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Faierstein K, Fiman M, Loutati R, Rubin N, Manor U, Am-Shalom A, Cohen-Shelly M, Blank N, Lotan D, Zhao Q, Schwammenthal E, Klempfner R, Zimlichman E, Raanani E, Maor E. Artificial Intelligence Assessment of Biological Age From Transthoracic Echocardiography: Discrepancies with Chronologic Age Predict Significant Excess Mortality. J Am Soc Echocardiogr 2024; 37:725-735. [PMID: 38740271 DOI: 10.1016/j.echo.2024.04.017] [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: 03/04/2024] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Age and sex can be estimated using artificial intelligence on the basis of various sources. The aims of this study were to test whether convolutional neural networks could be trained to estimate age and predict sex using standard transthoracic echocardiography and to evaluate the prognostic implications. METHODS The algorithm was trained on 76,342 patients, validated in 22,825 patients, and tested in 20,960 patients. It was then externally validated using data from a different hospital (n = 556). Finally, a prospective cohort of handheld point-of-care ultrasound devices (n = 319; ClinicalTrials.gov identifier NCT05455541) was used to confirm the findings. A multivariate Cox regression model was used to investigate the association between age estimation and chronologic age with overall survival. RESULTS The mean absolute error in age estimation was 4.9 years, with a Pearson correlation coefficient of 0.922. The probabilistic value of sex had an overall accuracy of 96.1% and an area under the curve of 0.993. External validation and prospective study cohorts yielded consistent results. Finally, survival analysis demonstrated that age prediction ≥5 years vs chronologic age was associated with an independent 34% increased risk for death during follow-up (P < .001). CONCLUSIONS Applying artificial intelligence to standard transthoracic echocardiography allows the prediction of sex and the estimation of age. Machine-based estimation is an independent predictor of overall survival and, with further evaluation, can be used for risk stratification and estimation of biological age.
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Affiliation(s)
- Kobi Faierstein
- Leviev Cardiovascular Institute, Sheba Medical Center, Ramat Gan, Israel; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
| | | | - Ranel Loutati
- Leviev Cardiovascular Institute, Sheba Medical Center, Ramat Gan, Israel
| | | | - Uri Manor
- Leviev Cardiovascular Institute, Sheba Medical Center, Ramat Gan, Israel; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | | | | | - Nimrod Blank
- Echocardiography Unit, Division of Cardiovascular Medicine, Baruch-Padeh Medical Center, Poria, Israel
| | - Dor Lotan
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York, New York
| | - Qiong Zhao
- Inova Heart and Vascular Institute, Inova Fairfax Hospital, Falls Church, Virginia
| | - Ehud Schwammenthal
- Leviev Cardiovascular Institute, Sheba Medical Center, Ramat Gan, Israel; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel; Aisap.ai, Ramat Gan, Israel
| | - Robert Klempfner
- Leviev Cardiovascular Institute, Sheba Medical Center, Ramat Gan, Israel; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel; Aisap.ai, Ramat Gan, Israel
| | - Eyal Zimlichman
- Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Ehud Raanani
- Leviev Cardiovascular Institute, Sheba Medical Center, Ramat Gan, Israel; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel; Aisap.ai, Ramat Gan, Israel
| | - Elad Maor
- Leviev Cardiovascular Institute, Sheba Medical Center, Ramat Gan, Israel; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel; Aisap.ai, Ramat Gan, Israel
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Della-Morte D, Pacifici F, Simonetto M, Dong C, Dueker N, Blanton SH, Wang L, Rundek T. The role of sirtuins and uncoupling proteins on vascular aging: The Northern Manhattan Study experience. Free Radic Biol Med 2024; 220:262-270. [PMID: 38729451 DOI: 10.1016/j.freeradbiomed.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 05/04/2024] [Accepted: 05/07/2024] [Indexed: 05/12/2024]
Abstract
Aging affects all organs. Arteries, in particular, are among the most affected. Vascular aging (VA) is defined as age-associated changes in function and structure of vessels. Classical VA phenotypes are carotid intima-media thickness (IMT), carotid plaque (CP), and arterial stiffness (STIFF). Individuals have different predisposition to these VA phenotypes and their associated risk of cardiovascular events. Some develop an early vascular aging (EVA), and others are protected and identified as having supernormal vascular aging (SUPERNOVA). The mechanisms leading to these phenotypes are not well understood. In the Northern Manhattan Study (NOMAS), we found genetic variants in the 7 Sirtuins (SIRT) and 5 Uncoupling Proteins (UCP) to be differently associated with risk to developing VA phenotypes. In this article, we review the results of genetic-epidemiology studies to better understand which of the single nucleotide polymorphisms (SNPs) in SIRT and UCP are responsible for both EVA and SUPERNOVA.
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Affiliation(s)
- David Della-Morte
- Department of Systems Medicine, School of Medicine, University of Rome Tor Vergata, 00133, Rome, Italy; Department of Neurology, The Evelyn McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, 33136, USA; Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University, 00166, Rome, Italy.
| | - Francesca Pacifici
- Department of Systems Medicine, School of Medicine, University of Rome Tor Vergata, 00133, Rome, Italy; Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University, 00166, Rome, Italy
| | - Marialaura Simonetto
- Department of Neurology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, 10021, USA
| | - Chuanhui Dong
- Department of Neurology, The Evelyn McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, 33136, USA
| | - Nicole Dueker
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA; Dr. John T. Macdonald, Department of Human Genetics, University of Miami, Miami, FL, 33136, USA
| | - Susan H Blanton
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA; Dr. John T. Macdonald, Department of Human Genetics, University of Miami, Miami, FL, 33136, USA
| | - Liyong Wang
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA; Dr. John T. Macdonald, Department of Human Genetics, University of Miami, Miami, FL, 33136, USA
| | - Tatjana Rundek
- Department of Neurology, The Evelyn McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, 33136, USA
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Han M, Yun J, Kim KH, Jung JW, Kim YD, Heo J, Park E, Nam HS. Early vascular aging determined by brachial-ankle pulse wave velocity and its impact on ischemic stroke outcome: a retrospective observational study. Sci Rep 2024; 14:13659. [PMID: 38871735 PMCID: PMC11176412 DOI: 10.1038/s41598-024-62847-w] [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: 10/12/2023] [Accepted: 05/22/2024] [Indexed: 06/15/2024] Open
Abstract
Vascular aging phenotype may be useful in predicting stroke prognosis. In the present study, the relationship between vascular aging phenotypes and outcomes after acute ischemic stroke was investigated. The study included consecutive patients with acute ischemic stroke who had brachial-ankle pulse wave velocity (baPWV) measured to assess vascular aging phenotype. The 2.5th and 97.5th percentile age-specific baPWVs were used as cutoffs to define supernormal vascular aging (SUPERNOVA) and early vascular aging (EVA), respectively, and the remainder was considered normal vascular aging (NVA). A total of 2738 patients were enrolled and followed for a median of 38.1 months. The mean age was 67.02 years and 1633 were male. EVA was 67, NVA was 2605, and SUPERNOVA was 66. Compared with NVA, multivariable logistic regression showed EVA was associated with poor functional outcome (modified Rankin Scale ≥ 3) at 3 months (odds ratio 2.083, 95% confidence interval 1.147‒3.783). Multivariable Cox regression showed EVA was associated with all-cause mortality (hazard ratio 2.320, 95% confidence interval 1.283‒4.197). EVA was associated with poor functional outcome and all-cause mortality after acute ischemic stroke, especially when diabetes or atrial fibrillation coexisted. These findings indicate the vascular aging phenotype, notably EVA, can aid in identifying high-risk stroke patients.
