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Campillo JT, Dupasquier V, Lebredonchel E, Rancé LG, Hemilembolo MC, Pion SDS, Boussinesq M, Missamou F, Perez Martin A, Chesnais CB. Association between arterial stiffness and Loa loa microfilaremia in a rural area of the Republic of Congo: A population-based cross-sectional study (the MorLo project). PLoS Negl Trop Dis 2024; 18:e0011915. [PMID: 38241411 PMCID: PMC10830006 DOI: 10.1371/journal.pntd.0011915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/31/2024] [Accepted: 01/12/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Loa loa filariasis (loiasis) is still considered a relatively benign disease. However, recent epidemiologic data suggest increased mortality and morbidity in L. loa infected individuals. We aimed to examine whether the density of L. loa microfilariae (mfs) in the blood is associated with cardiovascular disease. METHODOLOGY Using a point-of-care device (pOpmètre), we conducted a cross-sectional study to assess arterial stiffness and peripheral arterial disease (PAD) in 991 individuals living in a loiasis-endemic rural area in the Republic of the Congo. Microfilaremic individuals were matched for age, sex and village of residence with 2 amicrofilaremic subjects. We analyzed markers of arterial stiffness (Pulse-Wave Velocity, PWV), PAD (Ankle-Brachial Index, ABI) and cardiovascular health (Pulse Pressure, PP). The analysis considered parasitological results (L. loa microfilarial density [MFD], soil-transmitted helminths infection, asymptomatic malaria and onchocerciasis), sociodemographic characteristics and known cardiovascular risk factors (body mass index, smoking status, creatininemia, blood pressure). PRINCIPAL FINDINGS Among the individuals included in the analysis, 192/982 (19.5%) and 137/976 (14.0%) had a PWV or an ABI considered out of range, respectively. Out of range PWV was associated with younger age, high mean arterial pressure and high L. loa MFD. Compared to amicrofilaremic subjects, those with more than 10,000 mfs/mL were 2.17 times more likely to have an out of range PWV (p = 0.00). Factors significantly associated with PAD were older age, low pulse rate, low body mass index, smoking, and L. loa microfilaremia. Factors significantly associated with an elevation of PP were older age, female sex, high average blood pressure, low pulse rate and L. loa microfilaremia. CONCLUSION A potential link between high L. loa microfilaremia and cardiovascular health deterioration is suggested. Further studies are required to confirm and explore this association.
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Affiliation(s)
- Jérémy T. Campillo
- TransVIHMI, Université de Montpellier, INSERM Unité 1175, Institut de Recherche pour le Développement (IRD), Montpellier, France
| | - Valentin Dupasquier
- Department of Cardiology, Montpellier University Hospital, Montpellier, France
| | - Elodie Lebredonchel
- Département de Biochimie, Hôpitaux Universitaires Paris Nord Val de Seine–site Bichat, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Ludovic G. Rancé
- Department of Anesthesiology and Critical Care Medicine, Montpellier University Hospital, Montpellier, France
| | - Marlhand C. Hemilembolo
- TransVIHMI, Université de Montpellier, INSERM Unité 1175, Institut de Recherche pour le Développement (IRD), Montpellier, France
- Programme National de Lutte contre l’Onchocercose, Direction de l’Épidémiologie et de la Lutte contre la Maladie, Ministère de la Santé et de la Population, Brazzaville, Republic of Congo
| | - Sébastien D. S. Pion
- TransVIHMI, Université de Montpellier, INSERM Unité 1175, Institut de Recherche pour le Développement (IRD), Montpellier, France
| | - Michel Boussinesq
- TransVIHMI, Université de Montpellier, INSERM Unité 1175, Institut de Recherche pour le Développement (IRD), Montpellier, France
| | - François Missamou
- Programme National de Lutte contre l’Onchocercose, Direction de l’Épidémiologie et de la Lutte contre la Maladie, Ministère de la Santé et de la Population, Brazzaville, Republic of Congo
| | - Antonia Perez Martin
- Vascular Medicine Laboratory, Nîmes University Hospital, Nîmes, France
- IDESP, Université de Montpellier, INSERM, Montpellier, France
| | - Cédric B. Chesnais
- TransVIHMI, Université de Montpellier, INSERM Unité 1175, Institut de Recherche pour le Développement (IRD), Montpellier, France
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2
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Choudhary MK, Penninkangas RM, Eräranta A, Niemelä O, Mangani C, Maleta K, Ashorn P, Ashorn U, Pörsti I. Posture-Related Differences in Cardiovascular Function Between Young Men and Women: Study of Noninvasive Hemodynamics in Rural Malawi. J Am Heart Assoc 2022; 11:e022979. [PMID: 35195013 PMCID: PMC9075090 DOI: 10.1161/jaha.121.022979] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Cardiovascular risk is higher in men than in women, but little information exists about sex‐related differences in cardiovascular function from low‐income countries. We compared hemodynamics between sexes in rural Malawi in a cohort followed up since their birth. Methods and Results Supine, seated, and standing hemodynamics were recorded from 251 women and 168 men (mean age, 21 years; body mass index, 21 kg/m2) using oscillometric brachial waveform analyses (Mobil‐O‐Graph). The results were adjusted for estimated glomerular filtration rate, and plasma potassium, lipids, and glucose. Men had higher brachial and aortic systolic blood pressure and stroke index regardless of posture (P<0.001), and higher upright but similar supine diastolic blood pressure than women. Regardless of posture, heart rate was lower in men (P<0.001), whereas cardiac index did not differ between sexes. Women presented with lower supine and standing systemic vascular resistance index (P<0.001), whereas supine‐to‐standing increase in vascular resistance (P=0.012) and decrease in cardiac index (P=0.010) were higher in women. Supine left cardiac work index was similar in both sexes, whereas standing and seated left cardiac work index was higher in men than in women (P<0.001). Conclusions In young Malawian adults, men had higher systolic blood pressure, systemic vascular resistance, and upright cardiac workload, whereas women presented with higher posture‐related changes in systemic vascular resistance and cardiac output. These findings show systematic sex‐related differences in cardiovascular function in a cohort from a low‐income country with high exposure to prenatal and postnatal malnutrition and infectious diseases.
