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Kiran V R, P M N, Shah MI, Sivaprakasam M, Joseph J. Gaussian-Mixture Modelling of A-Mode Radiofrequency Scans for the Measurement of Arterial Wall Thickness. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:5598-5601. [PMID: 34892393 DOI: 10.1109/embc46164.2021.9631078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Measurement of arterial wall thickness is an integral component of vascular properties and health assessment. State-of-the-art automated or semi-automated techniques are majorly applicable to B-mode images and are not available for entry-level in-expensive devices. Considering this, we have earlier developed and validated an image-free (A-mode) ultrasound device, ARTSENS® for the evaluation of vascular properties. In this work, we present a novel gaussian-mixture modeling-based method to measure arterial wall thickness from A-mode frames, which is readily deployable to the existing technology. The method's performance was assessed based on systematic simulations and controlled phantom experiments. Simulations revealed that the method could be confidently applied to A-mode frames with above-moderate SNR (>15 dB). When applied to A-mode frames acquired from the flow-phantom setup (SNR > 25 dB), the mean error was limited to (2 ± 1%), and RMSE was 19 μm, on comparison with B-mode measurements. The measured and reference wall thickness strongly agreed with each other (r = 0.88, insignificant mean bias = 7 μm, p = 0.16). The proposed method was capable of performing real-time measurements.
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52
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Georgiopoulos G, Oikonomou D, Pateras K, Masi S, Magkas N, Delialis D, Ajdini E, Vlachou V, Stamatelopoulos K, Charakida M. A Bayesian meta-analysis on early tobacco exposure and vascular health: From childhood to early adulthood. Eur J Prev Cardiol 2021; 28:1315-1322. [PMID: 31747795 DOI: 10.1177/2047487319883557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/24/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Smoking has been consistently associated with increased cardiovascular risk in adults. Although exposure to tobacco products often starts in early life, evidence for the possible adverse effects on the cardiovascular system of the young is scarce. We sought to derive pooled estimates of smoking effects on indices of early vascular damage in children and adolescents. DESIGN AND METHODS We performed a systematic review and meta-analysis of clinical studies involving young individuals up to 21 years old that provided data on smoking exposure (active or passive) and flow-mediated dilatation, carotid to femoral pulse wave velocity and maximum carotid intima-media thickness. We employed three distinct methodologies of random-effects data synthesis, including the Sidik-Jonkman estimator, the Hartung and Knapp correction and a Bayesian method with a well-informed prior on the level of between-study variance. RESULTS In 12 studies and 5279 individuals in total, smoking exposure was related to deterioration in all three outcomes (mean adjusted flow-mediated dilatation decrease: -0.77%, 95% confidence interval -1.38--0.15, mean adjusted pulse wave velocity increase: 0.1 m/s, 95% confidence interval 0.02-0.17 and mean adjusted carotid intima-media thickness increase: 0.35 mm, 95% confidence interval 0.16-0.55, for the Sidik-Jonkman estimator). No difference was established between active and passive smoking on associations with arterial damage. CONCLUSIONS Exposure to tobacco products is associated with subclinical vascular damage early in life, even from childhood. Public health initiatives should target these very young age groups to prevent early smoking exposure and associated arterial damage and its sequelae.
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Affiliation(s)
- Georgios Georgiopoulos
- School of Biomedical Engineering and Imaging Sciences, King's College London, UK
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Greece
| | | | - Konstantinos Pateras
- Department of Biostatistics and Research Support, University Medical Center Utrecht, the Netherlands
| | - Stefano Masi
- National Centre for Cardiovascular Prevention and Outcomes, University College London, UK
| | - Nikolaos Magkas
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Greece
| | - Dimitrios Delialis
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Greece
| | - Erold Ajdini
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Greece
| | - Victoria Vlachou
- Department of Paediatric Neurology, Chelsea and Westminster Hospital, UK
| | - Kimon Stamatelopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Greece
- Cardiovascular Research Centre, Newcastle University, UK
| | - Marietta Charakida
- School of Biomedical Engineering and Imaging Sciences, King's College London, UK
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53
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Miyai N, Uchiba K, Tomiyama H, Matsumoto C, Kinoshita A, Vlachoupolos C, Nilsson PM, Arita M. District Differences in the Measured Values of Arterial Stiffness in Japan. Circ Rep 2021; 3:620-624. [PMID: 34703940 PMCID: PMC8492401 DOI: 10.1253/circrep.cr-21-0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/27/2021] [Accepted: 08/09/2021] [Indexed: 11/09/2022] Open
Abstract
Background: In Japan, district differences in the prevalence of cardiovascular disease (CVD) are well-known. This study examined district differences in Japan in measured values of arterial stiffness, an independent risk factor for CVD. Methods and Results: Local residents participating in health checkups conducted in the Wakayama (n=461) and Nagano (n=186) prefectures in 2018 were recruited to the study. Brachial-ankle pulse wave velocity (baPWV) was evaluated as an index of arterial stiffness. After multivariate adjustment, baPWV was significantly higher in the Wakayama than Nagano district in subjects aged ≥70 years (mean [±SE] 1,912±25 vs. 1,763±30 cm/s; P<0.01), but not in subjects aged <70 years. Multivariate linear regression analysis demonstrated that the Wakayama/Nagano district difference was significantly (P<0.01) associated with baPWV. Conclusions: District differences were observed in the measured values of arterial stiffness in Wakayama and Nagano. The Wakayama and Nagano prefectures are representative areas with a relatively high and relatively low prevalence of CVD, respectively, in Japan. Therefore, based on the results of the present study, we propose to conduct a study to examine whether district differences in arterial stiffness underlie district differences in the prevalence of CVD.
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Affiliation(s)
- Nobuyuki Miyai
- School of Health and Nursing Science, Wakayama Medical University Wakayama Japan
| | | | | | - Chisa Matsumoto
- Department of Cardiology, Tokyo Medical University Tokyo Japan
| | - Azuna Kinoshita
- School of Health and Nursing Science, Wakayama Medical University Wakayama Japan
| | - Charalambos Vlachoupolos
- Hypertension and Cardiometabolic Unit, First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens Athens Greece
| | - Peter M Nilsson
- Department of Clinical Sciences, Lund University, Skane University Hospital Malmo Sweden
| | - Mikio Arita
- Department of Cardiology, Sumiya Rehabilitation Hospital Wakayama Japan
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54
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Onuh JO, Qiu H. Metabolic Profiling and Metabolites Fingerprints in Human Hypertension: Discovery and Potential. Metabolites 2021; 11:687. [PMID: 34677402 PMCID: PMC8539280 DOI: 10.3390/metabo11100687] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/28/2021] [Accepted: 10/05/2021] [Indexed: 12/12/2022] Open
Abstract
Early detection of pathogenesis through biomarkers holds the key to controlling hypertension and preventing cardiovascular complications. Metabolomics profiling acts as a potent and high throughput tool offering new insights on disease pathogenesis and potential in the early diagnosis of clinical hypertension with a tremendous translational promise. This review summarizes the latest progress of metabolomics and metabolites fingerprints and mainly discusses the current trends in the application in clinical hypertension. We also discussed the associated mechanisms and pathways involved in hypertension's pathogenesis and explored related research challenges and future perspectives. The information will improve our understanding of the development of hypertension and inspire the clinical application of metabolomics in hypertension and its associated cardiovascular complications.
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Affiliation(s)
| | - Hongyu Qiu
- Center for Molecular and Translational Medicine, Institute of Biomedical Sciences, Georgia State University, Atlanta, GA 30303, USA;
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55
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Islam SJ, Beydoun N, Mehta A, Kim JH, Ko YA, Jin Q, Baltrus P, Topel ML, Liu C, Mujahid MS, Vaccarino V, Sims M, Ejaz K, Searles C, Dunbar SB, Lewis TT, Taylor HA, Pemu P, Quyyumi AA. Association of physical activity with arterial stiffness among Black adults. Vasc Med 2021; 27:13-20. [PMID: 34549642 DOI: 10.1177/1358863x211032725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Arterial stiffness is a precursor for the development of hypertension and premature cardiovascular disease (CVD). Physical activity has been associated with lower arterial stiffness among largely White populations, but the types of activity required and whether these findings apply to Black adults remain unknown. We examined whether physical activity levels were associated with arterial stiffness among Black adults in two independent cohorts. In the Morehouse-Emory Cardiovascular (MECA) Center for Health Equity, 378 Black adults (age 52.8 ± 10.3, 39.7% male) without known CVD living in Atlanta, GA were recruited. Arterial stiffness was measured as pulse wave velocity (PWV). Total and domain-specific physical activity were assessed by self-report. Multiple linear regression models were used to investigate differences across physical activity levels after adjusting for age, sex, CVD risk factors, and socioeconomic status. Findings were validated in an independent cohort of Black adults (n = 55, age 50.4 ± 9.2, 23.6% male). After adjustment for covariates, lower arterial stiffness was associated with higher self-reported levels of sport/exercise (6.92 ± 1.13 vs 7.75 ± 1.14, p < 0.001, highest vs lowest quartile) and home/life activities (7.34 ± 1.24 vs 7.73 ± 1.07, p = 0.04, highest vs lowest quartile), but not work, active living, or the overall physical activity scores. These findings were replicated in the independent cohort where higher levels of sport/exercise remained associated with lower arterial stiffness (6.66 ± 0.57 vs 8.21 ± 0.66, p < 0.001, highest vs lowest quartile). Higher levels of sport/exercise and home/life-related physical activities (in comparison to occupational physical activity) are associated with lower arterial stiffness in Black adults.
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Affiliation(s)
- Shabatun J Islam
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Nour Beydoun
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Anurag Mehta
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jeong Hwan Kim
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Yi-An Ko
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Qingchun Jin
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Peter Baltrus
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA, USA.,National Center for Primary Care, Morehouse School of Medicine, Atlanta, GA, USA
| | - Matthew L Topel
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Chang Liu
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Mahasin S Mujahid
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Viola Vaccarino
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Kiran Ejaz
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Charles Searles
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Sandra B Dunbar
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Herman A Taylor
- Department of Medicine, Morehouse School of Medicine, Atlanta, GA, USA
| | - Priscilla Pemu
- Department of Medicine, Morehouse School of Medicine, Atlanta, GA, USA
| | - Arshed A Quyyumi
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
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56
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Dudinskaya E, Tkacheva O, Bazaeva E, Matchekhina L, Eruslanova K, Sharashkina N, Kotovskaya Y, Larina V. Influence of Moxonidine and Bisoprolol on Morphofunctional Condition of Arterial Wall and Telomerase Activity in Postmenopausal Women with Arterial Hypertension and Osteopenia. The Results from a Moscow Randomized Study. Cardiovasc Drugs Ther 2021; 36:1147-1155. [PMID: 34524565 DOI: 10.1007/s10557-021-07235-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE To compare the effect of 12 months of treatment with moxonidine or bisoprolol on telomerase activity (TA) and parameters characterizing the arterial wall state in postmenopausal women with arterial hypertension (AH) and osteopenia. METHODS An open-label randomized study with 114 postmenopausal women with hypertension and osteopenia; pulse wave velocity (PWV), intima-media thickness (IMT), and TA were analyzed initially and after 12 months of therapy with moxonidine (n = 57) or bisoprolol (n = 57). RESULTS Both medications effectively lowered blood pressure (BP) in both groups. After 12 months, the moxonidine group showed a significant increase in TA by 45.5% (from 0.87 to 1.15; p < 0.001), in contrast to the bisoprolol group, where TA decreased by 14.1% (from 0.89 to 0.74; p = 0.001). Within 12 months, in the moxonidine group, PWV decreased by 1.9% (from 10.35 ± 2.56 to 10.05 ± 2.29 m/s; p = 0.039), and in the bisoprolol group it increased by 5.8% (from 10.36 ± 2.47 to 11.26 ± 2.60 m/s; p < 0.001). In the moxonidine group, IMT increased by 3.5% on the right and 1.4% on the left, in the bisoprolol group - by 5.7% on the right and 4.2% on the left. CONCLUSION A 12-month treatment with moxonidine but not with bisoprolol in postmenopausal women with AH and osteoporosis was associated with a decrease of arterial stiffness seen as statistically significantly reduced PVW and with increased TA.
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Affiliation(s)
- E Dudinskaya
- Laboratory of Age-related Metabolic Endocrine Disorders of Pirogov Russian National Research Medical University of Ministry of Health of Russian Federation "Russian Gerontology Research and Clinical Centre", Moscow, Russia.
| | - O Tkacheva
- Laboratory of Age-related Metabolic Endocrine Disorders of Pirogov Russian National Research Medical University of Ministry of Health of Russian Federation "Russian Gerontology Research and Clinical Centre", Moscow, Russia
| | - E Bazaeva
- Laboratory of Age-related Metabolic Endocrine Disorders of Pirogov Russian National Research Medical University of Ministry of Health of Russian Federation "Russian Gerontology Research and Clinical Centre", Moscow, Russia.,National Medical Research Centre for Therapy and Preventive Medicine, Moscow, Russia
| | - L Matchekhina
- Laboratory of Age-related Metabolic Endocrine Disorders of Pirogov Russian National Research Medical University of Ministry of Health of Russian Federation "Russian Gerontology Research and Clinical Centre", Moscow, Russia
| | - K Eruslanova
- Laboratory of Age-related Metabolic Endocrine Disorders of Pirogov Russian National Research Medical University of Ministry of Health of Russian Federation "Russian Gerontology Research and Clinical Centre", Moscow, Russia
| | - N Sharashkina
- Laboratory of Age-related Metabolic Endocrine Disorders of Pirogov Russian National Research Medical University of Ministry of Health of Russian Federation "Russian Gerontology Research and Clinical Centre", Moscow, Russia
| | - Yu Kotovskaya
- Laboratory of Age-related Metabolic Endocrine Disorders of Pirogov Russian National Research Medical University of Ministry of Health of Russian Federation "Russian Gerontology Research and Clinical Centre", Moscow, Russia
| | - V Larina
- Pirogov Russian National Research Medical University, Moscow, Russia
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Climie RE, Gregory AT, Denniss AR, Mynard JP, Pepe S. Vascular Ageing: A Key Frontier in the Fight Against Cardiovascular Disease. Heart Lung Circ 2021; 30:1585-1590. [PMID: 34503917 DOI: 10.1016/j.hlc.2021.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Rachel E Climie
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tas, Australia; Baker Heart and Diabetes Institute, Melbourne, Vic, Australia; Université de Paris, INSERM U970, Paris Centre de Recerche Cardiovasculaire, Paris, France.
| | | | - A Robert Denniss
- Heart, Lung and Circulation, Sydney, NSW, Australia; Department of Cardiology, Westmead Hospital, and University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Blacktown Hospital, and Western Sydney University, Sydney, NSW, Australia
| | - Jonathan P Mynard
- Heart Research, Murdoch Children's Research Institute, Melbourne, Vic, Australia; Department of Biomedical Engineering, University of Melbourne, Melbourne, Vic, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Vic, Australia.
| | - Salvatore Pepe
- Department of Paediatrics, University of Melbourne, Melbourne, Vic, Australia.
