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Lelis DDF, Cunha RS, Santos RD, Sposito AC, Griep RH, Barreto SM, Molina MDCB, Schmidt MI, Duncan BB, Bensenor I, Lotufo PA, Mill JG, Baldo MP. Association Between Triglycerides, High-Density Lipoprotein Cholesterol, and Their Ratio With the Pulse Wave Velocity in Adults From the ELSA-Brasil Study. Angiology 2023; 74:822-831. [PMID: 35972851 DOI: 10.1177/00033197221121434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Atherogenic dyslipidemia is a risk factor for cardiovascular diseases. The present study aimed to evaluate the association between triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and the triglycerides to high-density lipoprotein (TG/HDL-C) ratio with carotid-femoral pulse wave velocity (cf-PWV), a marker of vascular stiffness. Anthropometric, biochemical, and clinical data from 13,732 adults were used to assess this association. Individuals within the third TG/HDL-C tertile presented worse anthropometric, biochemical, and clinical profiles as compared with the participants in the lower TG/HDL-C tertile. There was a linear association between TG, HDL-C, and TG/HDL-C ratio and cf-PWV in both men and women (stronger in women). After adjustment for confounders, lower levels of HDL-C were associated with increased cf-PWV in men (9.63 ± .02 m/s) and women (8.90 ± .03 m/s). However, TG was not significantly associated with cf-PWV after adjustment, regardless of sex. An increased TG/HDL-C ratio is associated with higher cf-PWV only in women (9.01 ± .03 m/s), but after adjustment for HDL-C levels, the association was non-significant (8.99 ± .03 m/s). These results highlight the stronger association of HDL-C with arterial stiffness, and that the association of TG/HDL-C with cf-PWV is dependent on HDL-C.
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Affiliation(s)
- Deborah de Farias Lelis
- Department of Pathophysiology, Montes Claros State University (UNIMONTES), Montes Claros, Brazil
| | - Roberto S Cunha
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, Brazil
| | - Raul D Santos
- Lipid Clinic Heart Institute (Incor) University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - Andrei C Sposito
- Cardiology Division, Faculty of Medical Sciences, State University of Campinas (Unicamp), Campinas, Brazil
| | - Rosane Härter Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Rio de Janeiro, Brazil
| | | | | | - Maria Inês Schmidt
- School of Medicine and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Bruce B Duncan
- School of Medicine and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Isabela Bensenor
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
| | - Paulo Andrade Lotufo
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
| | - José Geraldo Mill
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, Brazil
| | - Marcelo Perim Baldo
- Department of Pathophysiology, Montes Claros State University (UNIMONTES), Montes Claros, Brazil
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Park J, Kang M, Ahn J, Kim MY, Choi MS, Lee YB, Kim G, Hur KY, Kim JH, Yang JH, Jin SM. Mean and Variability of Lipid Measurements and Risk for Development of Subclinical Left Ventricular Diastolic Dysfunction. Diabetes Metab J 2022; 46:286-296. [PMID: 34802217 PMCID: PMC8987686 DOI: 10.4093/dmj.2021.0080] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/08/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Subclinical left ventricular diastolic dysfunction (LVDD) is an emerging consequence of increased insulin resistance, and dyslipidemia is one of the few correctable risk factors of LVDD. This study evaluated the role of mean and visit-to-visit variability of lipid measurements in risk of LVDD in a healthy population. METHODS This was a 3.7-year (interquartile range, 2.1 to 4.9) longitudinal cohort study including 2,817 adults (median age 55 years) with left ventricular ejection fraction >50% who underwent an annual or biannual health screening between January 2008 and July 2016. The mean, standard deviation (SD), coefficient of variation (CV), variability independent of the mean (VIM), and average real variability of total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein B (apoB), non-HDL-C, and triglycerides were obtained from three to six measurements during the 5 years preceding the first echocardiogram. RESULTS Among the 2,817 patients, 560 (19.9%) developed LVDD. The mean of no component of lipid measurements was associated with risk of LVDD. CV (hazard ratio [HR], 1.35; 95% confidence interval [CI], 1.10 to 1.67), SD (HR, 1.27; 95% CI, 1.03 to 1.57), and VIM (HR, 1.26; 95% CI, 1.03 to 1.55) of LDL-C and all the variability parameters of apoB were significantly associated with development of LVDD. The association between CV-LDL and risk of LVDD did not have significant interaction with sex, increasing/decreasing trend at baseline, or use of stain and/or lipid-modifying agents. CONCLUSION The variability of LDL-C and apoB, rather than their mean, was associated with risk for LVDD.