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Affiliation(s)
- Minho Han
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemoon-Gu, Seoul, 03722, South Korea
- Integrative Research Center for Cerebrovascular and Cardiovascular Diseases, Yonsei University College of Medicine, Seoul, South Korea
| | - Jaeseob Yun
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemoon-Gu, Seoul, 03722, South Korea
| | - Kwang Hyun Kim
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemoon-Gu, Seoul, 03722, South Korea
| | - Jae Wook Jung
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemoon-Gu, Seoul, 03722, South Korea
| | - Young Dae Kim
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemoon-Gu, Seoul, 03722, South Korea
| | - JoonNyung Heo
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemoon-Gu, Seoul, 03722, South Korea
| | - Eunjeong Park
- Integrative Research Center for Cerebrovascular and Cardiovascular Diseases, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyo Suk Nam
- Department of Neurology, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemoon-Gu, Seoul, 03722, South Korea.
- Integrative Research Center for Cerebrovascular and Cardiovascular Diseases, Yonsei University College of Medicine, Seoul, South Korea.
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4
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Salvado R, Santos-Minguez S, Lugones-Sánchez C, Gonzalez-Sánchez S, Tamayo-Morales O, Quesada-Rico JA, Benito R, Rodríguez-Sánchez E, Gómez-Marcos MA, Casado-Vicente V, Guimarães-Cunha P, Hernandez-Rivas JM, Mira A, García-Ortiz L. Gut microbiota and its relationship with early vascular ageing in a Spanish population (MIVAS study). Eur J Clin Invest 2024:e14228. [PMID: 38655910 DOI: 10.1111/eci.14228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/01/2024] [Accepted: 04/06/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Gut microbiota and its by-products are increasingly recognized as having a decisive role in cardiovascular diseases. The aim is to study the relationship between gut microbiota and early vascular ageing (EVA). METHODS A cross-sectional study was developed in Salamanca (Spain) in which 180 subjects aged 45-74 years were recruited. EVA was defined by the presence of at least one of the following: carotid-femoral pulse wave velocity (cf-PWV), cardio-ankle vascular index (CAVI) or brachial-ankle pulse wave velocity (ba-PWV) above the 90th percentile of the reference population. All other cases were considered normal vascular ageing (NVA). MEASUREMENTS cf-PWV was measured by SphygmoCor® System; CAVI and ba-PWV were determined by Vasera 2000® device. Gut microbiome composition in faecal samples was determined by 16S rRNA Illumina sequencing. RESULTS Mean age was 64.4 ± 6.9 in EVA group and 60.4 ± 7.6 years in NVA (p < .01). Women in EVA group were 41% and 53% in NVA. There were no differences in the overall composition of gut microbiota between the two groups when evaluating Firmicutes/Bacteriodetes ratio, alfa diversity (Shannon Index) and beta diversity (Bray-Curtis). Bilophila, Faecalibacterium sp.UBA1819 and Phocea, are increased in EVA group. While Cedecea, Lactococcus, Pseudomonas, Succiniclasticum and Dielma exist in lower abundance. In logistic regression analysis, Bilophila (OR: 1.71, 95% CI: 1.12-2.6, p = .013) remained significant. CONCLUSIONS In the studied Spanish population, early vascular ageing is positively associated with gut microbiota abundance of the genus Bilophila. No relationship was found between phyla abundance and measures of diversity.
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Affiliation(s)
- Rita Salvado
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Sandra Santos-Minguez
- Instituto de Investigación del Cáncer, Instituto de Biología Molecular y Celular del Cáncer, Universidad de Salamanca-CSIC, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Cristina Lugones-Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
| | - Susana Gonzalez-Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
| | - Olaya Tamayo-Morales
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
| | - José A Quesada-Rico
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
- Facultad de Medicina, Universidad Miguel Hernández de Elche, Sant Joan, D'Alacant, Spain
| | - Rocío Benito
- Instituto de Investigación del Cáncer, Instituto de Biología Molecular y Celular del Cáncer, Universidad de Salamanca-CSIC, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
- Departamento de Medicina, Universidad de Salamanca, Salamanca, Spain
| | - Manuel A Gómez-Marcos
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
- Departamento de Medicina, Universidad de Salamanca, Salamanca, Spain
| | - Verónica Casado-Vicente
- Centro de Salud Parquesol. Gerencia de Salud Valladolid Oeste, Gerencia Regional de Salud de Castilla y Leon (SACyL), Valladolid, Spain
- Departamento de Medicina, Dermatología and Toxicología, Universidad de Valladolid, Valladolid, Spain
| | - Pedro Guimarães-Cunha
- Life and Health Sciences Research Institute (IICVS) and School of Medicine, Universidade do Minho, Braga, Portugal
- Center for the Research and Treatment of arterial Hypertension and cardiovascular Risk, Hospital Senhora da Oliveira, Guimarães, Portugal
| | - Jesús M Hernandez-Rivas
- Instituto de Investigación del Cáncer, Instituto de Biología Molecular y Celular del Cáncer, Universidad de Salamanca-CSIC, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Departamento de Medicina, Universidad de Salamanca, Salamanca, Spain
- Departamento de Hematología, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Alex Mira
- Departamento de Salud y Genómica, Fundación FISABIO, Valencia, Spain
- CIBER Centro de Epidemiología y Salud Pública, Madrid, Spain
| | - Luis García-Ortiz
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Red de Investigación en Cronicidad Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), Barcelona, Spain
- Departamento de Ciencias Biomédicas y del Diagnóstico, Universidad de Salamanca, Salamanca, Spain
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Ferreira J, Roque S, Lima Carneiro A, Longatto‐Filho A, Vila I, Cunha C, Silva C, Mesquita A, Cotter J, Correia‐Neves M, Mansilha A, Cunha PG. Reversion of the Inflammatory Markers in Patients With Chronic Limb-Threatening Ischemia. J Am Heart Assoc 2024; 13:e031922. [PMID: 38606780 PMCID: PMC11262488 DOI: 10.1161/jaha.123.031922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 02/23/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Peripheral artery disease is characterized by an intense inflammatory process that can be associated with a higher mortality rate, particularly in chronic limb-threatening ischemia (CLTI). This study aims to compare the evolution of inflammatory markers between patients with claudication with those with CLTI at 3, 6, and 12 months. METHODS AND RESULTS An observational, single-center, and prospective study was conducted. A total of 119 patients with peripheral artery disease (65 with claudication and 54 with CLTI) were observed and inflammatory markers collected at admission and 3, 6, and 12 months. At admission, patients with CLTI, when compared with patients with claudication, had significantly higher serum levels of C-reactive protein and fibrinogen (positive acute-phase proteins) and lower serum level of albumin, total cholesterol, and high-density lipoprotein (negative acute-phase proteins): C-reactive protein (g/dL), 2.90 (25th-75th percentile, 2.90-4.90) versus 6.80 (25th-75th percentile, 2.90-53.26) (P=0.000); fibrinogen (mg/dL), 293.00 (25th-75th percentile, 269.25-349.00) versus 415.50 (25th-75th percentile, 312.00-615.75) (P=0.000); total cholesterol (mg/dL), 161.79±95% [152.74-170.85] versus 146.42%±95% [135.30-157.53] (P=0.034); high-density lipoprotein (mg/dL), 50.00 (25th-75th percentile, 41.00-60.00) versus 37.00 (25th-75th percentile, 30.00-45.50) (P=0.000); albumin (g/dL): 4.00 (25th-75th percentile, 3.70-4.20) versus 3.60 (25th-75th percentile, 3.10-4.00) (P=0.003). The association between CLTI and total cholesterol was lost after adjusting for confounders. Three months after the resolution of the CLTI, there was an increase in the levels of negative acute-phase proteins and a decrease in positive acute-phase proteins. These inflammatory proteins did not register an evolution in patients with claudication. The differences in the inflammatory proteins between groups disappeared at 6 months. CONCLUSIONS CLTI has an inflammatory environment that can be partially reverted after resolution of the ischemic process, emphasizing the importance of timely intervention.