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58
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Laurent S, Chatellier G, Azizi M, Calvet D, Choukroun G, Danchin N, Delsart P, Girerd X, Gosse P, Khettab H, London G, Mourad JJ, Pannier B, Pereira H, Stephan D, Valensi P, Cunha P, Narkiewicz K, Bruno RM, Boutouyrie P. SPARTE Study: Normalization of Arterial Stiffness and Cardiovascular Events in Patients With Hypertension at Medium to Very High Risk. Hypertension 2021; 78:983-995. [PMID: 34455813 PMCID: PMC8415523 DOI: 10.1161/hypertensionaha.121.17579] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Supplemental Digital Content is available in the text. The SPARTE study (Strategy for Preventing cardiovascular and renal events based on ARTErial stiffness; URL: https://www.clinicaltrials.gov; Unique identifier: NCT02617238) is a multicenter open-label randomized controlled trial with blinded end point evaluation, undertaken at 25 French research centers in university hospitals. Patients with primary hypertension were randomly assigned (1:1) to a therapeutic strategy targeting the normalization of carotid-femoral pulse wave velocity (PWV) measured every 6 months (PWV group, n=264) versus a classical therapeutic strategy only implementing the European Guidelines for Hypertension Treatment (conventional group, n=272). In the PWV group, the therapeutic strategy used preferably a combination of ACE (angiotensin-converting enzyme) inhibitor or angiotensin receptor blocker and calcium channel blockers, as well as maximal recommended doses of ACE inhibitors and angiotensin receptor blockers. The primary outcome was a combined end point including particularly stroke and coronary events. Secondary outcomes included the time-course changes in brachial office blood pressure (BP), ambulatory BP, PWV, and treatments. After a median follow-up of 48.3 months, there was no significant between-group difference in primary outcome (hazard ratio, 0.74 [95% CI, 0.40–1.38], P=0.35). In the PWV group, combinations of renin-angiotensin-system blockers and calcium channel blockers were prescribed at higher dosage (P=0.028), office and ambulatory systolic blood pressure and diastolic blood pressure decreased more (P<0.001 and P<0.01, respectively), and PWV increased less (P=0.0003) than in the conventional group. The SPARTE study lacked sufficient statistical power to demonstrate its primary outcome. However, it demonstrated that a PWV-driven treatment for hypertension enables to further reduce office and ambulatory systolic blood pressure and diastolic blood pressure and prevent vascular aging in patients with hypertension at medium-to-very-high risk, compared with strict application of guidelines.
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Affiliation(s)
- Stephane Laurent
- From the Université de Paris, France (S.L., G. Chatellier, M.A., N.D., R.-M.B., P.B.).,Assistance-Publique Hopitaux de Paris, Georges Pompidou European Hospital, Paris, France (S.L., G. Chatellier, M.A., N.D., H.K., R.-M.B., P.B.)
| | - Gilles Chatellier
- From the Université de Paris, France (S.L., G. Chatellier, M.A., N.D., R.-M.B., P.B.).,Assistance-Publique Hopitaux de Paris, Georges Pompidou European Hospital, Paris, France (S.L., G. Chatellier, M.A., N.D., H.K., R.-M.B., P.B.).,Clinical Research Unit, INSERM U970, Paris (G. Chatellier, H.P.)
| | - Michel Azizi
- From the Université de Paris, France (S.L., G. Chatellier, M.A., N.D., R.-M.B., P.B.).,Assistance-Publique Hopitaux de Paris, Georges Pompidou European Hospital, Paris, France (S.L., G. Chatellier, M.A., N.D., H.K., R.-M.B., P.B.).,Hypertension Department and DMU CARTE, Paris, France (M.A.).,INSERM, CIC1418, Paris, France (M.A.)
| | - David Calvet
- Neurology department, GHU Paris Psychiatrie Neurosciences, Sainte-Anne Hospital (D.C.).,INSERM UMR 1266, FHU NeuroVasc, Paris, France (D.C.)
| | - Gabriel Choukroun
- Nephrology Dialysis Transplantation Department, CHU Amiens, France (G. Choukroun).,MP3CV Research Unit, University Picardie Jules Verne, France (G. Choukroun)
| | - Nicolas Danchin
- From the Université de Paris, France (S.L., G. Chatellier, M.A., N.D., R.-M.B., P.B.).,Assistance-Publique Hopitaux de Paris, Georges Pompidou European Hospital, Paris, France (S.L., G. Chatellier, M.A., N.D., H.K., R.-M.B., P.B.).,Cardiology Department, Georges Pompidou Hospital, Paris, France (N.D.)
| | | | - Xavier Girerd
- ICAN, Sorbonne University, Assistance-Publique Hopitaux de Paris, Paris, France (X.G.)
| | - Philippe Gosse
- Cardiology Department, Saint Andre Hospital, CHU Bordeaux, France (P.G.)
| | - Hakim Khettab
- Assistance-Publique Hopitaux de Paris, Georges Pompidou European Hospital, Paris, France (S.L., G. Chatellier, M.A., N.D., H.K., R.-M.B., P.B.).,INSERM U970, Cardiovascular Research Center - PARCC, Paris, France (H.K., R.-M.B., P.B.)
| | - Gerard London
- Department of Nephrology, Manhes Hospital, Fleury Merogis, France(G.L.)
| | | | - Bruno Pannier
- Department of Internal Medicine, Manhes Hospital, Fleury Merogis, France (B.P.)
| | - Helena Pereira
- Clinical Research Unit, INSERM U970, Paris (G. Chatellier, H.P.)
| | - Dominique Stephan
- University of Strasbourg, France (D.S.).,UMR 1260, INSERM-University of Strasbourg, France (D.S.)
| | - Paul Valensi
- Unit of Endocrinology-Diabetology-Nutrition, Assistance-Publique Hopitaux de Paris, Jean Verdier Hospital, University Sorbonne Paris Cite, Bondy, France (P.V.)
| | - Pedro Cunha
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Internal Medicine Department, Guimaraes, Portugal (P.C.).,Life and Health Research Institute (ICVS/3B's), Minho University, Portugal (P.C.)
| | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, Debinki, Gdansk, Poland (K.N.)
| | - Rosa-Maria Bruno
- From the Université de Paris, France (S.L., G. Chatellier, M.A., N.D., R.-M.B., P.B.).,Assistance-Publique Hopitaux de Paris, Georges Pompidou European Hospital, Paris, France (S.L., G. Chatellier, M.A., N.D., H.K., R.-M.B., P.B.).,INSERM U970, Cardiovascular Research Center - PARCC, Paris, France (H.K., R.-M.B., P.B.)
| | - Pierre Boutouyrie
- From the Université de Paris, France (S.L., G. Chatellier, M.A., N.D., R.-M.B., P.B.).,Assistance-Publique Hopitaux de Paris, Georges Pompidou European Hospital, Paris, France (S.L., G. Chatellier, M.A., N.D., H.K., R.-M.B., P.B.).,INSERM U970, Cardiovascular Research Center - PARCC, Paris, France (H.K., R.-M.B., P.B.)
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59
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Gyöngyösi H, Kőrösi B, Batta D, Nemcsik-Bencze Z, László A, Tislér A, Cseprekál O, Torzsa P, Eörsi D, Nemcsik J. Comparison of Different Cardiovascular Risk Score and Pulse Wave Velocity-Based Methods for Vascular Age Calculation. Heart Lung Circ 2021; 30:1744-1751. [PMID: 34426072 DOI: 10.1016/j.hlc.2021.06.518] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 05/25/2021] [Accepted: 06/01/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The calculation of vascular age can help patients understand the importance of adherence to healthy lifestyle and medications. However, multiple methods are available to calculate vascular age and no comparison data is available yet. Our aim was to evaluate vascular age based on the Framingham Risk Score (FRS), the Systematic COronary Risk Evaluation (SCORE) and carotid-femoral pulse wave velocity (PWV). METHODS Consecutive subjects between the age of 40-65 years, who took part in a screening program in three general practitioner practices were involved. PWV was measured by tonometry and was compared with normal values. Vascular age was defined based on FRS and SCORE according to literature data. RESULTS One hundred and seventy-two (172) patients were involved. The median chronological age was 55.5 (48.8-61.2) years. The median vascular age based on FRS and SCORE were 64 (54-79) years and 55 (44.2-60.7) years, respectively (p<0.05). Based on PWV, FRS and SCORE, 40.1%, 78.5% and 32% of the subjects had increased vascular age compared with chronological age, respectively (PWV+, FRS+, SCORE+, p<0.05). Fifty-eight (58) (84%) of the PWV+ subjects were also FRS+, and this proportion was high in case of SCORE+ patients as well (n=47, 85.4%). However, only moderate overlap was found between PWV+ and SCORE+ subjects as 17 (30.9%) of SCORE+ patients were also PWV+. CONCLUSION The differences found between the calculated vascular ages and the proportion of subjects with elevated vascular age warrants further detailed comparison of different vascular age calculation methods.
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Affiliation(s)
- Helga Gyöngyösi
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Beáta Kőrösi
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Dóra Batta
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Zsófia Nemcsik-Bencze
- Department of Radiology, Medical Imaging Center, Semmelweis University, Budapest, Hungary
| | | | - András Tislér
- Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
| | - Orsolya Cseprekál
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Péter Torzsa
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Dániel Eörsi
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - János Nemcsik
- Department of Family Medicine, Semmelweis University, Budapest, Hungary; Health Service of Zugló (ZESZ), Budapest, Hungary.
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Laurent S, Boutouyrie P. Vascular Ageing - State of Play, Gaps and Key Issues. Heart Lung Circ 2021; 30:1591-1594. [PMID: 34393046 DOI: 10.1016/j.hlc.2021.06.528] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/10/2021] [Accepted: 06/24/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Stéphane Laurent
- Department of Pharmacology, European Georges Pompidou Hospital and Assistance- Publique Hôpitaux de Paris, and Paris Cardiovascular Research Center (PARCC)- INSERM U970 and Paris University, Paris, France.
| | - Pierre Boutouyrie
- Department of Pharmacology, European Georges Pompidou Hospital and Assistance- Publique Hôpitaux de Paris, and Paris Cardiovascular Research Center (PARCC)- INSERM U970 and Paris University, Paris, France
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Vascular consequences of inflammation: a position statement from the ESH Working Group on Vascular Structure and Function and the ARTERY Society. J Hypertens 2021; 38:1682-1698. [PMID: 32649623 DOI: 10.1097/hjh.0000000000002508] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
: Inflammation is a physiological response to aggression of pathogenic agents aimed at eliminating the aggressor agent and promoting healing. Excessive inflammation, however, may contribute to tissue damage and an alteration of arterial structure and function. Increased arterial stiffness is a well recognized cardiovascular risk factor independent of blood pressure levels and an intermediate endpoint for cardiovascular events. In the present review, we discuss immune-mediated mechanisms by which inflammation can influence arterial physiology and lead to vascular dysfunction such as atherosclerosis and arterial stiffening. We also show that acute inflammation predisposes the vasculature to arterial dysfunction and stiffening, and alteration of endothelial function and that chronic inflammatory diseases such as rheumatoid arthritis, inflammatory bowel disease and psoriasis are accompanied by profound arterial dysfunction which is proportional to the severity of inflammation. Current findings suggest that treatment of inflammation by targeted drugs leads to regression of arterial dysfunction. There is hope that these treatments will improve outcomes for patients.
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Zhou Z, Xing AJ, Zhang JN, Xia WH, Su C, Xu SY, Zhang XY, Chen SH, Huang Z, Qian XX, Wu SL, Tao J. Hypertension, Arterial Stiffness, and Clinical Outcomes: A Cohort Study of Chinese Community-Based Population. Hypertension 2021; 78:333-341. [PMID: 34120451 DOI: 10.1161/hypertensionaha.121.17131] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Zhe Zhou
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
| | - Ai-Jun Xing
- Cardiology Department, Kailuan General Hospital, Tangshan, China (A.-J.X., Z.H., S.-L.W.)
| | - Jian-Ning Zhang
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
| | - Wen-Hao Xia
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
| | - Chen Su
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
| | - Shi-Yue Xu
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
| | - Xiao-Yu Zhang
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
| | - Shuo-Hua Chen
- Health Care Center, Kailuan Group, Tangshan, China (S.-H.C.)
| | - Zhe Huang
- Cardiology Department, Kailuan General Hospital, Tangshan, China (A.-J.X., Z.H., S.-L.W.)
| | - Xiao-Xian Qian
- Department of Cardiology, Third Affiliated Hospital (X.-X.Q.), Sun Yat-Sen University, Guangzhou, China
| | - Shou-Ling Wu
- Cardiology Department, Kailuan General Hospital, Tangshan, China (A.-J.X., Z.H., S.-L.W.)
| | - Jun Tao
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.), Sun Yat-Sen University, Guangzhou, China.,National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, China (Z.Z., J.-N.Z., W.-H.X., C.S., S.-Y.X., X.-Y.Z., J.T.)
