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Chansawang K, Lertpimonchai A, Siripaiboonpong N, Thienpramuk L, Vathesatogkit P, Limpijankit T, Charatkulangkun O. The severity and extent of periodontitis is associated with cardio-ankle vascular index, a novel arterial stiffness parameter. Clin Oral Investig 2020; 25:3487-3495. [PMID: 33180188 DOI: 10.1007/s00784-020-03670-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/29/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To evaluate the association between the severity and extent of periodontitis and arterial stiffness using the cardio-ankle vascular index (CAVI). MATERIALS AND METHODS A cross-sectional study of 2888 Electricity Generation Authority of Thailand (EGAT) employees aged 44-78 years was conducted. The severity of periodontitis was evaluated based on mean clinical attachment level (CAL). The percentage of sites with CAL ≥ 5 mm was used to divide the extent of periodontitis into healthy (0%), localized (> 0-< 30%), and generalized (≥ 30%). The CAVI value, a novel blood pressure-independent arterial stiffness parameter, was analyzed as both continuous and categorical data (low: < 9 or high: ≥ 9). Regression analysis was used to estimate the level of association. RESULTS The participants demonstrated a mean CAL, % sites with CAL ≥ 5 mm, and a CAVI value of 3.2 ± 1.2 mm, 16.0 ± 20.8%, and 8.24 ± 1.12, respectively. Higher mean CAVI was observed with greater mean CAL and % sites with CAL ≥ 5 mm. The mean CAVI of the healthy, localized, and generalized periodontitis groups were 8.01 ± 1.11, 8.22 ± 1.12, and 8.51 ± 1.04, respectively (p < 0.01). Linear and logistic regression analysis demonstrated a significant relationship between CAVI and all periodontal variables with β = 0.004-0.17 and OR = 1.01-1.58, respectively. CONCLUSIONS There is a significant dose-dependent association between the severity and extent of periodontitis and arterial stiffness measured by CAVI in Thai adults. CLINICAL RELEVANCE Preventing arterial stiffness, an early sign of cardiovascular events, by controlling the emerging risk factors, such as periodontitis, might have a high impact on health promotion.
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Affiliation(s)
- Kansurang Chansawang
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Pathumwan, Bangkok, 10330, Thailand
| | - Attawood Lertpimonchai
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Pathumwan, Bangkok, 10330, Thailand
- Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Nisachon Siripaiboonpong
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Pathumwan, Bangkok, 10330, Thailand
- Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, 10330, Thailand
| | | | | | | | - Orawan Charatkulangkun
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Pathumwan, Bangkok, 10330, Thailand.
- Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, 10330, Thailand.
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Nuamchit T, Siriwittayawan D, Thitiwuthikiat P. The Relationship Between Glycemic Control and Concomitant Hypertension on Arterial Stiffness in Type II Diabetes. Vasc Health Risk Manag 2020; 16:343-352. [PMID: 32943869 PMCID: PMC7459141 DOI: 10.2147/vhrm.s265157] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/03/2020] [Indexed: 12/27/2022] Open
Abstract
Purpose The impact of glycemic control on macrovascular complications and arterial stiffness in type II diabetes (T2D), as well as the extent of additive effect of hypertension, is unclear. The aims of this study were to investigate the impact of glycemic control on the cardio-ankle vascular index (CAVI), an indicator of arterial stiffness, and to determine the relative risk of concomitant diabetes and hypertension with arterial stiffness. Methods One hundred and nine participants were enrolled and classified as non-diabetes (n= 37) and diabetes (n=72); the diabetic group was further identified as controllable and uncontrollable T2D depending on their hemoglobin A1c (HbA1c) levels. Univariate and multiple regression analyses were used to assess the association between CAVI and glycemic control status and hypertension. Relative risk analysis for abnormal CAVI with exposure to diabetes and hypertension was investigated. Results In all participants, age, systolic blood pressure, body mass index, and fasting blood sugar were independent predictors of CAVI. In diabetic participants, glycemic control status or HbA1c levels did not significantly correlate with CAVI. Systolic blood pressure was an independent predictor for CAVI with β = 0.26. In addition, the coexistence of diabetes together with hypertension was significantly associated with a 2.4-fold increase in the risk of abnormal CAVI (95% CI, 1.410-4.184; p <0.001). Conclusion This study demonstrates that HbA1c as well as fasting blood sugar levels in diabetic participants do not correlate with arterial stiffness. Concomitant diabetes and hypertension significantly increase the risk of arterial stiffness.
