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Duan Q, Zhang D, Dong Q, Liao K, Yang Y, Ye L, Ge P, Qin S. Impact of Brachial-Ankle Pulse Wave Velocity on Myocardial Work by Non-invasive Left Ventricular Pressure-Strain in Non-hypertensive and Hypertensive Patients With Preserved Left Ventricular Ejection Fraction. Front Cardiovasc Med 2022; 9:814326. [PMID: 35224047 PMCID: PMC8866308 DOI: 10.3389/fcvm.2022.814326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/12/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Data regarding the influence of arterial stiffness on myocardial work (MW) has been scarce. This study was performed to investigate the association between brachial-ankle pulse wave velocity (baPWV) and MW by non-invasive left ventricular pressure–strain in a population of non-hypertensive and hypertensive individuals. Methods Two hundred and eight participants (104 hypertensive and 104 non-hypertensive individuals) were prospectively enrolled into the study. All participants underwent conventional echocardiography, as well as 2D speckle-tracking echocardiography to assess MW by non-invasive left ventricular pressure–strain and global longitudinal strain (GLS). baPWV measurements were made at the same day as the echocardiography. Then, participants were categorized according to baPWV tertiles. Correlation between baPWV and MW were analyzed. Predicting ability of baPWV for abnormal WM was analyzed using receiver operating characteristic (ROC) curve. Results The median baPWV from the low to high tertile groups were 1286.5 (1197.5–1343.5), 1490.0 (1444.5–1544.0), and 1803.8(1708.3–1972.0) cm/s, respectively. In simple linear regression analysis, baPWV had a significant positive association with global work index (GWI), global constructed work (GCW), and global wasted work (GWW), and a negative association with global work efficiency (GWE). The association remained significant after adjusting for major confounding factors in multiple linear regression analysis. The areas under the ROC curve of baPWV for predicting abnormal GWI, GCW, GWW, and GWE were 0.653, 0.666, 0.725, and 0.688, respectively (all p < 0.05). Conclusions BaPWV is significantly associated with all four components of MW using non-invasive left ventricular pressure-strain method in a mixed population of non-hypertensive and hypertensive individuals.
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Affiliation(s)
- Qin Duan
- Department of Cardiology, The First Branch, The First Affiliated Hospital of Chongqing Medical University, Chognqing, China
| | - Dongying Zhang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qian Dong
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Kangla Liao
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yunjin Yang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Liu Ye
- Department of Cardiology, The First Branch, The First Affiliated Hospital of Chongqing Medical University, Chognqing, China
| | - Ping Ge
- Department of Cardiology, The First Branch, The First Affiliated Hospital of Chongqing Medical University, Chognqing, China
- *Correspondence: Ping Ge
| | - Shu Qin
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Shu Qin
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102
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Cuffless Blood Pressure Measurement Using Linear and Nonlinear Optimized Feature Selection. Diagnostics (Basel) 2022; 12:diagnostics12020408. [PMID: 35204499 PMCID: PMC8870879 DOI: 10.3390/diagnostics12020408] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 01/30/2022] [Accepted: 01/30/2022] [Indexed: 02/04/2023] Open
Abstract
The cuffless blood pressure (BP) measurement allows for frequent measurement without discomfort to the patient compared to the cuff inflation measurement. With the availability of a large dataset containing physiological waveforms, now it is possible to use them through different learning algorithms to produce a relationship with changes in BP. In this paper, a novel cuffless noninvasive blood pressure measurement technique has been proposed using optimized features from electrocardiogram and photoplethysmography based on multivariate symmetric uncertainty (MSU). The technique is an improvement over other contemporary methods due to the inclusion of feature optimization depending on both linear and nonlinear relationships with the change of blood pressure. MSU has been used as a selection criterion with algorithms such as the fast correlation and ReliefF algorithms followed by the penalty-based regression technique to make sure the features have maximum relevance as well as minimum redundancy. The result from the technique was compared with the performance of similar techniques using the MIMIC-II dataset. After training and testing, the root mean square error (RMSE) comes as 5.28 mmHg for systolic BP and 5.98 mmHg for diastolic BP. In addition, in terms of mean absolute error, the result improved to 4.27 mmHg for SBP and 5.01 for DBP compared to recent cuffless BP measurement techniques which have used substantially large datasets and feature optimization. According to the British Hypertension Society Standard (BHS), our proposed technique achieved at least grade B in all cumulative criteria for cuffless BP measurement.
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103
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Wei FF, Wu Y, Xue R, Liu X, He X, Dong B, Zhen Z, Chen X, Liang W, Zhao J, He J, Dong Y, Staessen JA, Liu C. Clinical Significance of Mean and Pulse Pressure in Patients With Heart Failure With Preserved Ejection Fraction. Hypertension 2022; 79:241-250. [PMID: 34739763 PMCID: PMC8654124 DOI: 10.1161/hypertensionaha.121.17782] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/04/2021] [Indexed: 01/10/2023]
Abstract
It remains debated whether pulse pressure is associated with left ventricular traits and adverse outcomes over and beyond mean arterial pressure (MAP) in patients with heart failure (HF) with preserved ejection fraction. We investigated these associations in 3428 patients with HF with preserved ejection fraction (51.5% women; mean age, 68.6 years) enrolled in the TOPCAT trial (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist). We computed association sizes and hazards ratios with 1-SD increase in MAP and pulse pressure. In multivariable-adjusted analyses, association sizes (P≤0.039) for MAP were 0.016 cm and 0.014 cm for septal and posterior wall thickness, -0.15 for E/A ratio, -0.66 for E/e', and -0.64% for ejection fraction, independent of pulse pressure. With adjustment additionally applied for MAP, E/A ratio and longitudinal strain increased with higher pulse pressure with association sizes amounting to 0.067 (P=0.026) and 0.40% (P=0.023). In multivariable-adjusted analyses of both placebo and spironolactone groups, lower MAP and higher pulse pressure predicted the primary composite end point (P≤0.028) and hospitalized HF (P≤0.002), whereas MAP was also significantly associated with total mortality (P≤0.007). Sensitivity analyses stratified by sex, median age, and region generated confirmatory results with exception for the association of adverse outcomes with pulse pressure in patients with age ≥69 years. In conclusion, the clinical application of MAP and pulse pressure may refine risk estimates in patients with HF with preserved ejection fraction. This finding may help further investigation for the development of HF with preserved ejection fraction preventive strategies targeting pulsatility and blood pressure control.
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Affiliation(s)
- Fang-Fei Wei
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
| | - Yuzhong Wu
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
| | - Ruicong Xue
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
| | - Xiao Liu
- Department of Cardiology, the Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (X.L.)
| | - Xin He
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
| | - Bin Dong
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
| | - Zhe Zhen
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
| | - Xuwei Chen
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
| | - Weihao Liang
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
| | - Jingjing Zhao
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
| | - Jiangui He
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
| | - Yugang Dong
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
- National Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Disease, Guangzhou, China (Y.D., C.L.)
| | - Jan A. Staessen
- Research Institute Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium (J.A.S.)
- Biomedical Science Group, University of Leuven, Belgium (J.A.S.)
| | - Chen Liu
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
- NHC Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, China (F.-F.W., Y.W., R.X., X.H., B.D., Z.Z., X.C., W.L., J.Z., J.H., Y.D., C.L.)
- National Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Disease, Guangzhou, China (Y.D., C.L.)
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104
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Mansouri S, Alharbi Y, Alshrouf A, Alqahtani A. Cardiovascular Diseases Diagnosis by Impedance Cardiography. JOURNAL OF ELECTRICAL BIOIMPEDANCE 2022; 13:88-95. [PMID: 36694881 PMCID: PMC9837870 DOI: 10.2478/joeb-2022-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Indexed: 06/17/2023]
Abstract
Cardiovascular disease (CVD) represents the leading cause of mortality worldwide. In order to diagnose CVDs, there are a range of detection methods, among them, the impedance cardiography technique (ICG). It is a non-invasive and low-cost method. In this paper, we highlight recent advances and developments of the CDVs diagnosis mainly by the ICG method. We considered papers published during the last five years (from 2017 until 2022). Based on this study, we expressed the need for an ICG database for the different CDVs.
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Affiliation(s)
- Sofiene Mansouri
- Department of Biomedical Technology, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Laboratory of Biophysics and Medical Technologies, Higher Institute of Medical Technologies of Tunis, University of Tunis El Manar, TunisTunisia
| | - Yousef Alharbi
- Department of Biomedical Technology, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Anwar Alshrouf
- Department of Biomedical Technology, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Abdulrahman Alqahtani
- Department of Biomedical Technology, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Department of Medical Equipment Technology, College of Applied Medical Science, Majmaah University, Majmaah City, Saudi Arabia
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105
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Zhang H, Sun M, Hu Z, Cao Y, Hao M, Li Y, Jin L, Sun X, Wang X, Jiang X. Association of Arterial Stiffness with Functional Disability and Mobility Limitation: The Rugao Longitudinal Ageing Study. J Nutr Health Aging 2022; 26:598-605. [PMID: 35718869 DOI: 10.1007/s12603-022-1802-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Arterial stiffness is a common issue that may represent an indicator of vascular ageing. We aimed to investigate the association of arterial stiffness with the risk of functional disability and mobility limitation in older adults. DESIGN Prospective cohort study. SETTING AND PARTICIPANTS A total of 1699 older adults from the Rugao Longitudinal Ageing Study were included and analysed. MEASUREMENTS Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV). Functional disability and mobility limitation were evaluated by the activities of daily living and the Timed Up and Go test, respectively. The associations of baPWV and risk of functional disability and mobility limitation were analysed using logistic regression models. Restricted cubic spline regressions were applied to estimate the possible nonlinear relationships between them. RESULTS During the 3.5-year follow-up, 97 (10.00%) and 285 (31.11%) individuals were defined as new-onset functional disability and mobility limitation, respectively. After adjusting for confounding factors, elevated baPWV was significantly associated with a higher risk of incident functional disability (odds ratio [OR] 1.18, 95% confidence interval [CI] 1.06-1.31) and mobility limitation (OR 1.08, 95% CI 1.01-1.16). Additionally, consistent results were obtained from the stratified analyses of the different subgroups. Multivariable restricted cubic spline regression analysis further demonstrated that a near-linear association occurred between baPWV and the risk of incident functional disability and mobility limitation (P-overall < 0.01, P-nonlinear >0.05). CONCLUSION Arterial stiffness, as assessed by baPWV, was associated with the risk of functional disability and mobility limitation in this community-based cohort, and these associations were nearly linear.
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Affiliation(s)
- H Zhang
- Xiaoyan Jiang, Key Laboratory of Arrhythmias, Ministry of Education, Department of Pathology and Pathophysiology, School of Medicine, Tongji University, Shanghai, China. E-mail address:
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106
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Agbaje AO, Barker AR, Tuomainen TP. Effects of Arterial Stiffness and Carotid Intima-Media Thickness Progression on the Risk of Overweight/Obesity and Elevated Blood Pressure/Hypertension: a Cross-Lagged Cohort Study. Hypertension 2022; 79:159-169. [PMID: 34784721 PMCID: PMC8654123 DOI: 10.1161/hypertensionaha.121.18449] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 10/28/2021] [Indexed: 12/19/2022]
Abstract
We examined the temporal longitudinal associations of carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness, and carotid intima-media thickness (cIMT) with the risk of overweight/obesity and elevated blood pressure (BP)/hypertension. We studied 3862 adolescents aged 17.7 years from the Avon Longitudinal Study of Parents and Children, followed-up for 7 years. cfPWV and cIMT were measured by ultrasound. Total and trunk fat mass and lean mass were assessed by dual-energy X-ray absorptiometry. Body mass index and BP were measured. Data were analyzed using logistic regression, linear mixed-effect, and cross-lagged structural equation models, with covariate adjustments. Among 1719 male and 2143 female participants, higher cfPWV at 17.7 years was associated with the risk of elevated systolic BP/hypertension (odds ratio, 1.20 [1.02-1.41]; P=0.026), elevated diastolic BP/hypertension (1.77 [1.32-2.38]; P<0.0001), body mass index-overweight/obesity (1.19 [1.01-1.41]; P=0.041), and trunk fat mass overweight/obesity (1.24 [1.03-1.49]; P=0.023) at 24.5 years. Higher cIMT at 17.7 years had no associations with obesity and elevated BP at follow-up. cfPWV progression was directly associated with 7-year increase in systolic BP (effect estimate 16 mm Hg [9-24]; P<0.0001) and diastolic BP (28 mm Hg [23-34]; P<0.0001). cIMT progression was directly associated with the 7-year increase of all adiposity measures and diastolic BP. In the temporal analysis, baseline cfPWV was directly associated with follow-up systolic and diastolic BP, however, baseline BP was unassociated with follow-up cfPWV. cfPWV but not cIMT was bidirectionally associated with adiposity. Obesity and hypertension prevention from adolescence may require developing novel approaches to mitigate arterial stiffness.
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Affiliation(s)
- Andrew O. Agbaje
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland (A.O.A., T.-P.T.)
| | - Alan R. Barker
- Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, United Kingdom (A.R.B.)
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland (A.O.A., T.-P.T.)
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107
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Vatner SF, Zhang J, Vyzas C, Mishra K, Graham RM, Vatner DE. Vascular Stiffness in Aging and Disease. Front Physiol 2021; 12:762437. [PMID: 34950048 PMCID: PMC8688960 DOI: 10.3389/fphys.2021.762437] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 10/26/2021] [Indexed: 01/01/2023] Open
Abstract
The goal of this review is to provide further understanding of increased vascular stiffness with aging, and how it contributes to the adverse effects of major human diseases. Differences in stiffness down the aortic tree are discussed, a topic requiring further research, because most prior work only examined one location in the aorta. It is also important to understand the divergent effects of increased aortic stiffness between males and females, principally due to the protective role of female sex hormones prior to menopause. Another goal is to review human and non-human primate data and contrast them with data in rodents. This is particularly important for understanding sex differences in vascular stiffness with aging as well as the changes in vascular stiffness before and after menopause in females, as this is controversial. This area of research necessitates studies in humans and non-human primates, since rodents do not go through menopause. The most important mechanism studied as a cause of age-related increases in vascular stiffness is an alteration in the vascular extracellular matrix resulting from an increase in collagen and decrease in elastin. However, there are other mechanisms mediating increased vascular stiffness, such as collagen and elastin disarray, calcium deposition, endothelial dysfunction, and the number of vascular smooth muscle cells (VSMCs). Populations with increased longevity, who live in areas called “Blue Zones,” are also discussed as they provide additional insights into mechanisms that protect against age-related increases in vascular stiffness. Such increases in vascular stiffness are important in mediating the adverse effects of major cardiovascular diseases, including atherosclerosis, hypertension and diabetes, but require further research into their mechanisms and treatment.