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Sang Y, Mao K, Cao M, Wu X, Ruan L, Zhang C. Longitudinal association between cardiovascular health and arterial stiffness in the Chinese adult population. J Int Med Res 2021; 49:300060521998889. [PMID: 33787372 PMCID: PMC8020111 DOI: 10.1177/0300060521998889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective Arterial stiffness may be an intermediary biological pathway involved in the
association between cardiovascular health (CVH) and cardiovascular disease.
We aimed to evaluate the effect of CVH on progression of brachial–ankle
pulse wave velocity (baPWV) over approximately 4 years. Methods We included 1315 cardiovascular disease-free adults (49±12 years) who had two
checkups from 2010 to 2019. CVH metrics (current smoking, body mass index,
total cholesterol, blood pressure, and fasting plasma glucose) were assessed
at baseline, and the number of ideal CVH metrics and CVH score were
calculated. Additionally, baPWV was examined at baseline and follow-up. Results Median baPWV increased from 1340 cm/s to 1400 cm/s, with an average annual
change in baPWV of 15 cm/s. More ideal CVH metrics and a higher CVH score
were associated with lower baseline and follow-up baPWV, and the annual
change in baPWV, even after adjustment for confounding variables.
Associations between CVH parameters and baseline and follow-up baPWV
remained robust in different sex and age subgroups, but they were only able
to predict the annual change in baPWV in men and individuals older than 50
years. Conclusions Our findings highlight the benefit of a better baseline CVH profile for
progression of arterial stiffness.
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Affiliation(s)
- Yu Sang
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Kaimin Mao
- Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ming Cao
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaofen Wu
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lei Ruan
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Cuntai Zhang
- Department of Geriatrics, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
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Farsang C, Dézsi CA, Brzozowska-Villatte R, De Champvallins M, Glezer M, Karpov Y. Beneficial Effects of a Perindopril/Indapamide Single-Pill Combination in Hypertensive Patients with Diabetes and/or Obesity or Metabolic Syndrome: A Post Hoc Pooled Analysis of Four Observational Studies. Adv Ther 2021; 38:1776-1790. [PMID: 33630277 PMCID: PMC8004479 DOI: 10.1007/s12325-021-01619-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/05/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION To assess real-life effectiveness of a perindopril/indapamide (Per/Ind) single-pill combination (SPC) in patients with hypertension (HT) and type 2 diabetes mellitus (T2DM), obesity and/or metabolic syndrome (MetS). METHODS This post hoc analysis pooled raw data from four large observational studies (FORTISSIMO, FORSAGE, ACES, PICASSO). Patients, most with uncontrolled blood pressure (BP) on previous treatments were switched to Per/Ind (10 mg/2.5 mg) SPC at study entry. Office systolic and diastolic blood pressures (SBP and DBP) were measured at baseline, 1 month and 3 months. RESULTS In the overall pooled population (N = 16,763), mean age was 61 ± 12 years, HT duration 11 ± 8 years, and baseline SBP/DBP 162/94 mmHg. T2DM, obesity and MetS were present in 21%, 49% and 27% of patients, respectively. Subgroups had similar mean age and HT duration to the overall population; patients with T2DM were slightly older (64 ± 10 years) with a longer HT duration (13 ± 8 years). Mean BP was approximately 160/95 mmHg in each subgroup. At 1 month, mean SBP decreased by approximately 20 mmHg in the overall population, and by a further 10 mmHg at 3 months. Similar results were observed in the three subgroups, with mean changes from baseline at 3 months of - 28 ± 15/- 13 ± 10 in T2DM; - 30 ± 15/- 14 ± 10 in obesity; and - 31 ± 15/- 15 ± 9 mmHg in MetS. BP decreases were greatest in patients with grade II or grade III HT. BP control rates (< 140/90 mmHg or 140/85 mmHg for T2DM) at 3 months were 59% in T2DM, 67% in obese, and 66% in MetS. No specific safety concerns were raised, particularly concerning ionic (Na, K) or metabolic profiles. CONCLUSIONS Switching to Per/Ind SPC led to rapid and effective BP decreases in patients with T2DM, obesity, or MetS. BP control was achieved in 6-7 out of 10 previously treated but uncontrolled patients. Treatment was well tolerated. The results confirm the beneficial effects of a Per/Ind SPC for difficult-to-control patient populations.
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Affiliation(s)
- Csaba Farsang
- Semmelweis University Pharmacology and Therapeutics and St. Imre University Teaching Hospital, Budapest, Hungary.
| | - Csaba Andras Dézsi
- Department of Cardiology, Petz Aladár County Teaching Hospital, Gyor, Hungary
| | | | | | - Maria Glezer
- Department of Preventive and Emergency Cardiology, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Yuri Karpov
- National Medical Research Centre of Cardiology, Moscow, Russia
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Affiliation(s)
- Stéphane Laurent
- From the Department of Pharmacology, European Georges Pompidou Hospital, Assistance Publique - Hôpitaux de Paris, Paris Cardiovascular Research Center, PARCC-Inserm U970 and Paris University, France
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Rodilla E, López-Carmona MD, Cortes X, Cobos-Palacios L, Canales S, Sáez MC, Campos Escudero S, Rubio-Rivas M, Díez Manglano J, Freire Castro SJ, Vázquez Piqueras N, Mateo Sanchis E, Pesqueira Fontan PM, Magallanes Gamboa JO, González García A, Madrid Romero V, Tamargo Chamorro L, González Moraleja J, Villanueva Martínez J, González Noya A, Suárez-Lombraña A, Gracia Gutiérrez A, López Reboiro ML, Ramos Rincón JM, Gómez Huelgas R. Impact of Arterial Stiffness on All-Cause Mortality in Patients Hospitalized With COVID-19 in Spain. Hypertension 2021; 77:856-867. [PMID: 33377393 PMCID: PMC7884247 DOI: 10.1161/hypertensionaha.120.16563] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/23/2020] [Indexed: 01/08/2023]
Abstract
Older age and cardiovascular comorbidities are well-known risk factors for all-cause mortality in patients with coronavirus disease 2019 (COVID-19). Hypertension and age are the 2 principal determinants of arterial stiffness (AS). This study aimed to estimate AS in patients with COVID-19 requiring hospitalization and analyze its association with all-cause in-hospital mortality. This observational, retrospective, multicenter cohort study analyzed 12 170 patients admitted to 150 Spanish centers included in the SEMI-COVID-19 Network. We compared AS, defined as pulse pressure ≥60 mm Hg, and clinical characteristics between survivors and nonsurvivors. Mean age was 67.5 (±16.1) years and 42.5% were women. Overall, 2606 (21.4%) subjects died. Admission systolic blood pressure (BP) <120 and ≥140 mm Hg was a predictor of higher all-cause mortality (23.5% and 22.8%, respectively, P<0.001), compared with systolic BP between 120 and 140 mm Hg (18.6%). The 4379 patients with AS (36.0%) were older and had higher systolic and lower diastolic BP. Multivariate analysis showed that AS and systolic BP <120 mm Hg significantly and independently predicted all-cause in-hospital mortality (adjusted odds ratio [ORadj]: 1.27, P=0.0001; ORadj: 1.48, P=0.0001, respectively) after adjusting for sex (males, ORadj: 1.6, P=0.0001), age tertiles (second and third tertiles, ORadj: 2.0 and 4.7, P=0.0001), Charlson Comorbidity Index (second and third tertiles, ORadj: 4.8 and 8.6, P=0.0001), heart failure, and previous and in-hospital antihypertensive treatment. Our data show that AS and admission systolic BP <120 mm Hg had independent prognostic value for all-cause mortality in patients with COVID-19 requiring hospitalization.
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Affiliation(s)
- Enrique Rodilla
- From the Internal Medicine Department, Hypertension and Vascular Risk Unit, Sagunto University Hospital, Sagunto (Valencia), Spain (E.R., X.C., S.C., M.C.S.)
- Department of Medicine, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain (E.R., X.C., S.C., M.C.S.)
| | - Maria Dolores López-Carmona
- Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), Spain (M.D.L.-C., L.C.-P., R.G.H.)
| | - Xavi Cortes
- From the Internal Medicine Department, Hypertension and Vascular Risk Unit, Sagunto University Hospital, Sagunto (Valencia), Spain (E.R., X.C., S.C., M.C.S.)
- Department of Medicine, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain (E.R., X.C., S.C., M.C.S.)
| | - Lidia Cobos-Palacios
- Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), Spain (M.D.L.-C., L.C.-P., R.G.H.)
| | - Sergio Canales
- From the Internal Medicine Department, Hypertension and Vascular Risk Unit, Sagunto University Hospital, Sagunto (Valencia), Spain (E.R., X.C., S.C., M.C.S.)
- Department of Medicine, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain (E.R., X.C., S.C., M.C.S.)
| | - Maria Carmen Sáez
- From the Internal Medicine Department, Hypertension and Vascular Risk Unit, Sagunto University Hospital, Sagunto (Valencia), Spain (E.R., X.C., S.C., M.C.S.)
- Department of Medicine, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain (E.R., X.C., S.C., M.C.S.)
| | | | - Manuel Rubio-Rivas
- Internal Medicine Department, Bellvitge University Hospital-IDIBELL, L’Hospitalet de Llobregat (Barcelona), Spain (M.R.-R.)
| | - Jesus Díez Manglano
- Internal Medicine Department, Royo Villanova Hospital, Zaragoza, Spain (J.D.M.)
| | | | - Nuria Vázquez Piqueras
- Internal Medicine Department, Consorci Sanitari Integral, Moisès Broggi Hospital Sant Joan Despí (Barcelona), Spain (N.V.P.)
| | | | | | | | - Andrés González García
- Internal Medicine Department, Ramón y Cajal University Hospital, Madrid, Spain (A.G.G.)
- Internal Medicine Department, Defensa General Hospital, Zaragoza, Spain (A.G.G.)
| | | | | | | | | | - Amara González Noya
- Internal Medicine Department, Ourense University Hospital Complex, Ourense, Spain (A.G.N.)
| | | | - Anyuli Gracia Gutiérrez
- Internal Medicine Department, Ramón y Cajal University Hospital, Madrid, Spain (A.G.G.)
- Internal Medicine Department, Defensa General Hospital, Zaragoza, Spain (A.G.G.)
| | | | - José Manuel Ramos Rincón
- Department of Clinical Medicine, Miguel Hernandez University of Elche, Alicante, Spain (J.M.R.R.)
| | - Ricardo Gómez Huelgas
- Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), Spain (M.D.L.-C., L.C.-P., R.G.H.)
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An J, Tang Y, Cao X, Yuan H, Wei M, Yuan X, Zhang A, Li Y, Saguner A, Li G, Luo G. Systemic arterial blood pressure and intracerebral hemorrhage after mechanical thrombectomy in anterior cerebral circulation. J Investig Med 2021; 69:1008-1014. [PMID: 33653704 PMCID: PMC8223637 DOI: 10.1136/jim-2020-001554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2021] [Indexed: 12/11/2022]
Abstract
The relationship between systemic arterial blood pressure (BP) and intracerebral hemorrhage (ICH) after mechanical thrombectomy (MT) of the cerebral artery remains unclear. This study aimed to determine the effect of BP variables on ICH after MT in patients with acute occlusions of the anterior cerebral circulation. Patients undergoing MT due to acute occlusions of the anterior cerebral circulation were enrolled in this single-center study. Non-invasive BP data following MT were obtained within the first 24 hours, including mean, maximum, minimum, difference between maximum and minimum, SD and coefficient of variation for systolic BP (SBP) and diastolic BP (DBP) and mean arterial pressure. ICH was defined and classified according to the European Cooperative Acute Stroke Study-II. In 164 enrolled patients (median age 65 (IQR 56–75) years; 31.7% female), higher maximum (89.5 mm Hg vs 98.5 mm Hg, p=0.001) and SD (9.8 mm Hg vs 10.9 mm Hg, p=0.038) of DBP were associated with higher risk of ICH. The optimal cut-off values associated with ICH for maximum SBP were 155 mm Hg and for maximum DBP 92.5 mm Hg, respectively. Higher BP within 24 hours after MT in acute occlusions of the anterior cerebral circulation is associated with a greater risk of ICH. More studies are needed to further determine optimal BP goals in the acute phase after MT.