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Affiliation(s)
- Jiyun Park
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mira Kang
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Korea
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Mira Kang https://orcid.org/0000-0002-7842-0035 Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea E-mail:
| | - Jiyeon Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Min Young Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Min Sun Choi
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gyuri Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyu Yeon Hur
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Hoon Yang
- Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang-Man Jin
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Corresponding authors: Sang-Man Jin https://orcid.org/0000-0001-5929-3627 Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea E-mail:
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3
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Fukuda Y, Nitta K, Kurisu S, Watanabe N, Ikenaga H, Ishibashi K, Nakano Y. The Monocyte to High-Density Lipoprotein Cholesterol Ratio Is Associated with Left Ventricular Diastolic Function in Patients with No Significant Perfusion Abnormality. Int Heart J 2021; 62:866-871. [PMID: 34234077 DOI: 10.1536/ihj.20-810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The monocyte to high-density lipoprotein cholesterol (HDL-C) ratio has been considered to be a prognostic marker. Whether this ratio is associated with left ventricular (LV) diastolic function remains undetermined. We tested the hypothesis that the monocyte to HDL-C ratio is associated with LV diastolic parameters derived from gated myocardial perfusion single-photon emission computed tomography (SPECT) in patients with no significant perfusion abnormality.The study population included 196 patients with no significant perfusion abnormalities and preserved ejection fraction. The peak filling rate (PFR) and one-third mean filling rate (1/3 MFR) were obtained as LV diastolic parameters using gated SPECT. Monocyte counts and plasma HDL-C levels were also examined.Significant associations were observed between the monocyte to HDL-C ratio and PFR (r = -0.20; P = 0.005) and 1/3 MFR (r = -0.19; P = 0.009). Multivariate linear regression analysis was performed to determine factors associated with LV diastolic parameters. Age (β = -0.27; P < 0.001), LV end-diastolic volume (β = -0.19; P = 0.034), and monocyte to HDL-C ratio (β = -0.15; P = 0.027) were determined to be significantly associated with PFR. Moreover, age (β = -0.13; P = 0.007), LV mass index (β = -0.18; P = 0.037), and the monocyte to HDL-C ratio (β = -0.13; P = 0.045) were significantly associated with 1/3 MFR.These results demonstrated that the monocyte to HDL-C ratio is associated with LV diastolic function, as derived from gated SPECT in patients with no significant perfusion abnormality.
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Affiliation(s)
- Yukihiro Fukuda
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Kazuhiro Nitta
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Satoshi Kurisu
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Noriaki Watanabe
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Hiroki Ikenaga
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Ken Ishibashi
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Yukiko Nakano
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
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Nachar W, Merlet N, Maafi F, Mihalache-Avram T, Mecteau M, Gélinas D, Shi Y, Brodeur M, Alem S, Blondeau L, Cossette M, Guertin MC, Rhainds D, Busseuil D, Rhéaume E, Tardif JC. ApoA-I mimetic does not improve left ventricular diastolic dysfunction in rabbits without aortic valve stenosis. Int J Cardiol 2021; 331:199-205. [PMID: 33421451 DOI: 10.1016/j.ijcard.2020.12.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/23/2020] [Accepted: 12/30/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND We previously demonstrated that high-density lipoprotein (HDL) infusions may improve left ventricular diastolic dysfunction (LVDD) in an aortic valve stenosis (AVS) model. Whether the benefit was direct or mediated by the observed reduction in AVS severity is not clear. Here, we aimed to test the direct effect of an ApoA-I mimetic on LVDD in the absence of AVS. METHODS Rabbits were exposed to three different protocols to develop LVDD. First, rabbits were exposed to 0.5% cholesterol-rich diet for an average of 17 weeks. Second, rabbits were subjected to surgical ascending aortic constriction (AAC), to mimic the effect of fixed reduced aortic valve area, and studied after 10 weeks. The third model combined both cholesterol-enriched diet (for 12 weeks) and surgical AAC. The control group consisted of age-matched rabbits under normal diet. After development of LVDD, rabbits were randomized to receive infusions of saline or apoA-I mimetic (25 mg/kg) 3 times per week for 4 weeks. Detailed cardiac structure and function measurements were assessed at baseline and weekly during treatment period. Histological and molecular analyses were performed on LV samples. RESULTS In the three models, echocardiographic results showed development of LVDD over time, with preserved LV systolic and aortic valve functions versus controls. ApoA-I mimetic infusions did not significantly improve echocardiographic parameters nor molecular markers of cardiac inflammation, oxidative stress and fibrosis. CONCLUSION ApoA-I mimetic therapy did not directly improve LVDD. These results indicate that previously observed changes of LVDD were caused by AVS improvement induced by this treatment.