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Affiliation(s)
- Joana Ferreira
- Vascular Surgery Department—Physiology and SurgeryCentro Hospitalar Universitário de São JoãoPortoPortugal
- Life and Health Science Research Institute (ICVS), School of MedicineUniversity of MinhoBragaPortugal
- ICVS/3B’s—PT Government Associated LaboratoryBragaPortugal
- Academic Center Hospital da Senhora da OliveiraGuimarãesPortugal
- Clinical Academic Center Hospital de Trás‐os‐Montes e Alto Douro—Professor Doutor Nuno Grande—CACTMADVila RealPortugal
| | - Susana Roque
- Life and Health Science Research Institute (ICVS), School of MedicineUniversity of MinhoBragaPortugal
- ICVS/3B’s—PT Government Associated LaboratoryBragaPortugal
| | | | - Adhemar Longatto‐Filho
- Life and Health Science Research Institute (ICVS), School of MedicineUniversity of MinhoBragaPortugal
- ICVS/3B’s—PT Government Associated LaboratoryBragaPortugal
- Department of Pathology (LIM‐14)University of São Paulo School of MedicineSão PauloBrazil
- Molecular Oncology Research CenterBarretos Cancer HospitalBarretosSão PauloBrazil
| | - Isabel Vila
- Academic Center Hospital da Senhora da OliveiraGuimarãesPortugal
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk,Hospital da Senhora da OliveiraGuimarãesPortugal
- Internal Medicine DepartmentHospital da Senhora da Oliveira, GuimarãesBragaPortugal
| | - Cristina Cunha
- Academic Center Hospital da Senhora da OliveiraGuimarãesPortugal
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk,Hospital da Senhora da OliveiraGuimarãesPortugal
- Internal Medicine DepartmentHospital da Senhora da Oliveira, GuimarãesBragaPortugal
| | - Cristina Silva
- Academic Center Hospital da Senhora da OliveiraGuimarãesPortugal
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk,Hospital da Senhora da OliveiraGuimarãesPortugal
- Internal Medicine DepartmentHospital da Senhora da Oliveira, GuimarãesBragaPortugal
| | - Amílcar Mesquita
- Vascular Surgery Department—Hospital da Senhora da OliveiraGuimarãesPortugal
| | - Jorge Cotter
- Life and Health Science Research Institute (ICVS), School of MedicineUniversity of MinhoBragaPortugal
- ICVS/3B’s—PT Government Associated LaboratoryBragaPortugal
- Academic Center Hospital da Senhora da OliveiraGuimarãesPortugal
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk,Hospital da Senhora da OliveiraGuimarãesPortugal
- Internal Medicine DepartmentHospital da Senhora da Oliveira, GuimarãesBragaPortugal
| | - Margarida Correia‐Neves
- Life and Health Science Research Institute (ICVS), School of MedicineUniversity of MinhoBragaPortugal
- ICVS/3B’s—PT Government Associated LaboratoryBragaPortugal
| | - Armando Mansilha
- Vascular Surgery Department—Physiology and SurgeryCentro Hospitalar Universitário de São JoãoPortoPortugal
- Department of Angiology and Vascular SurgeryCentro Hospitalar Universitário de São JoãoPortoPortugal
- Faculty of MedicineUniversity of PortoPortoPortugal
| | - Pedro Guimarães Cunha
- Life and Health Science Research Institute (ICVS), School of MedicineUniversity of MinhoBragaPortugal
- ICVS/3B’s—PT Government Associated LaboratoryBragaPortugal
- Academic Center Hospital da Senhora da OliveiraGuimarãesPortugal
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk,Hospital da Senhora da OliveiraGuimarãesPortugal
- Internal Medicine DepartmentHospital da Senhora da Oliveira, GuimarãesBragaPortugal
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6
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Tap L, Borsboom K, Corsonello A, Lattanzio F, Mattace-Raso F. Deterioration of Kidney Function Is Affected by Central Arterial Stiffness in Late Life. J Clin Med 2024; 13:1334. [PMID: 38592133 PMCID: PMC10932462 DOI: 10.3390/jcm13051334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 02/14/2024] [Accepted: 02/19/2024] [Indexed: 04/10/2024] Open
Abstract
Cardiovascular diseases affect kidney function. The aim of this study was to investigate the possible associations between hemodynamic parameters and change in kidney function in individuals aged 75 years and older. Data on hemodynamics and blood and urine samples were collected at baseline and during one-year visits. Hemodynamics were split into two groups based on median values. Changes in the estimated glomerular filtration rate (eGFR) were investigated between low and high groups for each hemodynamic parameter using analysis of variance. Changes in the albumin-creatinine ratio (ACR) were examined as binary outcomes (large increase vs. stable) using logistic regression. The population consisted of 252 participants. Participants in the high central systolic blood pressure (cSBP) group had a greater decline in eGFR than participants in the low cSBP group (-6.3% vs. -2.7%, p = 0.006). Participants in the high aortic pulse wave velocity (aPWV) group had a greater decline in eGFR than those in the low aPWV group (-6.8% vs. -2.5%, p = 0.001). Other hemodynamic parameters were not associated with eGFR changes. Hemodynamics were not associated with changes in the ACR; aPWV and cSBP appear to be predictors for eGFR decline in older age; monitoring and treatment of elevated stiffness might be helpful in order to prevent kidney function decline.