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Affiliation(s)
| | | | - Arttu Eräranta
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Onni Niemelä
- Faculty of Medicine and Health Technology Tampere University Tampere Finland.,Department of Laboratory Medicine and Medical Research Unit Seinäjoki Central Hospital Seinäjoki Finland
| | - Charles Mangani
- School of Public Health and Family Medicine College of Medicine University of Malawi Blantyre Malawi
| | - Kenneth Maleta
- School of Public Health and Family Medicine College of Medicine University of Malawi Blantyre Malawi
| | - Per Ashorn
- Faculty of Medicine and Health Technology Tampere University Tampere Finland.,Department of Pediatrics Tampere University Hospital Tampere Finland
| | - Ulla Ashorn
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Ilkka Pörsti
- Faculty of Medicine and Health Technology Tampere University Tampere Finland.,Department of Internal Medicine Tampere University Hospital Tampere Finland
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3
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Meital LT, Schulze K, Magee R, O’Donnell J, Jha P, Meital CY, Donkin R, Bailey TG, Askew CD, Russell FD. Long Chain Omega-3 Polyunsaturated Fatty Acids Improve Vascular Stiffness in Abdominal Aortic Aneurysm: A Randomized Controlled Trial. Nutrients 2020; 13:E138. [PMID: 33396567 PMCID: PMC7824679 DOI: 10.3390/nu13010138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 11/16/2022] Open
Abstract
Abdominal aortic aneurysm (AAA) is a vascular disease involving permanent focal dilation of the abdominal aorta (≥30 mm) that can lead to catastrophic rupture. Destructive remodeling of aortic connective tissue in AAA contributes to wall stiffening, a mechanical parameter of the arterial system linked to a heightened risk of cardiovascular morbidity and mortality. Since aortic stiffening is associated with AAA progression, treatment options that target vascular inflammation would appear prudent. Given this, and growing evidence indicating robust anti-inflammatory and vasoprotective properties for long chain omega-3 polyunsaturated fatty acids (LC n-3 PUFAs), this study evaluated the impact of these nutrients (1.8 g/day for 12 weeks) on indices of vascular stiffness in patients with AAA. At baseline, pulse wave velocity (PWV) and augmentation index normalized to a heart rate of 75 bpm (AIx75) were significantly higher in patients with AAA compared to control participants (PWV: 14.2 ± 0.4 m.s-1 vs. 12.6 ± 0.4 m.s-1, p = 0.014; AIx75: 26.4 ± 1.7% vs. 17.3 ± 2.7%, p = 0.005). Twelve-week LC n-3 PUFA supplementation significantly decreased PWV (baseline: 14.2 ± 0.6 m.s-1, week 12: 12.8 ± 0.7 m.s-1, p = 0.014) and heart rate (baseline: 63 ± 3 bpm, week 12: 58 ± 3 bpm, p = 0.009) in patients with AAA. No change was observed for patients receiving placebo capsules. While this raises the possibility that LC n-3 PUFAs provide improvements in aortic stiffness in patients with AAA, the clinical implications remain to be fully elucidated.
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Affiliation(s)
- Lara T. Meital
- Centre for Genetics, Ecology & Physiology, University of the Sunshine Coast, Maroochydore, QLD 4556, Australia;
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD 4556, Australia; (R.D.); (C.D.A.)
| | - Karl Schulze
- Sunshine Vascular, Buderim, QLD 4556, Australia;
| | - Rebecca Magee
- Department of Surgery, Sunshine Coast University Hospital, Birtinya, QLD 4575, Australia; (R.M.); (J.O.); (P.J.)
| | - Jill O’Donnell
- Department of Surgery, Sunshine Coast University Hospital, Birtinya, QLD 4575, Australia; (R.M.); (J.O.); (P.J.)
| | - Pankaj Jha
- Department of Surgery, Sunshine Coast University Hospital, Birtinya, QLD 4575, Australia; (R.M.); (J.O.); (P.J.)
| | - Chaim Y. Meital
- Moffat Beach Family Medical Practice, Moffat Beach, QLD 4551, Australia;
| | - Rebecca Donkin
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD 4556, Australia; (R.D.); (C.D.A.)
| | - Tom G. Bailey
- Physiology and Ultrasound Laboratory in Science and Exercise (PULSE), Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Queensland, QLD 4343, Australia;
- School of Nursing, Midwifery and Social Work, The University of Queensland, Queensland, QLD 4343, Australia
| | - Christopher D. Askew
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD 4556, Australia; (R.D.); (C.D.A.)
