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Jurek A, Krzesiński P, Uziębło-Życzkowska B, Witek P, Zieliński G, Kazimierczak A, Wierzbowski R, Banak M, Gielerak G. The patient's sex determines the hemodynamic profile in patients with Cushing disease. Front Endocrinol (Lausanne) 2023; 14:1270455. [PMID: 37886640 PMCID: PMC10598757 DOI: 10.3389/fendo.2023.1270455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
Background Cushing disease (CD) may lead to accelerated cardiovascular remodeling and increased mortality. There are suspected differences in the mechanism of cardiovascular dysfunction between males and females with CD. The purpose of this study was to assess the effect of patient sex on the hemodynamic profile assessed via impedance cardiography and echocardiography in patients newly diagnosed with CD. Material and methods The 54 patients newly diagnosed with CD (mean age 41 years; 77.8% of females) who were included in this prospective clinical study underwent impedance cardiography to assess specific parameters (including systemic vascular resistance index [SVRI], total arterial compliance index [TACI], Heather index [HI], stroke index [SI], cardiac index [CI], velocity index [VI], and acceleration index [ACI]) and transthoracic echocardiography to assess heart chamber diameters and left ventricular systolic and diastolic function. Results Males with CD exhibited higher afterload, with higher SVRI (3,169.3 ± 731.8 vs. 2,339.3 ± 640.8 dyn*s*cm-5*m² in males and females, respectively; p=0.002), lower TACI (0.80 ± 0.30 vs. 1.09 ± 0.30 mL/mmHg*m2; p=0.008), and lower hemodynamic parameters of left ventricular function, with lower HI (9.46 ± 2.86 vs. 14.1 ± 5.06 Ohm/s2; p=0.0007), lower VI (35.1 ± 11.9 vs. 44.9 ± 13.1 1*1000-1*s-1; p=0.009), lower SI (36.5 ± 11.7 vs. 43.6 ± 9.57 mL/m2; p=0.04), lower CI (2.36 ± 0.46 vs. 3.17 ± 0.76 mL*m-2*min-1; p=0.0009), and lower ACI (50.4 ± 19.8 vs. 73.6 ± 25.0 1/100/s2; p=0.006). There were no significant differences between the sexes in left ventricular systolic or diastolic function assessed by echocardiography. Conclusion In comparison with females with CD, males with CD have a less favorable hemodynamic profile, with higher afterload and worse left ventricular function. Sex differences in cardiovascular system function should be taken into consideration in designing personalized diagnostic and therapeutic management of patients with CD.
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Affiliation(s)
- Agnieszka Jurek
- Department of Cardiology and Internal Medicine, Military Institute of Medicine – National Research Institute, Warsaw, Poland
| | - Paweł Krzesiński
- Department of Cardiology and Internal Medicine, Military Institute of Medicine – National Research Institute, Warsaw, Poland
| | - Beata Uziębło-Życzkowska
- Department of Cardiology and Internal Medicine, Military Institute of Medicine – National Research Institute, Warsaw, Poland
| | - Przemysław Witek
- Department of Internal Medicine, Endocrinology, and Diabetes, Medical University of Warsaw, Warsaw, Poland
| | - Grzegorz Zieliński
- Department of Neurosurgery, Military Institute of Medicine – National Research Institute, Warsaw, Poland
| | - Anna Kazimierczak
- Department of Cardiology and Internal Medicine, Military Institute of Medicine – National Research Institute, Warsaw, Poland
| | - Robert Wierzbowski
- Department of Cardiology and Internal Medicine, Military Institute of Medicine – National Research Institute, Warsaw, Poland
| | - Małgorzata Banak
- Department of Cardiology and Internal Medicine, Military Institute of Medicine – National Research Institute, Warsaw, Poland
| | - Grzegorz Gielerak
- Department of Cardiology and Internal Medicine, Military Institute of Medicine – National Research Institute, Warsaw, Poland
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Caraballo C, Mahajan S, Gu J, Lu Y, Spatz ES, Dreyer RP, Zhang M, Sun N, Ren Y, Zheng X, Zhao H, Lu H, Ma ZJ, Krumholz HM. Hemodynamic differences between women and men with elevated blood pressure in China: A non-invasive assessment of 45,082 adults using impedance cardiography. PLoS One 2022; 17:e0269777. [PMID: 35700163 PMCID: PMC9197037 DOI: 10.1371/journal.pone.0269777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 05/31/2022] [Indexed: 11/19/2022] Open
Abstract
Background Whether there are sex differences in hemodynamic profiles among people with elevated blood pressure is not well understood and could guide personalization of treatment. Methods and results We described the clinical and hemodynamic characteristics of adults with elevated blood pressure in China using impedance cardiography. We included 45,082 individuals with elevated blood pressure (defined as systolic blood pressure of ≥130 mmHg or a diastolic blood pressure of ≥80 mmHg), of which 35.2% were women. Overall, women had a higher mean systolic blood pressure than men (139.0 [±15.7] mmHg vs 136.8 [±13.8] mmHg, P<0.001), but a lower mean diastolic blood pressure (82.6 [±9.0] mmHg vs 85.6 [±8.9] mmHg, P<0.001). After adjusting for age, region, and body mass index, women <50 years old had lower systemic vascular resistance index (beta-coefficient [β] -31.7; 95% CI: -51.2, -12.2) and higher cardiac index (β 0.07; 95% CI: 0.04, 0.09) than men of their same age group, whereas among those ≥50 years old women had higher systemic vascular resistance index (β 120.4; 95% CI: 102.4, 138.5) but lower cardiac index (β -0.15; 95% CI: -0.16, -0.13). Results were consistent with a propensity score matching sensitivity analysis, although the magnitude of the SVRI difference was lower and non-significant. However, there was substantial overlap between women and men in the distribution plots of these variables, with overlapping areas ranging from 78% to 88%. Conclusions Our findings indicate that there are sex differences in hypertension phenotype, but that sex alone is insufficient to infer an individual’s profile.
