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Lindenberger M, Ziegler M, Bjarnegård N, Ebbers T, Dyverfeldt P. Regional and Global Aortic Pulse Wave Velocity in Patients with Abdominal Aortic Aneurysm. Eur J Vasc Endovasc Surg 2024; 67:506-513. [PMID: 37777048 DOI: 10.1016/j.ejvs.2023.09.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/22/2023] [Accepted: 09/22/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVE Abdominal aortic aneurysm (AAA) is commonly defined as localised aortic dilatation with a diameter > 30 mm. The pathophysiology of AAA includes chronic inflammation and enzymatic degradation of elastin, possibly increasing aortic wall stiffness and pulse wave velocity (PWV). Whether aortic stiffness is more prominent in the abdominal aorta at the aneurysm site is not elucidated. The aim of this study was to evaluate global and regional aortic PWV in patients with AAA. METHODS Experimental study of local PWV in the thoracic descending and abdominal aorta in patients with AAA and matched controls. The study cohort comprised 25 patients with an AAA > 30 mm (range 36 - 70 mm, all male, age range 65 - 76 years) and 27 age and sex matched controls free of AAA. PWV was measured with applanation tonometry (carotid-femoral PWV, cfPWV) as well as a 4D flow MRI technique, assessing regional aortic PWV. Blood pressure and anthropometrics were measured. RESULTS Global aortic PWV was greater in men with an AAA than controls, both by MRI (AAA 8.9 ± 2.4 m/s vs. controls 7.1 ± 1.5 m/s; p = .007) and cfPWV (AAA 11.0 ± 2.1 m/s vs. controls 9.3 ± 2.3 m/s; p = .007). Regionally, PWV was greater in the abdominal aorta in the AAA group (AAA 7.0 ± 1.8 m/s vs. controls 5.8 ± 1.0 m/s; p = .022), but similar in the thoracic descending aorta (AAA 8.7 ± 3.2 m/s vs. controls 8.2 ± 2.4 m/s; p = .59). Furthermore, PWV was positively associated with indices of central adiposity both in men with AAA and controls. CONCLUSION PWV is higher in men with AAA compared with matched controls in the abdominal but not the thoracic descending aorta. Furthermore, aortic stiffness was linked with central fat deposition. It remains to be seen whether there is a causal link between AAA and increased regional aortic stiffness.
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Affiliation(s)
- Marcus Lindenberger
- Department of Cardiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
| | - Magnus Ziegler
- Cardiovascular Sciences, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Centre for Medical Image Science and Visualisation (CMIV), Linköping University, Linköping, Sweden
| | - Niclas Bjarnegård
- Cardiovascular Sciences, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Tino Ebbers
- Cardiovascular Sciences, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Centre for Medical Image Science and Visualisation (CMIV), Linköping University, Linköping, Sweden
| | - Petter Dyverfeldt
- Cardiovascular Sciences, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Centre for Medical Image Science and Visualisation (CMIV), Linköping University, Linköping, Sweden
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Spronck B, Terentes-Printzios D, Avolio AP, Boutouyrie P, Guala A, Jerončić A, Laurent S, Barbosa EC, Baulmann J, Chen CH, Chirinos JA, Daskalopoulou SS, Hughes AD, Mahmud A, Mayer CC, Park JB, Pierce GL, Schutte AE, Urbina EM, Wilkinson IB, Segers P, Sharman JE, Tan I, Vlachopoulos C, Weber T, Bianchini E, Bruno RM. 2024 Recommendations for Validation of Noninvasive Arterial Pulse Wave Velocity Measurement Devices. Hypertension 2024; 81:183-192. [PMID: 37975229 PMCID: PMC10734786 DOI: 10.1161/hypertensionaha.123.21618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/18/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Arterial stiffness, as measured by arterial pulse wave velocity (PWV), is an established biomarker for cardiovascular risk and target-organ damage in individuals with hypertension. With the emergence of new devices for assessing PWV, it has become evident that some of these devices yield results that display significant discrepancies compared with previous devices. This discrepancy underscores the importance of comprehensive validation procedures and the need for international recommendations. METHODS A stepwise approach utilizing the modified Delphi technique, with the involvement of key scientific societies dedicated to arterial stiffness research worldwide, was adopted to formulate, through a multidisciplinary vision, a shared approach to the validation of noninvasive arterial PWV measurement devices. RESULTS A set of recommendations has been developed, which aim to provide guidance to clinicians, researchers, and device manufacturers regarding the validation of new PWV measurement devices. The intention behind these recommendations is to ensure that the validation process can be conducted in a rigorous and consistent manner and to promote standardization and harmonization among PWV devices, thereby facilitating their widespread adoption in clinical practice. CONCLUSIONS It is hoped that these recommendations will encourage both users and developers of PWV measurement devices to critically evaluate and validate their technologies, ultimately leading to improved consistency and comparability of results. This, in turn, will enhance the clinical utility of PWV as a valuable tool for assessing arterial stiffness and informing cardiovascular risk stratification and management in individuals with hypertension.
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Affiliation(s)
- Bart Spronck
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Netherlands (B.S.)
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia (B.S., A.P.A., I.T.)
| | - Dimitrios Terentes-Printzios
- 1st Cardiology Department, Hippokration Hospital, National and Kapodistrian University of Athens, Greece (D.T.-P., C.V.)
| | - Alberto P. Avolio
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia (B.S., A.P.A., I.T.)
| | - Pierre Boutouyrie
- Université Paris Cité, Inserm, Paris Cardiovascular Research Center (PARCC), France (P.B., S.L., R.M.B.)
- Service de Pharmacologie et Hypertension, Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Européen Georges Pompidou, Paris, France (P.B., S.L., R.M.B.)
| | - Andrea Guala
- Vall d’Hebron Institut de Recerca, Barcelona, Spain (A.G.)
- Centro de Investigación en Red en Enfermedades Cardiovasculares (CIBER-CV), Instituto de Salud Carlos III, Madrid, Spain (A.G.)
| | - Ana Jerončić
- Laboratory of Vascular Aging and Cardiovascular Prevention, Department of Research in Biomedicine and Health, University of Split School of Medicine, Croatia (A.J.)
| | - Stéphane Laurent
- Université Paris Cité, Inserm, Paris Cardiovascular Research Center (PARCC), France (P.B., S.L., R.M.B.)
- Service de Pharmacologie et Hypertension, Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Européen Georges Pompidou, Paris, France (P.B., S.L., R.M.B.)
| | | | - Johannes Baulmann
- Praxis Dres. Gille/Baulmann, Rheinbach, Germany (J.B.)
- Division of Cardiology, Medical University of Graz, Austria (J.B.)
| | - Chen-Huan Chen
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (C.-H.C.)
| | - Julio A. Chirinos
- Cardiovascular Division, University of Pennsylvania Perelman School of Medicine and Hospital of the University of Pennsylvania, Philadelphia, PA (J.A.C.)
| | - Stella S. Daskalopoulou
- Department of Medicine, Research Institute McGill University Health Centre, McGill University, Montreal, QC, Canada (S.S.D.)
| | - Alun D. Hughes
- Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, United Kingdom (A.D.H.)
| | - Azra Mahmud
- Department of Internal Medicine, Pharmacology, and Clinical Research, Shalamar Medical and Dental College, Lahore, Pakistan (A.M.)
| | - Christopher C. Mayer
- AIT Austrian Institute of Technology, Center for Health & Bioresources, Medical Signal Analysis, Vienna (C.C.M.)
| | - Jeong Bae Park
- JB Lab and Clinic, Department of Precision Medicine and Biostatistics, Wonju College of Medicine, Yonsei University, Seoul, Republic of Korea (J.B.P.)
| | - Gary L. Pierce
- Department of Health and Human Physiology, University of Iowa, IA (G.L.P.)
| | - Aletta E. Schutte
- School of Population Health, University of New South Wales, Sydney, Australia (A.E.S.)
- The George Institute for Global Health, Sydney, NSW, Australia (A.E.S., I.T.)
| | - Elaine M. Urbina
- Cincinnati Children’s Hospital Medical Center, OH (E.M.U.)
- University of Cincinnati, OH (E.M.U.)
| | - Ian B. Wilkinson
- Experimental Medicine and Therapeutics, University of Cambridge, United Kingdom (I.B.W.)
| | | | - James E. Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia (J.E.S.)
| | - Isabella Tan
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia (B.S., A.P.A., I.T.)
- The George Institute for Global Health, Sydney, NSW, Australia (A.E.S., I.T.)
| | - Charalambos Vlachopoulos
- 1st Cardiology Department, Hippokration Hospital, National and Kapodistrian University of Athens, Greece (D.T.-P., C.V.)
| | - Thomas Weber
- Cardiology Department, Klinikum Wels-Grieskirchen, Austria (T.W.)
| | - Elisabetta Bianchini
- Institute of Clinical Physiology, Italian National Research Council, Pisa (E.B.)
| | - Rosa Maria Bruno
- Université Paris Cité, Inserm, Paris Cardiovascular Research Center (PARCC), France (P.B., S.L., R.M.B.)
- Service de Pharmacologie et Hypertension, Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpital Européen Georges Pompidou, Paris, France (P.B., S.L., R.M.B.)