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Affiliation(s)
- Lisanne Tap
- Section of Geriatric Medicine, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Kim Borsboom
- Section of Geriatric Medicine, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
| | - Andrea Corsonello
- Italian National Research Center on Ageing (IRCCS INRCA), 60124 Ancona, Italy
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87100 Cosenza, Italy
| | - Fabrizia Lattanzio
- Italian National Research Center on Ageing (IRCCS INRCA), 60124 Ancona, Italy
| | - Francesco Mattace-Raso
- Section of Geriatric Medicine, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
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7
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Szaló G, Hellgren MI, Allison M, Li Y, Råstam L, Rådholm K, Bollano E, Duprez DA, Jacobs DR, Lindblad U, Daka B. Impaired artery elasticity predicts cardiovascular morbidity and mortality- A longitudinal study in the Vara-Skövde Cohort. J Hum Hypertens 2024; 38:140-145. [PMID: 37794130 PMCID: PMC10844075 DOI: 10.1038/s41371-023-00867-1] [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: 02/22/2023] [Revised: 09/07/2023] [Accepted: 09/26/2023] [Indexed: 10/06/2023]
Abstract
It is still debated whether arterial elasticity provides prognostic information for cardiovascular risk beyond blood pressure measurements in a healthy population. To investigate the association between arterial elasticity obtained by radial artery pulse wave analysis and risk for cardiovascular diseases (CVD) in men and women. In 2002-2005, 2362 individuals (men=1186, 50.2%) not taking antihypertensive medication were included. C2 (small artery elasticity) was measured using the HDI/Pulse Wave CR2000. Data on acute myocardial infarction or stroke, fatal or non-fatal, was obtained between 2002-2019. Cox- regression was used to investigate associations between C2 and future CVD, adjusting for confounding factors such as age, sex, systolic blood pressure, heart rate, HOMA-IR (Homeostatic Model Assessment for Insulin Resistance), LDL- cholesterol, CRP (C-Reactive Protein), alcohol consumption, smoking and physical activity. At baseline, the mean age of 46 ± 10.6 years and over the follow-up period, we observed 108 events 70 events in men [event rate: 5.9%], 38 in women [event rate: 3.2%]. In the fully adjusted model, and for each quartile decrease in C2, there was a significant increase in the risk for incident CVD by 36%. (HR = 1.36, 95% CI: 1.01-1.82, p = 0.041). The results were accentuated for all men (HR = 1.74, 95% CI: 1.21-2.50, p = 0.003) and women over the age of 50 years (HR = 1.70, 95% CI: 0.69-4.20). We showed a strong and independent association between C2 and CVD in men. In women after menopause, similar tendencies and effect sizes were observed.
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Affiliation(s)
- Gábor Szaló
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Margareta I Hellgren
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- The Skaraborg Institute, Skövde, Sweden
| | - Matthew Allison
- Division of Preventive Medicine, Department of Family Medicine, University of California San Diego, La Jolla, CA, USA
| | - Ying Li
- Biostatistics, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lennart Råstam
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Karin Rådholm
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Entela Bollano
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Daniel A Duprez
- Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Ulf Lindblad
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Bledar Daka
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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8
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Vicente-Gabriel S, Lugones-Sánchez C, Tamayo-Morales O, Vicente Prieto A, González-Sánchez S, Conde Martín S, Gómez-Sánchez M, Rodríguez-Sánchez E, García-Ortiz L, Gómez-Sánchez L, Gómez-Marcos MA. Relationship between addictions and obesity, physical activity and vascular aging in young adults (EVA-Adic study): a research protocol of a cross-sectional study. Front Public Health 2024; 12:1322437. [PMID: 38344236 PMCID: PMC10853417 DOI: 10.3389/fpubh.2024.1322437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/08/2024] [Indexed: 02/15/2024] Open
Abstract
Background Behavioral and substance addictions are prevalent health problems that, alongside obesity, are linked to reduced physical activity and increased sedentary time. Similarly, arterial stiffness and vascular aging are processes that begin gradually at an early age and are closely associated with morbidity and mortality from cardiovascular diseases. The main objective of this study is to analyze how addictions are related to obesity and body fat distribution, physical activity, sedentary time, arterial stiffness and vascular aging, as well as sleep quality, cognitive function and gender differences in young adults aged between 18 and 34 years. Methods This cross-sectional descriptive observational study will analyze data from 500 subjects (250 men and 250 women) aged 18-34 without cardiovascular disease, selected by simple random sampling with replacement from the urban population of the city center of Salamanca (34,044 people aged 18-34, with 18,450 women and 15,594 men). Behavioral and substance addictions, as well as sleep quality and cognitive impairment will be assessed using questionnaires. The Pittisburg Sleep Quality Index (PSQI) will be used to measure sleep quality and the Ford questionnaire will be used to measure insomnia in response to stress. For obesity, weight, height, waist and hip circumference, body composition will be measured with the Inbody 230® impedance meter. For physical activity and sedentary time, we will use the Actigraph® accelerometer alongside the international physical activity questionnaire (IPAQ) and the Marshall questionnaire. The Sphygmocor System® will be used for pulse wave analysis and carotid-femoral pulse wave velocity (cfPWV), while the Vasera VS-2000® will measure cardio ankle vascular index (CAVI) and brachial-ankle pulse wave velocity (baPWV). Vascular aging will be calculated with the 10th and 90th percentiles of cfPWV or baPWV. Demographic, analytical variables will be collected, as will data to assess vascular, cardiac, renal, and brain injury. Discussion Addictions are on the rise in today's society, affecting the mental health and well-being of those who suffer from them, generating important social problems such as job loss, family dysfunction, debt and social isolation. Together with obesity, they are prevalent health problems in young adults and are associated with lower physical activity and higher sedentary time. Meanwhile, arterial stiffness and vascular aging are processes that begin gradually at an early age and determine morbidity and mortality caused by cardiovascular diseases. The results of this project will allow us to understand the situation regarding behavioral and substance addictions in young adults. Better understanding of these addictions will in turn facilitate the development of more effective prevention strategies and intervention programs, which can then reduce the negative impact at both the individual and societal levels. Clinical trial registration [ClinicalTrials.gov], identifier [NCT05819840].