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Affiliation(s)
- César Caraballo
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut, United States of America
- Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Shiwani Mahajan
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut, United States of America
- Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Jianlei Gu
- SJTU-Yale Joint Center for Biostatistics, School of Life Science and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Engineering Research Center for Big Data in Pediatric Precision Medicine, Shanghai, China
| | - Yuan Lu
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut, United States of America
| | - Erica S. Spatz
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut, United States of America
- Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Rachel P. Dreyer
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - MaoZhen Zhang
- iKang Healthcare Group, Inc., Shanghai, China
- Department of Cardiology, Xinhua Hospital Affiliated with Shanghai Jiao Tong University, Shanghai, China
| | - NingLing Sun
- Department of Hypertension at Heart Center, Peking University People’s Hospital, Beijing, China
| | - Yihong Ren
- The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xin Zheng
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongyu Zhao
- SJTU-Yale Joint Center for Biostatistics, School of Life Science and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
- Department of Biostatistics, School of Public Health, Yale University, New Haven, Connecticut, United States of America
| | - Hui Lu
- SJTU-Yale Joint Center for Biostatistics, School of Life Science and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
- Center for Biomedical Informatics, Shanghai Children’s Hospital, Shanghai, China
| | - Zheng J. Ma
- SJTU-Yale Joint Center for Biostatistics, School of Life Science and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
- Department of Biostatistics, School of Public Health, Yale University, New Haven, Connecticut, United States of America
- Beijing Li-Heng Medical Technologies, Ltd, Beijing, China
| | - Harlan M. Krumholz
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut, United States of America
- Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, United States of America
- * E-mail:
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3
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Evaluation of arterial stiffness and central blood pressure by oscillometric method in normotensive offspring of hypertensive parents. Cardiol Young 2022; 32:888-895. [PMID: 34387175 DOI: 10.1017/s1047951121003206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Children with a family history of hypertension have higher blood pressure and hypertensive pathophysiological changes begin before clinical findings. Here, the presence of arterial stiffness was investigated using central blood pressure measurement and pulse wave analysis in normotensive children with at least one parent with essential hypertension. Twenty-four-hour ambulatory pulse wave analysis monitoring was performed by oscillometric method in a study group of 112 normotensive children of hypertensive parents aged between 7 and 18 comparing with a control group of 101 age- and gender-matched normotensive children of normotensive parents. Pulse wave velocity, central systolic and diastolic blood pressure, systolic, diastolic and mean arterial blood pressure values were higher in the study group than the control group (p < 0.001, p = 0.002, p = 0.008, p = 0.001, p = 0.005, p = 0.001, p = 0.001, respectively). In all age groups (7-10, 11-14, and 15-18 years), pulse wave velocity was higher in the study group than the control group (p < 0.001). Pulse wave velocity was higher in children whose both parents are hypertensive compared to the children whose only mothers are hypertensive (p = 0.011). Pulse wave velocity values were positively correlated with age, weight, height, and body mass index (p < 0.05). Higher pulse wave velocity, central systolic and diastolic blood pressure values detected in the study group can be considered as early signs of hypertensive vascular changes. Pulse wave analysis can be a reliable, non-invasive, and reproducible method that can allow taking necessary precautions regarding lifestyle to prevent disease and target organ damage by detecting early hypertensive changes in genetically risky children.