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Affiliation(s)
- Jiaqi An
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yonglan Tang
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiangqi Cao
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Huijie Yuan
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Meng Wei
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xingyun Yuan
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Aifeng Zhang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yongxin Li
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ardan Saguner
- Department of Cardiology, University Heart Center Zürich, Zürich, Switzerland
| | - Guoliang Li
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Guogang Luo
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Sang Y, Cao M, Wu X, Ruan L, Zhang C. Use of lipid parameters to identify apparently healthy men at high risk of arterial stiffness progression. BMC Cardiovasc Disord 2021; 21:34. [PMID: 33441079 PMCID: PMC7807880 DOI: 10.1186/s12872-020-01846-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/29/2020] [Indexed: 12/18/2022] Open
Abstract
Background Dyslipidemia contributes to the development and progression of arterial stiffness. We aimed to identify the most informative measures of serum lipids and their calculated ratios in terms of arterial stiffness progression risk. Methods Total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and brachial-ankle pulse wave velocity (baPWV) of 659 healthy males (47.4 ± 10.7 years) were measured at baseline. Values for non-HDL-C, TC/HDL-C, TG/HDL-C, LDL-C/HDL-C, and non-HDL-C/HDL-C were calculated. BaPWV was re-performed after 4.1 years follow-up. Elevated baPWV was defined as baPWV ≥ 1400 cm/s. Results Over the follow-up period, the mean baPWV value increased from 1340 cm/s to 1410 cm/s, and 331 individuals increased/persisted with high baPWV (outcome 1). Among the 448 subjects who had normal baseline baPWV, 100 incident elevated baPWV occurred (outcome 2). Only baseline logTG (OR 1.64 [95% CI: 1.14–2.37] for outcome 1; 1.89 [1.14–3.17] for outcome 2) and logTG/HDL-C (1.54 [1.15–2.10] for outcome 1; 1.60 [1.05–2.45] for outcome 2) were significantly associated with arterial stiffness progression after adjusting for confounding factors. Adding logTG or logTG/HDL-C to age and blood pressure improved the accuracy of risk predictions for arterial stiffness progression. These associations remained significant when lipids were analyzed as categorical variables. Conclusions Baseline serum TG and TG/HDL-C were independently associated with increases in/persistently high baPWV and incident elevated baPWV, and they performed more effectively than other lipid variables in identifying healthy men at high risk of arterial stiffness progression.
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Affiliation(s)
- Yu Sang
- Department of Geriatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ming Cao
- Department of Geriatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaofen Wu
- Department of Geriatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Ruan
- Department of Geriatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Cuntai Zhang
- Department of Geriatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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69
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Breet Y, Craig A, Smith W, Botha-Le Roux S, Gafane-Matemane LF, Brits S, van Rooyen JM, Hanssen H, Kruger R. Cross-Talk Between Large Artery Stiffness and Retinal Microvasculature in Children: The ExAMIN Youth SA Study. Front Pediatr 2021; 9:795301. [PMID: 34976899 PMCID: PMC8716632 DOI: 10.3389/fped.2021.795301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 11/22/2021] [Indexed: 12/05/2022] Open
Abstract
Background: Cross-talk between the macro-and microvasculature is considered an important contributor to target organ damage. Previous findings were predominantly in adult populations and investigation into this mechanism in children may provide insight into the development of early adverse vascular changes. Whether any ethnic differences in cross-talk is evident, also remains to be determined. Objective: To determine whether retinal microvascular diameters are associated with large artery stiffness in young children and whether ethnic differences are evident. Materials and Methods: In this cross-sectional study, 730 black (n = 437) and white (n = 293) school children aged 5-9 years were included. Pulse wave velocity (PWV) was measured and the central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) diameters were calculated from fundus images. The arterio-venous ratio (AVR) was subsequently calculated. Results: Pulse wave velocity was lower (p ≤ 0.001) in the black group when compared to the white group. The black group had a narrower CRAE, wider CRVE and lower AVR (all p < 0.001). Pulse wave velocity associated negatively with CRAE (r = -0.141, p = 0.003) and AVR (r = -0.185, p ≤ 0.001) in the black group only. A positive association between PWV and CRVE was seen in the black (r = 0.174, p ≤ 0.001) and white (r = 0.119, p = 0.043) group. Conclusion: Large artery stiffness is associated with retinal arterial narrowing and venular widening in children, suggesting cross-talk between the macro-and microvasculature. Ethnic differences in these associations are also evident. Our findings warrant further investigation into environmental and sociocultural risk factors contributing to premature cardiovascular disease development.
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Affiliation(s)
- Yolandi Breet
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,Medical Research Council (MRC) Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Ashleigh Craig
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Wayne Smith
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,Medical Research Council (MRC) Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Shani Botha-Le Roux
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,Medical Research Council (MRC) Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Lebo F Gafane-Matemane
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,Medical Research Council (MRC) Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Sanette Brits
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,Medical Research Council (MRC) Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Johannes M van Rooyen
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,Medical Research Council (MRC) Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Ruan Kruger
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,Medical Research Council (MRC) Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
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70
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Jin W, Chowienczyk P, Alastruey J. Estimating pulse wave velocity from the radial pressure wave using machine learning algorithms. PLoS One 2021; 16:e0245026. [PMID: 34181640 PMCID: PMC8238176 DOI: 10.1371/journal.pone.0245026] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/02/2021] [Indexed: 01/04/2023] Open
Abstract
One of the European gold standard measurement of vascular ageing, a risk factor for cardiovascular disease, is the carotid-femoral pulse wave velocity (cfPWV), which requires an experienced operator to measure pulse waves at two sites. In this work, two machine learning pipelines were proposed to estimate cfPWV from the peripheral pulse wave measured at a single site, the radial pressure wave measured by applanation tonometry. The study populations were the Twins UK cohort containing 3,082 subjects aged from 18 to 110 years, and a database containing 4,374 virtual subjects aged from 25 to 75 years. The first pipeline uses Gaussian process regression to estimate cfPWV from features extracted from the radial pressure wave using pulse wave analysis. The mean difference and upper and lower limits of agreement (LOA) of the estimation on the 924 hold-out test subjects from the Twins UK cohort were 0.2 m/s, and 3.75 m/s & -3.34 m/s, respectively. The second pipeline uses a recurrent neural network (RNN) to estimate cfPWV from the entire radial pressure wave. The mean difference and upper and lower LOA of the estimation on the 924 hold-out test subjects from the Twins UK cohort were 0.05 m/s, and 3.21 m/s & -3.11m/s, respectively. The percentage error of the RNN estimates on the virtual subjects increased by less than 2% when adding 20% of random noise to the pressure waveform. These results show the possibility of assessing the vascular ageing using a single peripheral pulse wave (e.g. the radial pressure wave), instead of cfPWV. The proposed code for the machine learning pipelines is available from the following online depository (https://github.com/WeiweiJin/Estimate-Cardiovascular-Risk-from-Pulse-Wave-Signal).
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Affiliation(s)
- Weiwei Jin
- Department of Biomedical Engineering, King’s College London, London, United Kingdom
- * E-mail: ,
| | - Philip Chowienczyk
- Department of Clinical Pharmacology, St. Thomas’ Hospital, King’s College London, London, United Kingdom
| | - Jordi Alastruey
- Department of Biomedical Engineering, King’s College London, London, United Kingdom
- World-Class Research Centre, Digital Biodesign and Personalized Healthcare, Sechenov University, Moscow, Russia
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71
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Climie RE, Bruno RM. Dynamic Pulse Wave Velocity Response to Hydrostatic Blood Pressure Gradient: A Pressure-Independent Marker of Vascular Aging? Am J Hypertens 2020; 33:1075-1077. [PMID: 32750109 DOI: 10.1093/ajh/hpaa127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 07/28/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Rachel E Climie
- Sports Cardiology, Baker Heart and Diabetes Institute, Melbourne, Australia
- INSERM, U970, Paris Cardiovascular Research Center (PARCC), Université de Paris, Paris, France
| | - Rosa-Maria Bruno
- INSERM, U970, Paris Cardiovascular Research Center (PARCC), Université de Paris, Paris, France
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72
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Prediction of age and brachial-ankle pulse-wave velocity using ultra-wide-field pseudo-color images by deep learning. Sci Rep 2020; 10:19369. [PMID: 33168888 PMCID: PMC7652944 DOI: 10.1038/s41598-020-76513-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/29/2020] [Indexed: 12/22/2022] Open
Abstract
This study examined whether age and brachial-ankle pulse-wave velocity (baPWV) can be predicted with ultra-wide-field pseudo-color (UWPC) images using deep learning (DL). We examined 170 UWPC images of both eyes of 85 participants (40 men and 45 women, mean age: 57.5 ± 20.9 years). Three types of images were included (total, central, and peripheral) and analyzed by k-fold cross-validation (k = 5) using Visual Geometry Group-16. After bias was eliminated using the generalized linear mixed model, the standard regression coefficients (SRCs) between actual age and baPWV and predicted age and baPWV from the UWPC images by the neural network were calculated, and the prediction accuracies of the DL model for age and baPWV were examined. The SRC between actual age and predicted age by the neural network was 0.833 for all images, 0.818 for central images, and 0.649 for peripheral images (all P < 0.001) and between the actual baPWV and the predicted baPWV was 0.390 for total images, 0.419 for central images, and 0.312 for peripheral images (all P < 0.001). These results show the potential prediction capability of DL for age and vascular aging and could be useful for disease prevention and early treatment.
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73
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Weber T, Mayer CC. "Man Is as Old as His Arteries" Taken Literally: In Search of the Best Metric. Hypertension 2020; 76:1425-1427. [PMID: 33026913 DOI: 10.1161/hypertensionaha.120.16128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Thomas Weber
- From the Cardiology Department, Klinikum Wels-Grieskirchen, Austria (T.W.)
| | - Christopher C Mayer
- Center for Health and Bioresources, Austrian Institute of Technology, Vienna (C.C.M.)
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74
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Laurent S, Boutouyrie P. Arterial Stiffness and Hypertension in the Elderly. Front Cardiovasc Med 2020; 7:544302. [PMID: 33330638 PMCID: PMC7673379 DOI: 10.3389/fcvm.2020.544302] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 09/17/2020] [Indexed: 12/21/2022] Open
Abstract
Hypertension prevalence increases with age. Age and high blood pressure are the two main determinants of arterial stiffness. In elderly hypertensives, large arteries stiffen and systolic and pulse pressures increase, due to wave reflections. A major reason for measuring arterial stiffness in clinical practice in elderly hypertensive patients comes from the repeated demonstration that arterial stiffness and wave reflections have a predictive value for CV events. A large body of evidence has been published during the last two decades, concerning the epidemiology, pathophysiology, and pharmacology of large arteries in hypertension in various settings of age. Particularly, two expert consensus documents have reviewed the methodological agreements for measuring arterial stiffness. The concepts of Early Vascular Aging (EVA) and Supernormal Vascular Aging (SUPERNOVA) help to better understand on which determinants of arterial stiffness it is possible to act, in order to limit target organ damage and cardiovascular complications. This review will address the issues of the cellular and molecular mechanisms of arterial stiffening in elderly hypertensives, the consequences of arterial stiffening on central systolic and pulse (systolic minus diastolic, PP) pressures and target organs, the methodology for measuring arterial stiffness, central pulse pressure and wave reflection, the epidemiological determinants of arterial stiffening in elderly hypertensives, the pharmacology of arterial destiffening, and how the concepts of EVA and SUPERNOVA apply to the detection of organ damage and prevention of CV complications.
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Affiliation(s)
- Stéphane Laurent
- Assistance-Publique Hôpitaux de Paris, Université de Paris, Paris, France
- PARCC-INSERM U970, Paris, France
- Department of Pharmacology and Hôpital Européen Georges Pompidou, Paris, France
| | - Pierre Boutouyrie
- Assistance-Publique Hôpitaux de Paris, Université de Paris, Paris, France
- PARCC-INSERM U970, Paris, France
- Department of Pharmacology and Hôpital Européen Georges Pompidou, Paris, France
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75
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Understanding Vascular Age: Are Clinical scoring systems useful for Early Vascular Aging Syndrome Prediction ? High Blood Press Cardiovasc Prev 2020; 27:569-577. [PMID: 33104966 DOI: 10.1007/s40292-020-00417-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/10/2020] [Indexed: 10/23/2022] Open
Abstract
INTRODUCTION Early vascular aging syndrome (EVAS) is defined as increased arterial stiffness compared to age and sex matched patients, EVAS is measured by pulse wave velocity (PWV). AIM In our study we aim to identify in patients with high risk of EVAS using the CHADS2, CHA2DS2-VASc, and CHA2DS2-VASc-HS scores. METHODS The CHADS2, CHA2DS2-VASc-HS and CHADS2VASC scoring systems are advised to determine management strategies in patients with nonvalvular atrial fibrillation. As they contain similar risk factors for the development or presence of EVAS, we believed that this risk scoring system could also be used to predict EVAS. This study was designed as a retrospective observational study. 2108 consecutive patients who had undergone 24-h blood pressure monitoring and measured PWV levels were included in the study. The patients were divided into the two groups according to corrected Pwv values. RESULTS CHADS2, CHA2DS2-VASc, and CHA2DS2-VASc-HS scores were positively correlated with PWV values (r =0.251, p < 0.001; r = 0.457, p < 0.001; and r = 0.385, p < 0.001, respectively). CHA2DS2-VASc-HS score was statistically better than CHA2DS2, CHA2DS2-VASc score to predict early vascular aging syndrome (p < 0.001). For the prediction of EVAS, the cut-off value of CHA2DS2-VASc-HS score was ≥ 1.5 with a sensitivity of 49% and a specificity of 50 % (AUC 0.605; 95% [CI] 0.58-0.63) in the ROC curve analyses. CONCLUSIONS The CHA2DS2-VASc-HS scoring system might be used in daily clinical practice to calculate the total risk assessment of EVAS. This score is relatively simple to use and time-saving technique.