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Affiliation(s)
- Sara Vicente-Gabriel
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Intensive Care Unit, Salamanca University Hospital, Salamanca, Spain
| | - Cristina Lugones-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
| | - Olaya Tamayo-Morales
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
| | - Alberto Vicente Prieto
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
| | - Susana González-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
| | - Sandra Conde Martín
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
| | - Marta Gómez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Home Hospitalization Unit, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Emiliano Rodríguez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Luis García-Ortiz
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Leticia Gómez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Emergency Department, La Paz University Hospital, Madrid, Spain
| | - Manuel A. Gómez-Marcos
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- Salamanca Primary Care Management, Castilla and León Health Service–SACYL, Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
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9
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Cavero-Redondo I, Saz-Lara A, Martínez-García I, Otero-Luis I, Martínez-Rodrigo A. Validation of an early vascular aging construct model for comprehensive cardiovascular risk assessment using external risk indicators for improved clinical utility: data from the EVasCu study. Cardiovasc Diabetol 2024; 23:33. [PMID: 38218806 PMCID: PMC10787504 DOI: 10.1186/s12933-023-02104-y] [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: 10/31/2023] [Accepted: 12/27/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs) remain a major global health concern, necessitating advanced risk assessment beyond traditional factors. Early vascular aging (EVA), characterized by accelerated vascular changes, has gained importance in cardiovascular risk assessment. METHODS The EVasCu study in Spain examined 390 healthy participants using noninvasive measurements. A construct of four variables (Pulse Pressure, Pulse Wave Velocity, Glycated Hemoglobin, Advanced Glycation End Products) was used for clustering. K-means clustering with principal component analysis revealed two clusters, healthy vascular aging (HVA) and early vascular aging (EVA). External validation variables included sociodemographic, adiposity, glycemic, inflammatory, lipid profile, vascular, and blood pressure factors. RESULTS EVA cluster participants were older and exhibited higher adiposity, poorer glycemic control, dyslipidemia, altered vascular properties, and higher blood pressure. Significant differences were observed for age, smoking status, body mass index, waist circumference, fat percentage, glucose, insulin, C-reactive protein, diabetes prevalence, lipid profiles, arterial stiffness, and blood pressure levels. These findings demonstrate the association between traditional cardiovascular risk factors and EVA. CONCLUSIONS This study validates a clustering model for EVA and highlights its association with established risk factors. EVA assessment can be integrated into clinical practice, allowing early intervention and personalized cardiovascular risk management.
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Affiliation(s)
- Iván Cavero-Redondo
- Health and Social Research Center, University of Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Alicia Saz-Lara
- Health and Social Research Center, University of Castilla-La Mancha, Cuenca, Spain.
| | | | - Iris Otero-Luis
- Health and Social Research Center, University of Castilla-La Mancha, Cuenca, Spain
| | - Arturo Martínez-Rodrigo
- Research Group in Electronic, Biomedical, and Telecommunication Engineering, University of Castilla-La Mancha, Cuenca, Spain
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10
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Liu Y, Lin L, Tao B, Ding X, Chen S, Wang G, Shi J, Huang Z, Yu J, Yang N, Wu S, Li Y. The effect of adverse pregnancy outcomes on vascular aging in young women: the Kailuan study. J Hum Hypertens 2023; 37:969-976. [PMID: 36750628 DOI: 10.1038/s41371-023-00805-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 01/05/2023] [Accepted: 01/17/2023] [Indexed: 02/09/2023]
Abstract
Adverse pregnancy outcomes (APOs) are at increased future cardiovascular risk and require effective risk mitigation. However, data regarding appropriate postpartum screening for young women with APOs are lacking. We aimed to investigate the association between APOs and vascular aging by the determination of high pulse wave velocity (PWV) in young women. Women who gave birth from 1990 to 2020 and underwent brachial-ankle pulse wave velocity (baPWV) assessments in the postpartum period were recruited. We excluded women with age ≥50 years at the baPWV assessment or missing postpartum health examinations. The history of APOs including hypertensive disorders of pregnancy, gestational diabetes, preterm delivery, and low birth weight were assessed by medical records. High PWV was defined as baPWV above the 90th percentile for different age group. Multivariable Logistic regression was used to evaluate the association of APOs and high PWV. 3193 participants were included in the analysis, including 912 (28.6%) individuals with APOs. The prevalence of high PWV in the non-APO group and the APOs group were 7.19% (164) and 13.9% (127), respectively (P < 0.05). Compared with non-APO group, the OR (95% CI) of APOs group was 1.67 (1.29-2.16). The risks in the 20-29, 30-39, and 40-49 age groups were 2.51 (1.13-5.59), 1.83 (1.30-2.59), and 1.35 (0.82-2.21) (P for trend <0.05). We conclude that APOs are risk factors of vascular aging for young women and the risk decreased with increasing age. BaPWV should be an important indicator for preventive cardiovascular risk management in young women with APOs. Clinical trial registration: Registration number ChiCTR-TNRC-11001489, http://www.chictr.org.cn/showproj.aspx?proj=8050 .
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Affiliation(s)
- Yan Liu
- Department of Graduate School, Tianjin Medical University, No. 22 Meteorological Terrace Road, Heping District, Tianjin, 300070, China
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, 57 Xinhua E Rd, Tangshan, 063000, China
| | - Liming Lin
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, 57 Xinhua E Rd, Tangshan, 063000, China
| | - Boni Tao
- Tianjin Binhai New Area Center for Disease Control and Prevention, No. 575 Jiashun Road, Binhai New Area, Tianjin, 300450, China
| | - Xiong Ding
- School of Public Health, North China University of Science and Technology, Tangshan, 063000, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, 57 Xinhua E Rd, Tangshan, 063000, China
| | - Guodong Wang
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, 57 Xinhua E Rd, Tangshan, 063000, China
| | - Jihong Shi
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, 57 Xinhua E Rd, Tangshan, 063000, China
| | - Zhe Huang
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, 57 Xinhua E Rd, Tangshan, 063000, China
| | - Jiaxin Yu
- Department of Cardiology, Tangshan Worker's Hospital, No.27 Culture Road, Tangshan, 063000, China
| | - Ning Yang
- Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin, 300457, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, 57 Xinhua E Rd, Tangshan, 063000, China.
| | - Yuming Li
- Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin, 300457, China.