- VasoActive Research Group, Sunshine Coast Health Institute, Sunshine Coast Hospital and Health Service, Birtinya, QLD 4575, Australia
| | - Fraser D. Russell
- Centre for Genetics, Ecology & Physiology, University of the Sunshine Coast, Maroochydore, QLD 4556, Australia;
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD 4556, Australia; (R.D.); (C.D.A.)
- VasoActive Research Group, Sunshine Coast Health Institute, Sunshine Coast Hospital and Health Service, Birtinya, QLD 4575, Australia
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Bawa-Allah A, Mashao MM, Nyundu TF, Phukubje EM, Nkosi BG, Ngema MV, Mlambo BW, Maseko MJ. SERUM LIPID PROFILE AND ARTERIAL STIFFNESS IN NON-DIPPERS. INTERNATIONAL JOURNAL OF MEDICINE AND MEDICAL RESEARCH 2020. [DOI: 10.11603/ijmmr.2413-6077.2020.1.11014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background. A non-dipping blood pressure profile (NDP) is associated with increased arterial stiffness and other cardiovascular target organ damage. Serum lipid profiles have been shown to be important determinants of arterial stiffness.
Objective. The aim of the research was to assess serum lipid profiles and arterial stiffness in non-dippers.
Methods. This cross-sectional study was conducted involving 796 (288 males and 508 females) participants of black African origin. A twenty-four-hour ambulatory BP monitoring was done using a Spacelabs 90207 (Spacelabs Inc., Redmond, Washington, USA) monitor. Carotid-Femoral pulse wave velocity measurements were performed using a high fidelity SPC-301 micromanometer (Millar instruments Inc., Houston, TX).
Results. Of the 288 males, 140 were classified as non-dippers. Of the 508 females, 273 were classified as non-dippers. In the general population, males had higher triglycerides when compared with females 1.46±0.96 vs 1.13±1.02, p<0.0001. Additionally, dipper males had higher serum TRGL when compared with dipper females 1.32±0.98 vs 1.06±0.58, p = 0.0012. Non-dipper males also had higher serum TRGL when compared with non-dipper females 1.61±2.05 vs 1.19±1.14, p=0.0078. Serum HDLc was lower in the non-dipper male group when compared to the non-dipper female group (p=0.008). In both male and female groups, non-dippers had higher CFPWV when compared with dippers; 7.53±3.60 vs 5.74±2.47, p<0.0001 and 6.64±2.52 vs 5.98±2.23, p=0.0021 respectively. However, non-dipper males had significantly higher CFPWV when compared with non-dipper females (7.53±3.60 vs 6.64±2.52, p=0.0031).
Conclusions. Therapies targeting a reduction of serum triglycerides levels might be beneficial in improving arterial compliance with or without the presence of non-dipping.
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Turi V, Iurciuc S, Crețu OM, Tit DM, Bungau S, Apostol A, Moleriu RD, Bustea C, Behl T, Diaconu CC, Petre I. Arterial function in hypertensive pregnant women. Is arterial stiffness a marker for the outcomes in pregnancy? Life Sci 2020; 264:118723. [PMID: 33160988 DOI: 10.1016/j.lfs.2020.118723] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/26/2020] [Accepted: 11/03/2020] [Indexed: 10/23/2022]
Abstract
AIMS Hypertension (HTN) in pregnancy is a major cause of maternal, foetal and neonatal morbimortality in both developing and developed countries. Arterial stiffness is a predictor of cardiovascular events and can be assessed through augmentation index (AIx) and pulse wave velocity (PWV). This study was intended to analyse the arterial stiffness in three categories, hypertensive pregnant women vs. healthy women (both pregnant and non-pregnant). MAIN METHODS Between 2018 and 2019, 150 women were prospectively included into three homogenous groups, of equal sizes (N = 50): pregnant women with HTN (group 1), pregnant women without HTN (group 2), and non-pregnant women (group 3). We assessed pregnant women 3 times (in all three trimesters) and six weeks postpartum, and the women from the control group once. KEY FINDINGS Significant differences (p < 0.001) of the hemodynamic and arterial stiffness parameters and of the heart rate (HR) (p = 0.006) were observed between groups 1 and 2. Women with pregnancy-induced HTN had different values of arterial function parameters long time before the first signs of high blood pressure (BP) occurred. Also, body mass index (BMI) had a deleterious effect in all patients, but especially in pregnant HTN women. Significant differences (p < 0.001) between groups 2 and 3 were observed regarding the BP and aortic PWV (PWVao) and, as well, significant differences (p < 0.05) between BMI, aortic systolic BP (p = 0.02), brachial AIx (p = 0.01) and pulse pressure (PP) (p = 0.049) values. SIGNIFICANCE The current study emphasizes the importance of the assessment of arterial function parameters and BMI as markers for future BP values and outcomes throughout gestation.