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Papaioannou TG, Oikonomou E, Lazaros G, Christoforatou E, Vogiatzi G, Tsalamandris S, Chasikidis C, Kalambogias A, Mystakidi VX, Galiatsatos N, Santouri M, Latsios G, Deftereos S, Tousoulis D. Aortic stiffening is associated with increased left ventricular mass in women but not in men. Eur J Prev Cardiol 2020; 27:2109-2112. [DOI: 10.1177/2047487319865054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | | | - George Lazaros
- First Department of Cardiology, Hippokration Hospital, Greece
| | | | | | | | | | | | | | | | - Mina Santouri
- First Department of Cardiology, Hippokration Hospital, Greece
| | - George Latsios
- First Department of Cardiology, Hippokration Hospital, Greece
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5
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Wong A, Figueroa A, Fischer SM, Bagheri R, Park SY. The Effects of Mat Pilates Training on Vascular Function and Body Fatness in Obese Young Women With Elevated Blood Pressure. Am J Hypertens 2020; 33:563-569. [PMID: 32236522 DOI: 10.1093/ajh/hpaa026] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/11/2020] [Accepted: 02/16/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Effective nonpharmacological interventions targeting the enhancement of vascular function and decline of body fatness (BF) in obese individuals are indispensable for the prevention of hypertension and cardiovascular events in young adults. Mat Pilates training (MPT) has gained significant popularity worldwide, yet its effects on vascular function and body composition are understudied. We examined the effects of MPT on vascular function and BF in young obese women with elevated blood pressure (BP). METHODS Twenty-eight young obese women with elevated BP were randomized to an MPT (n = 14) or a nonexercising control (CON, n = 14) group for 12 weeks. Systemic arterial stiffness (brachial-ankle pulse wave velocity (baPWV)), brachial and aortic BP, wave reflection (augmentation index (AIx)), plasma nitric oxide (NO) levels, and BF percentage (BF%) were assessed before and after 12 weeks. RESULTS MPT significantly reduced (P ˂ 0.05) baPWV (-0.7 ± 0.2 m/s), AIx (-4 ± 1%), brachial systolic BP (-5 ± 1 mm Hg), aortic systolic BP (-6 ± 1 mm Hg), and BF% (-2 ± 1%), while significantly increasing plasma NO (6 ± 2 µM) (P ˂ 0.05) compared with CON. MPT improved systemic arterial stiffness, aortic BP, wave reflection, circulating plasma NO, and BF% in young obese women with elevated BP. CONCLUSIONS MPT may be an effective intervention for the improvement of vascular function and BF in young obese women with elevated BP, a population at risk for hypertension and early vascular complications. CLINICAL TRIALS REGISTRATION Trial Number NCT03907384.