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Liang X, Liu F, Liang F, Ren Y, Tang X, Luo S, Huang D, Feng W. Association of decreases in PM2.5 levels due to the implementation of environmental protection policies with the incidence of obesity in adolescents: A prospective cohort study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 247:114211. [PMID: 36306623 DOI: 10.1016/j.ecoenv.2022.114211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 10/16/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
AIMS To explore the association between decreased levels of particulate matter (≤2.5 µm; PM2.5) due to the implementation of environmental protection policies and the incidence of obesity in adolescents in Chongqing, China through a prospective cohort study. METHODS A total of 2105 children (52.02% male; aged 7.33 ± 0.60 years at baseline) were enrolled from the Chongqing Children's Health Cohort. A mixed linear regression model was used to analyse the relationships of PM2.5 levels with obesity indicators after adjusting for covariates. Additionally, a Poisson regression model was used to determine the relationship between PM2.5 exposure and the incidence of overweight/obesity. RESULTS The average PM2.5 exposure levels from participant conception to 2014, from 2015 to 2017, and from 2018 to 2019 were 66.64 ± 5.33 μg/m3, 55.49 ± 3.78 μg/m3, and 42.50 ± 1.87 μg/m3, respectively; these levels significantly decreased over time (P < 0.001). Throughout the entire follow-up period, the incidence of overweight/obesity after a ≥ 25 μg/m3 decrease in the PM2.5 level was 4.57% among females; this incidence was the lowest among females who experienced remarkable decreases in PM2.5 exposure. A 1-µg/m3 decrease in the PM2.5 level significantly decreased the body mass index (BMI), BMI z score (BMIz), and weight of adolescents (all P < 0.001). Compared with a < 20-μg/m3 decrease in the PM2.5 level, a ≥ 25-μg/m3 decrease protected against increased BMI (net difference= -0.93; 95% confidence interval [CI]: (-1.23,-0.63) kg/m2), BMIz (-0.28 (-0.39, -0.17)), weight (-1.59 (-2.44, -0.74) kg), and incidence of overweight/obesity (0.48 (0.37, 0.62), P < 0.001). Moreover, compared with a < 20-μg/m3 decrease in the PM2.5 level, a ≥ 25-μg/m3 decrease resulted in significant absolute differences in BMI (-1.26 (-1.56, -0.96) kg/m2), BMIz (-0.53 (-0.65, -0.40)) and weight (-3.01 (-3.8, -2.19) kg) (all P < 0.001). CONCLUSIONS This study showed the etiological relevance of declining PM2.5 concentrations for the incidence of obesity in children and adolescents, suggesting that controlling ambient air pollutants may prevent the development of obesity in this age group. Continuous implementation of environmental protection policies in China has led to substantial health benefits.
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Affiliation(s)
- Xiaohua Liang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China.
| | - Fangchao Liu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Fengchao Liang
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China
| | - Yanling Ren
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
| | - Xian Tang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
| | - Shunqing Luo
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China; Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China
| | - Daochao Huang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
| | - Wei Feng
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400016, China
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Li G, Lv Y, Su Q, You Q, Yu L. The effect of aerobic exercise on pulse wave velocity in middle-aged and elderly people: A systematic review and meta-analysis of randomized controlled trials. Front Cardiovasc Med 2022; 9:960096. [PMID: 36061566 PMCID: PMC9433655 DOI: 10.3389/fcvm.2022.960096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/28/2022] [Indexed: 11/24/2022] Open
Abstract
A growing body of research examines the effect of aerobic exercise on pulse wave velocity (PWV) in middle-aged and elderly people, while findings of available studies were conflicting. The aim of this study was to explore the effect of aerobic exercise on PWV in middle-aged and elderly people. Searches were performed in PubMed, Web of Science, and EBSCO databases. Cochrane risk assessment tool was used to evaluate the methodological quality of the included literature. We included studies that satisfied the following criteria: (1) eligible studies should be randomized controlled trials (RCTs); (2) eligible studies should include both an intervention and a control group; (3) eligible studies should use the middle-aged or elderly people as subjects; and (4) eligible studies should use PWV as the outcome measure. From 972 search records initially identified, 11 studies with a total of 12 exercise groups (n = 245) and 11 control groups (n = 239) were eligible for meta-analysis. There was a significant effect of aerobic exercise on reducing PWV in middle-aged and elderly people [weighted mean difference (WMD), –0.75 (95% CI, –1.21 to –0.28), p = 0.002]. Specifically, a higher intensity [vigorous-intensity, –0.74 (–1.34 to –0.14), p = 0.02; moderate-intensity, –0.68 (–1.49 to 0.12), p = 0.10], a younger age [45 years ≤ age < 60 years, –0.57 (–0.78 to –0.37), p < 0.00001; age ≥ 60 years, –0.91 (–2.10 to 0.27), p = 0.13], a better health status [healthy, –1.19 (–2.06 to –0.31), p = 0.008; diseased, –0.32 (–0.64 to –0.01), p = 0.04], and a lower basal body mass index (BMI) [BMI < 25, –1.19 (–2.06 to –0.31), p = 0.008; 25 ≤ BMI < 30, –0.52 (–0.92 to –0.12), p = 0.01; BMI ≥ 30, –0.09 (–0.93 to 0.76), p = 0.84] were associatedwith larger reductions in PWV. Aerobic exercise, especially vigorous-intensity aerobic exercise, contributed to reducing PWV in middle-aged and elderly people. The effect of aerobic exercise on improving PWV was associated with characteristics of the participants. Specifically, a younger age, a better health status, and a lower basal BMI contributed to more significant reductions in PWV.
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Affiliation(s)
- Gen Li
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China
- Department of Strength and Conditioning Training, Beijing Sport University, Beijing, China
| | - Yuanyuan Lv
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Qing Su
- Ersha Sports Training Center of Guangdong Province, Guangzhou, China
| | - Qiuping You
- Sports Coaching College, Beijing Sport University, Beijing, China
| | - Laikang Yu
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China
- Department of Strength and Conditioning Training, Beijing Sport University, Beijing, China
- *Correspondence: Laikang Yu,
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Carotid-femoral pulse wave velocity acquisition methods and their associations with cardiovascular risk factors and subclinical biomarkers of vascular health. J Hypertens 2021; 40:658-665. [PMID: 34879390 DOI: 10.1097/hjh.0000000000003055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Different methods to measure carotid-femoral pulse wave velocity (CFPWV) may affect the measurements obtained and influence the association between CFPWV, cardiovascular risk factors and biomarkers of subclinical vascular health. The estimation of distance between the carotid and femoral artery measurement sites (the arterial path length) is particularly problematic. METHOD We determined if CFPWV and equation-based estimates of CFPWV were influenced by arterial path length and if this affected the association of CFPWV with cardiovascular risk factors and subclinical vascular biomarkers. The CFPWV derived from the measurement of surface distance (CFPWV-D), arterial path length formula (CFPWV-F), and estimated CFPWV (ePWV) were obtained from 489 older adults (67.2 ± 8.8 years). Macrovascular [carotid artery: lumen diameter (LD), inter-adventitial diameter (IAD), intima-media thickness (IMT) and total plaque area (TPA)] and microvascular [reactive hyperaemia index and urinary albumin-creatinine ratio (UACR)] biomarkers were also measured. RESULTS CFPWV-D was significantly greater than CFPWV-F [9.6 (8.0-11.2) vs. 8.9 (7.6-10.5) m/s, P < 0.001], because of estimated path length being longer in CFPWV-D than CFPWV-F (495.4 ± 44.8 vs. 465.3 ± 20.6 mm, P < 0.001). ePWV was significantly greater than both CFPWV-F and CFPWV-D [11.0 (10.0-12.2) m/s, P < 0.001]. The three CFPWV methods were similarly associated with LD, IAD, IMT, TPA and UACR but not with cardiovascular risk factors. CONCLUSION Different methods to measure CFPWV affect the derived measurement values and the association with cardiovascular risk factors but not the association with subclinical biomarkers of vascular health. These hitherto unreported observations are important considerations in experimental design, data interpretation and of particular importance, comparison between studies where CFPWV is measured.
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Brinkley TE, Leng I, Bailey MJ, Houston DK, Hugenschmidt CE, Nicklas BJ, Hundley WG. Effects of Exercise and Weight Loss on Proximal Aortic Stiffness in Older Adults With Obesity. Circulation 2021; 144:684-693. [PMID: 34333991 DOI: 10.1161/circulationaha.120.051943] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Obesity may accelerate age-related increases in aortic stiffness. Although aerobic exercise training generally has favorable effects on aortic structure and function, exercise alone may not be sufficient to improve aortic stiffness in older adults with obesity. We determined the effects of aerobic exercise training with and without moderate- to high-caloric restriction (CR) on the structure and function of the proximal aorta in 160 older (65-79 years) men and women with obesity (body mass index=30-45 kg/m2). METHODS Participants were randomly assigned to 1 of 3 groups: aerobic exercise training only (treadmill 4 days/week for 30 minutes at 65% to 70% of heart rate reserve; n=56), aerobic exercise training plus moderate CR (n=55), or aerobic exercise training plus more intensive CR (n=49) for 20 weeks. Aortic pulse wave velocity, aortic distensibility, and other measures of aortic structure and function were assessed by cardiovascular magnetic resonance imaging. Pearson correlation coefficients were examined to assess associations between changes in proximal aortic stiffness and changes in fitness, fatness, and other potential confounders. RESULTS Weight loss in the aerobic exercise training plus moderate CR (-8.0 kg [95% CI, -9.17 to -6.87]) and aerobic exercise training plus more intensive CR (-8.98 kg [95% CI, -10.23 to -7.73) groups was significantly greater compared with the aerobic exercise training-only group (-1.66 kg [95% CI, -2.94 to -0.38]; P<0.017 for both). There were significant treatment effects for descending aorta distensibility (P=0.008) and strain (P=0.004) and aortic arch pulse wave velocity (P=0.01) with the aerobic exercise training plus moderate CR group having a 21% increase in distensibility (P=0.016) and an 8% decrease in pulse wave velocity (P=0.058). None of the aortic stiffness measures changed significantly in the aerobic exercise training-only or aerobic exercise training plus more intensive CR groups, and there were no significant changes in any other measure of aortic structure or function in these groups. Overall, increases in aortic distensibility were correlated with improvements in body weight and body fat distribution, but these associations were not statistically significant after adjustment for multiple comparisons. CONCLUSIONS In older adults with obesity, combining aerobic exercise with moderate CR leads to greater improvements in proximal aortic stiffness than exercise alone. Registration: URL: https://clinicaltrials.gov; Unique identifier: NCT01048736.