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Affiliation(s)
- Vladiana Turi
- Department of Cardiology, "Victor Babeş" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania.
| | - Stela Iurciuc
- Department of Cardiology, "Victor Babeş" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Octavian Marius Crețu
- Department of Surgery, "Victor Babeş" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Delia Mirela Tit
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 29 N. Jiga St., Oradea 410028, Romania.
| | - Simona Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 29 N. Jiga St., Oradea 410028, Romania.
| | - Adrian Apostol
- Department of Cardiology, "Victor Babeş" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; Clinical Section of Cardiology, Timiş County Emergency Clinical Hospital "Pius Brînzeu", 156 Liviu Rebreanu Sq., 300723 Timisoara, Romania
| | - Radu Dumitru Moleriu
- Department of Mathematics, Faculty of Mathematics and Computer Science, West University of Timisoara, Timisoara, Romania.
| | - Cristiana Bustea
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410041 Oradea, Romania
| | - Tapan Behl
- Chitkara College of Pharmacy, Chitkara University, 140401, Punjab, India
| | - Camelia Cristina Diaconu
- Department 5, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania; Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania
| | - Izabella Petre
- Department XII of Obstetrics and Gynaecology, "Victor Babeş" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
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6
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Kowalczyk K, Jabłoński B, Kwarciany M, Karaszewski B, Narkiewicz K, Gąsecki D. Changes of augmentation index early after ischaemic stroke predict functional outcome. Blood Press 2020; 29:327-335. [PMID: 32456469 DOI: 10.1080/08037051.2020.1769468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Purpose: Outcome after ischaemic stroke (AIS) depends on multiple factors, including values of blood pressure (BP) and arterial stiffness (AS) in the early phase. It is also known that stroke outcome is affected by BP variability; however, the influence of AS oscillations in the early phase of stroke on its prognosis is unknown. The aim of our study was to assess the relationship between changes of AS markers and stroke outcome.Materials and methods: Baseline clinical data, BP parameters, and markers of AS (pulse wave velocity [PWV], augmentation index [AIx]) were assessed 1, 6, and >90 days after AIS. The outcomes were defined using modified Rankin scale (mRS) score: early favourable (EFO) and early poor (EPO), as mRS ≤1 and >2 points at discharge, respectively; late favourable (LFO) and late poor (LPO), as mRS ≤1 and >2 points on day >90, respectively.Results: In the recruited 50 patients (62.2 ± 12.1 years, 68% males), BP and PWV decreased while AIx did not change within 90 days after AIS. Twenty-eight patients (56%) had EFO, 10 (20%) - EPO, 29 (58%) - LFO, and 9 (18%) - LPO. In univariate analysis, rise in AIx in days 1-6 was associated with EFO (odds ratio [OR] = 1.09, 95% confidence interval [CI] = 1.02-1.17, p = 0.01) and LFO (OR = 1.08; 95%CI = 1.01-1.14, p = 0.02), whereas decrease in AIx in days 1-6 was associated with EPO (OR = 1.07, 95%CI = 1.00-1.15, p = 0.05). For EFO and LFO, the relationships remained significant after including confounders (p = 0.03 and p = 0.03, respectively).Conclusions: Rise in AIx within one week after ischaemic stroke may be of additional importance in determining better early and late favourable functional outcome.
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Affiliation(s)
- Kamil Kowalczyk
- Department of Adult Neurology, Medical University of Gdańsk, Gdańsk, Poland
| | - Bartosz Jabłoński
- Department of Adult Neurology, Medical University of Gdańsk, Gdańsk, Poland
| | - Mariusz Kwarciany
- Department of Adult Neurology, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland
| | - Dariusz Gąsecki
- Department of Adult Neurology, Medical University of Gdańsk, Gdańsk, Poland
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7
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Hussein A, Matthews JL, Syme C, Macgowan C, MacIntosh BJ, Shirzadi Z, Pausova Z, Paus T, Chen JJ. The association between resting-state functional magnetic resonance imaging and aortic pulse-wave velocity in healthy adults. Hum Brain Mapp 2020; 41:2121-2135. [PMID: 32034832 PMCID: PMC7268071 DOI: 10.1002/hbm.24934] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 12/11/2022] Open
Abstract
Resting‐state functional magnetic resonance imaging (rs‐fMRI) is frequently used to study brain function; but, it is unclear whether BOLD‐signal fluctuation amplitude and functional connectivity are associated with vascular factors, and how vascular‐health factors are reflected in rs‐fMRI metrics in the healthy population. As arterial stiffening is a known age‐related cardiovascular risk factor, we investigated the associations between aortic stiffening (as measured using pulse‐wave velocity [PWV]) and rs‐fMRI metrics. We used cardiac MRI to measure aortic PWV (an established indicator of whole‐body vascular stiffness), as well as dual‐echo pseudo‐continuous arterial‐spin labeling to measure BOLD and CBF dynamics simultaneously in a group of generally healthy adults. We found that: (1) higher aortic PWV is associated with lower variance in the resting‐state BOLD signal; (2) higher PWV is also associated with lower BOLD‐based resting‐state functional connectivity; (3) regions showing lower connectivity do not fully overlap with those showing lower BOLD variance with higher PWV; (4) CBF signal variance is a significant mediator of the above findings, only when averaged across regions‐of‐interest. Furthermore, we found no significant association between BOLD signal variance and systolic blood pressure, which is also a known predictor of vascular stiffness. Age‐related vascular stiffness, as measured by PWV, provides a unique scenario to demonstrate the extent of vascular bias in rs‐fMRI signal fluctuations and functional connectivity. These findings suggest that a substantial portion of age‐related rs‐fMRI differences may be driven by vascular effects rather than directly by brain function.
