephrol 2013; 45:1621-7. [PMID: 23575951 DOI: 10.1007/s11255-013-0431-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 03/27/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND Chronic kidney disease (CKD) is associated with high overall and cardiovascular mortality. Numerous studies have reported that increased heart rate is a risk factor for all-cause mortality. We investigated the link between sleep heart rate and artery stiffness in CKD patients. METHODS In a cross-sectional study, we enrolled 100 prevalent Chinese CKD patients (55 males, aged 52.5 ± 16.40 years). Heart rate was measured with an automatic system. Arterial stiffness was evaluated by using a calibrated tonometer. RESULTS Large artery elasticity index (LAEI) was positively correlated with body mass index and hemoglobin but negatively associated with age and systolic blood pressure. Furthermore, LAEI was negatively associated with glomerular filtration rate (GFR) and sleep heart rate. In multivariate regression, LAEI was independently predicted by SBP, BMI, age, sleep heart rate, and gender. Adjusted R (2) of the model was 0.486. CONCLUSION Elevated sleep heart rate is significantly associated with increased arterial stiffness in CKD patients. Further investigation is needed to explore the potential benefits of sleep heart rate lowering therapy in this patient group.
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85
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Low TT, Lam CSP. Women and Heart Failure: An Emerging Venus-Mars Concept. CURRENT CARDIOVASCULAR RISK REPORTS 2013. [DOI: 10.1007/s12170-013-0307-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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86
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Johnson J, Håkansson F, Shahgaldi K, Manouras A, Norman M, Sahlén A. Impact of tachycardia and sympathetic stimulation by cold pressor test on cardiac diastology and arterial function in elderly females. Am J Physiol Heart Circ Physiol 2013; 304:H1002-9. [PMID: 23355342 DOI: 10.1152/ajpheart.00837.2012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abnormal vascular-ventricular coupling has been suggested to contribute to heart failure with preserved ejection fraction in elderly females. Failure to increase stroke volume (SV) during exercise occurs in parallel with dynamic changes in arterial physiology leading to increased afterload. Such adverse vascular reactivity during stress may reflect either sympathoexcitation or be due to tachycardia. We hypothesized that afterload elevation induces SV failure by transiently attenuating left ventricular relaxation, a phenomenon described in animal research. The respective roles of tachycardia and sympathoexcitation were investigated in n = 28 elderly females (70 ± 4 yr) carrying permanent pacemakers. At rest, during atrial tachycardia pacing (ATP; 100 min(-1)) and during cold pressor test (hand immersed in ice water), we performed Doppler echocardiography (maximal untwist rate analyzed by speckle tracking imaging of rotational mechanics) and arterial tonometry (arterial stiffness estimated as augmentation index). Estimation of arterial compliance was based on an exponential relationship between arterial pressure and volume. We found that ATP produced central hypovolemia and a reduction in SV which was larger in patients with stiffer arteries (higher augmentation index). There was an associated adverse response of arterial compliance and vascular resistance during ATP and cold pressor test, causing an overall increase in afterload, but nonetheless enhanced maximal rate of untwist and no evidence of afterload-dependent failure of relaxation. In conclusion, tachycardia and cold provocation in elderly females produces greater vascular reactivity and SV failure in the presence of arterial stiffening, but SV failure does not arise secondary to afterload-dependent attenuation of relaxation.
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Affiliation(s)
- Jonas Johnson
- Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden
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Wang ET, Ku IA, Shah SJ, Daviglus ML, Schreiner PJ, Konety SH, Williams OD, Siscovick D, Bibbins-Domingo K. Polycystic ovary syndrome is associated with higher left ventricular mass index: the CARDIA women's study. J Clin Endocrinol Metab 2012; 97:4656-62. [PMID: 23012389 PMCID: PMC3591678 DOI: 10.1210/jc.2012-1597] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 08/29/2012] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The aim of the study was to determine whether young women with polycystic ovary syndrome (PCOS) have evidence of early structural changes in echocardiographic parameters as a measurement of cardiovascular risk. METHODS We investigated the association of PCOS and echocardiographic parameters in 984 black and white women in the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort followed prospectively for 20 yr. Women ages 34-46 (Year 16) completed questionnaires recalling symptoms of oligomenorrhea and hirsutism in their 20s and 30s. Serum androgens were obtained at Year 2. Women in their 20s and 30s were classified into four mutually exclusive groups: 1) PCOS; 2) isolated oligomenorrhea (IO); 3) isolated hyperandrogenism (IH); and 4) reference group. Outcome measures were defined as echocardiography data from Year 5. We used multivariable linear regression models to evaluate the association of PCOS and its components with left ventricular (LV) mass index, left atrial (LA) diameter, LV ejection fraction (LVEF), and mitral inflow early wave to late wave ratio. RESULTS Among 984 participants, 42 women (4.3%) were classified as PCOS, 67 (6.8%) as IO, and 178 (18.0%) as IH. In multivariable linear regression analyses, women with PCOS had a 3.14 g/m(2.7) (95% confidence interval, 0.48-5.81) higher LV mass index compared to the reference group (approximately 10% higher). PCOS women also had a 0.11 cm/m (95% confidence interval, 0.02-0.19) larger LA diameter, after adjustment for age and race. CONCLUSION PCOS, but not IO or IH, is associated with a higher LV mass index and larger LA diameter in young women, suggestive of early adverse cardiac remodeling. Additional longitudinal studies are needed to evaluate whether this difference persists over time.