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Affiliation(s)
- Tina E Brinkley
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine (T.E.B., D.K.H., C.E.H., B.J.N.)
| | - Iris Leng
- Division of Public Health Sciences, Department of Biostatistics and Data Science (I.L.)
| | - Margie J Bailey
- Hypertension and Vascular Research Center (M.J.B.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Denise K Houston
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine (T.E.B., D.K.H., C.E.H., B.J.N.)
| | - Christina E Hugenschmidt
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine (T.E.B., D.K.H., C.E.H., B.J.N.)
| | - Barbara J Nicklas
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine (T.E.B., D.K.H., C.E.H., B.J.N.)
| | - W Gregory Hundley
- Department of Internal Medicine, Virginia Commonwealth University, Richmond (W.G.H.)
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Age-related values of aortic pulse wave velocity in healthy subjects measured by Doppler echocardiography. J Hum Hypertens 2021; 35:1081-1087. [PMID: 33414505 DOI: 10.1038/s41371-020-00466-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 11/04/2020] [Accepted: 12/07/2020] [Indexed: 11/08/2022]
Abstract
Aortic pulse wave velocity (aPWV) is a measure of aortic stiffness, which is an indicator of vascular aging and prognostic marker for cardiovascular complications. aPWV can be measured with various methods, but with different reference values depending on the technique used. Therefore, we decided to evaluate age-related values of aPWV, measured by Doppler echocardiography. We included 134 healthy adults (mean age 44.1 ± 13.2 years, 54% of females) divided into five groups based on age decades (D1 21-30 years, n = 29; D2 31-40 years, n = 24; D3 41-50 years, n = 34; D4 51-60 years, n = 25; and D5 61-70 years, n = 22). With the use of a cardiac probe and ECG tracing, ten Doppler waveforms were sequentially recorded, first in the distal aortic arch, and than in the left external iliac artery. Transit time was measured as a delay of the foot of the Doppler waveform in the distal, relative to the proximal location. The distance was measured over the body surface. aPWV was calculated as distance/transit time. Median aPWV in the whole group was 5.05 m/s [4.55-5.99] and did not differ according to sex (females, 5.28 m/s [4.50-6.1] vs. males, 4.95 m/s [4.59-5.77], p = 0.46). Mean aPWV values with 95% confidence intervals (95% CI) for each decade were as follows: D1, 4.54 m/s (4.37-4.72), D2, 4.61 m/s (4.36-4.87), D3, 5.11 m/s (4.89-5.33), D4, 6.04 m/s (5.63-6.45), and D5, 6.77 m/s (6.35-7.19). We report age-related values of aPWV, in a healthy population, measured by Doppler echocardiography. This may be helpful in future research exploring the associations between aortic stiffness, cardiac function, and cardiovascular risk.
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Kroker-Lobos MF, Ford ND, Gonzalez-Casanova I, Martorell R, Ramirez-Zea M, Stein AD. Improved nutrition in early life and pulse wave velocity and augmentation index in mid-adulthood: Follow-up of the INCAP Nutrition Supplementation Trial Longitudinal Study. PLoS One 2020; 15:e0239921. [PMID: 33108379 PMCID: PMC7591084 DOI: 10.1371/journal.pone.0239921] [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: 05/08/2020] [Accepted: 09/15/2020] [Indexed: 11/25/2022] Open
Abstract
Nutrition in pregnancy and early childhood affects later blood pressure and precursors of atherosclerosis, but its influence on arterial stiffness is unexplored. This study determines whether exposure to improved nutrition during early life influences Augmentation index (AI) and pulse wave velocity (PWV) in mid-adulthood. We included 1221 adults (37-54y) who participated in a cluster-randomized nutritional supplementation trial of a protein-energy beverage (Atole), conducted between 1969–1977 in Guatemala. The comparison group received Fresco, a low-calorie protein-free beverage. In 2015–17, we measured anthropometry (weight, height, and waist-to-height ratio); AI and PWV (using carotid—femoral tonometry); blood pressure; fasting plasma glucose and serum lipids; and sociodemographic characteristics. Based on patterns of exposure, we characterized participants as fully, partially or unexposed to the intervention from conception to their second birthday (the ‘first 1000 days’). We fit pooled and sex-specific models using intention-to-treat, difference-in-difference regression analysis to test whether exposure to the supplement in the first 1000 days was associated with AI and PWV in adulthood adjusting for basal and current sociodemographic variables and current life-style and cardio-metabolic risk factors. Prevalence of obesity in men and women was 39.6% and 19.6%, and prevalence of hypertension was 44.0% and 36.0%, respectively. Women had higher AI (34.4±9.6%) compared to men (23.0± 9.8%), but had similar PWV (7.60±1.13 m/s and 7.60±1.31, respectively). AI did not differ significantly across intervention groups. PWV was lower in individuals with full exposure to the supplement during the first 1000 days (-0.39m/s, 95% CI -0.87, 0.09; p = 0.1) compared to unexposed individuals. This difference was similar after adjusting for cardio-metabolic risk factors (-0.45m/s; 95%C-0.93, 0.01; p = 0.06). Exposure to improved nutrition during the first 1000 days was marginally associated with lower PWV, but not with AI.
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Affiliation(s)
- Maria F. Kroker-Lobos
- INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Nicole D. Ford
- Hubert Department of Global Health, Rollins School of Public Health Emory University, Atlanta, Georgia, United States of America
| | - Ines Gonzalez-Casanova
- Hubert Department of Global Health, Rollins School of Public Health Emory University, Atlanta, Georgia, United States of America
| | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public Health Emory University, Atlanta, Georgia, United States of America
| | - Manuel Ramirez-Zea
- INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Aryeh D. Stein
- Hubert Department of Global Health, Rollins School of Public Health Emory University, Atlanta, Georgia, United States of America
- * E-mail:
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9
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Åström Malm I, De Basso R, Blomstrand P, Bjarnegård N. Increased arterial stiffness in males with abdominal aortic aneurysm. Clin Physiol Funct Imaging 2020; 41:68-75. [PMID: 33000520 PMCID: PMC7756894 DOI: 10.1111/cpf.12667] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/18/2020] [Accepted: 09/21/2020] [Indexed: 12/22/2022]
Abstract
Background Abdominal aortic aneurysm (AAA), a localized dilatation of the abdominal aorta, has a prevalence of about 1.5%–3% among 65‐ to 70‐year‐old males in Europe. AAA confers an increased risk of developing major cardiovascular events in addition to the risk of aneurysm rupture. The aim of this study was to evaluate whether the arterial wall distensibility is altered in subjects with AAA. Methods Two hundred and eighty‐four male subjects (182 with AAA and 102 controls) were enrolled in the study. Arterial wall distensibility was evaluated using non‐invasive applanation tonometry to measure regional pulse wave velocity between the carotid and femoral arteries and the carotid and radial arteries. In addition, blood pressure was measured, and the pulse pressure waveform was analysed. Results Higher aortic augmentation index (25.1% versus 20.6%; p < .001) and higher aortic pulse wave velocity (12.3 m/s versus 10.9 m/s; p < .001) were demonstrated in the AAA cohort. The slightly higher arm pulse wave velocity in the AAA group (9.4 m/s versus 9.1 m/s; p < .05) was abolished after adjusting for mean arterial blood pressure. Conclusions Males with AAA have decreased aortic wall distensibility and enhanced reflection waves in central aorta during systole. These results imply that increased arterial wall stiffness may be a contributing factor to the overall higher cardiovascular risk seen in patients with AAA.
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Affiliation(s)
- Ida Åström Malm
- Department of Natural Sciences and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Rachel De Basso
- Department of Natural Sciences and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Peter Blomstrand
- Department of Natural Sciences and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Clinical Physiology, County Hospital Ryhov, Jönköping, Sweden
| | - Niclas Bjarnegård
- Department of Diagnostics and Specialist Medicine, Faculty of Health, Medicine and Caring Sciences, University of Linköping, Linköping, Sweden
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10
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Hwang CL, Elokda A, Ozemek C, Arena R, Phillips SA. More than a matter of the heart: the concept of intravascular multimorbidity in cardiac rehabilitation. Expert Rev Cardiovasc Ther 2020; 18:557-562. [PMID: 32700592 DOI: 10.1080/14779072.2020.1798761] [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: 10/23/2022]
Abstract
INTRODUCTION Coronary artery disease (CAD) is the major cause of death of cardiovascular disease. It is initiated by atherosclerosis, which narrows the coronary arteries and limits blood flow and oxygen to the heart. Multiple pathophysiological conditions within the arteries, such as arterial wall thickening, endothelial dysfunction, and arterial stiffening, are associated with the development of atherosclerosis. AREAS COVERED We introduce a new concept of 'intravascular multimorbidity,' the presence and integration of multiple pathophysiological conditions within the arteries. We also introduce some measurements of intravascular multimorbidity and discuss how these measurements can be utilized in cardiac rehabilitation (CR). EXPERT OPINION We propose that the measures of intravascular multimorbidity in different arteries may provide information on disease severity and serve as unique prognostic 'barometers' to disease progression in patients with CAD. By measuring the underlying disease mechanisms within the arteries and understanding individual variability of disease progression/regression, these measures may also provide a unique prognostic window in CR. The window into intravascular multimorbidity can help guide clinical strategies, for example, assessing progress and appropriate titration of exercise. Intravascular multimorbidity may represent an important opportunity for more researchers and clinical professions to evaluate patients in CR.