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Affiliation(s)
- Walid Nachar
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada; Department of medicine, Université de Montréal, 2900 Edouard-Montpetit boulevard, Montreal H3T 1J4, Canada
| | - Nolwenn Merlet
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada
| | - Foued Maafi
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada; Department of medicine, Université de Montréal, 2900 Edouard-Montpetit boulevard, Montreal H3T 1J4, Canada
| | | | - Mélanie Mecteau
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada
| | - Danielle Gélinas
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada
| | - Yanfen Shi
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada
| | - Mathieu Brodeur
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada
| | - Sonia Alem
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada
| | - Lucie Blondeau
- Montreal Health Innovations Coordinating Centre (MHICC), 4100 Molson Street, Montreal H1Y 3N1, Canada
| | - Mariève Cossette
- Montreal Health Innovations Coordinating Centre (MHICC), 4100 Molson Street, Montreal H1Y 3N1, Canada
| | - Marie-Claude Guertin
- Montreal Health Innovations Coordinating Centre (MHICC), 4100 Molson Street, Montreal H1Y 3N1, Canada
| | - David Rhainds
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada
| | - David Busseuil
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada
| | - Eric Rhéaume
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada; Department of medicine, Université de Montréal, 2900 Edouard-Montpetit boulevard, Montreal H3T 1J4, Canada
| | - Jean-Claude Tardif
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada; Department of medicine, Université de Montréal, 2900 Edouard-Montpetit boulevard, Montreal H3T 1J4, Canada.
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Rueda-Ochoa OL, Smiderle-Gelain MA, Rizopoulos D, Dhana K, van den Berge JK, Echeverria LE, Ikram MA, Deckers JW, Franco OH, Kavousi M. Risk factors for longitudinal changes in left ventricular diastolic function among women and men. Heart 2019; 105:1414-1422. [PMID: 30936410 PMCID: PMC6820149 DOI: 10.1136/heartjnl-2018-314487] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 02/22/2019] [Accepted: 03/01/2019] [Indexed: 12/13/2022] Open
Abstract
Objective To evaluate changes in left ventricular diastolic function (LVDF) parameters and their associated risk factors over a period of 11 years among community-dwelling women and men. Methods Echocardiography was performed three times among 870 women and 630 men (age 67±3 years) from the prospective population-based Rotterdam Study during a period of 11-year follow-up. Changes in six continuous LVDF parameters were correlated with cardiovascular risk factors using a linear-mixed effect model (LMM). Results In women, smoking was associated with deleterious longitudinal changes in deceleration time (DT) (Beta (β): 7.73; 95% CI 2.56 to 12.9) and high-density lipoprotein cholesterol was associated with improvement of septal e′ (β: 0.37; 95% CI 0.13 to 0.62) and E/e′ ratio (β: −0.46; 95% CI −0.84 to –0.08) trajectories. Among men, diabetes was associated with deleterious longitudinal changes in A wave (β: 3.83; 95% CI 0.06 to 7.60), septal e′ (β: −0.40; 95% CI −0.70 to –0.09) and E/e′ ratio (β: 0.60; 95% CI 0.14 to 1.06) and body mass index was associated with deleterious longitudinal changes in A wave (β: 1.25; 95% CI 0.84 to 1.66), E/A ratio (β: −0.007; 95% CI −0.01 to –0.003), DT (β: 0.86; 95% CI 0.017 to 1.71) and E/e′ ratio (β: 0.12; 95% CI 0.06 to 0.19). Conclusions Smoking among women and metabolic factors (diabetes mellitus and body mass index) among men showed larger deleterious associations with longitudinal changes in LVDF parameters. The favourable association of HDL was mainly observed among women. This study, for the first time, evaluates risk factors associated with changes over time in continuous LVDF parameters among women and men and generates new hypothesis for further medical research.