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11
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Navarro Cáceres A, Navarro-Matías E, Gómez-Sánchez M, Tamayo-Morales O, Lugones-Sánchez C, González-Sánchez S, Rodríguez-Sánchez E, García-Ortiz L, Gómez-Sánchez L, Gómez-Marcos MA. Increase in Vascular Function Parameters According to Lifestyles in a Spanish Population without Previous Cardiovascular Disease-EVA Follow-Up Study. Nutrients 2023; 15:4614. [PMID: 37960267 PMCID: PMC10648779 DOI: 10.3390/nu15214614] [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: 10/03/2023] [Revised: 10/25/2023] [Accepted: 10/29/2023] [Indexed: 11/15/2023] Open
Abstract
The aim of this longitudinal descriptive observational study was to analyze the influence of different lifestyles on arterial stiffness (AS) throughout five years of follow-up and to describe the differences by sex in a Spanish adult population without cardiovascular disease at the start of the study. A random stratified sampling by age and sex was used to obtain 501 subjects included in the initial assessment. No cardiovascular disease was allowed in the subjects. The average age was 55.9 years, and 50.3% were women. A total of 480 subjects were analyzed again five years later. Alcohol and tobacco consumption were collected with standardized questionnaires. Adherence to the Mediterranean diet was assessed with the Mediterranean diet adherence screener (MEDAS) questionnaire. Physical activity was assessed with the short version of the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and sedentary time was assessed with the Marshall Sitting Questionnaire (MSQ). AS was assessed by measuring carotid-femoral pulse wave velocity (cfPWV) and central augmentation index (CAIx) with SphygmoCor System®, and ankle pulse wave velocity (baPWV) and cardio ankle vascular index (CAVI) with Vasera VS-1500®. Increases in vascular function measures per year of follow-up were: cfPWV = 0.228 ± 0.360 m/s, baPWV = 0.186 ± 0.308 m/s, CAVI = 0.041 ± 0.181 m/s, and CAIx = 0.387 ± 2.664 m/s. In multiple regression analysis, positive association was shown between an increase in baPWV and tobacco index (β = 0.007) and alcohol consumption (β = 0.005). Negative association was shown between CAVI and Mediterranean diet score (β = -0.051). In multinomial logistic regression analysis, the OR of tobacco index of subjects with a cfPWV increase >P75 was OR = 1.025 and of subjects classified between P25 and P75 was OR = 1.026 regarding subjects classified with an increase P75 was OR = 1.006 regarding subjects classified with an increase P75, and an OR = 0.841 was found of subjects classified between P25-75 regarding subjects classified with an increase
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Affiliation(s)
- Alicia Navarro Cáceres
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
| | - Elena Navarro-Matías
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
| | - Marta Gómez-Sánchez
- Home Hospitalization Service, Marqués de Valdecilla University Hospital, 39008 Santander, Spain;
| | - Olaya Tamayo-Morales
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
| | - Cristina Lugones-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
| | - Susana González-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
- Department of Medicine, University of Salamanca, 28046 Salamanca, Spain
| | - Luis García-Ortiz
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, 37007 Salamanca, Spain
| | - Leticia Gómez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Emergency Service, University Hospital of La Paz, 37007 Madrid, Spain
| | - Manuel A. Gómez-Marcos
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Institute of Biomedical Research of Salamanca (IBSAL), 37005 Salamanca, Spain; (A.N.C.); (E.N.-M.); (O.T.-M.); (C.L.-S.); (S.G.-S.); (E.R.-S.); (L.G.-O.)
- Castilla and León Health Service-SACYL, Regional Health Management, 37005 Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 37005 Salamanca, Spain
- Department of Medicine, University of Salamanca, 28046 Salamanca, Spain
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12
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Gómez-Sánchez L, Tamayo-Morales O, Suárez-Moreno N, Bermejo-Martín JF, Domínguez-Martín A, Martín-Oterino JA, Martín-González JI, González-Calle D, García-García Á, Lugones-Sánchez C, González-Sánchez S, Jiménez-Gómez R, García-Ortiz L, Gómez-Marcos MA, Navarro-Matías E. Relationship between the structure, function and endothelial damage, and vascular ageing and the biopsychological situation in adults diagnosed with persistent COVID (BioICOPER study). A research protocol of a cross-sectional study. Front Physiol 2023; 14:1236430. [PMID: 37772064 PMCID: PMC10523018 DOI: 10.3389/fphys.2023.1236430] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/17/2023] [Indexed: 09/30/2023] Open
Abstract
Background: SARS-CoV-2 infection affects the vascular endothelium, which mediates the inflammatory and thrombotic cascade. Moreover, alterations in the endothelium are related to arterial stiffness, which has been established as a marker of cardiovascular disease. The objective of this study is to analyse how the structure, vascular function, vascular ageing and endothelial damage are related to the biopsychological situation in adults diagnosed with persistent COVID and the differences by gender. Methods: This cross-sectional, descriptive, observational study will be carried out in the Primary Care Research Unit of Salamanca (APISAL) and in the BioSepsis laboratory of the University of Salamanca. The sample will be selected from the persistent COVID monographic office at the Internal Medicine Service of the University Hospital of Salamanca, and from the population of subjects diagnosed with persistent COVID in the clinical history of Primary Care. Through consecutive sampling, the study will include 300 individuals diagnosed with persistent COVID who meet the diagnosis criteria established by the WHO, after they sign the informed consent. Endothelial damage biomarkers will be measured using ELLA-SimplePlexTM technology (Biotechne). Their vascular structure and function will be analysed by measuring the carotid intima-media thickness (Sonosite Micromax); the pulse wave and carotid-femoral pulse wave velocity (cfPWV) will be recorded with Sphygmocor System®. Cardio Ankle Vascular Index (CAVI), brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index will be analysed with Vasera VS-2000®. The integral assessment of the subjects with persistent COVID will be conducted with different scales that evaluate fatigue, sleep, dyspnea, quality of life, attention, nutrition state, and fragility. We will also evaluate their lifestyles (diet, physical activity, smoking habits and alcohol consumption), psychological factors, and cognitive deterioration, which will be gathered through validated questionnaires; moreover, physical activity will be objectively measured using a pedometer for 7 days. Body composition will be measured through impedance using an Inbody 230. Vascular ageing will be calculated with 10 and 90 percentiles of cfPWV and baPWV. Furthermore, we will analyse the presence of vascular injury in the retina, heart, kidneys and brain, as well as cardiovascular risk. Demographic and analytical variables will also be gathered. Discussion: Arterial stiffness reflects the mechanic and functional properties of the arterial wall, showing the changes in arterial pressure, blood flow, and vascular diameter that occur with each heartbeat. SARS-CoV-2 affects the endothelial cells that are infected with this virus, increasing the production of pro-inflammatory cytokines and pro-thrombotic factors, which can cause early vascular ageing and an increase of arterial stiffness. Persistent COVID is a complex heterogeneous disorder that affects the lives of millions of people worldwide. The identifications of potential risk factors to better understand who is at risk of developing persistent COVID is important, since this would enable early and appropriate clinical support. It is unknown whether vascular alterations caused by COVID-19 resolve after acute infection or remain over time, favouring the increase of arterial stiffness and early vascular ageing. Therefore, it is necessary to propose studies that analyse the evolution of persistent COVID in this group of patients, as well as the possible variables that influence it. Clinical Trial registration: ClinicalTrials.gov, identifier NCT05819840.