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76
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Metabolically Healthy Obesity: Presence of Arterial Stiffness in the Prepubescent Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17196995. [PMID: 32987856 PMCID: PMC7579096 DOI: 10.3390/ijerph17196995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 09/19/2020] [Accepted: 09/23/2020] [Indexed: 12/19/2022]
Abstract
Aim: Arteriosclerotic cardiovascular disease, one of the world’s leading causes of death, first manifests itself at an early age. The identification of children who may have increased cardiovascular risk in the future could be an important prevention strategy. Our aim was to assess the clinical, analytical, and dietary variables associated with arterial stiffness (AS), measured by carotid-femoral pulse wave velocity (cfPWV) in a prepubescent population with metabolically healthy obesity (MHO). Subjects and Methods: A cross-sectional study in prepubescent subjects with obesity who had ≤1 metabolic syndrome criteria (abdominal perimeter and blood pressure ≥90th percentile, triglycerides >150 mg/dL, HDL-cholesterol <40 mg/dL, fasting plasma glucose ≥100 mg/dL) was conducted. Adherence to Mediterranean Diet, blood pressure, BMI, waist/height ratio (WHtR), glycemic status, lipid profile, and cfPWV were analyzed. 75 MHO children (boys: 43; girls: 32; p = 0.20) (age = 10.05 ± 1.29 years; BMI = 25.29 ± 3.5 kg/m2) were included. Results: We found a positive correlation between cfPWV and weight (r = 0.51; p < 0.0001), BMI (r = 0.44; p < 0.0001), WHtR (r = 0.26; p = 0.02), fasting insulin levels (r = 0.28; p = 0.02), and insulin resistance (Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index) (r = 0.25; p = 0.04). Multiple linear regression analysis identified BMI and HOMA-IR as independent parameters associated with cfPWV. Conclusions: Prepubescent children with obesity who were shown to be metabolically healthy presented with arterial stiffness, which is closely related to BMI and the state of insulin resistance.
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77
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Stelwagen J, Lubberts S, Steggink LC, Steursma G, Kruyt LM, Donkerbroek JW, van Roon AM, van Gessel AI, van de Zande SC, Meijer C, Gräfin Zu Eulenburg CH, Oosting SF, Nuver J, Walenkamp AME, Jan de Jong I, Lefrandt JD, Gietema JA. Vascular aging in long-term survivors of testicular cancer more than 20 years after treatment with cisplatin-based chemotherapy. Br J Cancer 2020; 123:1599-1607. [PMID: 32921790 PMCID: PMC7686327 DOI: 10.1038/s41416-020-01049-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/23/2020] [Accepted: 08/18/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Late effects of cisplatin-based chemotherapy in testicular cancer survivors (TCS) include cardiovascular morbidity, but little data is available beyond 20 years. The objective was to assess vascular damage in very long-term TCS. METHODS TCS (treated with chemotherapy or orchiectomy only) and age-matched healthy controls were invited. Study assessment included vascular stiffness with ultrasound measurement of carotid-femoral pulse wave velocity (cf-PWV). RESULTS We included 127 TCS consisting of a chemotherapy group (70 patients) and an orchiectomy group (57 patients) along with 70 controls. Median follow-up was 28 years (range: 20-42). The cf-PWV (m/s) was higher in TCS than in controls (geometrical mean 8.05 (SD 1.23) vs. 7.60 (SD 1.21), p = 0.04). The cf-PWV was higher in the chemotherapy group than in the orchiectomy group (geometrical mean 8.39 (SD 1.22) vs. 7.61 (SD 1.21), p < 0.01). In the chemotherapy group cf-PWV increased more rapidly as a function of age compared to controls (regression coefficient b 7.59 × 10-3 vs. 4.04 × 10-3; p = 0.03). CONCLUSION Very long-term TCS treated with cisplatin-based chemotherapy show increased vascular damage compatible with "accelerated vascular aging" and continue to be at risk for cardiovascular morbidity, thus supporting the need for intensive cardiovascular risk management. CLINICAL TRIAL REGISTRATION The clinical trial registration number is NCT02572934.
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Affiliation(s)
- Johannes Stelwagen
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Sjoukje Lubberts
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Lars C Steggink
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Gerrie Steursma
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Lara M Kruyt
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Jan Willem Donkerbroek
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Arie M van Roon
- Department of Internal Medicine, division of Vascular Medicine, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Anne I van Gessel
- Department of Internal Medicine, division of Vascular Medicine, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Saskia C van de Zande
- Department of Internal Medicine, division of Vascular Medicine, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Coby Meijer
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | | | - Sjoukje F Oosting
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Janine Nuver
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Annemiek M E Walenkamp
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Igle Jan de Jong
- Department of Urology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Joop D Lefrandt
- Department of Internal Medicine, division of Vascular Medicine, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Jourik A Gietema
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands.
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78
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Bruno RM, Nilsson PM, Engström G, Wadström BN, Empana JP, Boutouyrie P, Laurent S. Early and Supernormal Vascular Aging: Clinical Characteristics and Association With Incident Cardiovascular Events. Hypertension 2020; 76:1616-1624. [PMID: 32895017 DOI: 10.1161/hypertensionaha.120.14971] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Pulse wave velocity is an established marker of early vascular aging but may also help identifying individuals with supernormal vascular aging. We tested the hypothesis that individuals with the largest difference (Δ-age) between chronological and vascular age show the lowest rate of cardiovascular events and may thus be defined as supernormal vascular aging. Vascular age was defined as the predicted age in the best fitting multivariable regression model including classical risk factors and treatment and pulse wave velocity, in a subset of the Reference Values for Arterial Stiffness Collaboration Database (n=3347). Δ-age was then calculated as chronological age minus vascular age, and the 10th and 90th percentiles were used to define early (Δ-age<-5.7 years), normal (Δ-age -5.7 to 6.8 years) and supernormal vascular aging (Δ-age>6.8 years). The risk for fatal and nonfatal cardiovascular events associated with vascular aging categories was investigated in the Malmö Diet and Cancer Study cohort (n=2642). In the Malmö Diet and Cancer Study Cohort (6.6-year follow-up, 286 events), Δ-age was significantly (P<0.01) and inversely associated with cardiovascular events. Compared with normal vascular aging, supernormal vascular aging had lower risk (hazard ratio, 0.59 [95% CI, 0.41-0.85]), whereas early vascular aging had higher risk (hazard ratio, 2.70 [95% CI, 1.55-4.70]) of cardiovascular events, in particular coronary events. There was no significant association with all-cause mortality. This study represents the first validation of the clinical significance of the supernormal vascular aging concept, based on prospective data. Its further characterization may help discovering novel protective molecular pathways and providing preventive strategies for successful vascular aging.
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Affiliation(s)
- Rosa Maria Bruno
- From the INSERM, U970, Paris Cardiovascular Research Center-PARCC, France (R.M.B., J.-P.E., P.B., S.L.)
| | - Peter M Nilsson
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden (P.M.N., G.E., B.N.W.)
| | - Gunnar Engström
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden (P.M.N., G.E., B.N.W.)
| | - Benjamin Nilsson Wadström
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden (P.M.N., G.E., B.N.W.)
| | - Jean-Philippe Empana
- From the INSERM, U970, Paris Cardiovascular Research Center-PARCC, France (R.M.B., J.-P.E., P.B., S.L.).,Université de Paris, France (RM.B., J.-P.E., P.B., S.L.)
| | - Pierre Boutouyrie
- From the INSERM, U970, Paris Cardiovascular Research Center-PARCC, France (R.M.B., J.-P.E., P.B., S.L.).,Université de Paris, France (RM.B., J.-P.E., P.B., S.L.).,Assistance Publique-Hopitaux de Paris, France (P.B., S.L.)
| | - Stephane Laurent
- From the INSERM, U970, Paris Cardiovascular Research Center-PARCC, France (R.M.B., J.-P.E., P.B., S.L.).,Université de Paris, France (RM.B., J.-P.E., P.B., S.L.).,Assistance Publique-Hopitaux de Paris, France (P.B., S.L.)
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79
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Battistoni A, Michielon A, Marino G, Savoia C. Vascular Aging and Central Aortic Blood Pressure: From Pathophysiology to Treatment. High Blood Press Cardiovasc Prev 2020; 27:299-308. [PMID: 32572706 DOI: 10.1007/s40292-020-00395-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/13/2020] [Indexed: 12/30/2022] Open
Abstract
Large conductive arteries undergo to structural modifications by aging, eventually leading to increased vascular stiffness. As consequence, cardiovascular hemodynamic changes by increasing central blood pressure which may be also associated to the remodelling of peripheral resistance arteries that contribute to increase further the central vascular stiffness and blood pressure. These modifications resemble the ones that has been shown in essential hypertension, thus a condition of "early vascular aging" has been described in hypertensive patients. Since hypertension related target organs, particularly the heart, face aortic blood pressure rather than brachial blood pressure, it has been recently suggested that central blood pressure and other parameters of large arteries' stiffness, including pulse wave velocity (PWV), may better correlate with subclinical organ damage and might be useful to assess the cardiovascular risk of patients beyond the traditional risk factors. Different devices have been validated to measure central blood pressure and PWV, and are currently available for clinical use. The increasing application of these tools in clinical practice could improve the management of hypertensive patients by better defining the cardiovascular risk and address the antihypertensive therapy.
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Affiliation(s)
- Allegra Battistoni
- Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Division of Cardiology, Cardiology Unit and Chair Sant Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035-37 00189, Rome, Italy
| | - Alberto Michielon
- Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Division of Cardiology, Cardiology Unit and Chair Sant Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035-37 00189, Rome, Italy
| | - Gaetano Marino
- Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Division of Cardiology, Cardiology Unit and Chair Sant Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035-37 00189, Rome, Italy
| | - Carmine Savoia
- Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Division of Cardiology, Cardiology Unit and Chair Sant Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035-37 00189, Rome, Italy.
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80
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Campana EMG, Inuzuka S. Vascular Aging and Arterial Stiffness in Older Adults. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2020. [DOI: 10.36660/ijcs.20200132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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81
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Collins P, Maas A, Prasad M, Schierbeck L, Lerman A. Endothelial Vascular Function as a Surrogate of Vascular Risk and Aging in Women. Mayo Clin Proc 2020; 95:541-553. [PMID: 31982169 DOI: 10.1016/j.mayocp.2019.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 05/17/2019] [Accepted: 07/01/2019] [Indexed: 10/25/2022]
Abstract
Cardiovascular disease is the leading cause of morbidity and mortality in women. We suggest the need to develop a paradigm that connects sex- and age-specific nontraditional risk factors that serve as a common mechanism ultimately leading to an increased risk of cardiovascular events. Vascular injury with abnormal repair leading to functional, rather than structural, abnormalities can be regarded as accelerated vascular aging. It emerges as a common feature that can trigger the early diagnosis and risk stratification for cardiovascular disease in women. We discuss sex-specific risk factors that can contribute to vascular injury with age, and these might not always be considered by cardiovascular physicians. It is important for the primary physician to be aware of these risk factors to enable more intensified management of this at-risk population. Novel technologies that allow the assessment of vascular function noninvasively can serve as key diagnostic and therapeutic tools with which we can identify such individuals and target therapy to manage this important patient population appropriately and effectively. We hope that this article will stimulate interest in this field and encourage further research in these important areas.
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Affiliation(s)
- Peter Collins
- National Heart and Lung Institute, Imperial College London and Royal Brompton Hospital, London, United Kingdom.
| | - Angela Maas
- Radboud University Medical Center, Department Cardiology, Nijmegen, the Netherlands
| | - Megha Prasad
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | | | - Amir Lerman
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
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82
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Nosalski R, Siedlinski M, Denby L, McGinnigle E, Nowak M, Cat AND, Medina-Ruiz L, Cantini M, Skiba D, Wilk G, Osmenda G, Rodor J, Salmeron-Sanchez M, Graham G, Maffia P, Graham D, Baker AH, Guzik TJ. T-Cell-Derived miRNA-214 Mediates Perivascular Fibrosis in Hypertension. Circ Res 2020; 126:988-1003. [PMID: 32065054 PMCID: PMC7147427 DOI: 10.1161/circresaha.119.315428] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
RATIONALE Despite increasing understanding of the prognostic importance of vascular stiffening linked to perivascular fibrosis in hypertension, the molecular and cellular regulation of this process is poorly understood. OBJECTIVES To study the functional role of microRNA-214 (miR-214) in the induction of perivascular fibrosis and endothelial dysfunction driving vascular stiffening. METHODS AND RESULTS Out of 381 miRs screened in the perivascular tissues in response to Ang II (angiotensin II)-mediated hypertension, miR-214 showed the highest induction (8-fold, P=0.0001). MiR-214 induction was pronounced in perivascular and circulating T cells, but not in perivascular adipose tissue adipocytes. Global deletion of miR-214-/- prevented Ang II-induced periaortic fibrosis, Col1a1, Col3a1, Col5a1, and Tgfb1 expression, hydroxyproline accumulation, and vascular stiffening, without difference in blood pressure. Mechanistic studies revealed that miR-214-/- mice were protected against endothelial dysfunction, oxidative stress, and increased Nox2, all of which were induced by Ang II in WT mice. Ang II-induced recruitment of T cells into perivascular adipose tissue was abolished in miR-214-/- mice. Adoptive transfer of miR-214-/- T cells into RAG1-/- mice resulted in reduced perivascular fibrosis compared with the effect of WT T cells. Ang II induced hypertension caused significant change in the expression of 1380 T cell genes in WT, but only 51 in miR-214-/-. T cell activation, proliferation and chemotaxis pathways were differentially affected. MiR-214-/- prevented Ang II-induction of profibrotic T cell cytokines (IL-17, TNF-α, IL-9, and IFN-γ) and chemokine receptors (CCR1, CCR2, CCR4, CCR5, CCR6, and CXCR3). This manifested in reduced in vitro and in vivo T cell chemotaxis resulting in attenuation of profibrotic perivascular inflammation. Translationally, we show that miR-214 is increased in plasma of patients with hypertension and is directly correlated to pulse wave velocity as a measure of vascular stiffness. CONCLUSIONS T-cell-derived miR-214 controls pathological perivascular fibrosis in hypertension mediated by T cell recruitment and local profibrotic cytokine release.