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Affiliation(s)
- Erica T Wang
- Department of Obstetrics Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California 94115, USA.
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O'Neill SM, Liu J, O'Rourke MF, Khoo SK. The menopausal transition does not appear to accelerate age-related increases in arterial stiffness. Climacteric 2012; 16:62-9. [PMID: 23152960 DOI: 10.3109/13697137.2012.739220] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Arterial stiffness is an independent marker of cardiovascular risk that increases with age, hypertension, diabetes and hyperlipidemia, both for men and women (although more pronounced in women). This study was designed to establish whether menopause augments the age-dependent change. METHODS The study evaluated pulse wave analysis and pulse wave velocity using applanation tonometry in 468 women (aged 40-80 years) sampled from the general population. In multiple linear regression models, age was the predominant correlate of increasing aortic augmentation pressure (p < 0.0001), augmentation index (p < 0.0001), augmentation index adjusted to a heart rate of 75 beats/min (p < 0.0001) and carotid-femoral pulse wave velocity (p < 0.0001). RESULTS Analysis of covariance showed no significant difference in adjusted mean of augmentation pressure, augmentation index or pulse wave velocity between menopause groups (pre-, peri-, postmenopause). Adjusted means of augmentation pressure and pulse wave velocity were comparable between women on hormone therapy (n = 130) and non-users (n = 338). CONCLUSIONS The results of the present study challenge the assertion by some researchers that menopause accelerates age-dependent changes in arterial stiffness.
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Affiliation(s)
- S M O'Neill
- Betty Byrne Henderson Women's Health Research Centre, Royal Brisbane & Women's Hospital, Brisbane and the University of Queensland, Australia
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Doonan RJ, Mutter A, Egiziano G, Gomez YH, Daskalopoulou SS. Differences in arterial stiffness at rest and after acute exercise between young men and women. Hypertens Res 2012; 36:226-31. [PMID: 23051656 DOI: 10.1038/hr.2012.158] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is controversy as to whether there are sex differences in arterial stiffness. Acute physical stress can elicit vascular abnormalities not present at rest. Our objective was to assess sex differences in arterial stiffness at rest and in response to acute physical stress. Healthy young men (n=67) and women (n=55) underwent pulse wave analysis and carotid-femoral pulse wave velocity measurements at rest and 2, 5, 10 and 15 min following an exercise test to exhaustion. At rest, aortic systolic, diastolic, pulse and mean pressures were all significantly higher in men as was aortic pulse pressure at 10 and 15 min post exercise and aortic systolic pressure at 15 min. Carotid-femoral pulse wave velocity was significantly higher in men (6.0±0.7 m s(-1) vs. 5.6±0.6 m s(-1), P=0.03) at rest and at all time points post exercise. Heart rate-adjusted augmentation index was significantly lower (-10.7±10.2% vs. -4.0±10.9, P<0.0001) and subendocardial viability ratio was significantly higher (176.2±43.8% vs. 163.4±40.9, P=0.04) in men at rest. To our knowledge, this is the first study to assess sex differences in the arterial stiffness response to acute physical stress in young men and women. Although we were not able to elicit differences in vascular function after adjustment, which were not present at rest, we found that young men and women exhibit differences in arterial stiffness at rest and after acute physical stress.