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Affiliation(s)
- Alexei Wong
- Department of Health and Human Performance, Marymount University, Arlington, VA, USA
| | - Arturo Figueroa
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Stephen M Fischer
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan, Iran
| | - Song-Young Park
- Department of Health and Kinesiology, University of Nebraska-Omaha, Omaha, NE, USA
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Abstract
Hypertension represents one of the most important and most frequent cardiovascular risk factors responsible for heart failure (HF) development. Both sexes are equally affected by arterial hypertension. The difference is lying in the fact that prevalence of hypertension as well as hypertension-induced target organ damage varies during lifetime due to substantial variation of sex hormones in women. Left ventricular (LV) structural, functional, and mechanical changes induced by hypertension are well-known complications that occur in both sexes and they are responsible for HF development. However, their prevalence is significantly different between women and men, which could potentially explain the variation in HF occurrence and prognosis between the sexes. Studies have shown that the prevalence of left ventricular hypertrophy is higher in men. The data are not consistent regarding LV diastolic dysfunction and a similar report has been given for LV mechanical changes. Most investigations agree that LV longitudinal strain is lower among hypertensive men. However, even in the healthy population, men have lower LV longitudinal strain and the cutoff values are still missing. Therefore, it would be difficult to draw the conclusion that LV mechanical dysfunction is more prevalent among men. The main mechanisms responsible for sex-related LV remodeling are sex hormones and their influence on biohumoral systems. This review provides an updated overview of the available data about sex-related LV remodeling, as well as potential mechanisms for these changes, in the patients with arterial hypertension.
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Affiliation(s)
- Marijana Tadic
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Augustenburgerplatz 1, 13353, Berlin, Germany.
| | - Cesare Cuspidi
- Clinical Research Unit, University of Milan-Bicocca and Istituto Auxologico Italiano IRCCS, Viale della Resistenza 23, 20036, Meda, Italy
| | - Guido Grassi
- Clinica Medica, Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy
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7
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Mahajan S, Gu J, Caraballo C, Lu Y, Spatz ES, Zhao H, Zhang M, Sun N, Zheng X, Lu H, Yuan H, Ma ZJ, Krumholz HM. Relationship of Age With the Hemodynamic Parameters in Individuals With Elevated Blood Pressure. J Am Geriatr Soc 2020; 68:1520-1528. [PMID: 32212398 DOI: 10.1111/jgs.16411] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/10/2020] [Accepted: 02/14/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Age is known to be associated with the prevalence and pathophysiology of hypertension. However, there is little information on whether age stands as a good proxy for the specific hemodynamic profile of an individual with elevated blood pressure (BP), which could be important in the selection of therapy. DESIGN This is a cross-sectional study. SETTING People who underwent a noninvasive, hemodynamic assessment using impedance cardiography at 51 sites of iKang Health Checkup Centers throughout China between January 2012 and October 2018. PARTICIPANTS We included 116,851 individuals, aged 20 to 80 years. MAIN OUTCOMES AND MEASURES Relationship between age and hemodynamic parameters (cardiac index, systemic vascular resistance index [SVRI]), among individuals with elevated BP (systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg). RESULTS Final study population included 45,082 individuals with elevated BP: 29,194 men and 15,888 women with a mean (±SD) age of 48 (±13) and 54 (±12) years, respectively. Cardiac index was negatively associated with age with an adjusted, per decade decrease of 0.17 (95% confidence interval [CI] = 0.17-0.18) L/min/m2 in men and 0.24 (95% CI = 0.23-0.25) L/min/m2 in women. SVRI was positively associated with age with an adjusted, per-decade increase of 174.2 (95% CI = 168.8-179.7) dynes·s·cm-5 ·m2 in men and 214.1 (95% CI = 204.3-223.8) dynes·s·cm-5 ·m2 in women. However, there was substantial overlap in the distribution of these parameters across different age groups in both sexes. CONCLUSIONS In this large study, we observed that cardiac index decreased and SVRI increased with age among individuals with elevated BP. Even though there was a general trend with age, we observed heterogeneity within age strata, suggesting that age alone is inadequate to indicate the hemodynamic profile for an individual. J Am Geriatr Soc 68:1520-1528, 2020.