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Affiliation(s)
- Stephen F Vatner
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
| | - Jie Zhang
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
| | - Christina Vyzas
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
| | - Kalee Mishra
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
| | - Robert M Graham
- Victor Chang Cardiac Research Institute, University of New South Wales, Darlinghurst, NSW, Australia
| | - Dorothy E Vatner
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
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108
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Chen H, Wu W, Fang W, Chen Z, Yan X, Chen Y, Wu S. Does an increase in estimated pulse wave velocity increase the incidence of hypertension? J Hypertens 2021; 39:2388-2394. [PMID: 34261958 DOI: 10.1097/hjh.0000000000002945] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE As a risk indicator of hypertension, arterial stiffness is difficult to measure. Thus, we aimed to evaluate the association between estimated pulse wave velocity (ePWV) as a convenient indicator and the incidence of hypertension. METHODS The Kailuan cohort was selected for statistical analysis and 54 849 individuals were included in the final cohort. Multiple linear regression was used to analyse the correlation between ePWV and mean SBP (SBP_m) measured at five time points over a 10-year period and between ePWV and mean DBP (DBP_m) measured at five time points over a 10-year period. Logistic regression was used to analyse the effect of estimated arterial stiffness on hypertension. RESULTS The mean age of individuals was 48.44 ± 9.32 years, and 41 419 individuals (75.51%) were male. A multiple linear regression analysis showed that ePWV was positively correlated with both SBP_m and DBP_m. For every 1 cm/s increase in ePWV, SBP_m and DBP_m increased by 5.60 and 2.12 mmHg, respectively. A logistic regression analysis showed that in the total cohort, the incidence of hypertension in populations with moderate, moderate-high and high ePWV values was 3.03, 5.44 and 7.87-times higher, respectively, compared with individuals with low ePWV values. ePWV had a higher predictive value in female and middle age population compared with male and the eldly population grouped by sex and age respectively. CONCLUSION ePWV positively correlates with both SBP_m and DBP_m, and an increase in ePWV is associated with an increase in the incidence of hypertension.
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Affiliation(s)
- Haojia Chen
- Shantou University Medical College
- Department of Cardiology, First Hospital of Medical College of Shantou University
| | - Weiqiang Wu
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong
| | - Wei Fang
- Shantou University Medical College
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong
| | - Zhichao Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong
| | - Xiuzhu Yan
- School of Foreign Language, Guangdong Polytechnic Normal University, Guangzhou, Guangdong, China
| | - Youren Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan
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109
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叶 飞, 史 桂, 王 晓, 涂 珊, 张 志, 曾 丽. [Renal sympathetic denervation can significantly reduce blood pressure and improve arterial stiffness in hypertensive beagles]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:1609-1615. [PMID: 34916185 PMCID: PMC8685710 DOI: 10.12122/j.issn.1673-4254.2021.11.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate the effect of renal sympathetic denervation (RDN) on blood pressure and arterial stiffness in hypertensive beagles and explore the underlying mechanism. METHODS Sixteen beagles were randomly divided into RDN group (n=8, fed with a high-salt high-fat diet to establish models of hypertension and treated with RDN), sham-operated group (n=4, fed with a high-salt high-fat diet to induce hypertension but only examined with renal arteriography) and control group (n=4, fed with formula dog food). The changes in blood pressure, arterial stiffness, endothelial function, and sympathetic activity were compared among the 3 groups and correlation analysis was performed. RESULTS All the animal models of hypertension were established successfully in the beagles. At 3 months after the RDN, the changes in systolic blood pressure (SBP) differed significantly among the 3 groups (P=0.006), and the reduction in SBP was significantly greater in RDN group than in the other two groups (P < 0.05). The variations of diastolic blood pressure (DBP) also differed significantly among the 3 groups (P=0.016), and DBP reduction was more obvious in RDN group than in the control group (P=0.007), but similar to that in the sham-operated group (P=0.052). The changes of resistance index (RI) after the procedure were significantly different among the 3 groups (P=0.043), and the RDN group showed a greater reduction of RI than the control group (P=0.032) and sham group (P=0.043). Serum levels of eNOS, NO and Ang Ⅱ did not differ significantly among the groups either before or after RDN (P>0.05), but serum NE level was significantly higher in RDN group than in the control groupafter successful modeling (P=0.014), but similar to that in the sham group (P=0.560). Compared with the sham operation, RDN in the hypertensive beagles resulted in a significantly greater decrease of serum NE level (P=0.032) to almost the control level (P= 0.080). The changes of RI following RDN were significantly correlated with the changes of SBP, DBP and serum levels of NO and NE (P < 0.05). CONCLUSION RDN can significantly reduce blood pressure and improve arterial stiffness in hypertensive beagles possibly by reducing sympathetic activity and blood pressure and promoting NO synthesis.
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Affiliation(s)
- 飞 叶
- 中南大学湘雅三医院心内科,湖南 长沙 410013Department of Cardiology, Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - 桂霞 史
- 长沙卫生职业学院,湖南 长沙 410013Internal Medicine, Changsha Health Vocational College, Changsha 410013, China
| | - 晓艳 王
- 中南大学湘雅三医院心内科,湖南 长沙 410013Department of Cardiology, Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - 珊 涂
- 中南大学湘雅三医院心内科,湖南 长沙 410013Department of Cardiology, Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - 志辉 张
- 中南大学湘雅三医院心内科,湖南 长沙 410013Department of Cardiology, Third Xiangya Hospital of Central South University, Changsha 410013, China
| | - 丽雄 曾
- 中南大学湘雅三医院心内科,湖南 长沙 410013Department of Cardiology, Third Xiangya Hospital of Central South University, Changsha 410013, China
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Zhao K, Wu T, Yang C, Pan H, Xu T, Zhang J, Guo X, Tu J, Zhang D, Kong X, Zhou B, Sun W. Low-intensity pulsed ultrasound prevents angiotensin II-induced aortic smooth muscle cell phenotypic switch via hampering miR-17-5p and enhancing PPAR-γ. Eur J Pharmacol 2021; 911:174509. [PMID: 34547245 DOI: 10.1016/j.ejphar.2021.174509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 10/20/2022]
Abstract
Vascular events can trigger a pathological phenotypic switch in vascular smooth muscle cells (VSMCs), decreasing and disrupting the plasticity and diversity of vascular networks. The development of novel therapeutic approaches is necessary to prevent these changes. We aimed to investigate the effects and associated mechanisms of low-intensity pulsed ultrasound (LIPUS) irradiation on the angiotensin II (AngII)-induced phenotypic switch in VSMCs. In vivo, AngII was infused subcutaneously for 4 weeks to stimulate vascular remodeling in mice, and LIPUS irradiation was applied for 20 min every 2 days for 4 weeks. In vitro, cultured rat aortic VSMCs (RAVSMCs) were pretreated once with LIPUS irradiation for 20 min before 48-h AngII stimulation. Our results showed that LIPUS irradiation prevents AngII-induced vascular remodeling of the whole wall artery without discriminating between adventitia and media in vivo and RAVSMC phenotypic switching in vitro. LIPUS irradiation downregulated miR-17-5p expression and upregulated peroxisome proliferator-activated receptor gamma (PPAR-γ) expression. The PPAR-γ activator rosiglitazone could mimic the favorable effects of LIPUS irradiation on AngII-treated RAVSMCs. In contrast, GW9662 could impede the LIPUS-mediated downregulation of RAVSMC proliferation and inflammation under AngII stimulation conditions in vivo and in vitro. Also, the miR-17-5p agomir has the same effects as GW9662 in vitro. Besides, the inhibitory effects of GW9662 against the anti-remodeling effects of LIPUS irradiation in AngII-induced RAVSMCs could be blocked by pretreatment with the miR-17-5p antagomir. Overall, LIPUS irradiation prevents AngII-induced RAVSMCs phenotypic switching through hampering miR-17-5p and enhancing PPAR-γ, suggesting a new approach for the treatment of vascular disorders.
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MESH Headings
- Animals
- MicroRNAs/genetics
- MicroRNAs/metabolism
- PPAR gamma/metabolism
- PPAR gamma/genetics
- Angiotensin II/pharmacology
- Male
- Rats
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/radiation effects
- Muscle, Smooth, Vascular/cytology
- Myocytes, Smooth Muscle/drug effects
- Myocytes, Smooth Muscle/metabolism
- Myocytes, Smooth Muscle/radiation effects
- Phenotype
- Ultrasonic Waves
- Aorta/drug effects
- Aorta/metabolism
- Aorta/cytology
- Vascular Remodeling/drug effects
- Vascular Remodeling/radiation effects
- Cells, Cultured
- Mice
- Rats, Sprague-Dawley
- Mice, Inbred C57BL
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Affiliation(s)
- Kun Zhao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Tingting Wu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Chuanxi Yang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China; Department of Cardiology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, 200082, China
| | - Haotian Pan
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Tianhua Xu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Jing Zhang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Xiasheng Guo
- Key Laboratory of Modern Acoustics, Department of Physics, Collaborative Innovation Center of Advanced Microstructure, Nanjing University, Nanjing, Jiangsu, 210093, China
| | - Juan Tu
- Key Laboratory of Modern Acoustics, Department of Physics, Collaborative Innovation Center of Advanced Microstructure, Nanjing University, Nanjing, Jiangsu, 210093, China
| | - Dong Zhang
- Key Laboratory of Modern Acoustics, Department of Physics, Collaborative Innovation Center of Advanced Microstructure, Nanjing University, Nanjing, Jiangsu, 210093, China
| | - Xiangqing Kong
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Bin Zhou
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China; Department of Genetics, Pediatrics and Medicine Cardiology, Wilf Cardiovascular Research Institute, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Wei Sun
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
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Tsai SY, Huang WH, Chan HL, Hwang LC. The role of smoking cessation programs in lowering blood pressure: A retrospective cohort study. Tob Induc Dis 2021; 19:82. [PMID: 34720797 PMCID: PMC8534426 DOI: 10.18332/tid/142664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 06/11/2021] [Accepted: 09/28/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Cigarette smoking affects blood pressure and is a major risk factor for cardiovascular diseases. The role of smoking cessation programs with respect to blood pressure remains inconclusive. Thus, this study aimed to investigate the effects of a smoking cessation program on blood pressure. METHODS Participants who attended the smoking cessation program in an outpatient clinic of a tertiary medical center in Taiwan from 2017 to 2018 were enrolled in this retrospective cohort study. Their smoking cessation status was traced via phone calls during the third month, and the researchers collected participant characteristics and blood pressure before and after the program. Differences in the participants’ blood pressure, based on those with and those without hypertension, were compared using analysis of covariance. Univariable logistic regression models were used to determine factors associated with success in smoking cessation. In total, there were 721 participants. The participants had a mean age of 55.8±11.4 years and 68.1% of the participants were hypertensive. RESULTS During the program, the overall systolic blood pressure decreased by 4.0±17.9 mmHg and diastolic blood pressure decreased by 2.5±12.0 mmHg, from the baseline. Hypertensive participants showed a more prominent blood pressure lowering effect compared to non-hypertensive participants in terms of the subtraction difference of systolic blood pressure (-5.0±19.0 vs -1.9±15.2 mmHg, p=0.018) and diastolic blood pressure (-3.1±12.9 vs -1.1±9.6 mmHg, p=0.016). After multivariate control, the results showed that the adjusted subtraction difference of diastolic blood pressure was still more significant in the hypertensive group than in the non-hypertensive group. CONCLUSIONS The smoking cessation program significantly reduced both systolic blood pressure and diastolic blood pressure in the entire cohort. The results were more significant in the hypertensive group compared to the non-hypertensive group.
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Affiliation(s)
- Szu-Ying Tsai
- Department of Family Medicine, Mackay Memorial Hospital, Taipei City, Taiwan.,Department of Family Medicine, Taipei City Hospital, Zhongxing Branch, Taipei City, Taiwan
| | - Wei-Hsin Huang
- Department of Family Medicine, Mackay Memorial Hospital, Taipei City, Taiwan
| | - Hsin-Lung Chan
- Department of Family Medicine, Mackay Memorial Hospital, Taipei City, Taiwan
| | - Lee-Ching Hwang
- Department of Family Medicine, Mackay Memorial Hospital, Taipei City, Taiwan.,Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
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Li Y, Tai HC, Sladojevic N, Kim HH, Liao JK. Vascular Stiffening Mediated by Rho-Associated Coiled-Coil Containing Kinase Isoforms. J Am Heart Assoc 2021; 10:e022568. [PMID: 34612053 PMCID: PMC8751888 DOI: 10.1161/jaha.121.022568] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The pathogenesis of vascular stiffening and hypertension is marked by non‐compliance of vessel wall because of deposition of collagen fibers, loss of elastin fibers, and increased vascular thickening. Rho/Rho‐associated coiled‐coil containing kinases 1 and 2 (ROCK1 and ROCK2) have been shown to regulate cellular contraction and vascular remodeling. However, the role of ROCK isoforms in mediating pathogenesis of vascular stiffening and hypertension is not known. Methods and Results Hemizygous Rock mice (Rock1+/− and Rock2+/−) were used to determine the role of ROCK1 and ROCK2 in age‐related vascular dysfunction. Both ROCK activity and aortic stiffness increased to a greater extent with age in wild‐type mice compared with that of Rock1+/− and Rock2+/− mice. As a model for age‐related vascular stiffening, we administered angiotensin II (500 ng/kg per minute) combined with nitric oxide synthase inhibitor, L‐Nω‐nitroarginine methyl ester (0.5 g/L) for 4 weeks to 12‐week‐old male Rock1+/− and Rock2+/− mice. Similar to advancing age, angiotensin II/L‐Nω‐nitroarginine methyl ester caused increased blood pressure, aortic stiffening, and vascular remodeling, which were attenuated in Rock2+/−, and to a lesser extent, Rock1+/− mice. The reduction of aortic stiffening in Rock2+/− mice was accompanied by decreased collagen deposition, relatively preserved elastin content, and less aortic wall hypertrophy. Indeed, the upregulation of collagen I by transforming growth factor‐β1 or angiotensin II was greatly attenuated in Rock2−/− mouse embryonic fibroblasts. Conclusions These findings indicate that ROCK1 and ROCK2 mediate both age‐related and pharmacologically induced aortic stiffening, and suggest that inhibition of ROCK2, and to a lesser extent ROCK1, may have therapeutic benefits in preventing age‐related vascular stiffening.