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Affiliation(s)
- Teonchit Nuamchit
- Department of Cardiothoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Duangduan Siriwittayawan
- Department of Cardiothoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Piyanuch Thitiwuthikiat
- Department of Cardiothoracic Technology, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
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Gonzalez-Sanchez J, Garcia-Ortiz L, Rodriguez-Sanchez E, Maderuelo-Fernandez JA, Tamayo-Morales O, Lugones-Sanchez C, Recio-Rodriguez JI, Gomez-Marcos MA. The Relationship Between Alcohol Consumption With Vascular Structure and Arterial Stiffness in the Spanish Population: EVA Study. Alcohol Clin Exp Res 2020; 44:1816-1824. [PMID: 32623750 DOI: 10.1111/acer.14411] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Controversy exists regarding the way alcohol use is associated with vascular structure and arterial stiffness parameters. The purpose of this study is to evaluate the association between alcohol consumption with vascular structure and arterial stiffness in an adult population. METHODS We conducted a cross-sectional study. Five hundred and one participants were recruited by random sampling from an urban population of 43,946 individuals aged 35 to 75 years, assigned from 5 healthcare centers located in Salamanca, Spain. This was a subanalysis of the EVA study. Arterial stiffness was assessed by measuring cardio-ankle vascular index (CAVI) and brachial-ankle pulse wave velocity (ba-PWV) with the VaSera VS-1500® device, and carotid-femoral pulse wave velocity (cf-PWV) with the Sphygmocor® . Vascular structure was evaluated by measuring the carotid intima-media thickness (c-IMT) with a Sonosite Micromax® ultrasound. Alcohol consumption was calculated using a standardized questionnaire and quantified in g/wk. RESULTS In the multiple regression analysis adjusted for sex, age, smoking status, and systolic blood pressure, the c-IMT and cf-PWV values of individuals drinking > 70 g/wk were higher than those of the reference group (nondrinkers) by 0.02 mm (p = 0.030) and 0.42 m/s (p = 0.021), respectively. The association between alcohol consumption with vascular structure and arterial stiffness only attains statistical significance for cf-PWV (p = 0.039) and c-IMT (p = 0.019), showing an association which suggests a J-shaped association. This association was not statistically significant for ba-PWV and CAVI (p = 0.446 and p = 0.141, respectively), although a similar trend was observed with ba-PWV. CONCLUSIONS The results of this study suggest that heavy alcohol consumption (>70 g/wk) is associated with increased c-IMT and cf-PWV. Moreover, we found a J-shaped association between alcohol consumption and c-IMT and cf-PWV values as markers of vascular structure and arterial stiffness, with no association with ba-PWV and CAVI being observed.
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Affiliation(s)
- Jesus Gonzalez-Sanchez
- From the, Primary Care Research Unit of Salamanca (APISAL), (JG, LG, ER, JAM, OT, CL, JIR, MAG), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Department of Nursing and Physiotherapy (JG, JIR), University of Salamanca, Salamanca, Spain
| | - Luis Garcia-Ortiz
- From the, Primary Care Research Unit of Salamanca (APISAL), (JG, LG, ER, JAM, OT, CL, JIR, MAG), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences (LG), University of Salamanca, Salamanca, Spain.,Iberian Network on Arterial Structure (LG, ER, MAG), Central Hemodynamics and Neurocognition, Salamanca, Spain
| | - Emiliano Rodriguez-Sanchez
- From the, Primary Care Research Unit of Salamanca (APISAL), (JG, LG, ER, JAM, OT, CL, JIR, MAG), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Iberian Network on Arterial Structure (LG, ER, MAG), Central Hemodynamics and Neurocognition, Salamanca, Spain.,Department of Medicine (ER, MAG), University of Salamanca, Salamanca, Spain
| | - Jose A Maderuelo-Fernandez
- From the, Primary Care Research Unit of Salamanca (APISAL), (JG, LG, ER, JAM, OT, CL, JIR, MAG), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Olaya Tamayo-Morales
- From the, Primary Care Research Unit of Salamanca (APISAL), (JG, LG, ER, JAM, OT, CL, JIR, MAG), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Cristina Lugones-Sanchez
- From the, Primary Care Research Unit of Salamanca (APISAL), (JG, LG, ER, JAM, OT, CL, JIR, MAG), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Jose I Recio-Rodriguez
- From the, Primary Care Research Unit of Salamanca (APISAL), (JG, LG, ER, JAM, OT, CL, JIR, MAG), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Department of Nursing and Physiotherapy (JG, JIR), University of Salamanca, Salamanca, Spain