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Affiliation(s)
- Shiwani Mahajan
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.,Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Jianlei Gu
- Shanghai Jiao Tong University-Yale Joint Center for Biostatistics, School of Life Science and Biotechnology, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Engineering Research Center for Big Data in Pediatric Precision Medicine, Shanghai, China
| | - Cesar Caraballo
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.,Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Yuan Lu
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.,Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Erica S Spatz
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.,Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Hongyu Zhao
- Shanghai Jiao Tong University-Yale Joint Center for Biostatistics, School of Life Science and Biotechnology, Shanghai Jiao Tong University, Shanghai, China.,Department of Biostatistics, School of Public Health, Yale University, New Haven, Connecticut
| | - MaoZhen Zhang
- iKang Healthcare Group, Inc, Shanghai, China.,Department of Cardiology, Xinhua Hospital Affiliated With Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - NingLing Sun
- Department of Hypertension at Heart Center, People's Hospital, Peking University, Beijing, China
| | - Xin Zheng
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui Lu
- Shanghai Jiao Tong University-Yale Joint Center for Biostatistics, School of Life Science and Biotechnology, Shanghai Jiao Tong University, Shanghai, China.,Center for Biomedical Informatics, Shanghai Children's Hospital, Shanghai, China
| | - Hong Yuan
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Zheng J Ma
- Shanghai Jiao Tong University-Yale Joint Center for Biostatistics, School of Life Science and Biotechnology, Shanghai Jiao Tong University, Shanghai, China.,Department of Biostatistics, School of Public Health, Yale University, New Haven, Connecticut.,Beijing Li-Heng Medical Technologies, Ltd, Beijing, China
| | - Harlan M Krumholz
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.,Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.,Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut
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8
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Sex differences in excess and reservoir arterial blood pressures as markers of phenotype. J Hypertens 2019; 37:2159-2167. [DOI: 10.1097/hjh.0000000000002135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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9
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Wang Y, Zhang DY, Guo QH, Cheng YB, Huang QF, Sheng CS, Xu TY, Wang JG, Li Y. Short-term reproducibility of the 24-h ambulatory monitoring of brachial and central hemodynamics in untreated Chinese. Blood Press 2019; 28:250-257. [PMID: 31056948 DOI: 10.1080/08037051.2019.1612707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objective: Advanced technology allows non-invasive monitoring of the 24-h brachial and central hemodynamics simultaneously. However, related reproducibility data was limited in White patients. We therefore explored if the novel measurements would be reproducible in Chinese. Methods: From February 2017 to January 2018, 152 untreated patients who were suspected of hypertension and referred for ambulatory blood pressure (BP) monitoring were recruited. Ambulatory BP monitoring was repeated within one month (median, 12.5 days) using the Mobil-O-Graph monitors (IEM, Germany). Reproducibility was assessed as the intra-class correlation coefficient (ICC), coefficient of variation (CV), and repeatability coefficient (RC). Results: The 152 participants (average age, 58.6 years) included 54 men and 98 women. The first and second means of the ambulatory brachial and central BPs, pulse wave velocity (PWV), augmentation pressure, augmentation index (AIx) and AIx at a heart rate of 75 beats per minute (AIx@75) were all similar (p ≥ 0.065), except that the repeated daytime and 24-h brachial and central systolic BPs and pulse pressure slightly differed by approximately 1-2 mmHg (p ≤ 0.011). ICC ranged from 0.70 to 0.94 for all ambulatory BPs and ≥0.91 for the arterial measurements. CV was in the range from 5.0% to 10.3% for all BPs and PWV measurements, and from 15.5% to 22.3% for AIx and AIx@75. RC expressed as percentages of maximal variation was <15% for the PWVs and ranged from 25.5% to 54.7% for BPs, AIx and AIx@75. Conclusions: The 24-h ambulatory brachial and central BPs and arterial measurements were reproducible within a short time period in Chinese, and could therefore be used in clinical practice and research settings.