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Affiliation(s)
- Robert J Doonan
- Department of Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
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Regnault V, Thomas F, Safar ME, Osborne-Pellegrin M, Khalil RA, Pannier B, Lacolley P. Sex difference in cardiovascular risk: role of pulse pressure amplification. J Am Coll Cardiol 2012; 59:1771-7. [PMID: 22575315 DOI: 10.1016/j.jacc.2012.01.044] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Revised: 01/06/2012] [Accepted: 01/06/2012] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The study was to explore whether the brachial/carotid pulse pressure (B/C-PP) ratio selectively predicts the sex difference in age-related cardiovascular (CV) death. BACKGROUND Hypertension and CV complications are more severe in men and post-menopausal women than in pre-menopausal women. C-PP is lower than B-PP, and the B/C-PP ratio is a physiological marker of PP amplification between B and C arteries that tends toward 1.0 with age. METHODS The study involved 72,437 men (ages 41.0 ± 11.1 years) and 52,714 women (39.5 ± 11.6 years). C-PP was calculated for each sex by a multiple regression analysis including B-PP, age, height and risk factors, and a method validated beforehand in a subgroup of 834 subjects. During the 12 years of follow-up, 3,028 men and 969 women died. RESULTS In the total population, the adjusted hazard ratios (HR) (95% confidence interval [CI]) of B/C-PP ratio were: 1) for all-cause mortality: men, HR: 1.51 (95% CI: 1.47 to 1.56), women; HR: 2.46 (95% CI: 2.27 to 2.67) (p < 0.0001); and 2) for CV mortality: men, HR 1.81 (95% CI: 1.70 to 1.93); women, HR: 4.46 (95% CI: 3.66 to 5.45) (p < 0.0001). The B/C-PP impact on mortality did not significantly increase from younger men to those ≥ 55 years of age, from: HR: 1.44 (95% CI: 1.31 to 1.58) to HR 1.65 (95% CI: 1.48 to 1.84), but increased significantly with age in women: HR: 3.19 (95% CI: 2.08 to 4.89) versus HR: 5.60 (95% CI: 4.17 to 7.50) (p < 0.01). Thus, the mortality impact of B/C-PP ratio was 3-fold higher in women than in men ≥ 55 years old. CONCLUSIONS PP amplification is highly predictive of differences in CV risk between men and women. In post-menopausal women, the attenuation of PP amplification, mainly related to increased aortic stiffness, contributes to the significant increase in CV risk.
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Current world literature. Curr Opin Endocrinol Diabetes Obes 2012; 19:233-47. [PMID: 22531108 DOI: 10.1097/med.0b013e3283542fb3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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93
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Bailey AL, Smyth SS. Invasive coronary vasoreactivity testing to diagnose microvascular dysfunction in women. JACC Cardiovasc Interv 2012; 5:654-5. [PMID: 22721661 PMCID: PMC3690140 DOI: 10.1016/j.jcin.2012.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 03/02/2012] [Indexed: 10/28/2022]
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Koumaras C, Tzimou M, Stavrinou E, Griva T, Gossios TD, Katsiki N, Athyros VG, Mikhailidis DP, Karagiannis A. Role of Antihypertensive Drugs in Arterial ‘De-Stiffening’ and Central Pulsatile Hemodynamics. Am J Cardiovasc Drugs 2012; 12:143-56. [DOI: 10.2165/11599040-000000000-00000] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Abstract
A systematic review and meta-analysis was conducted using MEDLINE, EMBASE, and the Cochrane Library to investigate the association between preeclampsia and arterial stiffness. Twenty-three relevant studies were included. A significant increase in all arterial stiffness indices combined was observed in women with preeclampsia vs. women with normotensive pregnancies [standardized mean difference 1.62, 95% confidence interval (CI) 0.73-2.50]; carotid-femoral pulse wave velocity (cfPWV) and augmentation index (AIx) were also significantly increased (weighted mean difference, WMDcfPWV 1.04, 95% CI 0.34-1.74; WMDAIx 15.10, 95% CI 5.08-25.11), whereas carotid-radial PWV (crPWV) increase did not reach significance (WMDcrPWV 0.99, 95% CI -0.07 to 2.05). Significant increases in arterial stiffness measurements were noted in women with preeclampsia compared with those with gestational hypertension. Arterial stiffness measurements may also be useful in predicting preeclampsia and may play a role in the increased risk of future cardiovascular complications seen in women with a history of preeclampsia.
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Katsiki N, Koumaras C, Athyros VG, Karagiannis A. Thinking beyond traditional cardiovascular risk factors: the role of arterial stiffness in targeting residual risk. Angiology 2012; 63:9-11. [PMID: 22144689 DOI: 10.1177/0003319711406256] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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