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Affiliation(s)
- Chueh-Lung Hwang
- Department of Physical Therapy, University of Illinois at Chicago , Chicago, IL, USA
| | - Ahmed Elokda
- Department of Rehabilitation Sciences, Florida Golf Coast University , Fort Myers, FL, USA
| | - Cemal Ozemek
- Department of Physical Therapy, University of Illinois at Chicago , Chicago, IL, USA
| | - Ross Arena
- Department of Physical Therapy, University of Illinois at Chicago , Chicago, IL, USA
| | - Shane A Phillips
- Department of Physical Therapy, University of Illinois at Chicago , Chicago, IL, USA
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11
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Streese L, Königstein K, Goricki L, Infanger D, Wölnerhanssen B, Peters T, Schmidt-Trucksäss A, Hanssen H. Short- and Long-Term Effects of Bariatric Surgery on Vascular Phenotype. Obes Surg 2020; 29:1301-1308. [PMID: 30617916 DOI: 10.1007/s11695-018-03679-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Retinal microvascular diameters and large artery stiffness are valid biomarkers of cardiovascular risk. This study assessed short- and long-term micro- and macrovascular improvements after bariatric surgery (BS). METHODS Sixteen patients (44 ± 12 years) underwent BS in this observational study. Two weeks before as well as 6 weeks and 4 years after surgery, retinal vessel analysis and assessment of brachial-ankle pulse wave velocity (baPWV), cardio-ankle vascular index (CAVI), and anthropometry were performed. Three patients were lost to follow-up. RESULTS Six weeks after BS, retinal arteriolar diameters (CRAE) were wider (180.1 μm vs. 188.1 μm; p = 0.001), and the arteriolar-to-venular diameter ratio (AVR) was higher (0.82 vs. 0.86; p < 0.001) compared to baseline levels. During the 4 years of follow-up, the retinal changes sustained but further improvements did not occur. Both indices of large artery stiffness, baPWV and CAVI, remained unchanged 6 weeks and 4 years after surgery. CONCLUSIONS Retinal microvascular phenotype improved 6 weeks after BS. The improvements in microvascular health were maintained during 4 years of follow-up but, despite significant further reductions in body mass index, did not improve further long-term. baPWV and CAVI were unaffected after surgery indicating that BS primarily affects microvascular phenotype rather than large artery stiffness. Retinal vessel imaging seems to be a feasible diagnostic tool to monitor microvascular health after BS. Normalization of BMI and blood pressure may be necessary to achieve long-term improvement of large artery phenotype after BS.
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Affiliation(s)
- Lukas Streese
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland
| | - Karsten Königstein
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland
| | - Lara Goricki
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland
| | - Denis Infanger
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland
| | | | - Thomas Peters
- St. Clara Research Ltd, St. Claraspital, Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland.
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Abstract
INTRODUCTION Type 2 diabetes mellitus (T2DM) and obesity are both related to increased risk of cardiovascular disease and mortality. Early atherosclerotic vascular changes can be detected by non-invasive tests like carotid artery intima-media thickness (cIMT) and pulse wave velocity (PWV). Both cIMT and PWV are significantly impaired in T2DM patients and in obese patients, but the additional effect of T2DM on these vascular measurements in obese subjects has not been evaluated. METHODS Two hundred morbidly obese patients with or without T2DM were enrolled in a prospective cohort study and underwent extensive laboratory testing, including cIMT and PWV measurements. The cohort was divided into a group with and a group without T2DM. RESULTS Within this cohort, 43 patients (21.5%) were diagnosed with T2DM. These patients were older and had more often (a history of) hypertension as compared to patients without T2DM. HbA1c levels were significantly increased, while LDL cholesterol was significantly lower and the use of statins higher than in non-diabetic participants. cIMT and PWV were significantly increased in subjects suffering from T2DM. The variability in cIMT and PWV was related to differences in age and systolic blood pressure, but not to the presence of T2DM. CONCLUSION While T2DM negatively affects the vasculature in morbid obesity, hypertension and age seem to be the major risk factors, independent from the presence of T2DM. CLINICAL TRIAL REGISTRATION Dutch Trial Register NTR5172 .
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13
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Influence of Body Composition on Arterial Stiffness in Middle-Aged Adults: Healthy UAL Cross-Sectional Study. ACTA ACUST UNITED AC 2019; 55:medicina55070334. [PMID: 31277306 PMCID: PMC6681323 DOI: 10.3390/medicina55070334] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/28/2019] [Accepted: 07/01/2019] [Indexed: 12/31/2022]
Abstract
Background and objectives: Several anthropometric and body composition parameters have been linked to arterial stiffness (AS) as a biomarker of cardiovascular disease. However, little is known about which of these closely related factors is more strongly associated with AS. The aim of the present study was to analyze the relationship of different anthropometric and body composition parameters with AS in middle-aged adults. Materials and Methods: This cross-sectional study included 186 middle-aged participants (85 women, 101 men; age = 42.8 ± 12.6 years) evaluated as part of the Healthy UAL study, a population study conducted at the University of Almería with the main purpose of analyzing the etiology and risk factors associated with cardio-metabolic diseases. Anthropometric measures included neck, waist, and hip circumferences, as well as the waist-to-height ratio (WHtr). Bioimpedance-derived parameters included fat-free mass index (FFMI), fat mass index (FMI), and percent of body fat (%BF). AS was measured by pulse wave velocity (PWV). The relationships of interest were examined through stepwise regression analyses in which age and sex were also introduced as potential confounders. Results: Neck circumference (in the anthropometric model; R2: 0.889; β: age = 0.855, neck = 0.204) and FFMI (in the bio-impedance model; R2: 0.891; β: age = 0.906, FFMI = 0.199) emerged as significant cross-sectional predictors of AS. When all parameters were included together (both anthropometry and bio-impedance), both neck circumference and FFMI appeared again as being significantly associated with AS (R2: 0.894; β: age = 0.882, FFMI = 0.126, neck = 0.093). Conclusion: It was concluded that FFMI and neck circumference are correlated with AS regardless of potential confounders and other anthropometric and bioimpedance-derived parameters in middle-aged adults.
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14
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Styczyński G, Kalinowski P, Michałowski Ł, Paluszkiewicz R, Ziarkiewicz-Wróblewska B, Zieniewicz K, Tataj E, Szmigielski C, Jędrusik P. No association between aortic stiffness and liver steatosis in morbidly obese patients. Atherosclerosis 2019; 287:165-170. [PMID: 31040024 DOI: 10.1016/j.atherosclerosis.2019.04.206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 03/10/2019] [Accepted: 04/04/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS Patients with non-alcoholic fatty liver disease are characterized by increased aortic stiffness, but it is unclear whether this is related to non-alcoholic fatty liver disease itself or concomitant metabolic syndrome components, including hypertension and diabetes. Previous studies were methodologically limited by ultrasound-based assessment of liver steatosis or performing liver biopsy in patients with more severe disease. Therefore, we prospectively measured aortic pulse wave velocity (aPWV) in non-selected obese subjects admitted for bariatric surgery with liver biopsy, allowing assessment of the association between aortic stiffness and biopsy-confirmed liver steatosis. METHODS We evaluated 120 consecutive severely obese patients (79 females; mean age 42 ± 10 years, mean body mass index 45.0 ± 5.3 kg/m2) without cardiac disease or alcohol-induced liver disease, who were admitted for bariatric surgery. The presence or absence of liver steatosis was defined by wedge liver biopsy. aPWV was measured with the Doppler method at the time of preoperative transthoracic echocardiography. RESULTS Based on liver biopsy results, 82 patients (68%) had liver steatosis and 38 (32%) had no steatosis. Univariate linear regression analysis showed that age, mean arterial pressure, liver steatosis, heart rate, female gender, and diabetes were significantly associated with aPWV. However, only age, mean arterial pressure, heart rate, and diabetes remained significant in the multivariate model (p ≤ 0.001). CONCLUSIONS We found no independent association between biopsy-confirmed liver steatosis and aortic stiffness measured by Doppler aPWV in morbidly obese individuals. Aortic stiffness in these subjects is related to comorbidities and not to non-alcoholic fatty liver disease itself.
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Affiliation(s)
- Grzegorz Styczyński
- Department of Internal Medicine, Hypertension and Angiology, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland
| | - Piotr Kalinowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland
| | - Łukasz Michałowski
- Department of Pathology, Center for Biostructure Research, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland
| | - Rafał Paluszkiewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland
| | - Bogna Ziarkiewicz-Wróblewska
- Department of Pathology, Center for Biostructure Research, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland
| | - Emanuel Tataj
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland
| | - Cezary Szmigielski
- Department of Internal Medicine, Hypertension and Angiology, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland
| | - Piotr Jędrusik
- Department of Internal Medicine, Hypertension and Angiology, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland.