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Affiliation(s)
- Ryszard Nosalski
- From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (R.N., E.M., A.N.D.C., D.S., P.M., D.G., T.J.G.).,Department of Medicine, Jagiellonian University Medical College, Krakow, Poland (R.N., M.S., M.N., D.S., G.W., G.O., T.J.G.)
| | - Mateusz Siedlinski
- Department of Medicine, Jagiellonian University Medical College, Krakow, Poland (R.N., M.S., M.N., D.S., G.W., G.O., T.J.G.)
| | - Laura Denby
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, United Kingdom (L.D., J.R., A.H.B.)
| | - Eilidh McGinnigle
- From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (R.N., E.M., A.N.D.C., D.S., P.M., D.G., T.J.G.)
| | - Michal Nowak
- Department of Medicine, Jagiellonian University Medical College, Krakow, Poland (R.N., M.S., M.N., D.S., G.W., G.O., T.J.G.)
| | - Aurelie Nguyen Dinh Cat
- From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (R.N., E.M., A.N.D.C., D.S., P.M., D.G., T.J.G.)
| | - Laura Medina-Ruiz
- Institute of Infection, Immunity and Inflammation, University of Glasgow, United Kingdom (L.M.-R., G.G., P.M.)
| | - Marco Cantini
- Centre for the Cellular Microenvironment, School of Engineering, University of Glasgow, United Kingdom (M.C., M.S.-S.)
| | - Dominik Skiba
- From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (R.N., E.M., A.N.D.C., D.S., P.M., D.G., T.J.G.).,Department of Medicine, Jagiellonian University Medical College, Krakow, Poland (R.N., M.S., M.N., D.S., G.W., G.O., T.J.G.)
| | - Grzegorz Wilk
- Department of Medicine, Jagiellonian University Medical College, Krakow, Poland (R.N., M.S., M.N., D.S., G.W., G.O., T.J.G.)
| | - Grzegorz Osmenda
- Department of Medicine, Jagiellonian University Medical College, Krakow, Poland (R.N., M.S., M.N., D.S., G.W., G.O., T.J.G.)
| | - Julie Rodor
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, United Kingdom (L.D., J.R., A.H.B.)
| | - Manuel Salmeron-Sanchez
- Centre for the Cellular Microenvironment, School of Engineering, University of Glasgow, United Kingdom (M.C., M.S.-S.)
| | - Gerard Graham
- Institute of Infection, Immunity and Inflammation, University of Glasgow, United Kingdom (L.M.-R., G.G., P.M.)
| | - Pasquale Maffia
- From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (R.N., E.M., A.N.D.C., D.S., P.M., D.G., T.J.G.).,Institute of Infection, Immunity and Inflammation, University of Glasgow, United Kingdom (L.M.-R., G.G., P.M.).,Department of Pharmacy, University of Naples Federico II, Italy (P.M.)
| | - Delyth Graham
- From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (R.N., E.M., A.N.D.C., D.S., P.M., D.G., T.J.G.)
| | - Andrew H Baker
- Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, United Kingdom (L.D., J.R., A.H.B.)
| | - Tomasz J Guzik
- From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (R.N., E.M., A.N.D.C., D.S., P.M., D.G., T.J.G.).,Department of Medicine, Jagiellonian University Medical College, Krakow, Poland (R.N., M.S., M.N., D.S., G.W., G.O., T.J.G.)
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83
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Polonis K, Wawrzyniak R, Daghir-Wojtkowiak E, Szyndler A, Chrostowska M, Melander O, Hoffmann M, Kordalewska M, Raczak-Gutknecht J, Bartosińska E, Kaliszan R, Narkiewicz K, Markuszewski MJ. Metabolomic Signature of Early Vascular Aging (EVA) in Hypertension. Front Mol Biosci 2020; 7:12. [PMID: 32118038 PMCID: PMC7019377 DOI: 10.3389/fmolb.2020.00012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 01/17/2020] [Indexed: 12/14/2022] Open
Abstract
Arterial stiffening is a hallmark of early vascular aging (EVA) syndrome and an independent predictor of cardiovascular morbidity and mortality. In this case-control study we sought to identify plasma metabolites associated with EVA syndrome in the setting of hypertension. An untargeted metabolomic approach was used to identify plasma metabolites in an age-, BMI-, and sex-matched groups of EVA (n = 79) and non-EVA (n = 73) individuals with hypertension. After raw data processing and filtration, 497 putative compounds were characterized, out of which 4 were identified as lysophosphaditylcholines (LPCs) [LPC (18:2), LPC (16:0), LPC (18:0), and LPC (18:1)]. A main finding of this study shows that identified LPCs were independently associated with EVA status. Although LPCs have been shown previously to be positively associated with inflammation and atherosclerosis, we observed that hypertensive individuals characterized by 4 down-regulated LPCs had 3.8 times higher risk of EVA compared to those with higher LPC levels (OR = 3.8, 95% CI 1.7–8.5, P < 0.001). Our results provide new insights into a metabolomic phenotype of vascular aging and warrants further investigation of negative association of LPCs with EVA status. This study suggests that LPCs are potential candidates to be considered for further evaluation and validation as predictors of EVA in patients with hypertension.
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Affiliation(s)
- Katarzyna Polonis
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland.,Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Renata Wawrzyniak
- Department of Biopharmaceutics and Pharmacodynamics, Medical University of Gdansk, Gdansk, Poland
| | - Emilia Daghir-Wojtkowiak
- Department of Biopharmaceutics and Pharmacodynamics, Medical University of Gdansk, Gdansk, Poland
| | - Anna Szyndler
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | - Marzena Chrostowska
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | - Olle Melander
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Michał Hoffmann
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | - Marta Kordalewska
- Department of Biopharmaceutics and Pharmacodynamics, Medical University of Gdansk, Gdansk, Poland
| | - Joanna Raczak-Gutknecht
- Department of Biopharmaceutics and Pharmacodynamics, Medical University of Gdansk, Gdansk, Poland
| | - Ewa Bartosińska
- Department of Biopharmaceutics and Pharmacodynamics, Medical University of Gdansk, Gdansk, Poland
| | - Roman Kaliszan
- Department of Biopharmaceutics and Pharmacodynamics, Medical University of Gdansk, Gdansk, Poland
| | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | - Michał J Markuszewski
- Department of Biopharmaceutics and Pharmacodynamics, Medical University of Gdansk, Gdansk, Poland
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Abstract
With increasing age, the cardiovascular risk increases, as does frailty, with negative health consequences such as coronary disease, stroke, and vascular dementia. However, this aging process seems to take a more rapid course in some individuals, as reflected in the Early Vascular Aging (EVA) syndrome that over the recent 10 years has attracted increased attention. The core of the EVA syndrome is arterial stiffness in the media layer of large elastic arteries, a process that can be measured by pulse wave velocity, for example, along the aorta. Hypertension is a well-known cardiovascular risk factor in its own right, but also linked to the EVA process. However, several studies have shown that non-hemodynamic factors also contribute to arterial stiffness and EVA, such as impaired glucose metabolism, chronic inflammation, and oxidative stress. New perspectives have been introduced for linking early life programming affecting new-born babies and birth weight, with a later risk of hypertension, arterial stiffness and EVA. New drugs are being developed to treat EVA when lifestyle intervention and conventional risk factor controlling drugs are not enough. Finally, the opposite phenotype of EVA is Healthy Vascular Aging (HVA) or even Super Normal Vascular Aging (SUPERNOVA). If protective mechanisms can be found and mapped in these fortunate subjects with a slower than expected aging process, there could exist a potential to find new drug targets for preventive therapy.
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85
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Nixdorff U. [Meaningful diagnostics: imaging]. Herz 2020; 45:17-23. [PMID: 32002564 DOI: 10.1007/s00059-020-04890-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Imaging of subclinical atherosclerosis is an integrated component of a preventive medicine algorithm; i.e. on the basis of a cardiovascular risk stratification patients with a low and intermediate risk qualify for further imaging (cave: Bayes' theorem). Imaging procedures for subclinical atherosclerosis have one thing in common: atherosclerosis is detected and localized directly, for which cardiac multidetector computed tomography (MDCT; coronary calcium scoring, CACS) and vascular ultrasound (carotid and/or femoral arteries) are used to measure the plaque burden. The result is viewed as a risk modifier. The risk assessment is not related to symptoms. In addition to the detection and localization of atherosclerosis this also enables assessment of the "risk age" according to the tables of the European Society of Cardiology (ESC) and even the biological age, which can be estimated based on nomograms. This knowledge can be used to promote patient compliance and adherence to medication.
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Affiliation(s)
- Uwe Nixdorff
- European Prevention Center (EPC) im Medical Center Düsseldorf (GrandArc), Luise-Rainer-Str. 6-10, 40235, Düsseldorf, Deutschland.
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86
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Kruszyńska E, Łoboz-Rudnicka M, Palombo C, Vriz O, Kozakova M, Ołpińska B, Morizzo C, Łoboz-Grudzień K, Jaroch J. Carotid Artery Stiffness in Metabolic Syndrome: Sex Differences. Diabetes Metab Syndr Obes 2020; 13:3359-3369. [PMID: 33061497 PMCID: PMC7524178 DOI: 10.2147/dmso.s262192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/17/2020] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION The effect of metabolic syndrome (MS) on carotid stiffness (CS) in the context of gender is under research. OBJECTIVE We examined the relationship between the MS and CS in men (M) and women (W) and investigated if the impact of cardiovascular risk factors on CS is modulated by gender. PATIENTS AND METHODS The study included 419 subjects (mean age 54.3 years): 215 (51%) with MS (109 W and 106 M) and 204 (49%) without MS (98 W and 106 M). Carotid intima-media thickness (IMT) and CS parameters (beta stiffness index (beta), Peterson's elastic modulus (Ep), arterial compliance (AC) and one-point pulse wave velocity (PWV-beta)) were measured with the echo-tracking (eT) system. RESULTS ANCOVA demonstrated that MS was associated with elevated CS indices (p = 0.003 for beta and 0.025 for PWV-beta), although further sex-specific analysis revealed that this relationship was significant only in W (p = 0.021 for beta). Age was associated with CS in both M and W, pulse pressure (PP) and body mass index turned out to be determinants of CS solely in W, while the effect of mean arterial pressure (MAP) and heart rate was more pronounced in M. MANOVA performed in subjects with MS revealed that age and diabetes mellitus type 2 were determinants of CS in both sexes, diastolic blood pressure and MAP - solely in M and systolic blood pressure, PP and waist circumference - solely in W (the relationship between the waist circumference and AC was paradoxical). CONCLUSION The relationship between MS and CS is stronger in W than in M. In subjects with MS, various components of arterial pressure exert different sex-specific effects on CS - with the impact of the pulsative component of arterial pressure (PP) observed in W and the impact of the steady component (MAP) observed in M.
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Affiliation(s)
- Ewa Kruszyńska
- Cardiology Department, T. Marciniak Hospital, Emergency Medicine Center, Wrocław, Poland
| | - Maria Łoboz-Rudnicka
- Cardiology Department, T. Marciniak Hospital, Emergency Medicine Center, Wrocław, Poland
- Correspondence: Maria Łoboz-Rudnicka Email
| | - Carlo Palombo
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, School of Medicine, Pisa, Italy
| | - Olga Vriz
- Department of Cardiology and Emergency, San Antonio Hospital, Udine, Italy
| | - Michaela Kozakova
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Bogusława Ołpińska
- Cardiology Department, T. Marciniak Hospital, Emergency Medicine Center, Wrocław, Poland
| | - Carmela Morizzo
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, School of Medicine, Pisa, Italy
| | - Krystyna Łoboz-Grudzień
- Cardiology Department, T. Marciniak Hospital, Emergency Medicine Center, Wrocław, Poland
- Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
| | - Joanna Jaroch
- Cardiology Department, T. Marciniak Hospital, Emergency Medicine Center, Wrocław, Poland
- Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
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87
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Königstein K, Klenk C, Appenzeller-Herzog C, Hinrichs T, Schmidt-Trucksäss A. Impact of sedentary behavior on large artery structure and function in children and adolescents: a systematic review. Eur J Pediatr 2020; 179:17-27. [PMID: 31773330 DOI: 10.1007/s00431-019-03497-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/03/2019] [Accepted: 10/03/2019] [Indexed: 01/25/2023]
Abstract
Sedentary behavior contributes to increased atherosclerotic risk in adults. Whether or not this can be extended to pediatric populations is unclear. This systematic review assessed associations of sedentary behavior with large artery structure and function in pediatric populations. MEDLINE, EMBASE, CENTRAL, and Web of Science were searched from the earliest available date to 31st of December 2018. Analyses of associations of sedentary behavior with large artery structure or function in a pediatric (sub-)population were included, adhering to the PRISMA guidelines. The protocol was published in advance on PROSPERO (CRD42018112996). Study quality and quality of evidence were analyzed using NHLBI Study Quality assessment tools and GRADE. Six observational studies found no association of exposure and outcome variables, and one had contradicting results. One intervention found reduced flow-mediated dilation after 3 h of uninterrupted sitting. Exposure and outcome measures were highly heterogeneous. Study quality was low to moderate. Quality of evidence was very low or low in the observational studies and high in the intervention.Conclusion: In pediatric populations, current evidence is limited and of low quality about how acute effects of sedentary behavior translate into early vascular aging and the long-term development of vascular dysfunction and atherosclerotic risk. Future studies should emphasize a careful choice of the adequate type and measurement site of a biomarker for large artery structure and function as well as conduct a detailed assessment of sedentary behavior patterns.Trial registration: PROSPERO Registration Number: CRD42018112996What is known: • An independent association of sedentary behavior and biomarkers of large artery structure and function has been demonstrated in adults. • In children, sedentary behavior is directly associated with classical cardiovascular risk factors like elevated blood glucose levels, insulin resistance, high blood pressure, obesity, and elevated blood lipids.What is new: • Currently, only few studies of low quality in children and adolescents provide limited evidence about how acute effects of sedentary behavior translate into early vascular aging and the long-term development of atherosclerosis. • The type and measurement site of vascular biomarker need to be chosen carefully, and a detailed assessment of sedentary behavior patterns is important to minimize the methodological bias.