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Affiliation(s)
- Leticia Gómez-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Hospital de la Paz de Madrid, Servicio de Urgencias, Madrid, Spain
| | - Olaya Tamayo-Morales
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
| | - Nuria Suárez-Moreno
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
| | - Jesus F. Bermejo-Martín
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Andrea Domínguez-Martín
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
| | - José A. Martín-Oterino
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
- Hospital Universitario de Salamanca, Internal Medicine Department, Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - José I. Martín-González
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
- Hospital Universitario de Salamanca, Internal Medicine Department, Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - David González-Calle
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
- Hospital Universitario de Salamanca, Cardiology Department, Salamanca, Spain
| | - Ángel García-García
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
- Hospital Universitario de Salamanca, Emergency Department, Salamanca, Spain
| | - Cristina Lugones-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
| | - Susana González-Sánchez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
| | - Raquel Jiménez-Gómez
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
| | - Luis García-Ortiz
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Manuel A. Gómez-Marcos
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Elena Navarro-Matías
- Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Castilla and León Health Service–SACYL, Gerencia Regional de Salud, Valladolid, Spain
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13
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Jannasz I, Pruc M, Rahnama-Hezavah M, Targowski T, Olszewski R, Feduniw S, Petryka K, Szarpak L. The Impact of COVID-19 on Carotid-Femoral Pulse Wave Velocity: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:5747. [PMID: 37685813 PMCID: PMC10488425 DOI: 10.3390/jcm12175747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
COVID-19 is a complex multisystemic disease that can result in long-term complications and, in severe cases, death. This study investigated the effect of COVID-19 on carotid-femoral pulse wave velocity (cfPWV) as a measurement to evaluate its impact on arterial stiffness and might help predict COVID-19-related cardiovascular (CV) complications. PubMed, Web of Science, Embase, and the Cochrane Library were searched for relevant studies, and meta-analysis was performed. The study protocol was registered in PROSPERO (nr. CRD42023434326). The Newcastle-Ottawa Quality Scale was used to evaluate the quality of the included studies. Nine studies reported cfPWV among COVID-19 patients and control groups. The pooled analysis showed that cfPWV in COVID-19 patients was 9.5 ± 3.7, compared to 8.2 ± 2.2 in control groups (MD = 1.32; 95% CI: 0.38-2.26; p = 0.006). A strong association between COVID-19 infection and increased cfPWV suggests a potential link between the virus and increased arterial stiffness. A marked increase in arterial stiffness, a known indicator of CV risk, clearly illustrates the cardiovascular implications of COVID-19 infection. However, further research is required to provide a clearer understanding of the connection between COVID-19 infection, arterial compliance, and subsequent CV events.
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Affiliation(s)
- Iwona Jannasz
- Department of Geriatrics, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland
| | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland
- Department of Public Health, International Academy of Ecology and Medicine, 02-091 Kyiv, Ukraine
| | - Mansur Rahnama-Hezavah
- Chair and Department of Oral Surgery, Medical University of Lublin, 20-093 Lublin, Poland
| | - Tomasz Targowski
- Department of Geriatrics, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland
| | - Robert Olszewski
- Department of Gerontology, Public Health and Education, National Institute of Geriatrics Rheumatology and Rehabilitation, 02-637 Warsaw, Poland
| | - Stepan Feduniw
- Department of Gynecology, University Hospital Zurich, 8091 Zurich, Switzerland
- Department of Obstetrics, University Hospital Zurich, 8091 Zurich, Switzerland
| | | | - Lukasz Szarpak
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy in Warsaw, 00-136 Warsaw, Poland
- Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, 15-027 Bialystok, Poland
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14
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Climie RE, Alastruey J, Mayer CC, Schwarz A, Laucyte-Cibulskiene A, Voicehovska J, Bianchini E, Bruno RM, Charlton PH, Grillo A, Guala A, Hallab M, Hametner B, Jankowski P, Königstein K, Lebedeva A, Mozos I, Pucci G, Puzantian H, Terentes-Printzios D, Yetik-Anacak G, Park C, Nilsson PM, Weber T. Vascular ageing: moving from bench towards bedside. Eur J Prev Cardiol 2023; 30:1101-1117. [PMID: 36738307 PMCID: PMC7614971 DOI: 10.1093/eurjpc/zwad028] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/20/2022] [Accepted: 01/12/2023] [Indexed: 02/05/2023]
Abstract
Prevention of cardiovascular disease (CVD) remains one of the largest public health challenges of our time. Identifying individuals at increased cardiovascular risk at an asymptomatic, sub-clinical stage is of paramount importance for minimizing disease progression as well as the substantial health and economic burden associated with overt CVD. Vascular ageing (VA) involves the deterioration in vascular structure and function over time and ultimately leads to damage in the heart, brain, kidney, and other organs. Vascular ageing encompasses the cumulative effect of all cardiovascular risk factors on the arterial wall over the life course and thus may help identify those at elevated cardiovascular risk, early in disease development. Although the concept of VA is gaining interest clinically, it is seldom measured in routine clinical practice due to lack of consensus on how to characterize VA as physiological vs. pathological and various practical issues. In this state-of-the-art review and as a network of scientists, clinicians, engineers, and industry partners with expertise in VA, we address six questions related to VA in an attempt to increase knowledge among the broader medical community and move the routine measurement of VA a little closer from bench towards bedside.
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Affiliation(s)
- Rachel E. Climie
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, 7000 Hobart, Australia
- Sports Cardiology, Baker Heart and Diabetes Institute, 99 Commercial Rd, Melbourne 3000, Australia
- Integrative Epidemiology of Cardiovascular Disease, Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France
| | - Jordi Alastruey
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King’s College London, 249 Westminster Bridge Rd, London SE1 7EH, UK
| | - Christopher C. Mayer
- Medical Signal Analysis, Center for Health & Bioresources, AIT Austrian Institute of Technology, Giefinggasse 4, 1210 Vienna, Austria
| | - Achim Schwarz
- ALF Distribution GmbH, Stephanstrasse 19, 52064 Aachen, Germany
| | - Agne Laucyte-Cibulskiene
- Department of Clinical Sciences, Lund University, Skane University Hospital, Sölvegatan 19 - BMC F12, 221 84 Lund, Malmö, Sweden
- Faculty of Medicine, Vilnius University, M. K. C iurlionio g. 21, 03101 Vilnius, Lithuania
| | - Julija Voicehovska
- Department of Internal Diseases, Riga Stradins University, Dzirciema str. 16, Riga, L-1007, Latvia
- Nephrology and Renal Replacement Therapy Clinics, Riga East University Hospital, Hipokrata str. 2, Riga, LV-1079, Latvia