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Affiliation(s)
- Ahmad Hussein
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
| | - Jacob L Matthews
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
| | - Catriona Syme
- SickKids Hospital, Toronto, Canada.,Department of Physiology, University of Toronto, Toronto, Canada
| | - Christopher Macgowan
- SickKids Hospital, Toronto, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Bradley J MacIntosh
- Department of Medical Biophysics, University of Toronto, Toronto, Canada.,Physical Sciences Platform, Sunnybrook Research Institute, Toronto, Canada
| | - Zahra Shirzadi
- Department of Medical Biophysics, University of Toronto, Toronto, Canada.,Physical Sciences Platform, Sunnybrook Research Institute, Toronto, Canada
| | - Zdenka Pausova
- SickKids Hospital, Toronto, Canada.,Department of Physiology, University of Toronto, Toronto, Canada
| | - Tomáš Paus
- Physical Sciences Platform, Sunnybrook Research Institute, Toronto, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - J Jean Chen
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Canada
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8
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van Mil SR, Biter LU, van de Geijn GJM, Birnie E, Dunkelgrun M, Ijzermans JNM, van der Meulen N, Mannaerts GHH, Castro Cabezas M. The effect of sex and menopause on carotid intima-media thickness and pulse wave velocity in morbid obesity. Eur J Clin Invest 2019; 49:e13118. [PMID: 30972739 PMCID: PMC6617718 DOI: 10.1111/eci.13118] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 02/28/2019] [Accepted: 04/06/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Women are relatively protected from cardiovascular disease compared with men. Since morbid obesity is an independent risk factor for cardiovascular disease, the current study investigated whether the association between sex and cardiovascular risk factors and outcomes can be demonstrated in subjects suffering from morbid obesity. MATERIALS AND METHODS Two hundred subjects enrolled in a study on cardiovascular risk factors in morbid obesity underwent extensive laboratory screening, carotid intima-media thickness (cIMT) and pulse wave velocity (PWV) measurements. Gender differences were analysed using univariate and multivariable linear regression models. In addition, the effect of menopause on cIMT and PWV was analysed. Results of these models were reported as B coefficients with 95% confidence intervals. RESULTS The group consisted of 52 men and 148 women, with a mean age of 41 (±11.8) years and a mean body mass index (BMI) of 42.7 (±5.2) kg/m2 . Both, cIMT and PWV were significantly higher in men than in women, although the difference in cIMT disappeared after adjustment for covariables such as waist circumference, age, high-density lipoprotein cholesterol and mean arterial pressure. PWV was associated with sex after adjustments for covariables in morbidly obese patients. Postmenopausal women had significantly increased cIMT and PWV when compared with premenopausal women. CONCLUSION Sex differences in PWV persist in subjects suffering from morbid obesity. However, no difference was found in cIMT between morbidly obese men and women after adjustment for classic cardiovascular risk factors. Premenopausal morbidly obese women are protected for cardiovascular disease when compared with postmenopausal morbidly obese women.
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Affiliation(s)
- Stefanie R van Mil
- Departments of Surgery, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | - L Ulas Biter
- Departments of Surgery, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | | | - Erwin Birnie
- Statistics and Education, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands.,Department of Obstetrics and Gynaecology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Martin Dunkelgrun
- Departments of Surgery, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | - Jan N M Ijzermans
- Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, the Netherlands
| | - Noelle van der Meulen
- Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, the Netherlands
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9
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Borgo MV, Baldo MP, Alvim RDO, Zaniqueli D, Capingana DP, Magalhães P, Silva ABD, Oliosa PR, Sartório CL, Mill JG. Lipid disorders among Black Africans non-users of lipid-lowering medication. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2018; 62:552-559. [PMID: 30462809 PMCID: PMC10118650 DOI: 10.20945/2359-3997000000076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 08/17/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Angola is a sub-Saharan African country where the population has scarce access to lipidlowering medication. We sought to determine the frequency of lipid disorders among Angolan nonusers of lipid-lowering medication. MATERIAL AND METHODS A cross-sectional descriptive study was carried out in a sample of 604 workers from the public sector. Blood pressure and anthropometric data were measured along with biochemical parameters including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). LDL-C to HDL-C ratio (LDL-C/HDL-C) was obtained from LDL-C and HDL-C levels. RESULTS High frequencies of elevated blood pressure (44.8%), metabolic syndrome (20.2%), increased TC (39.2%) and increased LDL-C (19.3%) were found. Low HDL-C was more frequent in women (62.4% vs. 36.1%, p < 0.001). Isolated hypercholesterolemia was more frequent in men (9.6% vs. 2.5%, p < 0.001). Among men TC, TG, LDL-C and LDL-C/HDL-C ratio were higher and HDL-C was lower in obese than in low-weight and normal-weight participants. Among women TC, TG, LDL-C and LDL-C/HDL-C ratio were higher in obese than in normal-weight participants. Significant linear trend of increasing TC and LDL-C levels as age increased was detected for both genders (p for trend < 0.05). CONCLUSION The results of our study showed a high frequency of lipid disorders in Angolan non-users of lipid-lowering medication.