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Affiliation(s)
- Yuxin Li
- Division of Cell Regeneration and Transplantation Department of Functional Morphology Nihon University School of Medicine Tokyo Japan
| | - Haw-Chih Tai
- Section of Cardiology Department of Medicine University of Chicago IL
| | - Nikola Sladojevic
- Section of Cardiology Department of Medicine University of Chicago IL
| | - Hyung-Hwan Kim
- Neurovascular Laboratory Massachusetts General Hospital and Harvard Medical School Boston MA
| | - James K Liao
- Section of Cardiology Department of Medicine University of Chicago IL
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Hong J, Zheng Y, Wu S, Geng G, Liu Q, Poon CCY. Characterization of the vascular system using overnight wearable-based pulse arrival time and ambulatory blood pressure: A pilot study. Comput Biol Med 2021; 137:104861. [PMID: 34530334 DOI: 10.1016/j.compbiomed.2021.104861] [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: 07/01/2021] [Revised: 08/18/2021] [Accepted: 09/07/2021] [Indexed: 11/27/2022]
Abstract
Pulse arrival time (PAT) has been broadly investigated for its potential for cuffless blood pressure (BP) estimation and ease of measurement by wearable devices. It is also of great significance to explore whether PAT conveys complementary information to BP for vascular health assessment. In this paper, the differences between the 24-h ambulatory BP and wearable-based PAT were compared among 12 young normotensives and 15 elderly hypertensives in terms of the mean and coefficients of variation (CoVs). The correlations of the nocturnal normalized PAT (n-PAT) and BP with two arterial stiffness-related parameters (i.e., the intrinsic elastic modulus E0 and the vascular modulation factor α) estimated by a proposed model-based method were also compared. The results showed that the inter-subject variances of the nocturnal average n-PAT were significantly different between the hypertensives and the normotensives (P < 0.001), and the intra-subject CoVs of the nocturnal n-PAT were also significantly different between the two groups (P < 0.05). However, these findings were not shown in the nocturnal BP. The correlation coefficient between the nocturnal average n-PAT and ln(E0) is larger than that with the nocturnal BP, i.e., 0.91 vs. 0.56. Furthermore, the result also revealed that all the hypertensives receiving antihypertensive medications did not achieve the optimal control of the nocturnal BP while presented diverse arterial stiffness indicated by the nocturnal average n-PAT and ln(E0). It is concluded that wearable-based PAT contains complementary information about the vascular system to the ambulatory BP, which may be useful for designing effective antihypertensive treatments.
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Affiliation(s)
- Jingyuan Hong
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
| | - Yali Zheng
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China.
| | - Shenghao Wu
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
| | - Guoqiang Geng
- College of Health Science and Environmental Engineering, Shenzhen Technology University, Shenzhen, China
| | - Qing Liu
- School of Advanced Technology, Xi'an Jiaotong-Liverpool University, Suzhou, China
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Yoon BK, Sung J, Song YM, Kim SM, Son KA, Yoo JH, Park SJ, Kim DK. Effects of menopausal hormone therapy on ambulatory blood pressure and arterial stiffness in postmenopausal Korean women with grade 1 hypertension: a randomized, placebo-controlled trial. Clin Hypertens 2021; 27:18. [PMID: 34521477 PMCID: PMC8442403 DOI: 10.1186/s40885-021-00175-1] [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] [Received: 09/26/2020] [Accepted: 06/15/2021] [Indexed: 01/14/2023] Open
Abstract
Background Estrogen therapy in early menopausal women decreases the risk of coronary heart disease and parenteral, but not oral, estrogen is reported to reduce blood pressure (BP). Progestogens are typically added to estrogens to prevent unopposed endometrial stimulation. The effects of progestogen on BP have been less well studied to date. This study was conducted to explore the impacts of micronized progesterone (MP4) combined with percutaneous estradiol gel (PEG) on hemodynamics in postmenopausal Korean women with grade 1 hypertension. Methods Fifty-two postmenopausal women (aged 49–75 years) with systolic BP (SBP) of 140–160 mmHg or diastolic BP (DBP) of 90–100 mmHg were randomly assigned for 12 weeks to placebo (n = 16), estrogen therapy (ET) (n = 19) with PEG (0.1 %, 1 g./d), or estrogen + progestogen therapy (EPT, n = 17) with PEG and MP4 (100 mg/d). The primary endpoint was ambulatory BP and the secondary endpoints were arterial stiffness as brachial–ankle pulse-wave velocity (baPWV) and aortic parameters on applanation tonometry. Results One woman in the ET group dropped out, so 51 participants were finally analyzed. Outcome measures for ambulatory BP and arterial stiffness were not different between groups. Within-group comparisons showed that EPT significantly decreased daytime heart rate and baPWV: the changes from baseline (mean ± standard deviation) were − 2.5 ± 5.7 bpm (P = 0.03) and − 0.6 ± 1.4 m/s (P = 0.04), respectively. After adjusting for baseline, linear regression analysis revealed a significant difference in the relationship between baseline and 12-week baPWV among groups (P = 0.02). The relationship was significantly different between placebo and ET (P = 0.03) and EPT (P = 0.01), respectively, but not between ET and EPT. Additionally, pooled results of active treatments disclosed that SBP, DBP, PWV, and augmentation index at the aorta were significantly reduced relative to baseline. Conclusions There was no difference in ambulatory BP between ET and EPT in postmenopausal Korean women with grade 1 hypertension. Further, ET and EPT similarly decreased baPWV from baseline as compared with placebo. MP4 might not adversely influence estrogen effects on ambulatory BP and arterial stiffness. Trial registration Clinical Research Information Registry, KCT0005405, Registered 22 September 2020 - Retrospectively registered, https://cris.nih.go.kr/cris/search/detailSearch.do?all_type=Y&search_page=L&pageSize=10&page=1&seq=17608&search_lang=E. Supplementary Information The online version contains supplementary material available at 10.1186/s40885-021-00175-1.
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Affiliation(s)
- Byung-Koo Yoon
- Department of Obstetrics, Gynecology, and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Jidong Sung
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Yun-Mi Song
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Soo-Min Kim
- Department of Obstetrics, Gynecology, and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyung-A Son
- Department of Obstetrics, Gynecology, and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jun Hyun Yoo
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sung-Ji Park
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Duk-Kyung Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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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: 50] [Impact Index Per Article: 16.7] [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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Chi C, Liu Y, Xu Y, Xu D. Association Between Arterial Stiffness and Heart Failure With Preserved Ejection Fraction. Front Cardiovasc Med 2021; 8:707162. [PMID: 34458336 PMCID: PMC8385653 DOI: 10.3389/fcvm.2021.707162] [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: 05/09/2021] [Accepted: 07/14/2021] [Indexed: 01/23/2023] Open
Abstract
Cardiovascular diseases are the leading cause of mortality in the world. Heart failure with preserved ejection fraction (HFpEF) accounts for about half of all heart failure. Unfortunately, the mechanisms of HFpEF are still unclear, leading to little progress of effective treatment of HFpEF. Arterial stiffness is the decrement of arterial compliance. The media of large arteries degenerate in both physiological and pathological conditions. Many studies have proven that arterial stiffness is an independent risk factor for cardiovascular disorders including diastolic dysfunction. In this perspective, we discussed if arterial stiffness is related to HFpEF, and how does arterial stiffness contribute to HFpEF. Finally, we briefly summarized current treatment strategies on arterial stiffness and HFpEF. Though some new drugs were developed, the safety and effectiveness were not adequately assessed. New pharmacologic treatment for arterial stiffness and HFpEF are urgently needed.
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Affiliation(s)
- Chen Chi
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yifan Liu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Dachun Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
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118
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D'Elia L, Barbato A, Iacone R, Russo O, Strazzullo P, Galletti F. Metabolic syndrome and its components predict the development of arterial stiffening in a sample of adult men. Clin Exp Hypertens 2021; 44:26-33. [PMID: 34459325 DOI: 10.1080/10641963.2021.1969664] [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: 10/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Metabolic syndrome (MS) and its components are associated with greater cardiovascular risk. A number of studies found a positive association between MS and vascular damage, but few observational studies evaluated the predictive role of MS on arterial stiffening (AS). Therefore, the aim of this study was to estimate the ability of MS and its components to predict the risk of AS in an 8-year follow-up of a sample of adult men (Olivetti Heart Study). METHODS The analysis included 778 men without AS (pulse pressure >60 mmHg) at baseline. A positive diagnosis of MS was made by recognized criteria, if at least three components were present. RESULTS At the end of the follow-up period, there was an incidence of 11% in AS. The percentage of participants that developed AS was greater in the MS group than those without MS, also after adjustment for main confounders (odds ratio: 2.5, 95% confidence interval: 1.3-4.9). The risk of AS also increased with increase in the numbers of MS elements (p for trend <.01). In addition, the analysis of the predictive role of the single MS component showed that high blood pressure (HBP) was the strongest predictor. CONCLUSIONS The results of this prospective study indicate a predictive role of MS on AS, independently of main confounders. In addition, HBP seems the strongest predictor of AS among MS components.
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Affiliation(s)
- Lanfranco D'Elia
- Department of Clinical Medicine and Surgery, Esh Excellence Center of Hypertension, "Federico II" University of Naples Medical School,Naples, Italy
| | - Antonio Barbato
- Department of Clinical Medicine and Surgery, Esh Excellence Center of Hypertension, "Federico II" University of Naples Medical School,Naples, Italy
| | - Roberto Iacone
- Department of Clinical Medicine and Surgery, Esh Excellence Center of Hypertension, "Federico II" University of Naples Medical School,Naples, Italy
| | - Ornella Russo
- Department of Clinical Medicine and Surgery, Esh Excellence Center of Hypertension, "Federico II" University of Naples Medical School,Naples, Italy
| | - Pasquale Strazzullo
- Department of Clinical Medicine and Surgery, Esh Excellence Center of Hypertension, "Federico II" University of Naples Medical School,Naples, Italy
| | - Ferruccio Galletti
- Department of Clinical Medicine and Surgery, Esh Excellence Center of Hypertension, "Federico II" University of Naples Medical School,Naples, Italy
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Rabizadeh S, Gholami B, Mahmoudzadeh Kani S, Rajab A, Farrokhpour H, Esteghamati A, Nakhjavani M. Uncontrolled hypertension in patients with type 2 diabetes: What are the correlates? J Clin Hypertens (Greenwich) 2021; 23:1776-1785. [PMID: 34418281 PMCID: PMC8678846 DOI: 10.1111/jch.14352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/20/2021] [Accepted: 07/13/2021] [Indexed: 11/30/2022]
Abstract
Suboptimal blood pressure (BP) control in patients with type 2 diabetes is associated with adverse micro‐ and macrovascular complications. This study aimed to investigate the predictors of uncontrolled hypertension in an Iranian population with type 2 diabetes. This is a cross‐sectional study of 2612 patients with type 2 diabetes, including 944 patients with hypertension. Controlled and uncontrolled hypertension were assessed. Multivariate logistic regression modeling was used to determined independent predictors of uncontrolled hypertension. Of 2612 patients with type 2 diabetes, 944 (36.1%) patients had hypertension. Of all patients with hypertension, 580 (61.4%) were still on monotherapy. Uncontrolled hypertension was detected in 536 participants (56.8%). Patients with uncontrolled hypertension had significantly higher body mass index (BMI) (29.8±4.8 vs. 28.6±4.6), waist circumference (99.11±10.95 vs. 96.68±10.92), pulse pressure (67.3±17.3 vs. 48.4±10.7), total cholesterol (177.1±45.5 vs. 164.3±40.5), non‐HDL cholesterol (133.0±43.5 vs. 120.1±38.7), triglycerides (175.7±80.3 vs. 157.4±76.7), and Atherogenic Index of Plasma (AIP) (0.57±0.23 vs. 0.52±0.24) (p < .05 for all of them) compared to patients with controlled hypertension. Multivariate logistic regression analysis revealed that uncontrolled hypertension was significantly associated with BMI (p = .001), pulse pressure (p = .001), total cholesterol (p = .006), and non‐HDL cholesterol (p = .009). In patients with triglycerides levels > 200 mg/dl non‐HDL cholesterol had a significant correlation with uncontrolled hypertension (OR = 4.635, CI95%:1.781–12.064, p = .002). In conclusion, BMI, pulse pressure, total cholesterol, and non‐HDL cholesterol are significant predictors of uncontrolled hypertension in patients with type 2 diabetes. Also, ineffective monotherapy, medical inertia and patients’ non‐compliance were other contributors to the uncontrolled hypertension.