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Affiliation(s)
- Karsten Königstein
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland.
| | - Christopher Klenk
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland
| | | | - Timo Hinrichs
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland.
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89
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Zuo J, Hu Y, Chang G, Chu SL, Tan I, Butlin M, Avolio A. Relationship between arterial stiffness and chronic kidney disease in patients with primary hypertension. J Hum Hypertens 2019; 34:577-585. [PMID: 31664172 DOI: 10.1038/s41371-019-0275-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 10/08/2019] [Accepted: 10/10/2019] [Indexed: 11/09/2022]
Abstract
To investigate the association of noninvasive indices of arterial stiffness with chronic kidney disease (CKD) in patients with primary hypertension, 547 (mean age 60 years, 63% males) hypertensive hospital inpatients were recruited, comprising 337 hypertensives without CKD and 210 hypertensives with CKD. Noninvasive arterial stiffness indices were obtained, including central arterial haemodynamics derived from the radial artery waveform using SphygmoCor V8.0 system, carotid-femoral pulse wave velocity (cfPWV), large and small artery elasticity indices (C1, C2 respectively). Intima-media thickness (IMT) was evaluated by ultrasonography. The diagnosis of CKD was assessed by the estimated glomerular filtration rate (eGFR) or urinary albumin creatinine ratio (ACR). Compared with hypertension without CKD, hypertensive patients with CKD were older, had higher central systolic blood pressure, cfPWV, and IMT (all P < 0.01). With decreasing eGFR, cfPWV and augmentation index adjusted to heart rate of 75 bpm increased progressively whereas C2 decreased (P < 0.05) in subjects with CKD. In the overall population, cfPWV showed a significant trend of a negative association with eGFR (P = 0.04) after adjusting for age, gender, and brachial systolic blood pressure. Multiple logistic analysis showed that 1 SD (3 m/s) increase in cfPWV entailed a 1.35 (95% Cl: 1.018-1.790) times higher likelihood of the presence of CKD even after adjustment for confounding factors. The association of arterial stiffness and CKD suggests that cfPWV may be a potential hemodynamic index to evaluate cardiovascular risk in CKD patients with primary hypertension.
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Affiliation(s)
- Junli Zuo
- Department of Hypertension, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Department of Geriatrics, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
| | - Yueliang Hu
- Department of Geriatrics, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guili Chang
- Department of Hypertension, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shao-Li Chu
- Department of Hypertension, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Isabella Tan
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Mark Butlin
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Alberto Avolio
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
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90
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Vlachopoulos C, Terentes-Printzios D, Laurent S, Nilsson PM, Protogerou AD, Aznaouridis K, Xaplanteris P, Koutagiar I, Tomiyama H, Yamashina A, Sfikakis PP, Tousoulis D. Association of Estimated Pulse Wave Velocity With Survival: A Secondary Analysis of SPRINT. JAMA Netw Open 2019. [PMID: 30646390 DOI: 10.1001/jamanetworkopen] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
IMPORTANCE Aortic stiffness, as assessed by carotid-femoral pulse wave velocity, is an independent predictor of future events in individuals with hypertension. Recent data suggest a predictive role of estimated pulse wave velocity (ePWV) calculated by previously published equations using age and blood pressure in future events in individuals with hypertension. OBJECTIVE To investigate whether ePWV and its response to treatment predict survival in the Systolic Blood Pressure Intervention Trial (SPRINT). DESIGN, SETTING, AND PARTICIPANTS This exploratory, hypothesis-generating, post hoc secondary analysis conducted from October 1, 2018, to August 31, 2019, examined data from 9361 participants in SPRINT and calculated ePWV at baseline and at 12 months. Adjusted hazard ratios (HRs) with 95% CIs of ePWV per 1 SD were estimated using Cox proportional hazards regression models. A total of 8450 patients were assigned to 4 groups according to their treatment allocation and their response in ePWV after 12 months. INTERVENTIONS Participants were assigned a systolic blood pressure target of less than 120 mm Hg (intensive treatment) or less than 140 mm Hg (standard treatment). MAIN OUTCOMES AND MEASURES The primary composite cardiovascular outcome was myocardial infarction, other acute coronary syndromes, stroke, heart failure, or death from cardiovascular causes. RESULTS In the SPRINT population (3332 women and 6029 men; mean [SD] age, 67.9 [9.4] years), ePWV predicted the primary outcome (HR, 1.30 [95% CI, 1.17-1.43]; P < .001) and all-cause death (HR, 1.65 [95% CI, 1.46-1.86]; P < .001) independent of the Framingham Risk Score. Estimated pulse wave velocity improved the C statistic model for the primary outcome from 0.676 (95% CI, 0.65-0.70) to 0.683 (95% CI, 0.66-0.71; P = .049) and improved the C statistic model for all-cause death from 0.67 (95% CI, 0.64-0.69) to 0.69 (95% CI, 0.66-0.72; P = .03). Net reclassification index indicated improvement in risk discrimination for survival compared with the Framingham Risk Score (categorical net reclassification index = 0.111; P < .001). Regarding response to treatment, intensive treatment was superior to standard treatment only when it was accompanied with a response in ePWV at the first year, while, within the standard treatment group, individuals whose ePWV responded to antihypertensive treatment had improved all-cause mortality, with a 42% lower risk of death compared with nonresponders (HR, 0.58 [95% CI, 0.36-0.94]; P = .03); effects were independent of changes in systolic blood pressure. CONCLUSIONS AND RELEVANCE These results suggest that, in the SPRINT trial, ePWV predicted outcomes independent of the Framingham Risk Score, indicating an incremental role of markers of aortic stiffness on cardiovascular risk. Better survival of individuals whose ePWV responded to antihypertensive treatment independently of systolic blood pressure reduction suggests a role of markers of aortic stiffness as effective treatment targets in individuals with hypertension.
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Affiliation(s)
- Charalambos Vlachopoulos
- Hypertension and Cardiometabolic Unit, First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Terentes-Printzios
- Hypertension and Cardiometabolic Unit, First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Stephane Laurent
- Department of Pharmacology, European Georges Pompidou Hospital, Assistance Publique Hôpitaux de Paris, Inserm UMR 970, University Paris Descartes, Paris, France
| | - Peter M Nilsson
- Department of Clinical Sciences, Lund University, University Hospital, Malmö, Sweden
| | - Athanase D Protogerou
- Cardiovascular Prevention and Research Unit, Clinic and Laboratory of Pathophysiology, Laiko Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstatinos Aznaouridis
- Hypertension and Cardiometabolic Unit, First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Xaplanteris
- Hypertension and Cardiometabolic Unit, First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Iosif Koutagiar
- Hypertension and Cardiometabolic Unit, First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Hirofumi Tomiyama
- Division of Preemptive Medicine for Vascular Damage, Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Akira Yamashina
- Division of Preemptive Medicine for Vascular Damage, Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Petros P Sfikakis
- First Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Tousoulis
- Hypertension and Cardiometabolic Unit, First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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91
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Vlachopoulos C, Terentes-Printzios D, Laurent S, Nilsson PM, Protogerou AD, Aznaouridis K, Xaplanteris P, Koutagiar I, Tomiyama H, Yamashina A, Sfikakis PP, Tousoulis D. Association of Estimated Pulse Wave Velocity With Survival: A Secondary Analysis of SPRINT. JAMA Netw Open 2019; 2:e1912831. [PMID: 31596491 PMCID: PMC6802234 DOI: 10.1001/jamanetworkopen.2019.12831] [Citation(s) in RCA: 113] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
IMPORTANCE Aortic stiffness, as assessed by carotid-femoral pulse wave velocity, is an independent predictor of future events in individuals with hypertension. Recent data suggest a predictive role of estimated pulse wave velocity (ePWV) calculated by previously published equations using age and blood pressure in future events in individuals with hypertension. OBJECTIVE To investigate whether ePWV and its response to treatment predict survival in the Systolic Blood Pressure Intervention Trial (SPRINT). DESIGN, SETTING, AND PARTICIPANTS This exploratory, hypothesis-generating, post hoc secondary analysis conducted from October 1, 2018, to August 31, 2019, examined data from 9361 participants in SPRINT and calculated ePWV at baseline and at 12 months. Adjusted hazard ratios (HRs) with 95% CIs of ePWV per 1 SD were estimated using Cox proportional hazards regression models. A total of 8450 patients were assigned to 4 groups according to their treatment allocation and their response in ePWV after 12 months. INTERVENTIONS Participants were assigned a systolic blood pressure target of less than 120 mm Hg (intensive treatment) or less than 140 mm Hg (standard treatment). MAIN OUTCOMES AND MEASURES The primary composite cardiovascular outcome was myocardial infarction, other acute coronary syndromes, stroke, heart failure, or death from cardiovascular causes. RESULTS In the SPRINT population (3332 women and 6029 men; mean [SD] age, 67.9 [9.4] years), ePWV predicted the primary outcome (HR, 1.30 [95% CI, 1.17-1.43]; P < .001) and all-cause death (HR, 1.65 [95% CI, 1.46-1.86]; P < .001) independent of the Framingham Risk Score. Estimated pulse wave velocity improved the C statistic model for the primary outcome from 0.676 (95% CI, 0.65-0.70) to 0.683 (95% CI, 0.66-0.71; P = .049) and improved the C statistic model for all-cause death from 0.67 (95% CI, 0.64-0.69) to 0.69 (95% CI, 0.66-0.72; P = .03). Net reclassification index indicated improvement in risk discrimination for survival compared with the Framingham Risk Score (categorical net reclassification index = 0.111; P < .001). Regarding response to treatment, intensive treatment was superior to standard treatment only when it was accompanied with a response in ePWV at the first year, while, within the standard treatment group, individuals whose ePWV responded to antihypertensive treatment had improved all-cause mortality, with a 42% lower risk of death compared with nonresponders (HR, 0.58 [95% CI, 0.36-0.94]; P = .03); effects were independent of changes in systolic blood pressure. CONCLUSIONS AND RELEVANCE These results suggest that, in the SPRINT trial, ePWV predicted outcomes independent of the Framingham Risk Score, indicating an incremental role of markers of aortic stiffness on cardiovascular risk. Better survival of individuals whose ePWV responded to antihypertensive treatment independently of systolic blood pressure reduction suggests a role of markers of aortic stiffness as effective treatment targets in individuals with hypertension.
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Affiliation(s)
- Charalambos Vlachopoulos
- Hypertension and Cardiometabolic Unit, First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Terentes-Printzios
- Hypertension and Cardiometabolic Unit, First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Stephane Laurent
- Department of Pharmacology, European Georges Pompidou Hospital, Assistance Publique Hôpitaux de Paris, Inserm UMR 970, University Paris Descartes, Paris, France
| | - Peter M. Nilsson
- Department of Clinical Sciences, Lund University, University Hospital, Malmö, Sweden
| | - Athanase D. Protogerou
- Cardiovascular Prevention and Research Unit, Clinic and Laboratory of Pathophysiology, Laiko Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstatinos Aznaouridis
- Hypertension and Cardiometabolic Unit, First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Xaplanteris
- Hypertension and Cardiometabolic Unit, First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Iosif Koutagiar
- Hypertension and Cardiometabolic Unit, First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Hirofumi Tomiyama
- Division of Preemptive Medicine for Vascular Damage, Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Akira Yamashina
- Division of Preemptive Medicine for Vascular Damage, Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Petros P. Sfikakis
- First Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Tousoulis
- Hypertension and Cardiometabolic Unit, First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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92
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Laurent S, Bruno RM. Gut microbiome composition, a third player in the inflammation-arterial stiffness relationship. Eur Heart J 2019; 39:2398-2400. [PMID: 29860302 DOI: 10.1093/eurheartj/ehy300] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Stéphane Laurent
- Department of Pharmacology, European Georges Pompidou Hospital, Assistance Publique-Hôpitaux de Paris, PARCC INSERM UMR 970 and University Paris Descartes, Paris, France
| | - Rosa Maria Bruno
- Department of Clinical and Experimental Medicine, University of Pisa, and Institute of Clinical Physiology, CNR, Pisa, Italy
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93
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Characteristics of healthy vascular ageing in pooled population-based cohort studies: the global Metabolic syndrome and Artery REsearch Consortium. J Hypertens 2019; 36:2340-2349. [PMID: 30063641 DOI: 10.1097/hjh.0000000000001824] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Arterial ageing is characterized by increasing arterial stiffness as measured by pulse wave velocity (PWV). This process is enhanced in participants with early vascular ageing (EVA), but slowed in participants with healthy vascular ageing (HVA). We aimed to describe characteristics of EVA and HVA in a transcontinental study including 11 cohorts. METHODS In all, 18 490 participants from the global MARE Consortium, free of cardiovascular disease, participated with data on PWV and cardiometabolic risk factors. We defined HVA as the lowest 10% and EVA as the highest 10% of the standardized PWV distribution, adjusted for age intervals. HVA individuals were compared with the 90% of non-HVA individuals with ANCOVA, adjusted for age, sex and hypertension. RESULTS The 1723 HVA participants were at the same age as the rest of the population, more likely women (59.4 vs 57.0%), and with significantly lower levels of established cardiovascular risk factors (blood pressure, lipids, glucose). Similarly, the prevalence rate of obesity, diabetes mellitus, hypertension and the metabolic syndrome was lower in the HVA participants. In the presence of similar levels of cardiovascular risk factors, HVA participants in the 50-64 years of age group presented lower PWV 5.8 (SD 0.5) vs. 7.4 (1.4) m/s (P < 0.0001) than control individuals in the 35-49 years of age group, corresponding to an estimated difference in chronological age of 14 years. CONCLUSION Participants with healthy vascular ageing (HVA), belonging to the lowest end of the PWV distribution, are in general characterized by an up to 14 years estimated younger biological (vascular) age than those with higher PWV values, and have lower levels of risk factors.