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Affiliation(s)
- Ying Wang
- a Centre for Epidemiological Studies and Clinical Trials and Centre for Vascular Evaluations, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Ruijin Hospital , Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Dong-Yan Zhang
- a Centre for Epidemiological Studies and Clinical Trials and Centre for Vascular Evaluations, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Ruijin Hospital , Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Qian-Hui Guo
- a Centre for Epidemiological Studies and Clinical Trials and Centre for Vascular Evaluations, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Ruijin Hospital , Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Yi-Bang Cheng
- a Centre for Epidemiological Studies and Clinical Trials and Centre for Vascular Evaluations, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Ruijin Hospital , Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Qi-Fang Huang
- a Centre for Epidemiological Studies and Clinical Trials and Centre for Vascular Evaluations, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Ruijin Hospital , Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Chang-Sheng Sheng
- a Centre for Epidemiological Studies and Clinical Trials and Centre for Vascular Evaluations, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Ruijin Hospital , Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Ting-Yan Xu
- a Centre for Epidemiological Studies and Clinical Trials and Centre for Vascular Evaluations, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Ruijin Hospital , Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Ji-Guang Wang
- a Centre for Epidemiological Studies and Clinical Trials and Centre for Vascular Evaluations, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Ruijin Hospital , Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Yan Li
- a Centre for Epidemiological Studies and Clinical Trials and Centre for Vascular Evaluations, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Ruijin Hospital , Shanghai Jiaotong University School of Medicine , Shanghai , China
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10
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Oloyo AK, Imaga NO, Fatope Y, Sofola OA. Sex differences in cardiac and renal responses to a high salt diet in Sprague-Dawley rats. Heliyon 2019; 5:e01665. [PMID: 31193051 PMCID: PMC6514751 DOI: 10.1016/j.heliyon.2019.e01665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 04/09/2019] [Accepted: 05/02/2019] [Indexed: 01/11/2023] Open
Abstract
High dietary salt intake is an important risk factor for cardiovascular and renal diseases. However, sexual disparity exists in the response of target organs to high salt diet (HSD). To determine how sex affects cardiac and renal functions' response to HSD, 20 weanling Sprague-Dawley rats (10 males and 10 females) were divided into 4 groups of 5 rats each. The rats were fed a normal diet (0.3% NaCl) or HSD (8% NaCl) for 12 weeks. Fluid balance (FB) was determined from 24 hrs water intake and voided urine. Blood pressure (BP) was measured via arterial cannulation under anesthesia (25% w/v urethane and 1% w/v α-chloralose; 5 ml/kg, i.p). Serum levels of troponin I, aminotransaminases, creatinine, urea, uric acid and electrolytes as well as urinary concentration of albumin, creatinine, and electrolytes were measured using appropriate assay kits. Values are presented as mean ± S.E.M, compared by two-way ANOVA and Bonferroni post Hoc test. In the male rat, HSD significantly increased BP, serum: Troponin I, LDH and sodium (p < 0.05), urinary: albumin, sodium, potassium and FB (p < 0.05). In the female rat, HSD increased BP, serum: troponin I, LDH, sodium and creatinine clearance (p < 0.05), urinary: albumin, sodium and potassium (p < 0.01). However, HSD increased more, the BP, serum: Troponin I, LDH, urinary albumin and FB in male rats, while HSD increased urinary sodium more in female rats. Basal values in male vs. female of serum LDH and urinary albumin were significantly different. Thus, sex plays an important role in the response of the heart and kidney to salt stress.
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Affiliation(s)
- Ahmed Kolade Oloyo
- Department of Physiology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Surulere, Nigeria
| | - Ngozi O.A. Imaga
- Department of Biochemistry, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Surulere, Nigeria
| | - Yemisi Fatope
- Department of Biochemistry, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Surulere, Nigeria
| | - Olusoga A. Sofola
- Department of Physiology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Surulere, Nigeria
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11
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Exercise impedance cardiography reveals impaired hemodynamic responses to exercise in hypertensives with dyspnea. Hypertens Res 2018; 42:211-222. [PMID: 30504821 DOI: 10.1038/s41440-018-0145-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/17/2018] [Accepted: 07/18/2018] [Indexed: 12/28/2022]
Abstract
Patients with arterial hypertension (AH), especially women, often report exercise intolerance and dyspnea. However, these symptoms are not frequently reflected in standard assessments. The aim of the study was to evaluate the clinical value of impedance cardiography (ICG) in the hemodynamic assessment of patients with AH during exercise, particularly the differences between subgroups based on sex and the presence of dyspnea. Ninety-eight patients with AH (52 women; 54.5 ± 8.2 years of age) were evaluated for levels of N-terminal pro-B-type brain natriuretic peptide (NT-proBNP), exercise capacity (cardiopulmonary exercise testing (CPET) and the 6-min walk test (6MWT)), and exercise ICG. Patients with AH were stratified into the following four subgroups: males without dyspnea (MnD, n = 38); males with dyspnea (MD, n = 8); females without dyspnea (FnD, n = 27); and females with dyspnea (FD, n = 25). In comparison with the MnD subgroup, the FnD subgroup demonstrated significantly higher NT-proBNP levels; lower exercise capacity (shorter 6MWT distance, lower peak oxygen uptake (VO2), lower O2 pulse); higher peak stroke volume index (SVI); and higher SVI at the anaerobic threshold (AT). In comparison with the other subgroups, the FD subgroup walked a shorter distance during the 6MWT distance; had a steeper VE/VCO2 slope; had lower values of peak stroke volume (SV) and peak cardiac output (CO); and had a smaller change in CO from rest to peak. However, no other differences were identified (NT-proBNP, left ventricular diastolic dysfunction, or CPET parameters). Exercise impedance cardiography revealed an impaired hemodynamic response to exercise in hypertensive females with dyspnea. In patients with unexplained exercise intolerance, impedance cardiography may complement traditional exercise tests.