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Affiliation(s)
- Soghra Rabizadeh
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Gholami
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shiva Mahmoudzadeh Kani
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Armin Rajab
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Farrokhpour
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Manouchehr Nakhjavani
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
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González-Clemente JM, Cano A, Albert L, Giménez-Palop O, Romero A, Berlanga E, Vendrell J, Llauradó G. Arterial Stiffness in Type 1 Diabetes: The Case for the Arterial Wall Itself as a Target Organ. J Clin Med 2021; 10:3616. [PMID: 34441912 PMCID: PMC8397115 DOI: 10.3390/jcm10163616] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/07/2021] [Accepted: 08/09/2021] [Indexed: 12/11/2022] Open
Abstract
Arterial stiffness (AS) integrates the cumulative burden of known and unknown cardiovascular risk factors on the elastic wall of large arteries along the lifespan of an individual. As a marker of vascular aging, AS is an independent predictor of cardiovascular events and improves cardiovascular risk prediction when added to the Framingham Risk Score. In addition, AS may affect the microvasculature and promote the development of microvascular complications. Its impact on both the macro- and microvasculature has led to the concept that the arterial wall itself should be considered as a target organ. Here, we review the biological and clinical consequences of AS on the macro- and microvasculature and the measurement of AS in routine clinical practice. We also discuss the pathophysiological mechanisms underpinning AS development using diabetes and, in particular, type 1 diabetes, as a disease model with a high risk of cardiovascular events and microvascular complications that are accelerated by AS.
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Affiliation(s)
- José-Miguel González-Clemente
- Department of Endocrinology and Nutrition, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain; (A.C.); (L.A.); (O.G.-P.); (A.R.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Department of Endocrinology and Nutrition, Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.V.); (G.L.)
| | - Albert Cano
- Department of Endocrinology and Nutrition, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain; (A.C.); (L.A.); (O.G.-P.); (A.R.)
| | - Lara Albert
- Department of Endocrinology and Nutrition, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain; (A.C.); (L.A.); (O.G.-P.); (A.R.)
| | - Olga Giménez-Palop
- Department of Endocrinology and Nutrition, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain; (A.C.); (L.A.); (O.G.-P.); (A.R.)
| | - Ana Romero
- Department of Endocrinology and Nutrition, Hospital Universitari Parc Taulí, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain; (A.C.); (L.A.); (O.G.-P.); (A.R.)
| | - Eugenio Berlanga
- Clinical Laboratory, Biochemistry Department, UDIAT, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, 08208 Sabadell, Spain;
| | - Joan Vendrell
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Department of Endocrinology and Nutrition, Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.V.); (G.L.)
- Department of Endocrinology and Nutrition, Hospital Universitari Joan XXIII de Tarragona, Institut d’Investigacions Sanitàries Pere Virgili (IISPV), Universitat Rovira i Virgili, 43005 Tarragona, Spain
| | - Gemma Llauradó
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Department of Endocrinology and Nutrition, Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.V.); (G.L.)
- Department of Endocrinology and Nutrition, Institut Hospital del Mar d’Investigacions, Mèdiques (IMIM), Universitat Autònoma de Barcelona, 08003 Barcelona, Spain
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Che Mohd Nassir CMN, Damodaran T, Yusof SR, Norazit A, Chilla G, Huen I, K. N. BP, Mohamed Ibrahim N, Mustapha M. Aberrant Neurogliovascular Unit Dynamics in Cerebral Small Vessel Disease: A Rheological Clue to Vascular Parkinsonism. Pharmaceutics 2021; 13:1207. [PMID: 34452169 PMCID: PMC8398765 DOI: 10.3390/pharmaceutics13081207] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/29/2021] [Accepted: 08/03/2021] [Indexed: 12/26/2022] Open
Abstract
The distinctive anatomical assemble and functionally discrete multicellular cerebrovasculature dynamics confer varying rheological and blood-brain barrier permeabilities to preserve the integrity of cerebral white matter and its neural microenvironment. This homeostasis intricately involves the glymphatic system that manages the flow of interstitial solutes, metabolic waste, and clearance through the venous circulation. As a physiologically integrated neurogliovascular unit (NGVU) serving a particularly vulnerable cerebral white matter (from hypoxia, metabolic insults, infection, and inflammation), a likely insidious process over a lifetime could inflict microenvironment damages that may lead to pathological conditions. Two such conditions, cerebral small vessel disease (CSVD) and vascular parkinsonism (VaP), with poorly understood pathomechanisms, are frequently linked to this brain-wide NGVU. VaP is widely regarded as an atypical parkinsonism, described by cardinal motor manifestations and the presence of cerebrovascular disease, particularly white matter hyperintensities (WMHs) in the basal ganglia and subcortical region. WMHs, in turn, are a recognised imaging spectrum of CSVD manifestations, and in relation to disrupted NGVU, also include enlarged perivascular spaces. Here, in this narrative review, we present and discuss on recent findings that argue for plausible clues between CSVD and VaP by focusing on aberrant multicellular dynamics of a unique integrated NGVU-a crossroad of the immune-vascular-nervous system-which may also extend fresher insights into the elusive interplay between cerebral microvasculature and neurodegeneration, and the potential therapeutic targets.
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Affiliation(s)
- Che Mohd Nasril Che Mohd Nassir
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Thenmoly Damodaran
- Centre for Drug Research, Universiti Sains Malaysia, Minden 11800, Penang, Malaysia; (T.D.); (S.R.Y.)
| | - Siti R. Yusof
- Centre for Drug Research, Universiti Sains Malaysia, Minden 11800, Penang, Malaysia; (T.D.); (S.R.Y.)
| | - Anwar Norazit
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Selangor, Malaysia;
| | - Geetha Chilla
- A*STAR Institute of Bioengineering and Bioimaging, Helios, 11 Biopolis Way, Singapore 138667, Singapore; (G.C.); (I.H.); (B.P.K.N.)
| | - Isaac Huen
- A*STAR Institute of Bioengineering and Bioimaging, Helios, 11 Biopolis Way, Singapore 138667, Singapore; (G.C.); (I.H.); (B.P.K.N.)
| | - Bhanu Prakash K. N.
- A*STAR Institute of Bioengineering and Bioimaging, Helios, 11 Biopolis Way, Singapore 138667, Singapore; (G.C.); (I.H.); (B.P.K.N.)
| | - Norlinah Mohamed Ibrahim
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Selangor, Malaysia;
| | - Muzaimi Mustapha
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia;
- Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab II, Kubang Kerian 16150, Kelantan, Malaysia
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122
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Piotrowicz K, Gryglewska B, Grodzicki T, Gąsowski J. Arterial stiffness and frailty - A systematic review and metaanalysis. Exp Gerontol 2021; 153:111480. [PMID: 34265411 DOI: 10.1016/j.exger.2021.111480] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 12/24/2022]
Abstract
Frailty and cardiovascular disease share some of the pathophysiologic features. Our objective was to review and metaanalyse the available published evidence on the topic. We performed a comprehensive literature search for studies where pulse wave velocity (PWV) or carotid-ankle vascular index (CAVI) has been linked with frailty in older persons. Of the initial 362 abstracts, after the application of the PRISMA approach, 5 were analysed in detail. We calculated within-study and pooled standardised mean differences of aortic stiffness measures between frail and non-frail (0.62 [0.31-0.92], p < 0.0001, I2 = 88%), and pre-frail and non-frail (0.32 [0.14-0.51], p = 0.0006, I2 = 72%) groups. In two studies it was possible to extract directly or calculate based on published data the odds ratios for the concomitant frailty, associated in one case with CAVI greater by 1 m/s and in another with cfPWV >13 m/s, indicating greater probability of concomitant frailty given greater aortic stiffness. Across the studies, the prevalence of hypertension, diabetes mellitus, hyperlipidaemia, and smoking tended to increase from non-frail, to pre-frail, and frail groups, presenting a possibility of important confounding, but also a common pathophysiology. In conclusion, the pooled analysis of the published cross-sectional study results indicates a relation between aortic stiffness and frailty in older subjects. However, well designed prospective studies are needed to answer the questions of causality.
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Affiliation(s)
- Karolina Piotrowicz
- Jagiellonian University Medical College, Department of Internal Medicine and Gerontology, Kraków, Poland
| | - Barbara Gryglewska
- Jagiellonian University Medical College, Department of Internal Medicine and Gerontology, Kraków, Poland
| | - Tomasz Grodzicki
- Jagiellonian University Medical College, Department of Internal Medicine and Gerontology, Kraków, Poland
| | - Jerzy Gąsowski
- Jagiellonian University Medical College, Department of Internal Medicine and Gerontology, Kraków, Poland.
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123
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Wu Z, Zhou D, Liu Y, Li Z, Wang J, Han Z, Miao X, Liu X, Li X, Wang W, Guo X, Tao L. Association of TyG index and TG/HDL-C ratio with arterial stiffness progression in a non-normotensive population. Cardiovasc Diabetol 2021; 20:134. [PMID: 34229681 PMCID: PMC8262008 DOI: 10.1186/s12933-021-01330-6] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/28/2021] [Indexed: 12/17/2022] Open
Abstract
Background Cross-sectional studies have reported that insulin resistance (IR) is associated with arterial stiffness. However, the relationship between IR and arterial stiffness progression remains unclear. This study aims to evaluate the association of triglyceride glucose (TyG) index and triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio with arterial stiffness progression in a non-normotensive population. Methods A total of 1895 prehypertensive (systolic pressure 120–139 mmHg or diastolic pressure 80–90 mmHg) or hypertensive (systolic pressure ≥ 140 mmHg or diastolic pressure ≥ 90 mmHg or using antihypertensive medication) participants were enrolled in 2013 and 2014, and followed until December 31, 2019. Arterial stiffness progression was measured by brachial-ankle pulse wave velocity (baPWV) change (absolute difference between baseline and last follow-up), baPWV change rate (change divided by following years), and baPWV slope (regression slope between examination year and baPWV). Results During a median follow-up of 4.71 years, we observed an increasing trend of baPWV in the population. There were linear and positive associations of the TyG index and TG/HDL-C ratio with the three baPWV parameters. The difference (95% CI) in baPWV change (cm/s) comparing participants in the highest quartile versus the lowest of TyG index and TG/HDL-C ratio were 129.5 (58.7–200.0) and 133.4 (52.0–214.9), respectively. Similarly, the evaluated baPWV change rates (cm/s/year) were 37.6 (15.3–60.0) and 43.5 (17.8–69.2), while the slopes of baPWV were 30.6 (9.3–51.8) and 33.5 (9.0–58.0). The observed association was stronger in the hypertensive population. Conclusion Our study indicates that the TyG index and TG/HDL-C ratio are significantly associated with arterial stiffness progression in hypertensive population, not in prehypertensive population. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-021-01330-6.
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Affiliation(s)
- Zhiyuan Wu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Di Zhou
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Yue Liu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Zhiwei Li
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Jinqi Wang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Ze Han
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Xinlei Miao
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Xiangtong Liu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia
| | - Wei Wang
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Xiuhua Guo
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China. .,Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia.
| | - Lixin Tao
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China. .,Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia.
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Ogola BO, Clark GL, Abshire CM, Harris NR, Gentry KL, Gunda SS, Kilanowski-Doroh I, Wong TJ, Visniauskas B, Lawrence DJ, Zimmerman MA, Bayer CL, Groban L, Miller KS, Lindsey SH. Sex and the G Protein-Coupled Estrogen Receptor Impact Vascular Stiffness. Hypertension 2021; 78:e1-e14. [PMID: 34024124 PMCID: PMC8192475 DOI: 10.1161/hypertensionaha.120.16915] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Benard O. Ogola
- Tulane University, Department of Pharmacology, New Orleans, LA, USA
| | - Gabrielle L. Clark
- Tulane University, Department of Biomedical Engineering, New Orleans, LA, USA
| | - Caleb M. Abshire
- Tulane University, Department of Pharmacology, New Orleans, LA, USA
| | | | - Kaylee L. Gentry
- Tulane University, Department of Pharmacology, New Orleans, LA, USA
| | - Shreya S. Gunda
- Tulane University, Department of Pharmacology, New Orleans, LA, USA
| | | | - Tristen J. Wong
- Tulane University, Department of Pharmacology, New Orleans, LA, USA
| | | | - Dylan J. Lawrence
- Tulane University, Department of Biomedical Engineering, New Orleans, LA, USA
| | | | - Carolyn L. Bayer
- Tulane University, Department of Biomedical Engineering, New Orleans, LA, USA
| | - Leanne Groban
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Kristin S. Miller
- Tulane University, Department of Biomedical Engineering, New Orleans, LA, USA
| | - Sarah H. Lindsey
- Tulane University, Department of Pharmacology, New Orleans, LA, USA
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125
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Fiori G, Fuiano F, Scorza A, Conforto S, Sciuto SA. Non-Invasive Methods for PWV Measurement in Blood Vessel Stiffness Assessment. IEEE Rev Biomed Eng 2021; 15:169-183. [PMID: 34166202 DOI: 10.1109/rbme.2021.3092208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
In recent years, statistical studies highlighted an increasing incidence of cardiovascular diseases (CVD) which reflected on additional costs on the healthcare systems worldwide. Pulse wave velocity (PWV) measurement is commonly considered a CVD predictor factor as well as a marker of Arterial Stiffness (AS), since it is closely related to the mechanical characteristics of the arterial wall. An increase in PWV is due to a more rigid arterial system. Because of the prevalence of the elastic component, in young people the PWV is lower than in the elderly. Nowadays, invasive and non-invasive methods for PWV assessment are employed: there is an increasing attention in the development of non-invasive devices which mostly perform a regional PWV measurement (over a long arterial portion) rather than local (over a short arterial portion). The accepted gold-standard for non-invasive AS measurement is the carotid-femoral PWV used to evaluate the arterial damage, the corresponding cardiovascular risk and to adapt the proper therapy. This review article considers the main commercially available devices underlining their operating principles in terms of sensors, execution mode, pulse waveform acquired, site of measurement, distance and time estimation methods, as well as their main limitations in clinical practice.