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15
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Liang X, Su S, Hao G, Snieder H, Treiber F, Kapuku G, Wang X. Determinants of pulse wave velocity trajectories from youth to young adulthood: the Georgia Stress and Heart Study. J Hypertens 2019; 37:563-571. [PMID: 30234784 PMCID: PMC6355367 DOI: 10.1097/hjh.0000000000001933] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Increased arterial stiffness measured by pulse wave velocity (PWV) has been shown to be an important parameter of cardiovascular risk. Longitudinal development of PWV from youth to early adulthood and its possible sociodemographic, anthropometric, hemodynamic and behavioral moderators will be illustrated. METHODS Individual growth curves of carotid-distal PWV across age were created for 559 African American and European American men and women with a maximum of five assessments over an average of 7-year follow-up (mean age at participants' first assessment, 22.3 ± 3.4). RESULTS African Americans and men had significantly higher PWV than did European Americans and women (Ps < 0.01), respectively. A three-way interaction (P < 0.001) between age, sex and ethnicity was observed with African American men displaying a larger rate of increase in PWV with age than the other three ethnic and sex groups. The ethnicity and sex effects on PWV persisted when controlling for other moderators. Waist circumference was the strongest anthropometric predictor but its effect on PWV was only significant in women. Mean arterial pressure was the strongest hemodynamic predictor, marital status of parents was the strongest socioeconomic predictor and marijuana use was the strongest behavioral predictor of PWV. The best-fitting full model explained in total 59.4% of the between-subject variance in PWV with ethnicity, sex and age explaining 25.6%. CONCLUSION We observed significant ethnic and sex differences in longitudinal trajectories of PWV in youth and young adults. In addition, individual differences in PWV growth can largely be explained by mean arterial pressure, waist, marital status of parents and marijuana use.
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Affiliation(s)
- Xiaohua Liang
- Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China,
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA,
| | - Shaoyong Su
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA,
| | - Guang Hao
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA,
| | - Harold Snieder
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Frank Treiber
- College of Nursing, Medical University of South Carolina, Charleston, USA
| | - Gaston Kapuku
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA,
| | - Xiaoling Wang
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA,
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16
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Hwang CL, Bishop J, Ching J, Elokda A, da Silva ALG, Laddu D, Phillips SA. Precision Measurements to Assess Baseline Status and Efficacy of Healthy Living Medicine. Prog Cardiovasc Dis 2019; 62:55-59. [PMID: 30610884 DOI: 10.1016/j.pcad.2018.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 12/28/2018] [Indexed: 01/07/2023]
Abstract
Precision medicine recently has gained popularity, calling for more individualized approaches to prevent and/or reduce chronic-disease risk and to reduce non-communicable diseases such as cardiovascular disease (CVD). Encompassed under Precision medicine initiatives is the concept of healthy living medicine (HLM), which emphasizes the promotion of lifestyle and behavioral practices including physical activity and healthy dietary pattern. Precision measurements have the potential to improve the understanding of how risk factors influence disease trajectory, and further inform on how to precisely tailor clinical strategies to manage risk factors to prevent disease manifestation, and refine therapies according the patient's demographic, environment, and disease etiology. The purpose of this review is to summarize the application of established and emerging measurements that may be used in HLM to manage and optimize care in CVD prevention.
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Affiliation(s)
- Chueh-Lung Hwang
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Jennifer Bishop
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Jerry Ching
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Ahmed Elokda
- Department of Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers, FL, United States of America
| | - Andréa Lúcia Gonçalves da Silva
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America; Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America; Department of Physical Education and Health, Physiotherapy` Course at University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS, Brazil
| | - Deepika Laddu
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America; Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Shane A Phillips
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America; Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States of America.
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Syed-Abdul MM, Hu Q, Jacome-Sosa M, Padilla J, Manrique-Acevedo C, Heimowitz C, Parks EJ. Effect of carbohydrate restriction-induced weight loss on aortic pulse wave velocity in overweight men and women. Appl Physiol Nutr Metab 2018; 43:1247-1256. [DOI: 10.1139/apnm-2018-0113] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Increased aortic stiffness, measured by carotid-to-femoral pulse wave velocity (PWV), is an independent predictor of cardiovascular disease, and past data have shown that low-fat and low-energy diets, fed for 8–24 weeks, lower PWV. The purpose of this study was to determine whether a reduction in PWV would be achieved by dietary carbohydrate (CHO) restriction, shown to bring about weight loss over a shorter timeframe. Men (n = 10, age: 41.8 ± 10.2 years, BMI: 34.2 ± 3.0 kg/m2 (mean ± SD)) and women (n = 10, age: 38.6 ± 6.1 years, BMI: 33.5 ± 3.8 kg/m2) with characteristics of insulin resistance and the metabolic syndrome consumed a structured, CHO-restricted diet for 4 weeks (energy deficit, 645 kcal/day). For the whole group, subjects lost 5.4% ± 0.5% (P < 0.001) of body weight and experienced significant reductions in blood pressure (6%–8%), plasma insulin (34%), and triglycerides (34%). PWV was reduced by 6% ± 2% (7.1 ± 0.2 m/s to 6.7 ± 0.2 m/s, P = 0.008) and surprisingly, in women, it fell significantly (from 7.2 ± 0.3 m/s to 6.3 ± 0.3 m/s, P = 0.028), while no changes were observed in men (7.2 ± 0.3 vs. 7.0 ± 0.3 m/s, P = 0.144). This is the first study to demonstrate that weight loss can improve PWV in as little as 4 weeks and that dietary CHO restriction may be an effective treatment for reducing aortic stiffness in women. Future studies are needed to establish the mechanisms by which dietary CHO restriction may confer more cardiovascular benefits to women than to men.
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Affiliation(s)
- Majid M. Syed-Abdul
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
| | - Qiong Hu
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
| | - Miriam Jacome-Sosa
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
| | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO 65211, USA
- Department of Child Health, School of Medicine, University of Missouri, Columbia, MO 65212, USA
| | - Camila Manrique-Acevedo
- Division of Endocrinology, School of Medicine, University of Missouri, Columbia, MO 65212, USA
| | | | - Elizabeth J. Parks
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO 65211, USA
- Department of Child Health, School of Medicine, University of Missouri, Columbia, MO 65212, USA
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18
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Königstein K, Infanger D, Klenk C, Hinrichs T, Rossmeissl A, Baumann S, Hafner B, Hanssen H, Schmidt-Trucksäss A. Does obesity attenuate the beneficial cardiovascular effects of cardiorespiratory fitness? Atherosclerosis 2018; 272:21-26. [PMID: 29544085 DOI: 10.1016/j.atherosclerosis.2018.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 02/09/2018] [Accepted: 03/07/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND AIMS Higher cardiorespiratory fitness is associated with lower pulse wave velocity and arterial stiffness in normal weight individuals, and this has not been examined in obese individuals. It is unclear whether an altered body composition acts as a modifier of the association between cardiorespiratory fitness and arterial stiffness. We examined the association between peak oxygen uptake and brachial-ankle pulse wave velocity and analysed whether body composition attenuates this association in obese middle-aged individuals. METHODS Bio-impedance analysis-derived body composition assessment in 212 healthy and sedentary either overweight or obese individuals was followed by measurement of brachial-ankle pulse wave velocity and spiroergometric peak oxygen uptake. Multivariate analysis was performed to analyse the association between peak oxygen uptake and brachial-ankle pulse wave velocity and to assess the moderating effect of several body composition-related interaction terms (BMI, total body mass, body fat mass, waist circumference, waist-to-height ratio) on this association. RESULTS Peak oxygen uptake was inversely associated with brachial-ankle pulse wave velocity (β = -0.059, 95% CI = -0.099; -0.018, p = 0.005). Testing for the impact of different body composition-related interaction terms on this association showed no significance, 95% CI lateralized towards positivity. CONCLUSIONS This study shows an inverse association between cardiorespiratory fitness and arterial stiffness in middle-aged obese individuals. We also found a tendency towards an attenuating impact of an obese body composition on this association. Physical fitness seems to be a stronger modulator of cardiovascular risk than body composition but the success of training efforts may be compromised by obesity.
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Affiliation(s)
- Karsten Königstein
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland.
| | - Denis Infanger
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland
| | - Christopher Klenk
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland
| | - Timo Hinrichs
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland
| | - Anja Rossmeissl
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland
| | - Sandra Baumann
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland
| | - Benjamin Hafner
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Basel, Switzerland.
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Canepa M, Artom N, Ameri P, Carbone F, Montecucco F, Ghigliotti G, Brunelli C, Dallegri F, Pende A, Pisciotta L. Short-term effect of rosuvastatin treatment on arterial stiffness in individuals with newly-diagnosed heterozygous familial hypercholesterolemia. Int J Cardiol 2017; 255:215-220. [PMID: 29290422 DOI: 10.1016/j.ijcard.2017.12.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 12/04/2017] [Accepted: 12/16/2017] [Indexed: 01/27/2023]
Affiliation(s)
- Marco Canepa
- Cardiovascular Unit, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy
| | - Nathan Artom
- First Clinic of Internal Medicine, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy
| | - Pietro Ameri
- Cardiovascular Unit, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy
| | - Federico Carbone
- First Clinic of Internal Medicine, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy
| | - Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy
| | - Giorgio Ghigliotti
- Cardiovascular Unit, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy
| | - Claudio Brunelli
- Cardiovascular Unit, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy
| | - Franco Dallegri
- First Clinic of Internal Medicine, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy
| | - Aldo Pende
- First Clinic of Internal Medicine, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy
| | - Livia Pisciotta
- First Clinic of Internal Medicine, Department of Internal Medicine, Ospedale Policlinico San Martino, Genova, University of Genova, Largo Benzi 10, 16132 Genova, Italy.