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Kurpaska M, Krzesiński P, Gielerak G, Uziębło-Życzkowska B, Banak M, Piotrowicz K, Stańczyk A. Multiparameter assessment of exercise capacity in patients with arterial hypertension. Clin Exp Hypertens 2018; 41:599-606. [PMID: 30380940 DOI: 10.1080/10641963.2018.1523917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Introduction: Arterial hypertension (AH) can lead to the development of heart failure. Aim: Evaluating the relationship between parameters of exercise capacity assessed via a six-minute walk test (6MWT) and cardiopulmonary exercise test (CPET), with a hemodynamic assessment via impedance cardiography (ICG), in patients with AH. Methods: Exercise capacity was assessed in 98 hypertensive patients (54.5 ± 8.2 years) by means of oxygen uptake (VO2) get from CPET, 6MWT distance (6MWTd) and hemodynamic parameters measured by ICG: heart rate (HR), stroke volume (SV), cardiac output (CO). Correlations between these parameters at rest, at anaerobic threshold (AT) and at peak of exercise as well as their changes (Δpeak-rest, Δpeak-AT, ΔAT-rest) were evaulated. Results: A large proportion of patients exhibited reduced exercise capacity, with 45.9% not reaching 80% of predicted peak VO2 and 43.9% not reaching predicted 6MWTd. Clinically relevant correlations were noted between the absolute peak values and AT values of VO2 vs HR and VO2 vs CO. Furthermore ΔVO2(peak-AT) correlated with ΔHR(peak-AT), ΔCO(peak-AT) and ΔSV(peak-AT); ΔVO2(peak-rest) with ΔHR(peak-rest) and ΔCO(peak-rest); ΔVO2(AT-rest) with ΔHR(AT-rest) and ΔCO(AT-rest). Stronger correlations between changes in the evaluated parameters were demonstrated in the subgroup of subjects with peak VO2 < 80% of the predicted value; particularly ΔVO2(peak-AT) correlated with ΔSV(peak-AT) and ΔCO(peak-AT). Conclusions: The hemodynamic parameters show significant correlations with more measures of cardiovascular capacity of proven clinical utility. Impedance cardiography is a reliable method for assessing the cardiovascular response to exercise.