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Affiliation(s)
- Oscar L Rueda-Ochoa
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Basic Sciences, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Marco A Smiderle-Gelain
- Department of Cardiology, Federal University of Health Sciences UFCSPA, Porto Alegre, Porto Alegre, Brazil
| | | | - Klodian Dhana
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | | | - Luis E Echeverria
- Heart Failure and Heart Transplant Clinic, Fundacion Cardiovascular de Colombia, Floridablanca, Colombia
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Jaap W Deckers
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
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Mallat S, Jurjus A, Bou Assi T, Jurjus A, Shams A, El Sayegh S, Berbari A. Markers of arterial stiffness in a sample of Lebanese subjects with Grade I essential hypertension. SAGE Open Med 2017; 5:2050312117712886. [PMID: 28611919 PMCID: PMC5466276 DOI: 10.1177/2050312117712886] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 05/10/2017] [Indexed: 01/18/2023] Open
Abstract
Objectives: Arterial stiffness is becoming a major global condition associated with an increased risk of cardiovascular problems and death. Several markers have been linked to arterial stiffness. Methods: To determine and evaluate these relations, anthropometric parameters (weight, height, and pulse rate), biochemical profile, and central and peripheral indices of arterial function were measured in 114 Lebanese subjects with Grade I essential hypertension. Results: Age was associated with a higher pulse wave velocity (p = .001), central systolic blood pressure (p = .013), central pulse pressure (p = .028), central augmentation index (p ≤ .0001) with a lower heart rate (p = .08), and glomerular filtration rate (p = .019). Pulse wave velocity was found to be higher in older subjects (>65 years) and correlated with higher body mass index (r = .85) independent of age. Aging also correlated with higher plasma glucose and alterations in calcium–phosphorus metabolism. Conclusion: Aging is associated with increased arterial stiffness which is reflected by an increase in the pulse wave velocity, augmentation index, central pulse pressure, and central systolic blood pressure with a reduction in heart rate. Also, a higher body mass index and a lower estimated glomerular filtration rate (< 60 mL/min/1.73 m2) are associated with increased arterial stiffness while calcium and phosphorus metabolism may play a role by promoting vascular calcification.
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Affiliation(s)
- Samir Mallat
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Abdo Jurjus
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Tarek Bou Assi
- Department of Laboratory Medicine, Psychiatric Hospital of the Cross, Jal El Dib, Lebanon
| | - Alice Jurjus
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ali Shams
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Skye El Sayegh
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Adel Berbari
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.,Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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Wen J, Zhong Y, Kuang C, Liao J, Chen Z, Yang Q. Lipoprotein ratios are better than conventional lipid parameters in predicting arterial stiffness in young men. J Clin Hypertens (Greenwich) 2017; 19:771-776. [PMID: 28560757 DOI: 10.1111/jch.13038] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 02/27/2017] [Accepted: 03/05/2017] [Indexed: 01/30/2023]
Abstract
Although dyslipidemia is associated with cardiovascular disease, there are conflicting data about the role of serum lipids and their ratios in promoting arterial stiffness. The authors aimed to compare serum lipid profiles to predict arterial stiffness, which was assessed by brachial-ankle pulse wave velocity in young Chinese men. A total of 1015 participants aged 18 to 44 years without serious comorbidities were recruited for conventional detection. Anthropometrics, brachial-ankle pulse wave velocity, serum lipids, and other laboratory data were measured. Univariate analysis and multivariate logistic regression were performed to examine the relationship between serum lipid profiles and brachial-ankle pulse wave velocity. Participants with high brachial-ankle pulse wave velocity exhibited higher levels of total cholesterol, triglyceride (TG), low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol (HDL-C), total cholesterol/HDL-C, TG/HDL-C, low-density lipoprotein cholesterol/HDL-C, and non-HDL-C/HDL-C. The subsequent multivariable logistic regression showed that TG/HDL-C, total cholesterol/HDL-C, non-HDL-C/HDL-C, and TG significantly increased the risk for arterial stiffness after adjustment for confounding factors. Results indicate that lipid ratios are superior to conventional lipid parameters for predicting arterial stiffness in young men and that the TG/HDL-C ratio has the strongest association with arterial stiffness.