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Gomez-Sanchez L, Garcia-Ortiz L, Patino-Alonso MC, Recio-Rodriguez JI, Rigo F, Martí R, Agudo-Conde C, Rodriguez-Sanchez E, Maderuelo-Fernandez JA, Ramos R, Gomez-Marcos MA. Adiposity measures and arterial stiffness in primary care: the MARK prospective observational study. BMJ Open 2017; 7:e016422. [PMID: 28963288 PMCID: PMC5623460 DOI: 10.1136/bmjopen-2017-016422] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The cardiovascular risk of obesity is potentially increased by arterial stiffness. OBJECTIVE To assess the relationship of adiposity measures with arterial stiffness in Caucasian adults with intermediate cardiovascular risk. SETTING Six Spanish health centres. PARTICIPANTS We enrolled 2354 adults (age range, 35-74 years; mean age, 61.4±7.7 years, 61.9% male). METHODS This is a cross-sectional study that analyses data from the baseline visit of the improving interMediAte RisK management (MARK) study. The main outcome variables were body mass index (BMI), waist-to-height ratio (WHtR), Clínica Universidad de Navarra-body adiposity estimation (CUN-BAE) body fat percentage and body roundness index (BRI). Vascular function was assessed by the cardio-ankle vascular index (CAVI) with the VaSera device; brachial-ankle pulse wave velocity (baPWV) was determined using a validated equation. RESULTS The mean adiposity measures were a BMI of 29.2±4.4, WHtR of 0.61±0.07, CUN-BAE of 35.7±1.7 and BRI of 5.8±1.7. The mean stiffness measures were a CAVI of 8.8±1.2 and baPWV of 14.9±2.5. In multiple linear regression analyses, all adiposity measures were negatively associated with CAVI and baPWV (p<0.01 for all) after adjustment for possible factors of confusion. The proportion of CAVI variability via the adiposity measures were 5.5% for BMI, 5.8% for CUN-BAE, 3.8% for WHtR and 3.7% for BRI. These were higher among diabetic, obese, younger (≤62 years) and non-hypertensive subjects who had similar activity and sedentary profiles. CONCLUSIONS Adiposity measures are negatively associated with arterial stiffness measures. The percentage of variation in CAVI explained by its relation to the different measures of adiposity ranges from 5.8% (CUN-BAE) to 3.7% (BRI). In the case of baPWV, it oscillates between 0.7% (CUN-BAE and BMI) and 0.1% (WHtR). TRIAL REGISTRATION NUMBER NCT01428934.
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Affiliation(s)
- Leticia Gomez-Sanchez
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Luis Garcia-Ortiz
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Maria C Patino-Alonso
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
- Department of Statistics, University of Salamanca, Salamanca, Spain
| | - Jose I Recio-Rodriguez
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| | - Fernando Rigo
- San Agustín Health Center, Illes Balears Health Service (IBSALUT), Palma of Mallorca, Spain
| | - Ruth Martí
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Girona, Spain
- Institut d'Investigació Biomèdica of Girona Dr. Josep Trueta (IDBGI), Girona, Spain
| | - Cristina Agudo-Conde
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Emiliano Rodriguez-Sanchez
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Jose A Maderuelo-Fernandez
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Rafel Ramos
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Girona, Spain
- Institut d'Investigació Biomèdica of Girona Dr. Josep Trueta (IDBGI), Girona, Spain
- Departament of Ciències Mèdiques, Universitat de Girona, Girona, Spain
| | - Manuel A Gomez-Marcos
- Primary Care Research Unit, The Alamedilla Health Center, Castilla and León Health Service (SACyL), Salamanca, Spain
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
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Aatola H, Koivistoinen T, Tuominen H, Juonala M, Lehtimäki T, Viikari JSA, Raitakari OT, Kähönen M, Hutri-Kähönen N. Influence of Child and Adult Elevated Blood Pressure on Adult Arterial Stiffness: The Cardiovascular Risk in Young Finns Study. Hypertension 2017; 70:531-536. [PMID: 28674036 DOI: 10.1161/hypertensionaha.117.09444] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 04/05/2017] [Accepted: 05/01/2017] [Indexed: 01/26/2023]
Abstract
Elevated blood pressure (BP) in childhood has been associated with increased adult arterial stiffness, the independent predictor of cardiovascular and all-cause mortality. The favorable BP change from childhood to adulthood and the risk of high adult arterial stiffness has not been reported. We examined the effect of child and adult BP on pulse wave velocity (PWV) assessed in adulthood among 1540 white adults followed-up for 27 years since baseline (1980, aged 6-18 years). Childhood elevated BP was defined according to the tables from the National High Blood Pressure Education Program. In adulthood, BP was classified as elevated if systolic BP ≥120 mm Hg, diastolic BP ≥80 mm Hg, or self-reported use of antihypertensive medications. PWV was measured in 2007 by whole-body impedance cardiography, and high PWV was defined as values at or above the age-, sex-, and heart rate-specific 80th percentile. Individuals with persistently elevated BP and individuals with normal child but elevated adult BP had increased risk of high adult PWV (relative risk [95% confidence interval], 3.18 [2.22-4.55] and 2.64 [1.79-3.88], respectively) in comparison with individuals with normal (both child and adult) BP. In contrast, individuals with elevated BP in childhood but not in adulthood did not have significantly increased risk of high PWV (relative risk [95% confidence interval], 1.26[0.80-1.99]). The results were consistent when different definitions for child and adult elevated BP were applied. These findings highlight the importance of BP control in the primary prevention of cardiovascular diseases.
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Affiliation(s)
- Heikki Aatola
- From the Departments of Clinical Physiology (H.A., T.K., H.T., M.K.), Clinical Chemistry, Fimlab Laboratories (T.L.), and Pediatrics (N.H.-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Departments of Medicine (M.J., J.S.A.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.) and Research Centre of Applied and Preventive Cardiovascular Medicine (M.J., O.T.R.), University of Turku, Finland; and Division of Medicine (J.S.A.V.), Turku University Hospital, Finland.
| | - Teemu Koivistoinen
- From the Departments of Clinical Physiology (H.A., T.K., H.T., M.K.), Clinical Chemistry, Fimlab Laboratories (T.L.), and Pediatrics (N.H.-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Departments of Medicine (M.J., J.S.A.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.) and Research Centre of Applied and Preventive Cardiovascular Medicine (M.J., O.T.R.), University of Turku, Finland; and Division of Medicine (J.S.A.V.), Turku University Hospital, Finland
| | - Heikki Tuominen
- From the Departments of Clinical Physiology (H.A., T.K., H.T., M.K.), Clinical Chemistry, Fimlab Laboratories (T.L.), and Pediatrics (N.H.-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Departments of Medicine (M.J., J.S.A.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.) and Research Centre of Applied and Preventive Cardiovascular Medicine (M.J., O.T.R.), University of Turku, Finland; and Division of Medicine (J.S.A.V.), Turku University Hospital, Finland
| | - Markus Juonala
- From the Departments of Clinical Physiology (H.A., T.K., H.T., M.K.), Clinical Chemistry, Fimlab Laboratories (T.L.), and Pediatrics (N.H.-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Departments of Medicine (M.J., J.S.A.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.) and Research Centre of Applied and Preventive Cardiovascular Medicine (M.J., O.T.R.), University of Turku, Finland; and Division of Medicine (J.S.A.V.), Turku University Hospital, Finland
| | - Terho Lehtimäki
- From the Departments of Clinical Physiology (H.A., T.K., H.T., M.K.), Clinical Chemistry, Fimlab Laboratories (T.L.), and Pediatrics (N.H.-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Departments of Medicine (M.J., J.S.A.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.) and Research Centre of Applied and Preventive Cardiovascular Medicine (M.J., O.T.R.), University of Turku, Finland; and Division of Medicine (J.S.A.V.), Turku University Hospital, Finland
| | - Jorma S A Viikari
- From the Departments of Clinical Physiology (H.A., T.K., H.T., M.K.), Clinical Chemistry, Fimlab Laboratories (T.L.), and Pediatrics (N.H.-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Departments of Medicine (M.J., J.S.A.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.) and Research Centre of Applied and Preventive Cardiovascular Medicine (M.J., O.T.R.), University of Turku, Finland; and Division of Medicine (J.S.A.V.), Turku University Hospital, Finland
| | - Olli T Raitakari
- From the Departments of Clinical Physiology (H.A., T.K., H.T., M.K.), Clinical Chemistry, Fimlab Laboratories (T.L.), and Pediatrics (N.H.-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Departments of Medicine (M.J., J.S.A.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.) and Research Centre of Applied and Preventive Cardiovascular Medicine (M.J., O.T.R.), University of Turku, Finland; and Division of Medicine (J.S.A.V.), Turku University Hospital, Finland
| | - Mika Kähönen
- From the Departments of Clinical Physiology (H.A., T.K., H.T., M.K.), Clinical Chemistry, Fimlab Laboratories (T.L.), and Pediatrics (N.H.-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Departments of Medicine (M.J., J.S.A.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.) and Research Centre of Applied and Preventive Cardiovascular Medicine (M.J., O.T.R.), University of Turku, Finland; and Division of Medicine (J.S.A.V.), Turku University Hospital, Finland
| | - Nina Hutri-Kähönen
- From the Departments of Clinical Physiology (H.A., T.K., H.T., M.K.), Clinical Chemistry, Fimlab Laboratories (T.L.), and Pediatrics (N.H.-K.), Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Finland; Department of Emergency Medicine, Kanta-Häme Central Hospital, Hämeenlinna, Finland (T.K.); Departments of Medicine (M.J., J.S.A.V.) and Clinical Physiology and Nuclear Medicine (O.T.R.) and Research Centre of Applied and Preventive Cardiovascular Medicine (M.J., O.T.R.), University of Turku, Finland; and Division of Medicine (J.S.A.V.), Turku University Hospital, Finland