| | - Manuel A Gomez-Marcos
- From the, Primary Care Research Unit of Salamanca (APISAL), (JG, LG, ER, JAM, OT, CL, JIR, MAG), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Iberian Network on Arterial Structure (LG, ER, MAG), Central Hemodynamics and Neurocognition, Salamanca, Spain.,Department of Medicine (ER, MAG), University of Salamanca, Salamanca, Spain
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Takahashi K, Yamamoto T, Tsuda S, Maruyama M, Shirai K. The Background of Calculating CAVI: Lesson from the Discrepancy Between CAVI and CAVI 0. Vasc Health Risk Manag 2020; 16:193-201. [PMID: 32547046 PMCID: PMC7251085 DOI: 10.2147/vhrm.s223330] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/09/2020] [Indexed: 12/18/2022] Open
Abstract
Arterial stiffness is a good predictor of cardiovascular events. As a substitute for elastic modulus representing stiffness, pulse wave velocity (PWV) has been used for over a century as it is easy to measure; however, PWV is known to essentially depend on blood pressure at the time of measurement. The cardio-ankle vascular index (CAVI) is a relatively new index of global arterial stiffness of the origin of the aorta to the ankle arteries. The characteristic feature is its independency from blood pressure at the measuring time. Recently, a variant index CAVI0 was proposed, which was claimed to be a more accurate arterial stiffness index than CAVI, considering independency from blood pressure. The purpose of this review is to evaluate the properties of CAVI more precisely by comparing with CAVI0, and to confirm the true meaning of CAVI as an index of arterial stiffness. First, the properties of PWV depending on the blood pressure and the variation of PWV values in the cardiac cycle were analyzed. Then, we attempted to clarify the point at which the PWV, adopted in CAVI or in CAVI0, was measured in cardiac cycle. A comprehensive comparison of the clinical data of CAVI and CAVI0 showed that CAVI is more appropriate than CAVI0. In conclusion, CAVI is reconfirmed to be a reliable and useful index of blood pressure-independent arterial stiffness composed of both organic and functional stiffness.
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Zeng X, Zhu H, Liu W, Zhong J, Luo J. Electrocardiogram-Based R Wave Pulse Wave Index for Assessment of Carotid Atherosclerosis. Med Sci Monit 2020; 26:e919606. [PMID: 31941880 PMCID: PMC6984354 DOI: 10.12659/msm.919606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Carotid atherosclerosis (CA) is a common disease in middle-aged and elderly people, which is closely related to cardiovascular and cerebrovascular disease. In this study, we investigated the benefits of the electrocardiogram (ECG)-based R wave pulse wave index (ERWVI) for the diagnosis of CA. MATERIAL AND METHODS According to CA examinations by color Doppler ultrasound, patients were assigned to positive and negative groups. The ECG R wave-Pulse wave transit time (ERWPTT) was obtained by synchronously collecting ECG signals (R wave in ECG) and the time variations in maximum finger pulse oxygen (DOP) on the ECG monitor. RESULTS ERPWI was positively correlated with sex, age, BMI, diastolic/systolic blood pressure, fasting blood glucose, uric acid, cholesterol and triglyceride levels, LDL-cholesterol, non-alcoholic fatty liver disease (NAFLD), creatinine, and homocysteine, and was negatively correlated with HDL-cholesterol (P<0.05). With the increase of ERPWI, the incidence of CA significantly increased to various degrees among the subgroups (P<0.05). The binary logistic regression model showed that ERPWI was an independent risk factor for atherosclerosis. The ROC curve showed that when ERPWI was above 0.505, the incidence of CA increased significantly. CONCLUSIONS There is a close relationship between ERPWI and CA. ERPWI is an independent risk factor for CA. ERPWI ≥0.505 can be used as a diagnostic threshold for CA and a reference index for the diagnosis of CA.
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Affiliation(s)
- XiangHui Zeng
- Department of Cardiology, Ganzhou Municipal Hospital, Ganzhou, Jiangxi, China (mainland)
| | - HengQing Zhu
- Department of Cardiology, Ganzhou Municipal Hospital, Ganzhou, Jiangxi, China (mainland)
| | - WeiBin Liu
- Department of Cardiology, Ganzhou Municipal Hospital, Ganzhou, Jiangxi, China (mainland)
| | - JiuDong Zhong
- Department of Physical Examination, Ganzhou Municipal Hospital, Ganzhou, Jiangxi, China (mainland)
| | - JianPing Luo
- Department of Cardiology, Ganzhou People's Hospital, Ganzhou, Jiangxi, China (mainland)
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