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Affiliation(s)
- Jianghua Wen
- Department of Health Examination, Jiangmen Central Hospital, Jiangmen, Guangdong, China
| | - Yuyu Zhong
- Department of Health Examination, Jiangmen Central Hospital, Jiangmen, Guangdong, China
| | - Chaoqun Kuang
- Department of Health Examination, Jiangmen Central Hospital, Jiangmen, Guangdong, China
| | - Jierong Liao
- Department of Health Examination, Jiangmen Central Hospital, Jiangmen, Guangdong, China
| | - Zhijin Chen
- Department of Health Examination, Jiangmen Central Hospital, Jiangmen, Guangdong, China
| | - Qiong Yang
- Department of Endocrinology, Guilin Medical University Affiliated Hospital, Guilin City, Guangxi, China
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8
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Kang YM, Jung CH, Jang JE, Hwang JY, Kim EH, Park JY, Kim HK, Lee WJ. The association of incident hypertension with metabolic health and obesity status: definition of metabolic health does not matter. Clin Endocrinol (Oxf) 2016; 85:207-15. [PMID: 27038124 DOI: 10.1111/cen.13074] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 02/23/2016] [Accepted: 03/30/2016] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Metabolically healthy obese (MHO) phenotype refers to obese individuals with a favourable metabolic profile. Its prognostic value remains controversial and may partly depend on differences in how the phenotype is defined. We aimed to investigate whether the MHO phenotype is associated with future development of incident hypertension in a Korean population according to various definitions of metabolic health. SUBJECTS AND METHODS The study population comprised 31 033 Koreans without hypertension. Participants were stratified into metabolically healthy nonobese (MHNO), metabolically unhealthy nonobese (MUNO), metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO) by body mass index (cut-off value, 25·0 kg/m(2) ) and metabolic health state, using four different definitions: Adult Treatment Panel (ATP)-III, Wildman, Karelis and the homoeostasis model assessment (HOMA) criteria. RESULTS Over the median follow-up period of 35·0 months (range, 4·5-81·4 months), 4589 of the 31 033 individuals (14·8%) developed incident hypertension. Compared with the MHNO group, the MHO group showed increased association with incident hypertension with multivariate-adjusted odds ratios of 1·56 (95% confidence interval [CI], 1·41-1·72), 1·58 (95% CI 1·42-1·75), 1·52 (95% CI 1·35-1·71) and 1·46 (95% CI 1·33-1·61), when defined by ATP-III, Wildman, Karelis and HOMA criteria, respectively. CONCLUSION MUO individuals showed the highest association with the incident hypertension (adjusted odds ratios up to 2·00). MHO subjects showed an approximately 1·5-fold higher association with incident hypertension than their nonobese counterpart regardless of the definition of metabolic health used. Thus, considering both metabolic health and obesity is important for the assessment of potential cardiovascular outcomes.
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Affiliation(s)
- Yu Mi Kang
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang Hee Jung
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Eun Jang
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jenie Yoonoo Hwang
- Department of Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Hee Kim
- Department of Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joong-Yeol Park
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hong-Kyu Kim
- Department of Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Je Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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9
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HDL mimetic peptide CER-522 treatment regresses left ventricular diastolic dysfunction in cholesterol-fed rabbits. Int J Cardiol 2016; 215:364-71. [PMID: 27128563 DOI: 10.1016/j.ijcard.2016.04.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 03/29/2016] [Accepted: 04/03/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVES High-density lipoprotein (HDL) infusions induce rapid improvement of experimental atherosclerosis in rabbits but their effect on ventricular function remains unknown. We aimed to evaluate the effects of the HDL mimetic peptide CER-522 on left ventricular diastolic dysfunction (LVDD). METHODS Rabbits were fed with a cholesterol- and vitamin D2-enriched diet until mild aortic valve stenosis and hypercholesterolemia-induced LV hypertrophy and LVDD developed. Animals then received saline or 10 or 30mg/kg CER-522 infusions 6 times over 2weeks. We performed serial echocardiograms and LV histology to evaluate the effects of CER-522 therapy on LVDD. RESULTS LVDD was reduced by CER-522 as shown by multiple parameters including early filling mitral deceleration time, deceleration rate, Em/Am ratio, E/Em ratio, pulmonary venous velocities, and LVDD score. These findings were associated with reduced macrophages (RAM-11 positive cells) in the pericoronary area and LV, and decreased levels of apoptotic cardiomyocytes in CER-522-treated rabbits. CER-522 treatment also resulted in decreased atheromatous plaques and internal elastic lamina area in coronary arteries. CONCLUSIONS CER-522 improves LVDD in rabbits, with reductions of LV macrophage accumulation, cardiomyocyte apoptosis, coronary atherosclerosis and remodelling.