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Augustine JA, Yoon ES, Choo J, Heffernan KS, Jae SY. The Relationship Between Cardiorespiratory Fitness and Aortic Stiffness in Women with Central Obesity. J Womens Health (Larchmt) 2016; 25:680-6. [DOI: 10.1089/jwh.2015.5314] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jacqueline A. Augustine
- Human Performance Laboratory, Department of Exercise Science, Syracuse University, Syracuse, New York
| | - Eun Sun Yoon
- Department of Sport Science, University of Seoul, Seoul, South Korea
| | - Jina Choo
- College of Nursing, Korea University, Seoul, South Korea
| | - Kevin S. Heffernan
- Human Performance Laboratory, Department of Exercise Science, Syracuse University, Syracuse, New York
| | - Sae Young Jae
- Department of Sport Science, University of Seoul, Seoul, South Korea
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Cruickshank JK, Silva MJ, Molaodi OR, Enayat ZE, Cassidy A, Karamanos A, Read UM, Faconti L, Dall P, Stansfield B, Harding S. Ethnic Differences in and Childhood Influences on Early Adult Pulse Wave Velocity: The Determinants of Adolescent, Now Young Adult, Social Wellbeing, and Health Longitudinal Study. Hypertension 2016; 67:1133-41. [PMID: 27141061 PMCID: PMC4861702 DOI: 10.1161/hypertensionaha.115.07079] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 03/10/2016] [Indexed: 12/22/2022]
Abstract
Supplemental Digital Content is available in the text. Early determinants of aortic stiffness as pulse wave velocity are poorly understood. We tested how factors measured twice previously in childhood in a multiethnic cohort study, particularly body mass, blood pressure, and objectively assessed physical activity affected aortic stiffness in young adults. Of 6643 London children, aged 11 to 13 years, from 51 schools in samples stratified by 6 ethnic groups with different cardiovascular risk, 4785 (72%) were seen again at aged 14 to 16 years. In 2013, 666 (97% of invited) took part in a young adult (21–23 years) pilot follow-up. With psychosocial and anthropometric measures, aortic stiffness and blood pressure were recorded via an upper arm calibrated Arteriograph device. In a subsample (n=334), physical activity was measured >5 days via the ActivPal. Unadjusted pulse wave velocities in black Caribbean and white UK young men were similar (mean±SD 7.9±0.3 versus 7.6±0.4 m/s) and lower in other groups at similar systolic pressures (120 mm Hg) and body mass (24.6 kg/m2). In fully adjusted regression models, independent of pressure effects, black Caribbean (higher body mass/waists), black African, and Indian young women had lower stiffness (by 0.5–0.8; 95% confidence interval, 0.1–1.1 m/s) than did white British women (6.9±0.2 m/s). Values were separately increased by age, pressure, powerful impacts from waist/height, time spent sedentary, and a reported racism effect (+0.3 m/s). Time walking at >100 steps/min was associated with reduced stiffness (P<0.01). Effects of childhood waist/hip were detected. By young adulthood, increased waist/height ratios, lower physical activity, blood pressure, and psychosocial variables (eg, perceived racism) independently increase arterial stiffness, effects likely to increase with age.
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Affiliation(s)
- J Kennedy Cruickshank
- From the Cardiovascular Medicine Group, Division of Diabetes and Nutritional Sciences, Kings College London, London, United Kingdom (J.K.C., M.J.S., Z.E.E., A.K., L.F., S.H.); Medical Research Council/ Chief Scientist's Office (MRC/CSO), Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, United Kingdom (O.R.M., A.C., U.M.R.); and Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom (P.D., B.S.).
| | - Maria J Silva
- From the Cardiovascular Medicine Group, Division of Diabetes and Nutritional Sciences, Kings College London, London, United Kingdom (J.K.C., M.J.S., Z.E.E., A.K., L.F., S.H.); Medical Research Council/ Chief Scientist's Office (MRC/CSO), Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, United Kingdom (O.R.M., A.C., U.M.R.); and Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom (P.D., B.S.)
| | - Oarabile R Molaodi
- From the Cardiovascular Medicine Group, Division of Diabetes and Nutritional Sciences, Kings College London, London, United Kingdom (J.K.C., M.J.S., Z.E.E., A.K., L.F., S.H.); Medical Research Council/ Chief Scientist's Office (MRC/CSO), Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, United Kingdom (O.R.M., A.C., U.M.R.); and Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom (P.D., B.S.)
| | - Zinat E Enayat
- From the Cardiovascular Medicine Group, Division of Diabetes and Nutritional Sciences, Kings College London, London, United Kingdom (J.K.C., M.J.S., Z.E.E., A.K., L.F., S.H.); Medical Research Council/ Chief Scientist's Office (MRC/CSO), Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, United Kingdom (O.R.M., A.C., U.M.R.); and Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom (P.D., B.S.)
| | - Aidan Cassidy
- From the Cardiovascular Medicine Group, Division of Diabetes and Nutritional Sciences, Kings College London, London, United Kingdom (J.K.C., M.J.S., Z.E.E., A.K., L.F., S.H.); Medical Research Council/ Chief Scientist's Office (MRC/CSO), Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, United Kingdom (O.R.M., A.C., U.M.R.); and Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom (P.D., B.S.)
| | - Alexis Karamanos
- From the Cardiovascular Medicine Group, Division of Diabetes and Nutritional Sciences, Kings College London, London, United Kingdom (J.K.C., M.J.S., Z.E.E., A.K., L.F., S.H.); Medical Research Council/ Chief Scientist's Office (MRC/CSO), Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, United Kingdom (O.R.M., A.C., U.M.R.); and Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom (P.D., B.S.)
| | - Ursula M Read
- From the Cardiovascular Medicine Group, Division of Diabetes and Nutritional Sciences, Kings College London, London, United Kingdom (J.K.C., M.J.S., Z.E.E., A.K., L.F., S.H.); Medical Research Council/ Chief Scientist's Office (MRC/CSO), Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, United Kingdom (O.R.M., A.C., U.M.R.); and Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom (P.D., B.S.)
| | - Luca Faconti
- From the Cardiovascular Medicine Group, Division of Diabetes and Nutritional Sciences, Kings College London, London, United Kingdom (J.K.C., M.J.S., Z.E.E., A.K., L.F., S.H.); Medical Research Council/ Chief Scientist's Office (MRC/CSO), Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, United Kingdom (O.R.M., A.C., U.M.R.); and Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom (P.D., B.S.)
| | - Philippa Dall
- From the Cardiovascular Medicine Group, Division of Diabetes and Nutritional Sciences, Kings College London, London, United Kingdom (J.K.C., M.J.S., Z.E.E., A.K., L.F., S.H.); Medical Research Council/ Chief Scientist's Office (MRC/CSO), Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, United Kingdom (O.R.M., A.C., U.M.R.); and Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom (P.D., B.S.)
| | - Ben Stansfield
- From the Cardiovascular Medicine Group, Division of Diabetes and Nutritional Sciences, Kings College London, London, United Kingdom (J.K.C., M.J.S., Z.E.E., A.K., L.F., S.H.); Medical Research Council/ Chief Scientist's Office (MRC/CSO), Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, United Kingdom (O.R.M., A.C., U.M.R.); and Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom (P.D., B.S.)
| | - Seeromanie Harding
- From the Cardiovascular Medicine Group, Division of Diabetes and Nutritional Sciences, Kings College London, London, United Kingdom (J.K.C., M.J.S., Z.E.E., A.K., L.F., S.H.); Medical Research Council/ Chief Scientist's Office (MRC/CSO), Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, United Kingdom (O.R.M., A.C., U.M.R.); and Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom (P.D., B.S.)
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Noninvasive methods to assess pulse wave velocity: comparison with the invasive gold standard and relationship with organ damage. J Hypertens 2016; 33:1023-31. [PMID: 25668350 DOI: 10.1097/hjh.0000000000000518] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To compare noninvasive methods to assess pulse wave velocity (PWV) with the invasive gold standard in terms of absolute values, age-related changes, and relationship with subclinical organ damage. METHODS Invasive aortic PWV (aoPWVinv) was measured in 915 patients undergoing cardiac catheterization (mean age 61 years, range 27-87 years). Carotid-femoral PWV (cfPWV) was measured with tonometry, using subtracted distance (cfPWVsub), body height-based estimated distance (cfPWVbh), direct distance × 0.8 (cfPWVdir0.8), and caliper-based distance (cfPWVcalip) for travel distance calculation. Aortic PWV was estimated (aoPWVestim) from single-point radial waveforms, age, and SBP. RESULTS Invasive and noninvasive transit times were strikingly similar (median values 60.8 versus 61.7 ms). In the entire group, median value of aoPWVinv was 8.3 m/s, of cfPWVsub and cfPWVbh 8.1 m/s, and of aoPWVest 8.5 m/s. CfPWVsub overestimated aoPWVinv in younger patients by 0.7 m/s and underestimated aoPWVinv in older patients by 1.7 m/s, with good agreement from 50 to 70 years of age. AoPWVestim differed from aoPWVinv by no more than 0.4 m/s across all age groups. CfPWVdir0.8, measured in 632 patients, overestimated aoPWVinv by 1.7 m/s in younger patients, with good agreement in middle-aged and older patients. CfPWVcalip, measured in 336 patients, underestimated aoPWVinv in all ages. In 536 patients with preserved systolic function, aoPWVinv and aoPWVestim were superior to cfPWVs in predicting coronary atherosclerosis, renal function impairment, left atrial enlargement, and diastolic dysfunction. CONCLUSION CfPWVsub, cfPWVdir0.8, and aoPWVestim are reasonable surrogates for aoPWVinv. AoPWVinv predicts subclinical organ damage better than cfPWVs, and as good as aoPWVestim.