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94
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Vascular aging and preclinical target organ damage in community-dwelling elderly: the Northern Shanghai Study. J Hypertens 2019; 36:1391-1398. [PMID: 29389744 DOI: 10.1097/hjh.0000000000001692] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Vascular aging represents a mediating step between risk factors and cardiovascular events, and preclinical target organ damage (TOD) integrates the cumulative effect of cardiovascular risk factors. This study is aimed at the relationships between vascular aging and TOD. METHODS Two thousand and ninety-eight participants (45.52% men, aged 71.3 ± 6.1 years) were recruited from June 2014 to June 2017 from the communities in the northern Shanghai area. Preclinical TOD was assessed in all the participants. Other clinical information was obtained by standard questionnaire. Healthy vascular aging (HVA) was defined as absence of hypertension and a relatively normal carotid-femoral PWV based on participants' age and blood pressure. We fitted logistic regression models to assess the probability of non-HVA in association with all the preclinical TOD. RESULTS Six hundred and forty-two (30.6%) elderly participants had HVA, and the prevalence of HVA decreased from 30.84% (aged 65-66) to 20.72% (aged ≥75). Increased age, increased SBP, metabolic syndrome, increased BMI and family history of premature cardiovascular disease (CVD) were significantly associated with accelerated vascular aging (P = 0.031 to P < 0.001). After multivariate adjustments, accelerated vascular aging was associated with left ventricular diastolic dysfunction (LVDD; OR (95% CI) 1.83 (1.23, 2.71), P = 0.003), left ventricular hypertrophy (LVH; OR (95% CI) 1.97 (1.54, 2.51), P < 0.001) and micro-albuminuria (MAU; OR (95% CI) 1.66 (1.35, 2.03), P < 0.001). CONCLUSION Management of blood pressure and metabolic profile may help to alleviate vascular aging and accelerated vascular aging is associated with LVH, LVDD and MAU, which may serve as a potential target to reverse cardiac and renal TOD.
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95
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Uejima T, Dunstan FD, Arbustini E, Łoboz-Grudzień K, Hughes AD, Carerj S, Favalli V, Antonini-Canterin F, Vriz O, Vinereanu D, Zamorano JL, Popescu BA, Evangelista A, Lancellotti P, Lefthériotis G, Kozakova M, Palombo C, Fraser AG. Age-specific reference values for carotid arterial stiffness estimated by ultrasonic wall tracking. J Hum Hypertens 2019; 34:214-222. [PMID: 31435004 PMCID: PMC8076029 DOI: 10.1038/s41371-019-0228-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 05/24/2019] [Accepted: 06/17/2019] [Indexed: 12/12/2022]
Abstract
Interaction between arterial stiffness and hypertension plays an important role in the development of cardiovascular disease. Accordingly, assessment of arterial stiffness may provide a tool for estimating cardiovascular risk and monitoring therapy in hypertensive patients. Radiofrequency-based vascular ultrasound allows accurate noninvasive assessment of local mechanical properties of large arteries, but for its use in clinical practice, reference values according to age and sex are mandatory for each vascular site. To provide reference values for common carotid artery stiffness as assessed by an echo-tracking imaging system Hitachi-Aloka, we pooled measurements collected in 1847 healthy subjects aged 3–74 years (1008 males and 839 females) recruited in 14 European centers in the E-tracking International Collaboration (ETIC). Statistical models were developed to describe relationships of different stiffness indices with age and to calculate median values and Z-scores corresponding to ± 1 and ± 2 standard deviations. In our apparently healthy population, age accounted for 53% of variability in the elastic modulus (epsilon), 39% in arterial compliance, 47% in stiffness index (β), and 56% in local pulse wave velocity; on average, blood pressure accounted for a further 7.5% of variability. Dependence on age was not linear; changes in mean values increased at older ages, especially for epsilon and β. There was an interaction between age and gender for arterial compliance, which was higher in males. We present nomograms and a software that can be used for the automated calculation of Z-scores for local carotid stiffness in individual patients. These tools can be used to establish prognostic indicators or surrogate targets for treatment monitoring.
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Affiliation(s)
- Tokuhisa Uejima
- Wales Heart Research Institute, School of Medicine, Cardiff University, Cardiff, UK
| | - Frank D Dunstan
- Department of Primary Care & Public Health, School of Medicine, Cardiff University, Cardiff, UK
| | - Eloisa Arbustini
- Centre for Inherited Cardiovascular Diseases, I.R.C.C.S. Foundation San Matteo Hospital, Pavia, Italy
| | | | - Alun D Hughes
- Institute of Cardiovascular Science, University College London, London, UK
| | - Scipione Carerj
- Department of Internal Medicine and Pharmacology, University of Messina, Messina, Italy
| | - Valentina Favalli
- Centre for Inherited Cardiovascular Diseases, I.R.C.C.S. Foundation San Matteo Hospital, Pavia, Italy
| | - Francesco Antonini-Canterin
- Azienda Ospedaliera S Maria degli Angeli, Pordenone, Italy.,Rehabilitative Cardiology ORAS, Motta di Livenza, Treviso, Italy
| | - Olga Vriz
- Institute of Cardiology, Ospedale di San Daniele del Friuli, Udine, Italy.,Heart Centre, King Faisal Specialist Hospital, Riyadh, Saudi Arabia
| | - Dragos Vinereanu
- University of Medicine and Pharmacy Carol Davila, University and Emergency Hospital, Bucharest, Romania
| | - Jose L Zamorano
- Department of Cardiology, University Hospital Ramón y Cajal, Madrid, Spain
| | - Bogdan A Popescu
- University of Medicine and Pharmacy Carol Davila, University and Emergency Hospital, Bucharest, Romania.,Department of Cardiology, Euroecolab, Emergency Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu, Bucharest, Romania
| | - Arturo Evangelista
- Department of Cardiology, Hospital General Universitari Vall d'Hebron, Barcelona, Spain
| | - Patrizio Lancellotti
- GIGA Cardiovascular Science, Centre Hospitalier Universitaire de Liège Sart Tilman, Liège, Belgium
| | - Georges Lefthériotis
- Centre Hospitalier Universitaire de Nice, Unité de Médecine et Physiologie Vasculaire, Université Côte d'Azur, LP2M CNRS-7073, Nice, France
| | - Michaela Kozakova
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Carlo Palombo
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.
| | - Alan G Fraser
- Wales Heart Research Institute, School of Medicine, Cardiff University, Cardiff, UK
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96
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Laurent S, Boutouyrie P, Cunha PG, Lacolley P, Nilsson PM. Concept of Extremes in Vascular Aging. Hypertension 2019; 74:218-228. [DOI: 10.1161/hypertensionaha.119.12655] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Stephane Laurent
- From the Department of Pharmacology, INSERM U970, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, France (S.L., P.B.)
| | - Pierre Boutouyrie
- From the Department of Pharmacology, INSERM U970, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, France (S.L., P.B.)
| | - Pedro Guimarães Cunha
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Serviço de Medicina Interna do Hospital da Senhora da Oliveira, Guimarães, Portugal (P.G.C.)
- Life and Health Science Research Institute, School of Medicine, University of Minho, Guimarães, Portugal (P.G.C.)
| | | | - Peter M. Nilsson
- Department of Clinical Sciences, Lund University, Skane University Hospital, Malmo, Sweden (P.M.N.)
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97
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Danninger K, Hafez A, Binder RK, Aichberger M, Hametner B, Wassertheurer S, Weber T. High prevalence of hypertension and early vascular aging: a screening program in pharmacies in Upper Austria. J Hum Hypertens 2019; 34:326-334. [DOI: 10.1038/s41371-019-0222-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 05/22/2019] [Accepted: 06/10/2019] [Indexed: 02/01/2023]
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98
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Huang JT, Cheng HM, Yu WC, Lin YP, Sung SH, Chen CH. Increased Nighttime Pulse Pressure Variability but Not Ambulatory Blood Pressure Levels Predicts 14-Year All-Cause Mortality in Patients on Hemodialysis. Hypertension 2019; 74:660-668. [PMID: 31352830 DOI: 10.1161/hypertensionaha.119.13204] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Increased short-term blood pressure (BP) variability is associated with adverse cardiovascular outcomes in patients with hypertension. The present study investigated the long-term prognostic significance of the short-term blood pressure variability in patients on hemodialysis. A total of 149 patients (53.0% male; mean age: 54.5±15.1 years) receiving regular hemodialysis for >6 months were enrolled. They completed a 44-hour (excluding the hemodialysis session) ambulatory BP monitoring and comprehensive hemodynamic assessments, including carotid-femoral pulse wave velocity and pressure waveform decomposition (forward and backward wave amplitude). Blood pressure variability parameters, including average real variability (ARV) of systolic BP, diastolic BP, and pulse pressure (ARVp) during daytime, nighttime, and overall 44 hours were calculated. During a median follow-up of 14 years, 78 deaths (52.4%) were confirmed. In multivariable Cox regression analysis, none of the ambulatory BP parameters were predictive of mortality. In contrast, nighttime ARVp was consistently and significantly associated with all-cause mortality in multivariable Cox models adjusting for age, sex, albumin, hemodialysis treatment adequacy, and 44-hour systolic BP (continuous variable analysis, per 1-SD, hazard ratio=1.348; 95% CI, 1.029-1.767; categorical variable analysis, ≥8.5 versus <8.5 mm Hg; hazard ratio=1.825; 95% CI, 1.074-3.103). Forward wave amplitude and 44-hour systolic BP were identified as the 2 most important determinants of nighttime ARVp. Addition of nighttime ARVp to the base model significantly improved prediction of all-cause mortality (Net reclassification improvement =0.198; P=0.0012). In hemodialysis patients, increased short-term nighttime pulse pressure variability but not ambulatory BP levels were significantly predictive of long-term all-cause mortality.
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Affiliation(s)
- Jui-Tzu Huang
- From the Faculty of Medicine (J.-T.H., H.-M.C., W.-C.Y., Y.-P.L., S.-H.S., C.-H.C.), National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Hao-Min Cheng
- From the Faculty of Medicine (J.-T.H., H.-M.C., W.-C.Y., Y.-P.L., S.-H.S., C.-H.C.), National Yang-Ming University School of Medicine, Taipei, Taiwan.,Institute of Public Health and Community Medicine Research Center (H.-M.C., C.-H.C.), National Yang-Ming University School of Medicine, Taipei, Taiwan.,Center for Evidence-based Medicine (H.-M.C), Taipei Veterans General Hospital, Taiwan.,Department of Medical Education (H.-M.C., C.-H.C.), Taipei Veterans General Hospital, Taiwan
| | - Wen-Chung Yu
- From the Faculty of Medicine (J.-T.H., H.-M.C., W.-C.Y., Y.-P.L., S.-H.S., C.-H.C.), National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Internal Medicine (W.-C.Y., Y.-P.L., S.-H.S.), Taipei Veterans General Hospital, Taiwan
| | - Yao-Ping Lin
- From the Faculty of Medicine (J.-T.H., H.-M.C., W.-C.Y., Y.-P.L., S.-H.S., C.-H.C.), National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Internal Medicine (W.-C.Y., Y.-P.L., S.-H.S.), Taipei Veterans General Hospital, Taiwan
| | - Shih-Hsien Sung
- From the Faculty of Medicine (J.-T.H., H.-M.C., W.-C.Y., Y.-P.L., S.-H.S., C.-H.C.), National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Internal Medicine (W.-C.Y., Y.-P.L., S.-H.S.), Taipei Veterans General Hospital, Taiwan
| | - Chen-Huan Chen
- From the Faculty of Medicine (J.-T.H., H.-M.C., W.-C.Y., Y.-P.L., S.-H.S., C.-H.C.), National Yang-Ming University School of Medicine, Taipei, Taiwan.,Institute of Public Health and Community Medicine Research Center (H.-M.C., C.-H.C.), National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Medical Education (H.-M.C., C.-H.C.), Taipei Veterans General Hospital, Taiwan
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99
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Lambert GW, Lambert EA, Lim MH. Letter by Lambert et al Regarding Article, "Individual and Neighborhood Deprivation and Carotid Stiffness: The Paris Prospective Study III". Hypertension 2019; 74:e29. [PMID: 31230542 DOI: 10.1161/hypertensionaha.119.13381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Gavin W Lambert
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
| | - Elisabeth A Lambert
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
| | - Michelle H Lim
- Health and Wellbeing (SHAW) Laboratory, Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
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100
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Climie RE, Boutouyrie P, Perier MC, Guibout C, van Sloten TT, Thomas F, Danchin N, Sharman JE, Laurent S, Jouven X, Empana JP. Individual and Neighborhood Deprivation and Carotid Stiffness. Hypertension 2019; 73:1185-1194. [DOI: 10.1161/hypertensionaha.118.12186] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Rachel E. Climie
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
- Baker Heart and Diabetes Institute; Melbourne, Australia (R.E.C.)
- Menzies Institute for Medical Research, University of Tasmanian, Hobart, Australia (R.E.C., J.E.S.)
| | | | - Marie-Cecile Perier
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
| | - Catherine Guibout
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
| | - Thomas T. van Sloten
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
- Cardiovascular Research Institute Maastricht and Department of Internal Medicine, Maastricht University Medical Centre, the Netherlands (T.T.v.S.)
| | - Frederique Thomas
- Investigations Préventives et cliniques (IPC), Paris, France (F.T., N.D.)
| | - Nicolas Danchin
- Investigations Préventives et cliniques (IPC), Paris, France (F.T., N.D.)
| | - James E. Sharman
- Menzies Institute for Medical Research, University of Tasmanian, Hobart, Australia (R.E.C., J.E.S.)
| | | | - Xavier Jouven
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
| | - Jean-Philippe Empana
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
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