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Yilmaz H, Cakmak M, Inan O, Darcin T, Aktas A, Gurel OM, Bilgic MA, Bavbek N, Akcay A. Association of ambulatory arterial stiffness index with sEPCR in newly diagnosed hypertensive patients. Ren Fail 2015; 37:1409-13. [PMID: 26335397 DOI: 10.3109/0886022x.2015.1074472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIM Increased arterial stiffness is strongly associated with cardiovascular diseases, while thrombotic events are more common than hemorrhagic events in hypertensive patients. Markers of a hypercoagulable state may also predict future cardiovascular events in hypertensive patients. Here, we speculated that increased arterial stiffness might lead to the development of a hypercoagulable state that can play a role in the thrombotic complications of hypertension. Soluble endothelial protein C receptor (sEPCR) is one such marker of hypercoagulation. The ambulatory arterial stiffness index (AASI) could be accepted as a non-invasive measure of arterial stiffness. The aim of this study was to investigate association of AASI with levels of sEPCR in newly diagnosed hypertensive patients. MATERIALS AND METHODS The study included 263 newly diagnosed essential hypertensive patients and 55 healthy normotensive controls. All subjects underwent 24 h ambulatory blood pressure monitoring (ABPM); the AASI was derived from ABPM tracings. Plasma sEPCR was measured by ELISA. RESULTS Hypertensive patients (n = 263) had higher AASI, C-reactive protein (CRP) and sEPCR versus the normotensive healthy group (n = 55). Univariate analysis showed that AASI was positively associated with age (r = 0.212, p < 0.001) body mass index (r = 0.412, p < 0.001), pulse pressure (r = 0.350, p < 0.001), plasma sEPCR (r = 0.894, p < 0.001), 24-h heart rate (r = 0.176, p = 0.001) and inversely related to high-density lipoprotein (HDL) (r = -0.293, p < 0.001). Multivariate analyses revealed that sEPCR and HDL are independently correlated to AASI. CONCLUSION We suggest that increased AASI is associated with elevated sEPCR. It might be responsible for subsequent thrombotic events in newly diagnosed hypertensive patients.
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Affiliation(s)
- Hakki Yilmaz
- a Department of Internal Medicine, Section of Nephrology , Dr. A. Y. Ankara Oncology Training and Research Hospital , Ankara , Turkey
| | - Muzaffer Cakmak
- b Department of Internal Medicine , Turgut Ozal University, School of Medicine , Ankara , Turkey
| | - Osman Inan
- c Department of Internal Medicine , Yenimahalle Training and Research Hospital , Ankara , Turkey
| | - Tahir Darcin
- d Department of Internal Medicine , Agri State Hospital , Agri , Turkey
| | - Aynur Aktas
- e Department of Internal Medicine, Section of Endocrinology , Dr. A. Y. Ankara Oncology Training and Research Hospital , Ankara , Turkey
| | - Ozgul Malcok Gurel
- f Department of Cardiology , Turgut Ozal University, School of Medicine , Ankara , Turkey , and
| | - Mukadder Ayse Bilgic
- g Department of Internal Medicine, Section of Nephrology , Turgut Ozal University, School of Medicine , Ankara , Turkey
| | - Nuket Bavbek
- g Department of Internal Medicine, Section of Nephrology , Turgut Ozal University, School of Medicine , Ankara , Turkey
| | - Ali Akcay
- g Department of Internal Medicine, Section of Nephrology , Turgut Ozal University, School of Medicine , Ankara , Turkey
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Koumaras C, Katsiki N, Athyros VG, Karagiannis A. Metabolic syndrome and arterial stiffness: the past, the present and the future. J Cardiovasc Med (Hagerstown) 2014; 14:687-9. [PMID: 24335882 DOI: 10.2459/jcm.0b013e3283657c96] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Charalambos Koumaras
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
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Abstract
OBJECTIVES The present study aimed to investigate the incidence and predictors of hypertension in an Iranian adult population. METHODS Isfahan Cohort Study was a longitudinal population-based study that was conducted on adults aged 35 years or older, living in urban and rural areas of three districts in central Iran. After 7 years of follow-up, 3283 participants were re-evaluated using a standard protocol similar to the baseline. At both measurements, participants underwent medical interview, physical examination, and fasting blood measurements. Participants (n = 833) with prevalent hypertension were excluded from the analysis, resulting in a sample size of 2450. RESULTS The participants' age was 47.3 ± 9.4 years (mean ± SD) and 50.7% were men. During the follow-up period, 542 (22.1%) individuals developed hypertension, 49.6% of whom were aware of their disease, 42.4% were treated, but only 24.9% were controlled. Incidence rates have shown no sex-specific difference across age and blood pressure (BP) categories. Multivariate-adjusted model controlled for all study covariates showed that age, male sex, general and central obesity, hypertriglyceridemia, impaired fasting glucose, diabetes mellitus, baseline BP at least 120/80 mmHg (nonoptimal BP), and parental history of hypertension independently contributed to the development of hypertension. Higher education level and more than 10% decrease in waist circumference over 7-year follow-up represented protective effects. In men, weight loss decreased and weight gain increased the risk of developing hypertension. Nonoptimal BP along with central obesity and hypertriglyceridemia together were responsible for 71% of the burden of hypertension. CONCLUSION Our findings imply that there are other factors in addition to nonoptimal BP that deserve integrating into the risk assessment criteria for developing hypertension.