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Diaz A, Zócalo Y, Bia D, Wray S, Fischer EC. Reference intervals and percentiles for carotid-femoral pulse wave velocity in a healthy population aged between 9 and 87 years. J Clin Hypertens (Greenwich) 2018; 20:659-671. [PMID: 29532992 PMCID: PMC8031202 DOI: 10.1111/jch.13251] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 01/27/2018] [Accepted: 01/31/2018] [Indexed: 11/28/2022]
Abstract
There is little information regarding age-related reference intervals (RIs) of carotid-femoral pulse wave velocity (cfPWV) for large healthy populations in South America. The aims of this study were to determine cfPWV RIs and percentiles in a cohort of healthy children, adolescents, and adults and to generate year-to-year percentile curves and body-height percentile curves for children and adolescents. cfPWV was measured in 1722 healthy participants with no cardiovascular risk factors (9-87 years, 60% men). First, RIs were evaluated for males and females through correlation and covariate analysis. Then, mean and standard deviation age-related equations were obtained for cfPWV using parametric regression methods based on fractional polynomials and age-specific (year-to-year) percentile curves that were defined using the standard normal distribution. Age-specific first, 2.5th, 5th, 10th, 25th, 50th, 75th, 90th, 95th, 97.5th, and 99th percentile curves were calculated. Finally, height-related cfPWV percentile curves for children and adolescents (<21 years) were established. After adjusting for age and blood pressure differences with respect to females, males showed higher cfPWV levels (6.60 vs 6.45 m/s; P < .01). Thus, specific RIs for males and females were reported. The study provides the largest database to date concerning cfPWV in healthy people from Argentina. Specific RIs and percentiles of cfPWV are now available according to age and sex. Specific percentiles of cfPWV according to body height were reported for people younger than 21 years.
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Affiliation(s)
- Alejandro Diaz
- Instituto de Investigación en Ciencias de la SaludUNICENCONICETTandilArgentina
| | - Yanina Zócalo
- Physiology DepartmentSchool of MedicineCentro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE)Republic UniversityMontevideoUruguay
| | - Daniel Bia
- Physiology DepartmentSchool of MedicineCentro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE)Republic UniversityMontevideoUruguay
| | - Sandra Wray
- Instituto de Medicina TraslacionalTrasplante y Bioingeniería ‐ IMTTyBUniversidad Favaloro ‐ CONICETBuenos AiresArgentina
| | - Edmundo Cabrera Fischer
- Instituto de Medicina TraslacionalTrasplante y Bioingeniería ‐ IMTTyBUniversidad Favaloro ‐ CONICETBuenos AiresArgentina
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11
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Díaz A, Zócalo Y, Bia D, Sabino F, Rodríguez V, Cabrera FIscher EI. Reference intervals of aortic pulse wave velocity assessed with an oscillometric device in healthy children and adolescents from Argentina. Clin Exp Hypertens 2018. [DOI: 10.1080/10641963.2018.1445754] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Alejandro Díaz
- Instituto de Investigación en Ciencias de la Salud. UNICEN. CONICET, Tandil, Argentina
| | - Yanina Zócalo
- Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, Montevideo, Uruguay
| | - Daniel Bia
- Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, Montevideo, Uruguay
| | - Franco Sabino
- Instituto de Investigación en Ciencias de la Salud. UNICEN. CONICET, Tandil, Argentina
| | - Victoria Rodríguez
- Instituto de Investigación en Ciencias de la Salud. UNICEN. CONICET, Tandil, Argentina
| | - Edmundo Ignacio Cabrera FIscher
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería - IMTTyB. Universidad Favaloro - CONICET, Buenos Aires, Argentina
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12
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Diaz A, Tringler M, Wray S, Ramirez AJ, Cabrera Fischer EI. The effects of age on pulse wave velocity in untreated hypertension. J Clin Hypertens (Greenwich) 2017; 20:258-265. [PMID: 29267992 DOI: 10.1111/jch.13167] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 09/14/2017] [Accepted: 09/22/2017] [Indexed: 01/18/2023]
Abstract
Increased arterial stiffness is an important determinant of cardiovascular risk, able to predict morbidity and mortality, and closely associated with ageing and blood pressure. The aims of this study were: (1) To determine the age-dependent reference pulse wave velocity (PWV), and compare it with values from hypertensive patients, and (2) to evaluate the impact of isolated and untreated hypertension on arterial stiffness. A total of 1079 patients were enrolled and divided into a control group (NT) of asymptomatic normotensive patients and a group of asymptomatic hypertensive patients (HT). Blood pressure, carotid-femoral PWV, and body mass index were measured in each subject, whose blood was drawn for laboratory tests. Aortic mean PWV in the NT group was 6.85 ± 1.66 m/s, which increased linearly (R2 = 0.62; P < .05) with age. In patients over 50 years of age, PWV was significantly higher than in younger patients (8.35 vs 5.92 m/s, respectively, P < .001). This significant difference persisted when observing male and female patients separately. In the hypertensive group, mean PWV value was 8.04 ± 1.8 m/s (range 4.5-15.8 m/s) and increased (R2 = 0.243; P < .05) with age. The PWV increase in HT was significantly higher (0.93 m/s per decade, P < .001) than in NT (0.44 m/s per decade). Our study provides normal values of PVW per decade, and shows that these values increase with age, especially after 50 years of age, particularly in HT patients. This stiffness growth rate may be responsible for increased cardiovascular risk in both groups.