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126
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Föhse FK, Rollefstad S, Ikdahl E, Wibetoe G, Sexton J, Hisdal J, Semb AG. Degree of arterial stiffness is comparable across inflammatory joint disease entities. Scand J Rheumatol 2021; 51:186-195. [PMID: 34132621 DOI: 10.1080/03009742.2021.1920169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives: Inflammatory joint disease (IJD) is associated with an increased risk of developing cardiovascular disease (CVD). Arterial stiffness is both a risk factor and a surrogate marker for CVD. This study aims to compare arterial stiffness across patients with rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis, and, by extension, to explore the relationship between arterial stiffness and the estimated CVD risk by the Systematic COronary Risk Evaluation (SCORE) algorithm.Method: During the study period, from April 2017 to June 2018, 196 patients with IJD visited the Preventive Cardio-Rheuma Clinic in Oslo, Norway. A CVD risk stratification was performed, including the assessment of traditional risk factors and the measurement of arterial stiffness.Results: Thirty-six patients (18.4%) had elevated aortic pulse wave velocity (aPWV) (≥ 10 m/s). After adjustment for age and heart rate, arterial stiffness was comparable across the IJD entities (p = 0.69). Associated factors, revealed by regression analysis, were age, blood pressure, heart rate, presence of carotid plaques, establis hed CVD, non-steroidal anti-inflammatory drugs, and statin use. Furthermore, aPWV was positively correlated with estimated CVD risk (r = 0.7, p < 0.001) and patients with a very high predicted CVD risk (SCORE ≥ 10%) had significantly higher aPWV than patients at lower CVD risk (9.2 vs 7.5 m/s, p < 0.001).Conclusion: The degree of arterial stiffness was comparable across the IJD entities and was highly associated with the estimated CVD risk. Our findings support the need for an increased focus on prevention of CVD in all patients with IJD.
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Affiliation(s)
- F K Föhse
- Department of Vascular Surgery, Oslo University Hospital-Aker, Oslo, Norway.,Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - S Rollefstad
- Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - E Ikdahl
- Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - G Wibetoe
- Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - J Sexton
- Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - J Hisdal
- Department of Vascular Surgery, Oslo University Hospital-Aker, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - A G Semb
- Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
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Kessler J, Totoson P, Devaux S, Moretto J, Wendling D, Demougeot C. Animal models to study pathogenesis and treatments of cardiac disorders in rheumatoid arthritis: Advances and challenges for clinical translation. Pharmacol Res 2021; 170:105494. [PMID: 34139344 DOI: 10.1016/j.phrs.2021.105494] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/08/2021] [Accepted: 02/11/2021] [Indexed: 11/15/2022]
Abstract
Although cardiac diseases such as acute myocardial infarction, heart failure and arrhythmias are the leading cause of cardiovascular complications in rheumatoid arthritis (RA), their pathogenesis is far from being understood and optimal therapeutic options to treat specifically these disorders in RA are lacking. Preclinical studies on animal models of arthritis can help to decipher the complex link between arthritis and the heart, and to identify critical pathways and novel therapeutic targets. This review presented the available data on cardiac disorders in animal models of RA, as well as the current knowledge on pathophysiology and pharmacology of these disorders. Future directions for translational studies in a cardiorheumatic perspective are proposed.
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Affiliation(s)
- Julie Kessler
- PEPITE EA 4267, FHU INCREASE, Univ. Bourgogne Franche-Comté, F-25000 Besançon, France; Service de Rhumatologie, CHU Minjoz, 25000 Besançon, France
| | - Perle Totoson
- PEPITE EA 4267, FHU INCREASE, Univ. Bourgogne Franche-Comté, F-25000 Besançon, France
| | - Sylvie Devaux
- PEPITE EA 4267, FHU INCREASE, Univ. Bourgogne Franche-Comté, F-25000 Besançon, France
| | - Johnny Moretto
- PEPITE EA 4267, FHU INCREASE, Univ. Bourgogne Franche-Comté, F-25000 Besançon, France
| | - Daniel Wendling
- Service de Rhumatologie, CHU Minjoz, 25000 Besançon, France; EA 4266 " Agents Pathogènes et Inflammation ", EPILAB, Univ. Bourgogne Franche-Comté, F-25000 Besançon, France
| | - Céline Demougeot
- PEPITE EA 4267, FHU INCREASE, Univ. Bourgogne Franche-Comté, F-25000 Besançon, France.
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128
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Wartolowska KA, Webb AJS. Blood Pressure Determinants of Cerebral White Matter Hyperintensities and Microstructural Injury: UK Biobank Cohort Study. Hypertension 2021; 78:532-539. [PMID: 34058855 PMCID: PMC8260341 DOI: 10.1161/hypertensionaha.121.17403] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Supplemental Digital Content is available in the text. Small vessel disease and related stroke and dementia risks are linked to aging and hypertension, but it is unclear whether the pulsatile or steady blood pressure (BP) component is more important for the development of macrostructural hyperintensities and microstructural white matter damage. This was a cross-sectional analysis of the UK Biobank cohort study of community-based adults from 22 UK centers. Linear associations were determined between neuroimaging markers (white matter hyperintensity [WMH] volume and diffusion imaging indices) and mean arterial pressure and pulse pressure (PP), both unadjusted and adjusted for age, sex, cardiovascular risk factors, antihypertensive medication, BP source, and assessment center. In 37 041 participants aged 45 to 82 years (53% female), univariable analyses demonstrated that increases in both BP components were associated with greater WMH volume and white matter injury on diffusion indices, with a larger effect for PP (standardized effect size for WMH: mean arterial BP: 0.182 [95% CIs, 0.170–0.193]; PP: 0.285 [95% CIs, 0.274–0.296]). In multivariable analyses, associations with mean arterial pressure remained similar, but associations with PP diminished, reflecting covariance with age and risk factors (standardized effect size for WMH: mean arterial BP: 0.106 [95% CIs, 0.095–0.117]; PP: 0.011 [95% CIs, −0.001 to 0.023]). The synergistic interaction between PP and age increased the effect of age on WMH and diffusion indices. Both macrostructural and microstructural white matter injury had similar associations with the pulsatile and steady components of hypertension, although PP accentuated the relationship between age and white matter damage.
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Affiliation(s)
- Karolina A Wartolowska
- Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - Alastair J S Webb
- Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
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129
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Association of central arterial stiffness with hippocampal blood flow and N-acetyl aspartate concentration in hypertensive adult Dahl salt sensitive rats. J Hypertens 2021; 39:2113-2121. [PMID: 34001812 PMCID: PMC8452328 DOI: 10.1097/hjh.0000000000002899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Central arterial stiffness (CAS) is associated with elevated arterial blood pressure (BP) and is likely associated with stiffening of cerebral artery walls, with attendant cerebral hypoperfusion, neuronal density loss and cognitive decline. Dahl salt-sensitive (Dahl-S) rats exhibit age-associated hypertension and memory loss, even on a normal salt intake. METHOD We sought to explore whether central arterial pulse wave velocity (PWV), a marker of CAS, is associated with hippocampal cerebral blood flow (CBF) and neuronal density in hypertensive Dahl-S rats. We measured systolic BP (by tail-cuff plethysmography), aortic PWV (by echocardiography) and CBF and N-acetyl aspartate (NAA) (by magnetic resonance imaging) in 6 month-old male Dahl-S rats (n = 12). RESULTS Greater PWV was significantly associated with lower CBF and lower NAA concentration in the hippocampus, supporting a role of CAS in cerebrovascular dysfunction and decline in cognitive performance with aging. CONCLUSION These findings implicate increased CAS in cerebral hypoperfusion and loss of neuronal density and function in the Dahl-S model of age-associated cardiovascular dysfunction.
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130
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Yang G, Qian T, Sun H, Xu Q, Hou X, Hu W, Zhang G, Drummond GR, Sobey CG, Witting PK, Denton KM, Charchar FJ, Golledge J, Wang Y. Adjustment for body mass index changes inverse associations of HDL-cholesterol with blood pressure and hypertension to positive associations. J Hum Hypertens 2021; 36:570-579. [PMID: 33976343 DOI: 10.1038/s41371-021-00548-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/16/2021] [Accepted: 04/26/2021] [Indexed: 11/09/2022]
Abstract
The associations between high-density lipoprotein cholesterol (HDL-C) and blood pressure (BP) or hypertension are inconsistent in previous studies. This study aimed to assess these associations in a large cohort of Chinese adults and across different age groups. This cross-sectional association study included 22,081 Chinese adults. Associations of HDL-C with BP and hypertension were analyzed using linear or logistic regression, with or without adjustment for confounding factors. HDL-C was inversely associated with BP and hypertension. These associations were still apparent after adjustment for age, sex, fasting plasma glucose, and low-density lipoprotein cholesterol. Sub-analyses revealed: (1) in the whole cohort and females alone, HDL-C was inversely associated with BP and hypertension in young and middle-aged but not older participants; (2) in males alone, HDL-C was not associated with systolic BP or hypertension. However, HDL-C was either inversely, or not, or positively associated with BP in young, middle-aged, and older males, respectively. After further adjustment for body mass index (BMI), the negative associations of HDL-C with BP and hypertension in the whole cohort became positive ones, and the positive associations only presented in males. These findings suggest that further adjustment for BMI changes inverse associations of HDL-cholesterol with BP and hypertension to positive associations in a cohort of Chinese adults.
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Affiliation(s)
- Guang Yang
- Department of Gerontology, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China.
| | - Tingting Qian
- Department of Geriatric Medicine, School of Clinical Medicine, Weifang Medical University, Weifang, Shandong, China
| | - Hui Sun
- Department of Gerontology, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Qun Xu
- Department of Gerontology, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Xujuan Hou
- The Health Physical Examination Center, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Wenqi Hu
- The Health Physical Examination Center, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Guang Zhang
- The Health Physical Examination Center, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong Province, China
| | - Grant R Drummond
- Centre for Cardiovascular Biology and Disease Research and Department of Physiology, Anatomy & Microbiology, School of Life Sciences, La Trobe University, Melbourne, VIC, Australia
| | - Christopher G Sobey
- Centre for Cardiovascular Biology and Disease Research and Department of Physiology, Anatomy & Microbiology, School of Life Sciences, La Trobe University, Melbourne, VIC, Australia
| | - Paul K Witting
- Discipline of Pathology, School of Medical Sciences, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Kate M Denton
- Department of Physiology, Monash University, Melbourne, VIC, Australia.,Cardiovascular Disease Program, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC, Australia
| | - Fadi J Charchar
- School of Science, Psychology and Sport, Federation University Australia, Ballarat, VIC, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.,Department of Vascular and Endovascular Surgery, The Townsville University Hospital, Townsville, QLD, Australia
| | - Yutang Wang
- School of Science, Psychology and Sport, Federation University Australia, Ballarat, VIC, Australia.
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131
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Rodrigues-Diez RR, Tejera-Muñoz A, Orejudo M, Marquez-Exposito L, Santos-Sanchez L, Rayego-Mateos S, Cantero-Navarro E, Tejedor-Santamaria L, Marchant V, Ortiz A, Egido J, Mezzano S, Selgas R, Navarro-González JF, Valdivielso JM, Lavoz C, Ruiz-Ortega M. Interleukin-17A: Potential mediator and therapeutic target in hypertension. Nefrologia 2021; 41:244-257. [PMID: 36166242 DOI: 10.1016/j.nefroe.2021.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 11/15/2020] [Indexed: 06/16/2023] Open
Abstract
Interleukin-17A (IL-17A) is a proinflammatory cytokine produced by cells of the immune system, predominantly Th17 and γδ lymphocytes. In this paper, we review the role of IL-17A in the pathogenesis of hypertension and in target organ damage. Preclinical studies in mice have shown that systemic adminstration of IL-17A increases blood pressure, probably by acting on multiple levels. Furthermore, IL-17A plasma concentrations are already elevated in patients with mild or moderate hypertension. Many studies in hypertensive mice models have detected IL-17A-producing cells in target organs such as the heart, vessels and kidneys. Patients with hypertensive nephrosclerosis show kidney infiltration by Th17 lymphocytes and γδ lymphocytes that express IL-17A. In addition, in experimental models of hypertension, the blockade of IL-17A by genetic strategies or using neutralizing antibodies, disminished blood pressure, probablyby acting on the small mesenteric arteries as well as in the regulation of tubule sodium transport. Moreover, IL-17A inhibition reduces end-organs damage. As a whole, the data presented in this review suggest that IL-17A participates in the regulation of blood pressure and in the genesis and maintenance of arterial hypertension, and may constitute a therapeutic target of hypertension-related pathologies in the future.
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Affiliation(s)
- Raúl R Rodrigues-Diez
- Laboratorio de Patología Renal y Vascular, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, Spain; Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Tejera-Muñoz
- Laboratorio de Patología Renal y Vascular, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, Spain; Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, Spain
| | - Macarena Orejudo
- Renal, Vascular and Diabetes Research Laboratory, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, Spain; Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Marquez-Exposito
- Laboratorio de Patología Renal y Vascular, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, Spain; Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Santos-Sanchez
- Laboratorio de Patología Renal y Vascular, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, Spain; Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, Spain
| | - Sandra Rayego-Mateos
- Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, Spain; Vascular and Renal Translational Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Elena Cantero-Navarro
- Laboratorio de Patología Renal y Vascular, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, Spain; Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, Spain
| | - Lucia Tejedor-Santamaria
- Laboratorio de Patología Renal y Vascular, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, Spain; Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, Spain
| | - Vanessa Marchant
- Laboratorio de Patología Renal y Vascular, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, Spain; Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, Spain
| | - Alberto Ortiz
- Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, Spain; Nephrology and Hypertension, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, Spain
| | - Jesús Egido
- Renal, Vascular and Diabetes Research Laboratory, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, Spain; Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Sergio Mezzano
- Laboratorio de Nefrología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Rafael Selgas
- Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación La Paz (IdiPAZ), Hospital Universitario La Paz, Universidad Autónoma, IRSIN, Madrid, Spain
| | - Juan F Navarro-González
- Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, Spain; Unidad de Investigación y Servicio de Nefrología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain; Instituto de Tecnologías Biomédicas, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Tenerife, Spain
| | - Jose M Valdivielso
- Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, Spain; Vascular and Renal Translational Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Carolina Lavoz
- Laboratorio de Nefrología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Marta Ruiz-Ortega
- Laboratorio de Patología Renal y Vascular, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, Spain; Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, Spain.