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Liang W, Chen D, Chen W, Cheng G. The ascending aortic elasticity feature in normotensive subjects: evaluation with coronary CT angiography. Clin Imaging 2014; 38:686-92. [PMID: 25034400 DOI: 10.1016/j.clinimag.2014.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 05/27/2014] [Accepted: 06/02/2014] [Indexed: 11/17/2022]
Abstract
To evaluate the ascending aortic elasticity feature, 118 normotensive subjects who underwent coronary computed tomography angiography (CCTA) were enrolled. Two groups of parameters assessing elasticity were calculated based on the measurements of volume and area of ascending aorta. Multivariate analysis revealed that some factors including age, systolic BP, diastolic BP, heart rate, smoking status and hyperlipidemia independently related to decreased aortic elasticity. Both measuring methods are applicable for evaluation of aortic elasticity. As the prevalence of CCTA, it is meaningful that CCTA can provide not only the structural details of ascending aorta but also functional information of the vessel elasticity.
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Affiliation(s)
- Wenqian Liang
- Department of Imaging Center, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Ave. N., Guangzhou, Guangdong 510515, China
| | - Dandan Chen
- Department of Imaging Center, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Ave. N., Guangzhou, Guangdong 510515, China
| | - Weicui Chen
- Department of Imaging Center, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Ave. N., Guangzhou, Guangdong 510515, China
| | - Guanxun Cheng
- Department of Imaging Center, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Ave. N., Guangzhou, Guangdong 510515, China.
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14
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Tadic M, Ivanovic B, Cuspidi C. Metabolic syndrome and right ventricle: an updated review. Eur J Intern Med 2013; 24:608-16. [PMID: 24001437 DOI: 10.1016/j.ejim.2013.08.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 08/06/2013] [Accepted: 08/07/2013] [Indexed: 12/19/2022]
Abstract
The cluster of metabolic and hemodynamic abnormalities which characterize the metabolic syndrome (MS) is responsible for subclinical cardiac and extra-cardiac damage such as left ventricular hypertrophy, diastolic dysfunction, carotid atherosclerosis and microalbuminuria. The development of different non-invasive imaging methods enabled a detail investigation of right ventricular structure and function, and revealed that right ventricular remodeling followed changes in the left ventricular structure and function in patients with arterial hypertension, diabetes or obesity. Previous investigations also reported that the coexistence of two components of the MS induced more significant cardiac remodeling than the presence of only one MS risk-factor. The relationship between different components of the MS (increased blood pressure, abdominal obesity, increased fasting glucose level and dyslipidemia) and right ventricular remodeling could be explained by several hemodynamic and non-hemodynamic mechanisms. However, the association between right ventricular remodeling and the MS has not been sufficiently investigated so far. The aim of this article was to review recent articles focusing on the association between metabolic syndrome components and the metabolic syndrome itself with impairments in right ventricular structure and function assessed by different imaging techniques.
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Affiliation(s)
- Marijana Tadic
- University Clinical Hospital Centre "Dr Dragisa Misovic", Heroja Milana Tepica 1, 11000 Belgrade, Serbia.
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Skoczynska A, Skórka T, Wojakowska A, Nowacki D, Turczyn B, Poręba R, Tyrankiewicz U, Byk K, Szuba A. Heart function in magnetic resonance imaging and the mesenteric artery reactivity in rats receiving lead-contaminated drinking water. Hum Exp Toxicol 2013; 33:455-65. [DOI: 10.1177/0960327113491507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The aim of this study was to evaluate the effect of lead (Pb)-contaminated drinking water on magnetic resonance imaging (MRI)-estimated cardiac function, vascular reactivity, and serum lipids in rats. For 3 months, male Wistar rats, aged 4–6 weeks, were given drinking water with the addition of lead acetate at a concentration of 100 ppm Pb (10 rats) or water free from Pb (8 control rats). The cardiac MRI was performed at rest and under β-adrenergic stimulation on a 4.7 T scanner using electrocardiogram-triggered gradient echo (FLASH) cine sequence. After 1–2 weeks of the MRI test, experiments were performed ex vivo. After stabilization of perfusion pressure (PP), norepinephrine at doses from 0.01 to 5.0 μg was dissolved in Krebs solution, injected in a volume of 100 μl, and next infused at a concentration of 0.5 μg/ml into the isolated mesenteric artery. In this manner, preconstricted mesenteric bed was used to determine PP changes induced by acetylcholine, given at doses from 0.05 to 5.0 μg, before and during the infusion of nitric oxide synthase inhibitor (1.0 μg/ml). At the end, dobutamine (5 mg), followed by potassium chloride (10.5 mg), was injected. Lipid levels were determined enzymatically, blood Pb level was measured by the atomic absorption spectrophotometer. This study showed that Pb impairs the left ventricular systolic and diastolic function. Pb-induced changes in response to resistance of vessels to vasoactive agents may be secondary to the reduced left ventricular ejection fraction. The high-density lipoprotein subfraction 2 (HDL2) is involved in the cardiovascular effect of Pb.