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Affiliation(s)
- Małgorzata Kurpaska
- a Department of Cardiology and Internal Medicine, Military Institute of Medicine , Warsaw , Poland
| | - Paweł Krzesiński
- a Department of Cardiology and Internal Medicine, Military Institute of Medicine , Warsaw , Poland
| | - Grzegorz Gielerak
- a Department of Cardiology and Internal Medicine, Military Institute of Medicine , Warsaw , Poland
| | - Beata Uziębło-Życzkowska
- a Department of Cardiology and Internal Medicine, Military Institute of Medicine , Warsaw , Poland
| | - Małgorzata Banak
- a Department of Cardiology and Internal Medicine, Military Institute of Medicine , Warsaw , Poland
| | - Katarzyna Piotrowicz
- a Department of Cardiology and Internal Medicine, Military Institute of Medicine , Warsaw , Poland
| | - Adam Stańczyk
- a Department of Cardiology and Internal Medicine, Military Institute of Medicine , Warsaw , Poland
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Baldo MP, Cunha RS, Ribeiro ALP, Lotufo PA, Chor D, Barreto SM, Bensenor IM, Pereira AC, Mill JG. Racial Differences in Arterial Stiffness are Mainly Determined by Blood Pressure Levels: Results From the ELSA-Brasil Study. J Am Heart Assoc 2017. [PMID: 28637779 PMCID: PMC5669170 DOI: 10.1161/jaha.117.005477] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background Black people have a higher risk of developing hypertension and presenting higher vascular stiffening. Our aim was to investigate whether the association between race and aortic stiffness could be explained by differences in the primary risk factors. Methods and Results We analyzed data from 11 472 adults (mean age, 51.9±8.9; 53.8% female) self‐reported as white (n=6173), brown (n=3364), or black (n=1935). Their carotid‐to‐femoral pulse wave velocity (cf‐PWV) as well as clinical and anthropometric parameters were measured. cf‐PWV was higher in blacks than in whites or browns (men: white, 9.63±1.81; brown, 9.63±1.88; black, 9.98±1.99; women: white, 8.84±1.64; brown, 9.02±1.68; black, 9.34±1.91; P<0.05). However, this difference disappeared after adjustments for age, mean arterial pressure, heart rate, waist circumference, fasting glucose, and glomerular filtration rate (men: white, 9.68±1.54; brown, 9.68±1.50; black, 9.73±1.52; women: white, 8.93±1.32; brown, 8.98±1.29; black, 9.02±1.32; P>0.05). The association between race and arterial stiffness was significant for brown and black women in the highest cf‐PWV quartile, even after controlling for covariates. There were no differences in the age‐related increase in cf‐PWV among the racial groups after adjustment, confirming the strong effect of age and mean arterial pressure on cf‐PWV revealed by the multiple linear regression. Conclusions Racial differences in cf‐PWV were mainly attributed to differences in mean arterial pressure and age, although they cannot fully explain the association between race and cf‐PWV in women in the highest cf‐PWV values. This suggests that therapeutic approaches to overcome the effects of aging on the vascular system should focus on blood pressure control, especially in the black population.
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Affiliation(s)
- Marcelo P Baldo
- Department of Pathophysiology, Montes Claros State University, Montes Claros, MG, Brazil
| | - Roberto S Cunha
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Antônio L P Ribeiro
- Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Paulo A Lotufo
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
| | - Dora Chor
- Escola Nacional de Saúde Pública Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Sandhi M Barreto
- Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Isabela M Bensenor
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
| | | | - José Geraldo Mill
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
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Relationships between urinary electrolytes excretion and central hemodynamics, and arterial stiffness in hypertensive patients. Hypertens Res 2017; 40:746-751. [DOI: 10.1038/hr.2017.29] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 01/18/2017] [Accepted: 01/21/2017] [Indexed: 12/19/2022]
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Alvarez-Alvarado S, Jaime SJ, Ormsbee MJ, Campbell JC, Post J, Pacilio J, Figueroa A. Benefits of whole-body vibration training on arterial function and muscle strength in young overweight/obese women. Hypertens Res 2017; 40:487-492. [DOI: 10.1038/hr.2016.178] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 11/14/2016] [Accepted: 11/30/2016] [Indexed: 12/22/2022]
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Krzesiński P, Stańczyk A, Piotrowicz K, Gielerak G, Uziębło-Zyczkowska B, Skrobowski A. Abdominal obesity and hypertension: a double burden to the heart. Hypertens Res 2016; 39:349-55. [DOI: 10.1038/hr.2015.145] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 09/02/2015] [Accepted: 11/05/2015] [Indexed: 01/22/2023]
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Krzesiński P, Stańczyk A, Gielerak G, Piotrowicz K. The hemodynamic patterns in hypertensive men and women of different age. J Hum Hypertens 2015; 30:177-85. [DOI: 10.1038/jhh.2015.63] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 05/02/2015] [Accepted: 05/14/2015] [Indexed: 11/09/2022]
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