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Ma T, Liu X, Ren Q, Zhang Z, Sun X, Zheng Y, Deng X, Yu X, Fan Y. Flow-mediated dilation analysis coupled with nitric oxide transport to enhance the assessment of endothelial function. J Appl Physiol (1985) 2021; 131:1-14. [PMID: 33830813 DOI: 10.1152/japplphysiol.00039.2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Flow-mediated dilation (FMD), mainly mediated by nitric oxide (NO), aims to assess the shear-induced endothelial function, which is widely quantified by the relative change in arterial diameter after dilation (FMD%). However, FMD% is affected by individual differences in blood pressure, blood flow, and arterial diameter. To reduce these differences and enhance the assessment of FMD to endothelial function, we continuously measured not only the brachial artery diameter and blood flow with ultrasound but also blood pressure with noninvasive monitor during standard FMD test. We further constructed an analytical model of FMD coupled with NO transport, blood flow, and arterial deformation. Combining the time-averaged and peak values of arterial diameter, blood flow, and pressure, and the modeling, we assumed the artery was completely healthy and calculated an ideally expected FMD% (eFMD%). Then, we expressed the fractional flow-mediated dilation (FFMD%) for the ratio of measured FMD% (mFMD%) to eFMD%. Furthermore, using the continuous waveforms of arterial diameter, blood flow, and pressure, the endothelial characteristic parameter (ϵ) was calculated, which describes the function of the endothelium to produce NO and ranges from 1 to 0 representing the endothelial function from healthiness to complete loss. We found that the mFMD% and eFMD% between the young age (n = 5, 21.2 ± 1.8 yr) and middle age group (n = 5, 34.0 ± 2.1 yr) have no significant difference (P = 0.222, P = 0.385). In contrast, the FFMD% (P = 0.008) and ϵ (P = 0.007) both show significant differences. Therefore, the fractional flow-mediated dilation (FFMD%) and the endothelial characteristic parameter (ϵ) may have the potential for specifically diagnosing the endothelial function.NEW & NOTEWORTHY FMD% is affected by various factors, which limits its ability to assess the endothelial function. We developed an analytical model of FMD process coupled with nitric oxide based on the mathematical modeling and physiological measurements. Two model-derived indicators (FFMD% and ϵ) were introduced based on the modeling. Our results indicated that FFMD% and ϵ may have the potential to distinguish the endothelial function between the young- and middle age groups.
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Affiliation(s)
- Tianxiang Ma
- Beijing Advanced Innovation Centre for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Chinese Education Ministry, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Xiao Liu
- Beijing Advanced Innovation Centre for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Chinese Education Ministry, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Quan Ren
- Beijing Advanced Innovation Centre for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Chinese Education Ministry, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Zhexi Zhang
- Beijing Advanced Innovation Centre for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Chinese Education Ministry, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Xiaoning Sun
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuehong Zheng
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiaoyan Deng
- Beijing Advanced Innovation Centre for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Chinese Education Ministry, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Xiaojun Yu
- School of Automation, Northwestern Polytechnical University, Shaanxi, China
| | - Yubo Fan
- Beijing Advanced Innovation Centre for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Chinese Education Ministry, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.,School of Engineering Medicine, Beihang University, Beijing, China
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133
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Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) associates with a considerable high rate of mortality and represents currently the most important concern in global health. The risk of more severe clinical manifestation of COVID-19 is higher in males and steeply raised with age but also increased by the presence of chronic comorbidities. Among the latter, early reports suggested that arterial hypertension associates with higher susceptibility to SARS-CoV-2 infection, more severe course and increased COVID-19-related deaths. Furthermore, experimental studies suggested that key pathophysiological hypertension mechanisms, such as activation of the renin-angiotensin system (RAS), may play a role in COVID-19. In fact, ACE2 (angiotensin-converting-enzyme 2) is the pivotal receptor for SARS-CoV-2 to enter host cells and provides thus a link between COVID-19 and RAS. It was thus anticipated that drugs modulating the RAS including an upregulation of ACE2 may increase the risk for infection with SARS-CoV-2 and poorer outcomes in COVID-19. Since the use of RAS-blockers, ACE inhibitors or angiotensin receptor blockers, represents the backbone of recommended antihypertensive therapy and intense debate about their use in the COVID-19 pandemic has developed. Currently, a direct role of hypertension, independent of age and other comorbidities, as a risk factor for the SARS-COV-2 infection and COVID-19 outcome, particularly death, has not been established. Similarly, both current experimental and clinical studies do not support an unfavorable effect of RAS-blockers or other classes of first line blood pressure lowering drugs in COVID-19. Here, we review available data on the role of hypertension and its management on COVID-19. Conversely, some aspects as to how the COVID-19 affects hypertension management and impacts on future developments are also briefly discussed. COVID-19 has and continues to proof the critical importance of hypertension research to address questions that are important for global health.
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Affiliation(s)
- Carmine Savoia
- Clinical and Molecular Medicine Department, Division of Cardiology, Sant' Andrea Hospital, Sapienza University of Rome, Rome, Italy (C.S., M.V.)
| | - Massimo Volpe
- Clinical and Molecular Medicine Department, Division of Cardiology, Sant' Andrea Hospital, Sapienza University of Rome, Rome, Italy (C.S., M.V.)
| | - Reinhold Kreutz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institut für Klinische Pharmakologie und Toxikologie (R.K.)
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134
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Rodrigues-Diez RR, Tejera-Muñoz A, Orejudo M, Marquez-Exposito L, Santos L, Rayego-Mateos S, Cantero-Navarro E, Tejedor-Santamaria L, Marchant V, Ortiz A, Egido J, Mezzano S, Selgas R, Navarro-González JF, Valdivielso JM, Lavoz C, Ruiz-Ortega M. [Interleukin-17A: Possible mediator and therapeutic target in hypertension]. Nefrologia 2021; 41:244-257. [PMID: 33775443 DOI: 10.1016/j.nefro.2020.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 11/15/2020] [Indexed: 12/18/2022] Open
Abstract
Interleukin-17A (IL-17A) is a proinflammatory cytokine produced by cells of the immune system, predominantly Th17 lymphocytes and γδ lymphocytes. In this paper, we review the role of IL-17A in the pathogenesis of hypertension and target organ damage. Studies in mice have shown that IL-17A increases blood pressure, probably by acting on multiple levels. Furthermore, IL-17A plasma concentrations are already elevated in patients with mild or moderate hypertension. Preclinical studies on arterial hypertension have detected IL-17A-producing cells in target organs such as the heart, vessels and kidneys. Patients with hypertensive nephrosclerosis show kidney infiltration by Th17 lymphocytes and γδ lymphocytes that express IL-17A. In addition, in experimental models of hypertension, blocking IL-17A by genetic strategies, or using neutralising antibodies, lowers blood pressure by acting on the vascular wall and tubule sodium transport and reduces damage to target organs. As a whole, the data presented in this review suggest that IL-17A participates in the regulation of blood pressure and in the genesis and maintenance of arterial hypertension, and may constitute a therapeutic target in the future.
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Affiliation(s)
- Raúl R Rodrigues-Diez
- Laboratorio de Patología Renal y Vascular, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, España; Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, España
| | - Antonio Tejera-Muñoz
- Laboratorio de Patología Renal y Vascular, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, España; Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, España
| | - Macarena Orejudo
- Renal, Vascular and Diabetes Research Laboratory, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, España; Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Instituto de Salud Carlos III, Madrid, España
| | - Laura Marquez-Exposito
- Laboratorio de Patología Renal y Vascular, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, España; Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, España
| | - Laura Santos
- Laboratorio de Patología Renal y Vascular, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, España; Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, España
| | - Sandra Rayego-Mateos
- Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, España; Vascular and Renal Translational Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, España
| | - Elena Cantero-Navarro
- Laboratorio de Patología Renal y Vascular, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, España; Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, España
| | - Lucia Tejedor-Santamaria
- Laboratorio de Patología Renal y Vascular, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, España; Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, España
| | - Vanessa Marchant
- Laboratorio de Patología Renal y Vascular, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, España; Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, España
| | - Alberto Ortiz
- Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, España; Nephrology and Hypertension, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, España
| | - Jesús Egido
- Renal, Vascular and Diabetes Research Laboratory, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, España; Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Instituto de Salud Carlos III, Madrid, España
| | - Sergio Mezzano
- Laboratorio de Nefrología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Rafael Selgas
- Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, España; Instituto de Investigación La Paz (IdiPAZ), Hospital Universitario La Paz, Universidad Autónoma, IRSIN, Madrid, España
| | - Juan F Navarro-González
- Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, España; Unidad de Investigación y Servicio de Nefrología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España; Instituto de Tecnologías Biomédicas, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Tenerife, España
| | - Jose M Valdivielso
- Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, España; Vascular and Renal Translational Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, España
| | - Carolina Lavoz
- Laboratorio de Nefrología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Marta Ruiz-Ortega
- Laboratorio de Patología Renal y Vascular, Fundación Instituto de Investigación Sanitaria-Fundación Jiménez Díaz-Universidad Autónoma Madrid, Madrid, España; Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, España.
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Tuktarov AM, Kazanceva TS, Filippov AE, Obrezan AG. The Relationship of Modifiable Risk Factors with Indicators of Arterial Stiffness and Vascular Age in Patients with Arterial Hypertension. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2021. [DOI: 10.20996/1819-6446-2021-02-12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim. To study the relationship of modifiable risk factors (RF) with indicators of arterial stiffness and vascular age based on the contour analysis of the pulse wave velocity in hypertensive patients.Material and methods. The material of the study was the data from a survey of patients undergoing clinical observation at the polyclinic of MMC SOGAZ. A total of 107 patients were examined, in which 70 were men and 37 were women. The average age was 52.3±18.29. Photoplethysmography was used as a special research method, performed using the AngioScan-01 diagnostic complex. The main indicators used to evaluate the stiffness of large vessels were: stiffness index (SI), reflection index (RI), augmentation index (Alp75), age index (AGI), pulse wave types (PV) and vascular age (VA).Results. The mean values of arterial stiffness indices in patients with essential arterial hypertension (AH) and healthy individuals (control) had significant differences. The mean SI, Alp75, and VA values in the group of patients with AH were 7.8±1.03, 7.0±14.44 and 50.8±15.93 versus 7.2±1.73, 0.5±18.02 and 43.8±16.94, respectively (p< 0.05). In both groups, a strong inverse correlation of passport age with C-type PV was revealed (r=0.74, p< 0.01), which reflected the dynamics of a gradual age-dependent decrease in vascular compliance. The average VA value in the control group was 63.1±16.99 years with an average passport age of 59.5±8.79 years, which significantly differed from VA in hypertensive patients (p< 0,05). Overweight, hypercholesterolemia, elevated low-density lipoprotein levels, lack of adequate antihypertensive control, and left ventricular diastolic dysfunction were significantly associated with early vascular (arterial) aging.Conclusion. Patients with hypertension, in addition to high blood pressure, significantly differ from normotensive control in terms of arterial stiffness. The lack of control over modifiable RF of patients with hypertension is associated with early vascular aging.
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Affiliation(s)
- A. M. Tuktarov
- St. Petersburg State University;
LLC “International Medical Center “SOGAZ”
| | | | - A. E. Filippov
- St. Petersburg State University;
LLC “International Medical Center “SOGAZ”
| | - A. G. Obrezan
- St. Petersburg State University;
LLC “International Medical Center “SOGAZ”
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Lee J, Park W, Sung E, Kim B, Kim N, Park S, Shin C, Park J. The effect of oral glucose tolerance testing on changes in arterial stiffness and blood pressure in elderly women with hypertension and relationships between the stage of diabetes and physical fitness levels. Phys Act Nutr 2021; 24:34-43. [PMID: 33539693 PMCID: PMC7934524 DOI: 10.20463/pan.2020.0026] [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: 12/22/2020] [Accepted: 12/30/2020] [Indexed: 11/23/2022] Open
Abstract
[Purpose] The purpose of this study was to assess changes in blood glucose level, blood pressure, and arterial stiffness after a 75 g oral glucose tolerance test (OGTT) in elderly women aged over 65 years with hypertension and either normal glycemic control, impaired fasting glucose tolerance, or diabetes mellitus. We also wished to investigate the relationship between stages of diabetes and physical fitness. [Methods] A total of 24 elderly women with hypertension were assigned to a control group (CON; n=7), impaired fasting glucose group (IFG; n=9), and diabetes mellitus group (DM; n=8). In each group, blood glucose level, brachial ankle pulse wave velocity (PWV), and blood pressure were measured at baseline as well as 60 and 120 minutes after a 75 g OGTT. Physical fitness factors such as hand grip strength, balance test, 4 m gait speed test, chair stand test, short physical performance battery, and 6-minute walking test were subsequently assessed. [Results] In all three groups, blood glucose levels were significantly increased at 60 and 120 minutes after a 75 g OGTT. In the DM group, blood glucose levels were significantly higher before and after a 75 g OGTT than in the CON group. In the CON group, PWV was significantly increased at 60 minutes after a 75 g OGTT; however, there were no changes in other groups after glucose ingestion. In the CON group, systolic and diastolic blood pressures were significantly decreased at 60 and 120 minutes after a 75 g OGTT compared to baseline. However, there was no change in blood pressure after ingestion in the DM group. The IFG group had greater grip strength than the CON group; however, there were no differences in other variables between the groups. [Conclusion] After a 75 g OGTT, elderly women with hypertension and diabetes maintain higher blood glucose levels compared to those with hypertension alone. Unlike elderly women with hypertension alone, those with hypertension and diabetes did not show changes in arterial stiffness and blood pressure after a 75 g OGTT. Therefore, elderly women with hypertension and diabetes may not be able to control their blood vessels following a 75 g OGTT due to impaired vascular endothelial function. Moreover, there was no association between diabetes stage and physical fitness in elderly women with hypertension.