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Affiliation(s)
- A Skoczynska
- Department of Internal and Occupational Diseases, Wroclaw Medical University, Wrocław, Poland
| | - T Skórka
- Department of Magnetic Resonance Imaging, Institute of Nuclear Physics, Polish Academy of Sciences, Kraków, Poland
| | - A Wojakowska
- Department of Internal and Occupational Diseases, Wroclaw Medical University, Wrocław, Poland
| | - D Nowacki
- Department of Internal and Occupational Diseases, Wroclaw Medical University, Wrocław, Poland
| | - B Turczyn
- Department of Internal and Occupational Diseases, Wroclaw Medical University, Wrocław, Poland
| | - R Poręba
- Department of Internal and Occupational Diseases, Wroclaw Medical University, Wrocław, Poland
| | - U Tyrankiewicz
- Department of Magnetic Resonance Imaging, Institute of Nuclear Physics, Polish Academy of Sciences, Kraków, Poland
| | - K Byk
- Department of Magnetic Resonance Imaging, Institute of Nuclear Physics, Polish Academy of Sciences, Kraków, Poland
| | - A Szuba
- Department of Internal and Occupational Diseases, Wroclaw Medical University, Wrocław, Poland
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Licht CMM, de Geus EJC, Penninx BWJH. Dysregulation of the autonomic nervous system predicts the development of the metabolic syndrome. J Clin Endocrinol Metab 2013; 98:2484-93. [PMID: 23553857 DOI: 10.1210/jc.2012-3104] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
CONTEXT Stress is suggested to lead to metabolic dysregulations as clustered in the metabolic syndrome. Although dysregulation of the autonomic nervous system is found to associate with the metabolic syndrome and its dysregulations, no longitudinal study has been performed to date to examine the predictive value of this stress system in the development of the metabolic syndrome. OBJECTIVE We examined whether autonomic nervous system functioning predicts 2-year development of metabolic abnormalities that constitute the metabolic syndrome. DESIGN Data of the baseline and 2-year follow-up assessment of a prospective cohort: the Netherlands Study of Depression and Anxiety was used. SETTING Participants were recruited in the general community, primary care, and specialized mental health care organizations. PARTICIPANTS A group of 1933 participants aged 18-65 years. MAIN OUTCOME MEASURES The autonomic nervous system measures included heart rate (HR), respiratory sinus arrhythmia (RSA; high RSA reflecting high parasympathetic activity), pre-ejection period (PEP; high PEP reflecting low sympathetic activity), cardiac autonomic balance (CAB), and cardiac autonomic regulation (CAR). Metabolic syndrome was based on the updated Adult Treatment Panel III criteria and included high waist circumference, serum triglycerides, blood pressure, serum glucose, and low high-density lipoprotein (HDL) cholesterol. RESULTS Baseline short PEP, low CAB, high HR, and CAR were predictors of an increase in the number of components of the metabolic syndrome during follow-up. High HR and low CAB were predictors of a 2-year decrease in HDL cholesterol, and 2-year increase in diastolic and systolic blood pressure. Short PEP and high CAR also predicted a 2-year increase in systolic blood pressure, and short PEP additionally predicted 2-year increase in diastolic blood pressure. Finally, a low baseline RSA was predictive for subsequent decreases in HDL cholesterol. CONCLUSION Increased sympathetic activity predicts an increase in metabolic abnormalities over time. These findings suggest that a dysregulation of the autonomic nervous system is an important predictor of cardiovascular diseases and diabetes through dysregulating lipid metabolism and blood pressure over time.
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Affiliation(s)
- Carmilla M M Licht
- Department of Psychiatry, Vrije Universiteit (VU) University Medical Center Amsterdam, The Netherlands.
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Balta S, Cakar M, Demirkol S, Unlu M, Kucuk U, Arslan Z. Arterial stiffness itself without other inflammatory markers may not provide information to clinicians. J Clin Hypertens (Greenwich) 2013; 15:303. [PMID: 23551738 PMCID: PMC8033830 DOI: 10.1111/jch.12072] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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