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Affiliation(s)
- Alejandro Diaz
- CONICET School of Health Sciences IICS National University of the Center of Buenos Aires Province, Tandil, Argentina
| | - Matías Tringler
- CONICET School of Health Sciences IICS National University of the Center of Buenos Aires Province, Tandil, Argentina
| | - Sandra Wray
- Instituto de Medicina Traslacional, Trasplante, y Bioingeniería (IMeTTyB), Universidad Favaloro, CONICET, Buenos Aires, Argentina
| | - Agustín J Ramirez
- Instituto de Medicina Traslacional, Trasplante, y Bioingeniería (IMeTTyB), Universidad Favaloro, CONICET, Buenos Aires, Argentina.,Arterial Hypertension and Metabolic Unit, University Hospital Favaloro Foundation Buenos Aires, Argentina
| | - Edmundo I Cabrera Fischer
- Instituto de Medicina Traslacional, Trasplante, y Bioingeniería (IMeTTyB), Universidad Favaloro, CONICET, Buenos Aires, Argentina
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13
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Silva AB, Capingana DP, Magalhães P, Molina MDCB, Baldo MP, Mill JG. Predictors and Reference Values of Pulse Wave Velocity in Prepubertal Angolan Children. J Clin Hypertens (Greenwich) 2016; 18:725-32. [PMID: 26663634 PMCID: PMC8031821 DOI: 10.1111/jch.12739] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 09/17/2015] [Accepted: 09/22/2015] [Indexed: 11/29/2022]
Abstract
Carotid-femoral pulse wave velocity (PWV) has been used as the gold standard method to estimate arterial stiffness. However, its use in clinical practice is still limited because reference values for specific groups, such as black children, remain unknown. The authors aimed to investigate predictors and to propose preliminary reference values of PWV in this population. Prepubertal schoolchildren (N=157; mean age, 9.36±1.41 year) from Luanda (Angola) with normal blood pressure values and without obesity were included. Mean PWV was 5.73±0.68 m/s, with no difference between the sexes. Univariate regression analysis showed a significant (P<.05) positive correlation between PWV and height, age, body weight, lean body weight, and blood pressure. In multivariate analysis, however, only height remained an independent predictor of PWV [PWV=0.018×height (cm)+3.230]. Curves of PWV percentiles as a function of height are proposed, thus identifying normal PWV in black children.
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Affiliation(s)
- Amílcar B.T. Silva
- Department of Physiological SciencesFederal University of Espírito SantoEspírito SantoBrazil
- Department of Physiological SciencesMedical School of the Agostinho Neto UniversityLuandaAngola
| | - Daniel P. Capingana
- Department of Physiological SciencesMedical School of the Agostinho Neto UniversityLuandaAngola
| | - Pedro Magalhães
- Department of Physiological SciencesMedical School of the Agostinho Neto UniversityLuandaAngola
| | | | - Marcelo P. Baldo
- Department of Physiological SciencesFederal University of Espírito SantoEspírito SantoBrazil
| | - José Geraldo Mill
- Department of Physiological SciencesFederal University of Espírito SantoEspírito SantoBrazil
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Baena CP, Lotufo PA, Mill JG, Cunha RDS, Benseñor IJ. Serum Uric Acid and Pulse Wave Velocity Among Healthy Adults: Baseline Data From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Am J Hypertens 2015; 28:966-70. [PMID: 25609603 DOI: 10.1093/ajh/hpu298] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 12/15/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We aimed to evaluate a possible association between serum uric acid (SUA) levels and carotid-to-femoral pulse wave velocity (cf-PWV) among healthy participants of the ELSA-Brasil. METHODS We excluded subjects using antihypertensive medication, diuretics, allopurinol, binge drinkers, body mass index (BMI) >35 kg/m2, and those with history of cardiovascular diseases (CVD). In a cross-sectional and sex-specific analysis, linear regression models were built having cf-PWV as dependent variable and SUA as independent variable. Multiple adjustments were subsequently made for age, heart rate and blood pressure, BMI, and fasting glucose levels as covariates. Product interaction terms were built to test interaction between SUA and other covariates. RESULTS We analyzed 1,875 men and 1,713 women (mean ages, 48.9±8.4 and 50.2±8.7 years, respectively). SUA was linearly associated with cf-PWV in men (P = 0.01) and in women (P = 0.01). After full adjustment, the association remained significant for men (P = 0.01) and no longer significant for women (P = 0.10). Fully adjusted linear coefficients β (95% CI) were 0.06 (0.015; 0.112) and 0.04 (-0.01; 0.12) in men and women, respectively. Significant interaction between SUA and age (P = 0.02) fasting glucose (P < 0.01) and BMI (P = 0.02) was found only for women. CONCLUSION In an apparently healthy population, SUA was significantly associated to cf-PWV in men but not in women.