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Affiliation(s)
- Jaesong Lee
- Department of Physical Education, Korea University, Seoul, Republic of Korea
| | - Wonil Park
- Department of Physical Education, Korea University, Seoul, Republic of Korea
| | - Eunsook Sung
- Department of Physical Education, Korea University, Seoul, Republic of Korea
| | - Bokbeom Kim
- Department of Physical Education, Korea University, Seoul, Republic of Korea
| | - Nahyun Kim
- Department of Physical Education, Korea University, Seoul, Republic of Korea
| | - Saejong Park
- Department of Sports Science, Korea Institute of Sport Science, Seoul, Republic of Korea
| | - Chulho Shin
- Department of Health Care, Namseoul University, Cheonan, Republic of Korea
| | - Jonghoon Park
- Department of Physical Education, Korea University, Seoul, Republic of Korea
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137
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Beutel F, Van Hoof C, Rottenberg X, Reesink K, Hermeling E. Pulse Arrival Time Segmentation Into Cardiac and Vascular Intervals - Implications for Pulse Wave Velocity and Blood Pressure Estimation. IEEE Trans Biomed Eng 2021; 68:2810-2820. [PMID: 33513094 DOI: 10.1109/tbme.2021.3055154] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study demonstrates a novel method for pulse arrival time (PAT) segmentation into cardiac isovolumic contraction (IVC) and vascular pulse transit time to approximate central pulse wave velocity (PWV). METHODS 10 subjects (38 ± 10 years, 121 ± 12 mmHg SBP) ranging from normotension to hypertension were repeatedly measured at rest and with induced changes in blood pressure (BP), and thus PWV. ECG was recorded simultaneously with ultrasound-based carotid distension waveforms, a photoplethysmography-based peripheral waveform, noninvasive continuous and intermittent cuff BP. Central PAT was segmented into cardiac and vascular time intervals using a fiducial point in the carotid distension waveform that reflects the IVC onset. Central and peripheral PWVs were computed from (segmented) intervals and estimated arterial path lengths. Correlations with Bramwell-Hill PWV, systolic and diastolic BP (SBP/DBP) were analyzed by linear regression. RESULTS Central PWV explained more than twice the variability (R2) in Bramwell-Hill PWV compared to peripheral PWV (0.56 vs. 0.27). SBP estimated from central PWV undercuts the IEEE mean absolute deviation threshold of 5 mmHg, significantly lower than peripheral PWV or PAT (4.2 vs. 7.1 vs. 10.1 mmHg). CONCLUSION Cardiac IVC onset signaled in carotid distension waveforms enables PAT segmentation to obtain unbiased vascular pulse transit time. Corresponding PWV estimates provide the basis for single-site assessment of central arterial stiffness, confirmed by significant correlations with Bramwell-Hill PWV and SBP. SIGNIFICANCE In a small-scale cohort, we present proof-of-concept for a novel method to estimate central PWV and BP, bearing potential to improve the practicality of cardiovascular risk assessment in clinical routines.
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van der Bruggen MM, Reesink KD, Spronck PJM, Bitsch N, Hameleers J, Megens RTA, Schalkwijk CG, Delhaas T, Spronck B. An integrated set-up for ex vivo characterisation of biaxial murine artery biomechanics under pulsatile conditions. Sci Rep 2021; 11:2671. [PMID: 33514757 PMCID: PMC7846753 DOI: 10.1038/s41598-021-81151-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/07/2020] [Indexed: 01/19/2023] Open
Abstract
Ex vivo characterisation of arterial biomechanics enables detailed discrimination of the various cellular and extracellular contributions to arterial stiffness. However, ex vivo biomechanical studies are commonly performed under quasi-static conditions, whereas dynamic biomechanical behaviour (as relevant in vivo) may differ substantially. Hence, we aim to (1) develop an integrated set-up for quasi-static and dynamic biaxial biomechanical testing, (2) quantify set-up reproducibility, and (3) illustrate the differences in measured arterial stiffness between quasi-static and dynamic conditions. Twenty-two mouse carotid arteries were mounted between glass micropipettes and kept fully vasodilated. While recording pressure, axial force (F), and inner diameter, arteries were exposed to (1) quasi-static pressure inflation from 0 to 200 mmHg; (2) 300 bpm dynamic pressure inflation (peaking at 80/120/160 mmHg); and (3) axial stretch (λz) variation at constant pressures of 10/60/100/140/200 mmHg. Measurements were performed in duplicate. Single-point pulse wave velocities (PWV; Bramwell-Hill) and axial stiffness coefficients (cax = dF/dλz) were calculated at the in vivo value of λz. Within-subject coefficients of variation were ~ 20%. Dynamic PWVs were consistently higher than quasi-static PWVs (p < 0.001); cax increased with increasing pressure. We demonstrated the feasibility of ex vivo biomechanical characterisation of biaxially-loaded murine carotid arteries under pulsatile conditions, and quantified reproducibility allowing for well-powered future study design.
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Affiliation(s)
- Myrthe M van der Bruggen
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 50, Room 3.359, 6229ER, Maastricht, The Netherlands
| | - Koen D Reesink
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 50, Room 3.359, 6229ER, Maastricht, The Netherlands
| | | | - Nicole Bitsch
- Muroidean Facility, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Jeroen Hameleers
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 50, Room 3.359, 6229ER, Maastricht, The Netherlands
| | - Remco T A Megens
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 50, Room 3.359, 6229ER, Maastricht, The Netherlands.,Institute for Cardiovascular Prevention, Ludwig-Maximilians-Universität, Munich, Germany
| | - Casper G Schalkwijk
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Tammo Delhaas
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 50, Room 3.359, 6229ER, Maastricht, The Netherlands
| | - Bart Spronck
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 50, Room 3.359, 6229ER, Maastricht, The Netherlands. .,Department of Biomedical Engineering, School of Engineering & Applied Science, Yale University, New Haven, CT, USA.
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Abstract
OBJECTIVE Using the brachial--ankle pulse wave velocity (baPWV) as a biomarker for arteriosclerosis, we studied the effect of blood pressure (BP) and BP control on arteriosclerosis progression. METHODS AND RESULTS The community-based longitudinal Kailuan study included 6552 participants [4938 (75.37%) men] with a mean follow-up of 4.62 ± 2.21 years. Hypertension was defined based on the Joint National Committee (JNC7) criteria and the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines. All study participants had hypertension and were stratified as follows according to BP at baseline and follow-up: the normal--normal [normal BP (under therapy) at baseline and final follow-up], normal--hypertensive, hypertensive--normal, and hypertensive--hypertensive groups. Using the JNC7-based hypertension definition, the annual baPWV increase was the highest (P < 0.001) in the hypertensive--hypertensive group [17.32 cm/s; 95% confidence interval [CI]:9.7--24.9], followed by the normal--hypertensive group (14.44 cm/s; 95% CI:5.5--23.4), and the hypertensive--normal group (0.88 cm/s; 95% CI: -7.84 to 9.60), with the normal--normal group as the reference group in a multivariable model. The model additionally included parameters, such as age, baseline baPWV, heart rate, BMI, serum glucose concentration, prevalence of antihypertensive treatment and alcohol consumption, heart rate, and estimated glomerular filtration rate. Applying the ACC/AHA guidelines and the same multivariable model, the annual baPWV increase was the highest (P < 0.001) in the hypertensive--hypertensive group (43.54 cm/s; 95% CI: 22.54--64.55), followed by the normal--hypertensive group (34.01 cm/s; 95% CI: 10.39--57.62) and the hypertensive--normal group (24.12 cm/s; 95% CI: 1.24--47.00). CONCLUSION Lower BP and medical reduction in increased BP were associated with a reduction in the baPWV increase and may delay the progression of arteriosclerosis in hypertensive patients.
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140
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Thomas E, Bellafiore M, Gentile A, Paoli A, Palma A, Bianco A. Cardiovascular Responses to Muscle Stretching: A Systematic Review and Meta-analysis. Int J Sports Med 2021; 42:481-493. [PMID: 33440445 DOI: 10.1055/a-1312-7131] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The aim of this study will be to review the current body of literature to understand the effects of stretching on the responses of the cardiovascular system. A literature search was performed using the following databases: Scopus, NLM Pubmed and ScienceDirect. Studies regarding the effects of stretching on responses of the cardiovascular system were investigated. Outcomes regarded heart rate(HR), blood pressure, pulse wave velocity (PWV of which baPWV for brachial-ankle and cfPWV for carotid-femoral waveforms), heart rate variability and endothelial vascular function. Subsequently, the effects of each outcome were quantitatively synthetized using meta-analytic synthesis with random-effect models. A total of 16 studies were considered eligible and included in the quantitative synthesis. Groups were also stratified according to cross-sectional or longitudinal stretching interventions. Quality assessment through the NHLBI tools observed a "fair-to-good" quality of the studies. The meta-analytic synthesis showed a significant effect of d=0.38 concerning HR, d=2.04 regarding baPWV and d=0.46 for cfPWV. Stretching significantly reduces arterial stiffness and HR. The qualitative description of the studies was also supported by the meta-analytic synthesis. No adverse effects were reported, after stretching, in patients affected by cardiovascular disease on blood pressure. There is a lack of studies regarding vascular adaptations to stretching.
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Affiliation(s)
- Ewan Thomas
- Sport and Exercise Sciences Research Unit, Department of Psychological, Educational Science and Human Movement University of Palermo, Palermo, Italy
| | - Marianna Bellafiore
- Sport and Exercise Sciences Research Unit, Department of Psychological, Educational Science and Human Movement University of Palermo, Palermo, Italy
| | - Ambra Gentile
- Sport and Exercise Sciences Research Unit, Department of Psychological, Educational Science and Human Movement University of Palermo, Palermo, Italy
| | - Antonio Paoli
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Antonio Palma
- Sport and Exercise Sciences Research Unit, Department of Psychological, Educational Science and Human Movement University of Palermo, Palermo, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychological, Educational Science and Human Movement University of Palermo, Palermo, Italy
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141
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Li C, Wang Z, Liu S, Guo S, Song Y, Liu L, Zhou Z, Wang B, Huang M, Wang R, Zhai L, Gao Y, Qin X, Wang X, Zheng H, Zhao Z. Association of Brachial Ankle Pulse Wave Velocity With New Onset Stroke in Hypertensive Patients Aged Less Than 65 With Normal Fasting Glucose Among Chinese Community-Based Population. Front Endocrinol (Lausanne) 2021; 12:828286. [PMID: 35145484 PMCID: PMC8822600 DOI: 10.3389/fendo.2021.828286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 12/30/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Previous studies have shown an association of stroke and brachial ankle pulse wave velocity (baPWV). However, due to limitations on total population size and small numbers of stroke cases, lack of power has prevented further detection among subgroups such as age and laboratory testing. METHODS A total of 19217 participants including 660 incident stroke patients were pooled in the present study. Participants were divided to 2 groups, aged less than 65 years [56.0 (50.0, 61.0)] and aged 65 years or more [70.0 (67.0, 74.0)]. RESULTS After adjustment for demographic, anthropometric, and laboratory parameters, the incident stroke was positively associated to baPWV in the group aged less than 65 years (OR, 1.16; 95% CI, 1.05-1.28), but not in the older group aged 65 or more. When baPWV was assigned as quartiles, a significant, increased risk of new-onset stroke was found in quartiles 3-4 compared with quartile 1. In addition, the predictive value of baPWV for incident stroke was modified by fasting glucose in participants aged less than 65 years (P-interaction = 0.010). An increase in baPWV was strongly, positively associated to new-onset stroke in the subgroup of normal fasting glucose (< 5.6 mmol/L) (OR, 1.34; 95% CI, 1.15 - 1.57), but no effect was seen in the impaired fasting glucose (5.6-7.0 mmol/L) or diabetic fasting glucose (> 7.0 mmol/L) subgroups. CONCLUSIONS Increased baPWV was significantly associated with new-onset stroke in a hypertensive population aged less than 65 years. Particularly, it is of great importance to monitor baPWV for predicting incident stroke in "relatively healthy" hypertensive patients, i.e. aged less than 65 years with normal fasting glucose.
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Affiliation(s)
- Cao Li
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhuo Wang
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and nutritional engineering, China Agricultural University, Beijing, China
| | - Shuai Liu
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Shanshan Guo
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yun Song
- Institute of Biomedicine, Anhui Medical University, Hefei, China
- Department of Scientific Research, Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Lishun Liu
- Department of Scientific Research, Shenzhen Evergreen Medical Institute, Shenzhen, China
- Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
| | - Ziyi Zhou
- Department of Scientific Research, Shenzhen Evergreen Medical Institute, Shenzhen, China
- Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
| | - Binyan Wang
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Meiqing Huang
- Department of Scientific Research, Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Ruiqing Wang
- Health Management Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Lijie Zhai
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yiming Gao
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xianhui Qin
- Institute of Biomedicine, Anhui Medical University, Hefei, China
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Huaguang Zheng
- Health Management Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- *Correspondence: Huaguang Zheng, ; Zhigang Zhao,
| | - Zhigang Zhao
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- *Correspondence: Huaguang Zheng, ; Zhigang Zhao,
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Kreutz R, Abd el-Hady Algharably E. Blood Pressure Control. ENCYCLOPEDIA OF MOLECULAR PHARMACOLOGY 2021:317-322. [DOI: 10.1007/978-3-030-57401-7_30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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143
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Lona G, Hauser C, Köchli S, Infanger D, Endes K, Faude O, Hanssen H. Blood Pressure Increase and Microvascular Dysfunction Accelerate Arterial Stiffening in Children: Modulation by Physical Activity. Front Physiol 2020; 11:613003. [PMID: 33391029 PMCID: PMC7773656 DOI: 10.3389/fphys.2020.613003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 11/30/2020] [Indexed: 12/19/2022] Open
Abstract
Background Atherosclerotic remodeling starts early in life and can accelerate in the presence of cardiovascular risk (CV) factors. Regular physical activity (PA) can mitigate development of large and small artery disease during lifespan. We aimed to investigate the association of changes in body mass index (BMI), blood pressure (BP), PA behavior and retinal microvascular diameters with large artery pulse wave velocity (PWV) in prepubertal children over 4 years. Methods The school-based prospective cohort study included 262 children initially aged 6–8 years, assessing the above CV risk factors and retinal vessels by standardized procedures at baseline (2014) and follow-up (2018). PWV was assessed by an oscillometric device at follow-up. Results Children with increased systolic BP over 4 years showed higher PWV at follow-up (β [95% CI] 0.006 [0.002 to 0.011] mmHg per unit, P = 0.002). In contrast, increased vigorous PA corresponded to a lower PWV at follow-up (β [95% CI] −0.009 [−0.018 to <0−0.001] 10 min/day per unit, P = 0.047). Progression of retinal arteriolar narrowing and venular widening were linked to a higher PWV after 4 years (β [95% CI] −0.014 [−0.023 to −0.004] 0.01 changes per unit, P = 0.003). Conclusion Increase in systolic BP and progression of microvascular dysfunction were associated with higher PWV after 4 years. Children with increasing levels of vigorous PA were found to have lower PWV at follow-up. Habitual vigorous PA has the potential to decelerate the process of early vascular aging in children and may thus help counteract CV disease development later in life. Clinical Trial Registration ClinicalTrials.gov, Identifier: NCT03085498.