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Brunner EJ, Shipley MJ, Ahmadi-Abhari S, Tabak AG, McEniery CM, Wilkinson IB, Marmot MG, Singh-Manoux A, Kivimaki M. Adiposity, obesity, and arterial aging: longitudinal study of aortic stiffness in the Whitehall II cohort. Hypertension 2015; 66:294-300. [PMID: 26056335 PMCID: PMC4490910 DOI: 10.1161/hypertensionaha.115.05494] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 05/12/2015] [Indexed: 01/28/2023]
Abstract
We sought to determine whether adiposity in later midlife is an independent predictor of accelerated stiffening of the aorta. Whitehall II study participants (3789 men; 1383 women) underwent carotid-femoral applanation tonometry at the mean age of 66 and again 4 years later. General adiposity by body mass index, central adiposity by waist circumference and waist:hip ratio, and fat mass percent by body impedance were assessed 5 years before and at baseline. In linear mixed models adjusted for age, sex, ethnicity, and mean arterial pressure, all adiposity measures were associated with aortic stiffening measured as increase in pulse wave velocity (PWV) between baseline and follow-up. The associations were similar in the metabolically healthy and unhealthy, according to Adult Treatment Panel-III criteria excluding waist circumference. C-reactive protein and interleukin-6 levels accounted for part of the longitudinal association between adiposity and PWV change. Adjusting for chronic disease, antihypertensive medication and risk factors, standardized effects of general and central adiposity and fat mass percent on PWV increase (m/s) were similar (0.14, 95% confidence interval: 0.05-0.24, P=0.003; 0.17, 0.08-0.27, P<0.001; 0.14, 0.05-0.22, P=0.002, respectively). Previous adiposity was associated with aortic stiffening independent of change in adiposity, glycaemia, and lipid levels across PWV assessments. We estimated that the body mass index-linked PWV increase will account for 12% of the projected increase in cardiovascular risk because of high body mass index. General and central adiposity in later midlife were strong independent predictors of aortic stiffening. Our findings suggest that adiposity is an important and potentially modifiable determinant of arterial aging.
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Affiliation(s)
- Eric J Brunner
- From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.).
| | - Martin J Shipley
- From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.)
| | - Sara Ahmadi-Abhari
- From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.)
| | - Adam G Tabak
- From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.)
| | - Carmel M McEniery
- From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.)
| | - Ian B Wilkinson
- From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.)
| | - Michael G Marmot
- From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.)
| | - Archana Singh-Manoux
- From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.)
| | - Mika Kivimaki
- From the UCL Research Department of Epidemiology and Public Health, London, United Kingdom (E.J.B., M.J.S., S.A.-A., A.G.T., C.M.M., M.G.M., A.S.-M., M.K.); Semmelweis University Faculty of Medicine, 1st Department of Medicine, Budapest, Hungary (A.G.T.); Clinical Pharmacology Unit, Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom (C.M.M., J.B.W.); INSERM, Centre for Research in Epidemiology & Public Health, Hôpital Paul Brousse, Bâtiment, France (A.S.-M.)
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Affiliation(s)
- Peter M Nilsson
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
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Strasser B, Arvandi M, Pasha EP, Haley AP, Stanforth P, Tanaka H. Abdominal obesity is associated with arterial stiffness in middle-aged adults. Nutr Metab Cardiovasc Dis 2015; 25:495-502. [PMID: 25770757 DOI: 10.1016/j.numecd.2015.01.002] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 12/26/2014] [Accepted: 01/18/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS The relation between adiposity and arterial stiffness remains controversial. We determined whether abdominal and visceral adipose tissue may be a better predictor of arterial stiffness than general obesity in middle-aged adults. METHODS AND RESULTS A total of 146 participants (76 men, 70 women; 50 years) were studied. The automatic vascular screening device (Omron VP-1000plus) was used to measure blood pressure simultaneously in the arms and ankles and to determine arterial stiffness by pulse wave velocity (PWV). Using multiple linear regressions, the relations between indicators of obesity and arterial stiffness were examined after adjustment for confounders. Both carotid-femoral PWV and brachial-ankle PWV were significantly associated with BMI (both P < 0.05) but not with body fat percentage. Measures of abdominal obesity, including waist circumference and visceral fat mass (via DXA), were strongly associated with PWV and remained positively associated with arterial stiffness after adjustment for age and gender. Cardiovascular fitness as assessed by maximal oxygen consumption was related to body fat percentage but not with visceral fat. More favorable cardiovascular health profile was associated with both lower visceral fat mass and PWV (both P < 0.001). CONCLUSION Abdominal obesity and visceral fat are associated with large artery stiffness. These findings support the importance of adiposity measures as a risk factor for arterial stiffening in middle-aged adults.
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Affiliation(s)
- B Strasser
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA; Institute for Nutritional Sciences and Physiology, University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria.
| | - M Arvandi
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria
| | - E P Pasha
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA
| | - A P Haley
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - P Stanforth
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA
| | - H Tanaka
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA
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Canepa M, Ameri P, AlGhatrif M, Pestelli G, Milaneschi Y, Strait JB, Giallauria F, Ghigliotti G, Brunelli C, Lakatta EG, Ferrucci L. Role of bone mineral density in the inverse relationship between body size and aortic calcification: results from the Baltimore Longitudinal Study of Aging. Atherosclerosis 2014; 235:169-75. [PMID: 24842457 DOI: 10.1016/j.atherosclerosis.2014.04.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 04/01/2014] [Accepted: 04/12/2014] [Indexed: 01/06/2023]
Abstract
OBJECTIVE There is a J-shaped relationship between body mass index (BMI) and cardiovascular outcomes in elderly patients (obesity paradox). Whether low BMI correlates with aortic calcification (AC) and whether this association is accounted for by bone demineralization is uncertain. METHODS Presence of AC was evaluated in 687 community-dwelling individuals (49% male, mean age 67 ± 13 years) using CT images of the thoracic, upper and lower abdominal aorta, and scored from 0 to 3 according to number of sites that showed any calcification. Whole-body bone mineral density (BMD) was evaluated by dual-energy X-ray absorptiometry. Predictors of AC were assessed by logistic regression, and the role of BMD using mediation analysis. RESULTS Age and cardiovascular risk factors were positively associated while both BMI (r = -0.11, p < 0.01) and BMD (r = -0.17, p < 0.0001) were negatively associated with AC severity. In multivariate models, lower BMI (OR 0.96, 95%CI 0.92-0.99, p = 0.01), older age, higher systolic blood pressure, use of lipid-lowering drugs and smoking were independent predictors of AC. A nonlinear relationship between BMI and AC was noticed (p = 0.03), with decreased AC severity among overweight participants. After adjusting for BMD, the coefficient relating BMI to AC was reduced by 14% and was no longer significant, whereas BMD remained negatively associated with AC (OR 0.82, 95%CI 0.069-0.96, p = 0.01), with a trend for a stronger relationship in older participants. CONCLUSION Low BMI is associated with increased AC, possibly through calcium mobilization from bone, resulting in low BMD. Prevention of weight loss and bone demineralization with aging may help reducing AC.
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Affiliation(s)
- Marco Canepa
- Longitudinal Studies Section, Translational Gerontology Branch, NIA/NIH, Baltimore, MD, USA; Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, NIA/NIH, Baltimore, MD, USA; Department of Internal Medicine, University of Genova, Genova, Italy.
| | - Pietro Ameri
- Department of Internal Medicine, University of Genova, Genova, Italy
| | - Majd AlGhatrif
- Longitudinal Studies Section, Translational Gerontology Branch, NIA/NIH, Baltimore, MD, USA; Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, NIA/NIH, Baltimore, MD, USA; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Gabriele Pestelli
- Department of Internal Medicine, University of Genova, Genova, Italy
| | - Yuri Milaneschi
- Longitudinal Studies Section, Translational Gerontology Branch, NIA/NIH, Baltimore, MD, USA; Department of Psychiatry, VU University Medical Center/GGZ inGeest, Amsterdam, The Netherlands
| | - James B Strait
- Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, NIA/NIH, Baltimore, MD, USA
| | - Francesco Giallauria
- Longitudinal Studies Section, Translational Gerontology Branch, NIA/NIH, Baltimore, MD, USA
| | | | - Claudio Brunelli
- Department of Internal Medicine, University of Genova, Genova, Italy
| | - Edward G Lakatta
- Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, NIA/NIH, Baltimore, MD, USA
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, NIA/NIH, Baltimore, MD, USA
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