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Affiliation(s)
- Cristina Pellegrino Baena
- Pontifícia Universidade Católica do Paraná, Curitiba, Brazil; Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil;
| | - Paulo Andrade Lotufo
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Isabela J Benseñor
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
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15
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Reference values of pulse wave velocity in healthy people from an urban and rural argentinean population. Int J Hypertens 2014; 2014:653239. [PMID: 25215227 PMCID: PMC4158305 DOI: 10.1155/2014/653239] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 07/22/2014] [Accepted: 08/09/2014] [Indexed: 11/17/2022] Open
Abstract
In medical practice the reference values of arterial stiffness came from multicenter registries obtained in Asia, USA, Australia and Europe. Pulse wave velocity (PWV) is the gold standard method for arterial stiffness quantification; however, in South America, there are few population-based studies. In this research PWV was measured in healthy asymptomatic and normotensive subjects without history of hypertension in first-degree relatives. Normal PWV and the 95% confidence intervals values were obtained in 780 subjects (39.8 ± 18.5 years) divided into 7 age groups (10–98 years). The mean PWV found was 6.84 m/s ± 1.65. PWV increases linearly with aging with a high degree of correlation (r2 = 0.61; P < 0.05) with low dispersion in younger subjects. PWV progressively increases 6–8% with each decade of life; this tendency is more pronounced after 50 years. A significant increase of PWV over 50 years was demonstrated. This is the first population-based study from urban and rural people of Argentina that provides normal values of the PWV in healthy, normotensive subjects without family history of hypertension. Moreover, the age dependence of PWV values was confirmed.
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Kuznetsova TY, Korneva VA, Bryantseva EN, Barkan VS, Orlov AV, Posokhov IN, Rogoza AN. The 24-hour pulse wave velocity, aortic augmentation index, and central blood pressure in normotensive volunteers. Vasc Health Risk Manag 2014; 10:247-51. [PMID: 24812515 PMCID: PMC4011902 DOI: 10.2147/vhrm.s61978] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to examine the pulse wave velocity, aortic augmentation index corrected for heart rate 75 (AIx@75), and central systolic and diastolic blood pressure during 24-hour monitoring in normotensive volunteers. Overall, 467 subjects (206 men and 261 women) were recruited in this study. Participants were excluded from the study if they were less than 19 years of age, had blood test abnormalities, had a body mass index greater than 2 7.5 kg/m2, had impaired glucose tolerance, or had hypotension or hypertension. Ambulatory blood pressure monitoring (ABPM) with the BPLab® device was performed in each subject. ABPM waveforms were analyzed using the special automatic Vasotens® algorithm, which allows the calculation of pulse wave velocity, AIx@75, central systolic and diastolic blood pressure for “24-hour”, “awake”, and “asleep” periods. Circadian rhythms and sex differences in these indexes were identified. Pending further validation in prospective outcome-based studies, our data may be used as preliminary diagnostic values for the BPLab ABPM additional index in adult subjects.
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Affiliation(s)
| | - Viktoria A Korneva
- Faculty of Medicine, Petrozavodsk State University, Petrozavodsk, Russia
| | - Evgeniya N Bryantseva
- Diagnostics Department, The hospital within the Russian Railroad Network, Chita, Russia
| | - Vitaliy S Barkan
- Diagnostics Department, The hospital within the Russian Railroad Network, Chita, Russia
| | - Artemy V Orlov
- Department 65 Competitive System Analysis, National Research Nuclear University MEPhI, Moscow, Russia
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Magalhães P. Prevalence of the metabolic syndrome and determination of optimal cut-off values of waist circumference in university employees from Angola. Cardiovasc J Afr 2014; 25:27-33. [PMID: 24626517 PMCID: PMC3959186 DOI: 10.5830/cvja-2013-086] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 12/09/2013] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Estimates of the prevalence of the metabolic syndrome in Africans may be inconsistent due to lack of African-specific cut-off values of waist circumference (WC). This study determined the prevalence of the metabolic syndrome and defined optimal values of WC in Africans. METHODS This cross-sectional study collected demographic, anthropometric and clinical data of 615 Universitary employees, in Luanda, Angola. The metabolic syndrome was defined using the third report of the National Cholesterol Education Program Adult Treatment Panel (ATPIII) and the Joint Interim Statement (JIS) criteria. Receiver operating characteristics curves were constructed to assess cut-off values of WC. RESULTS The crude prevalence of the metabolic syndrome was higher with the JIS definition (27.8%, age-standardised 14.1%) than with the ATP III definition (17.6%, age-standardised 8.7%). Optimal cut-off values of WC were 87.5 and 80.5 cm in men and women, respectively. CONCLUSION There was a high prevalence of the metabolic syndrome among our African subjects. Our data suggest different WC cut-off values for Africans in relation to other populations.
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Affiliation(s)
- Pedro Magalhães
- Department of Physiology, Faculty of Medicine, University Agostinho Neto, Luanda, Angola
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