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Affiliation(s)
- Giulia Lona
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Christoph Hauser
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Sabrina Köchli
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Denis Infanger
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Katharina Endes
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Oliver Faude
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
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Safar ME, Regnault V, Lacolley P. Sex Differences in Arterial Stiffening and Central Pulse Pressure: Mechanistic Insights? J Am Coll Cardiol 2020; 75:881-883. [PMID: 32130923 DOI: 10.1016/j.jacc.2019.12.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 12/30/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Michel E Safar
- Diagnosis and Therapeutics Center, Hôtel-Dieu Hospital, Paris, France.
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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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146
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Li X, Shi R, Meng Q, Zhang X, Chen X. Does arterial stiffness affect orthostatic hypotension among high-altitude Tibetans? Postgrad Med 2020; 133:173-180. [PMID: 32926805 DOI: 10.1080/00325481.2020.1823683] [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: 02/08/2023]
Abstract
OBJECTIVE This study aimed to investigate the association between arterial stiffness and orthostatic hypotension (OH) and orthostatic blood pressure (BP) changes among Tibetans living at high altitude. METHODS A total of 630 high-altitude Tibetans were included (56.53 ± 10.16 years; 246 men). Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV). OH was defined as a decrease in systolic BP (SBP) >20 mmHg or a decrease in diastolic BP (DBP) >10 mmHg after 1 min or 3 min of moving from supine to standing position. RESULTS The prevalence of OH in this population was 6.3%. Compared with subjects without OH, the subjects with OH had a higher baPWV (P < 0.001). Multiple logistical regression found that baPWV was significantly associated with the occurrence of OH (OR 1.147, CI 95% 1.028-1.280, P = 0.014). Spearman correlation analysis showed that baPWV was negatively associated with orthostatic changes in SBP and DBP(r = -0.256, P < 0.001 and r = -0.194, P < 0.001, respectively). Further multiple stepwise linear regression analysis showed that baPWV was independently correlated with orthostatic BP changes (SBP: β = -0.599, P < 0.001; DBP: β = -0.333, P < 0.001). Moreover, increased baPWV was correlated with attenuation of orthostatic heart rate changes. No significant association was observed between hematocrit or hemoglobin concentration and OH. CONCLUSION BaPWV was significantly associated with the occurrence of OH and orthostatic changes in the SBP and DBP, which suggests that arterial stiffness may be a potential mechanism of impaired hemodynamic response to orthostatic challenges among high-altitude Tibetans.
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Affiliation(s)
- Xinran Li
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Rufeng Shi
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qingtao Meng
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xin Zhang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiaoping Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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147
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Tougaard NH, Theilade S, Winther SA, Tofte N, Ahluwalia TS, Hansen TW, Rossing P, Frimodt-Møller M. Carotid-Femoral Pulse Wave Velocity as a Risk Marker for Development of Complications in Type 1 Diabetes Mellitus. J Am Heart Assoc 2020; 9:e017165. [PMID: 32955366 PMCID: PMC7792427 DOI: 10.1161/jaha.120.017165] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background The value of carotid‐femoral pulse wave velocity (cfPWV) as risk factor for development of complications in type 1 diabetes mellitus remains to be determined. We investigated associations between cfPWV and renal outcomes, cardiovascular events, and all‐cause mortality in people with type 1 diabetes mellitus. Methods and Results cfPWV was measured with SphygmoCor in 633 people with type 1 diabetes mellitus. Median (interquartile range) follow‐up was 6.2 (5.8−6.7) years. End points included progression in albuminuria group, decline in estimated glomerular filtration rate (eGFR) ≥30%, end‐stage kidney disease, cardiovascular event, mortality, and a composite renal end point. Hazard ratios (HRs) were calculated per 1‐SD increase in cfPWV. Adjustments included age, sex, hemoglobin A1c, mean arterial pressure, body mass index, low‐density lipoprotein cholesterol, smoking, urine albumin excretion rate, and eGFR. The cohort included 45% women, mean (SD) age was 54 (13) years, mean (SD) eGFR was 83.2 (27.9) mL/min per 1.73 m2, and mean (SD) cfPWV was 10.4 (3.3) m/s. Median (interquartile range) albumin excretion rate was 17 (17‐63) mg/24 h. After adjustment, higher cfPWV was associated with increased hazard of progression in albuminuria (HR, 1.59; 95% CI, 1.10−2.32); decline in eGFR ≥30% (HR, 1.38; 95% CI, 1.06−1.79); cardiovascular event (HR, 1.31; 95% CI, 1.01−1.70); mortality (HR, 1.36; 95% CI, 1.00−1.85); and the composite renal end point (HR, 1.30; 95% CI, 1.04−1.63), but not with end‐stage kidney disease (HR, 1.18; 95% CI, 0.62−2.26). Higher cfPWV was associated with steeper yearly increase in albumin excretion and steeper yearly decline in eGFR after adjustment (P=0.002 and P=0.01, respectively). Conclusions cfPWV was associated with increased hazard of renal outcomes, cardiovascular event, and mortality. cfPWV may be suited for risk stratification in type 1 diabetes mellitus.
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Affiliation(s)
| | - Simone Theilade
- Steno Diabetes Center Copenhagen Gentofte Denmark.,Herlev-Gentofte Hospital Copenhagen Denmark
| | | | - Nete Tofte
- Steno Diabetes Center Copenhagen Gentofte Denmark
| | | | | | - Peter Rossing
- Steno Diabetes Center Copenhagen Gentofte Denmark.,University of Copenhagen Copenhagen Denmark
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148
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Abstract
: Hypertension is a worldwide known cause of morbidity and mortality in the elderly and is a major risk factor for cardiovascular complications such as stroke, myocardial infarction, renal complications and heart failure. Although the mechanisms of hypertension remain largely unknown, a recent new concept is that aortic stiffening is a cause of hypertension in middle-aged and older individuals, which highlighted the importance of aortic stiffening in the development of age-related hypertension. Understanding the pathogenesis of aortic stiffness therefore became one of the important approaches to preventing and controlling hypertension. This review discusses the recent progress of the potential causes of aortic stiffening and its implication on the pathogenesis of hypertension, in terms of aging, inflammation, metabolic syndromes, neuroendocrine and the interaction among these causes.
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Affiliation(s)
- John O. ONUH
- Center for Molecular and Translational Medicine, Georgia State University, Atlanta, GA, USA, 30303
| | - Hongyu QIU
- Center for Molecular and Translational Medicine, Georgia State University, Atlanta, GA, USA, 30303
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149
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Abstract
RATIONALE Previous studies on the relationship between diabetes and arterial stiffness were mostly cross-sectional. A few longitudinal studies focused on one single direction. Whether the association between arterial stiffness and diabetes is bidirectional remains unclear to date. OBJECTIVE To explore the temporal relationship between arterial stiffness and fasting blood glucose (FBG) status. METHODS AND RESULTS Included were 14 159 participants of the Kailuan study with assessment of brachial-ankle pulse wave velocity (baPWV) from 2010 to 2015, and free of diabetes, cardiovascular and cerebrovascular diseases, and chronic kidney disease at baseline. FBG and baPWV were repeatedly measured at baseline and follow-ups. Cox proportional hazard regression model was used to estimate hazard ratios and 95% confidence intervals (CIs) of incident diabetes across baseline baPWV groups: <1400 cm/s (ref), 1400≤ baPWV <1800 cm/s, and ≥1800 cm/s. Path analysis was used to analyze the possible temporal causal relationship between baPWV and FBG, among 8956 participants with repeated assessment of baPWV and FBG twice in 2010 to 2017. The mean baseline age of the observed population was 48.3±12.0 years. During mean 3.72 years of follow-up, 979 incident diabetes cases were identified. After adjusting for potential confounders, the hazard ratio (95% CI) for risk of diabetes was 1.59 (1.34-1.88) for the borderline arterial stiffness group and 2.11 (1.71-2.61) for the elevated arterial stiffness group, compared with the normal ideal arterial stiffness group. In the path analysis, baseline baPWV was associated with follow-up FBG (the standard regression coefficient was 0.09 [95% CI, 0.05-0.10]). In contrast, the standard regression coefficient of baseline FBG for follow-up baPWV (β=0.00 [95% CI, -0.02 to 0.02]) was not significant. CONCLUSIONS Arterial stiffness, as measured by baPWV, was associated with risk of developing diabetes. Arterial stiffness appeared to precede the increase in FBG.
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Affiliation(s)
- Mengyi Zheng
- Graduate School (M.Z., Y.S.), North China University of Science and Technology, Kailuan General Hospital, Tangshan, Hebei Province, China.,Department of Cardiology (M.Z., S.C., Y.S., Q.Z., S.W.), North China University of Science and Technology, Kailuan General Hospital, Tangshan, Hebei Province, China
| | - Xinyuan Zhang
- Department of Nutritional Sciences, the Pennsylvania State University, University Park, PA (X.Z., X.G.)
| | - Shuohua Chen
- Department of Cardiology (M.Z., S.C., Y.S., Q.Z., S.W.), North China University of Science and Technology, Kailuan General Hospital, Tangshan, Hebei Province, China
| | - Yongjian Song
- Graduate School (M.Z., Y.S.), North China University of Science and Technology, Kailuan General Hospital, Tangshan, Hebei Province, China.,Department of Cardiology (M.Z., S.C., Y.S., Q.Z., S.W.), North China University of Science and Technology, Kailuan General Hospital, Tangshan, Hebei Province, China
| | - Quanhui Zhao
- Department of Cardiology (M.Z., S.C., Y.S., Q.Z., S.W.), North China University of Science and Technology, Kailuan General Hospital, Tangshan, Hebei Province, China
| | - Xiang Gao
- Department of Nutritional Sciences, the Pennsylvania State University, University Park, PA (X.Z., X.G.)
| | - Shouling Wu
- Department of Cardiology (M.Z., S.C., Y.S., Q.Z., S.W.), North China University of Science and Technology, Kailuan General Hospital, Tangshan, Hebei Province, China
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150
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De Munck DG, De Moudt S, Roth L, De Meyer GRY, Martinet W, Fransen P. Defective Autophagy in Vascular Smooth Muscle Cells Alters Vascular Reactivity of the Mouse Femoral Artery. Front Physiol 2020; 11:548943. [PMID: 33071811 PMCID: PMC7538838 DOI: 10.3389/fphys.2020.548943] [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: 04/04/2020] [Accepted: 08/31/2020] [Indexed: 12/28/2022] Open
Abstract
Autophagy is an important cellular survival process that enables degradation and recycling of defective organelles and proteins to maintain cellular homeostasis. Hence, defective autophagy plays a role in many age-associated diseases, such as atherosclerosis, arterial stiffening and hypertension. Recently, we showed in mice that autophagy in vascular smooth muscle cells (VSMCs) of large elastic arteries such as the aorta is important for Ca2+ mobilization and vascular reactivity. Whether autophagy plays a role in the smaller muscular arteries, such as the femoral artery, and thereby contributes to for example, blood pressure regulation is currently unknown. Therefore, we determined vascular reactivity of femoral artery segments of mice containing a VSMC specific deletion of the essential autophagy gene Atg7 (Atg7F/F SM22α-Cre+) and compared them to femoral artery segments of corresponding control mice (Atg7+/+ SM22α-Cre+). Our results indicate that similar to the aorta, femoral artery segments showed enhanced contractility. Specifically, femoral artery segments of Atg7F/F SM22α-Cre+ mice showed an increase in phasic phenylephrine (PE) induced contractions, together with an enhanced sensitivity to depolarization induced contractions. In addition, and importantly, VSMC sensitivity to exogenous nitric oxide (NO) was significantly increased in femoral artery segments of Atg7F/F SM22α-Cre+ mice. Notwithstanding the fact that small artery contractility is a significant pathophysiological determinant for the development of hypertension, 7 days of treatment with angiotensin II (AngII), which increased systolic blood pressure in control mice, was ineffective in Atg7F/F SM22α-Cre+ mice. It is likely that this was due to the increased sensitivity of VSMCs to NO in the femoral artery, although changes in the heart upon AngII treatment were also present, which could also be (partially) accountable for the lack of an AngII-induced rise in blood pressure in Atg7F/F SM22α-Cre+ mice. Overall, our study indicates that apart from previously shown effects on large elastic arteries, VSMC autophagy also plays a pivotal role in the regulation of the contractile and relaxing properties of the smaller muscular arteries. This may suggest a role for autophagy in vascular pathologies, such as hypertension and arterial stiffness.
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Affiliation(s)
- Dorien G De Munck
- Laboratory of Physiopharmacology, Department of Pharmaceutical Sciences, University of Antwerp, Antwerp, Belgium
| | - Sofie De Moudt
- Laboratory of Physiopharmacology, Department of Pharmaceutical Sciences, University of Antwerp, Antwerp, Belgium
| | - Lynn Roth
- Laboratory of Physiopharmacology, Department of Pharmaceutical Sciences, University of Antwerp, Antwerp, Belgium
| | - Guido R Y De Meyer
- Laboratory of Physiopharmacology, Department of Pharmaceutical Sciences, University of Antwerp, Antwerp, Belgium
| | - Wim Martinet
- Laboratory of Physiopharmacology, Department of Pharmaceutical Sciences, University of Antwerp, Antwerp, Belgium
| | - Paul Fransen
- Laboratory of Physiopharmacology, Department of Pharmaceutical Sciences, University of Antwerp, Antwerp, Belgium
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