| | - Elisabetta Bianchini
- Institute of Clinical Physiology, Italian National Research Council (CNR), Via Moruzzi, 1, 56124 Pisa (PI), Italy
| | - Rosa-Maria Bruno
- Integrative Epidemiology of Cardiovascular Disease, Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France
| | - Peter H. Charlton
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, 2 Worts Causeway, Cambridge CB1 8RN, UK
| | - Andrea Grillo
- Medicina Clinica, Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
| | - Andrea Guala
- Vall d’Hebron Institut de Recerca (VHIR), Paseo de la Vall d’Hebron, 129, 08035 Barcelona, Spain
| | - Magid Hallab
- Clinique Bizet, 23 Georges Bizet, 75116 Paris, France
| | - Bernhard Hametner
- Medical Signal Analysis, Center for Health & Bioresources, AIT Austrian Institute of Technology, Giefinggasse 4, 1210 Vienna, Austria
| | - Piotr Jankowski
- Department of Internal Medicine and Geriatric Cardiology, Centre of Postgraduate Medical Education, 231 Czerniakowska St., 00-416 Warsaw, Poland
| | - Karsten Königstein
- Department of Sport, Exercise and Health (DSBG) University of Basel, Grosse Allee 6, 4052 Basel, Switzerland
| | - Anna Lebedeva
- Department of Internal Medicine and Cardiology, Dresden Heart Centre, Dresden University of Technology, Fetscher str. 76, 01307 Dresden, Germany
| | - Ioana Mozos
- Department of Functional Sciences-Pathophysiology, Center for Translational Research and Systems Medicine, ‘Victor Babes’ University of Medicine and Pharmacy, T. Vladimirescu Street 14, 300173 Timisoara, Romania
| | - Giacomo Pucci
- Unit of Internal Medicine, Terni University Hospital - Department of Medicine and Surgery, University of Perugia, Terni, Italy
| | - Houry Puzantian
- Hariri School of Nursing, American University of Beirut, P.O. Box 11-0236, Riad El Solh 1107 2020, Beirut, Lebanon
| | - Dimitrios Terentes-Printzios
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece
| | - Gunay Yetik-Anacak
- Department of Pharmacology, Faculty of Pharmacy, Acibadem Mehmet Ali Aydinlar University, Kayisdagi Cad. No:32 Atasehir, 34752 Istanbul, Turkey
| | - Chloe Park
- MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London WC1E 7HB, UK; and
| | - Peter M. Nilsson
- Department of Clinical Sciences, Lund University, Skane University Hospital, Sölvegatan 19 - BMC F12, 221 84 Lund, Malmö, Sweden
| | - Thomas Weber
- Cardiology Department, Klinikum Wels-Grieskirchen, Grieskirchnerstrasse 42, 4600 Wels, Austria
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15
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Mian O, Santi N, Boodhwani M, Beauchesne L, Chan K, Dennie C, Wells GA, Coutinho T. Arterial Age and Early Vascular Aging, But Not Chronological Age, Are Associated With Faster Thoracic Aortic Aneurysm Growth. J Am Heart Assoc 2023; 12:e029466. [PMID: 37581401 PMCID: PMC10492926 DOI: 10.1161/jaha.122.029466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/27/2023] [Indexed: 08/16/2023]
Abstract
Background Aneurysm size is an imperfect risk assessment tool for those with thoracic aortic aneurysm (TAA). Assessing arterial age may help TAA risk stratification, as it better reflects aortic health. We sought to evaluate arterial age as a predictor of faster TAA growth, independently of chronological age. Methods and Results We examined 137 patients with TAA. Arterial age was estimated according to validated equations, using patients' blood pressure and carotid-femoral pulse wave velocity. Aneurysm growth was determined prospectively from available imaging studies. Multivariable linear regression assessed the association of chronological age and arterial age with TAA growth, and multivariable logistic regression assessed associations of chronological and arterial age with the presence of accelerated aneurysm growth (defined as growth>median in the sample). Mean±SD chronological and arterial ages were 62.2±11.3 and 54.2±24.5 years, respectively. Mean baseline TAA size and follow-up time were 45.9±4.0 mm and 4.5±1.9 years, respectively. Median (interquartile range) TAA growth was 0.31 (0.14-0.52) mm/year. Older arterial age (ß±SE for 1 year: 0.004±0.001, P<0.0001) was independently associated with faster TAA growth, while chronological age was not (P=0.083). In logistic regression, each 5-year increase in arterial age was associated with a 23% increase in the odds of accelerated TAA growth (95% CI, 1.085-1.394; P=0.001). Conclusions Arterial age is independently associated with accelerated aneurysm expansion, while chronological age is not. Our results highlight that a noninvasive and inexpensive assessment of arterial age can potentially be useful for TAA risk stratification and disease monitoring as compared with the current clinical standard (chronological age).
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Affiliation(s)
- Owais Mian
- Department of Internal MedicineUniversity of TorontoOntarioCanada
| | - Nicolas Santi
- Division of CardiologyUniversity of TorontoOntarioCanada
| | - Munir Boodhwani
- Division of Cardiac SurgeryUniversity of Ottawa Heart InstituteOntarioCanada
| | - Luc Beauchesne
- Division of CardiologyUniversity of Ottawa Heart InstituteOntarioCanada
| | - Kwan‐Leung Chan
- Division of CardiologyUniversity of Ottawa Heart InstituteOntarioCanada
| | - Carole Dennie
- Department of RadiologyThe Ottawa HospitalOntarioCanada
| | - George A. Wells
- School of Epidemiology and Public HealthUniversity of OttawaOntarioCanada
- Cardiovascular Research Methods CentreUniversity of Ottawa Heart InstituteOntarioCanada
| | - Thais Coutinho
- Division of CardiologyUniversity of Ottawa Heart InstituteOntarioCanada
- School of Epidemiology and Public HealthUniversity of OttawaOntarioCanada
- Division of Cardiac Prevention and RehabilitationUniversity of Ottawa Heart InstituteOntarioCanada
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16
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Liao S, Liu H, Lin WH, Zheng D, Chen F. Filtering-induced changes of pulse transmit time across different ages: a neglected concern in photoplethysmography-based cuffless blood pressure measurement. Front Physiol 2023; 14:1172150. [PMID: 37560157 PMCID: PMC10407099 DOI: 10.3389/fphys.2023.1172150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/12/2023] [Indexed: 08/11/2023] Open
Abstract
Background: Pulse transit time (PTT) is a key parameter in cuffless blood pressure measurement based on photoplethysmography (PPG) signals. In wearable PPG sensors, raw PPG signals are filtered, which can change the timing of PPG waveform feature points, leading to inaccurate PTT estimation. There is a lack of comprehensive investigation of filtering-induced PTT changes in subjects with different ages. Objective: This study aimed to quantitatively investigate the effects of aging and PTT definition on the infinite impulse response (IIR) filtering-induced PTT changes. Methods: One hundred healthy subjects in five different ranges of age (i.e., 20-29, 30-39, 40-49, 50-59, and over 60 years old, 20 subjects in each) were recruited. Electrocardiogram (ECG) and PPG signals were recorded simultaneously for 120 s. PTT was calculated from the R wave of ECG and PPG waveform features. Eight PTT definitions were developed from different PPG waveform feature points. The raw PPG signals were preprocessed then further low-pass filtered. The difference between PTTs derived from preprocessed and filtered PPG signals, and the relative difference, were calculated and compared among five age groups and eight PTT definitions using the analysis of variance (ANOVA) or Scheirer-Ray-Hare test with post hoc analysis. Linear regression analysis was used to investigate the relationship between age and filtering-induced PTT changes. Results: Filtering-induced PTT difference and the relative difference were significantly influenced by age and PTT definition (p < 0.001 for both). Aging effect on filtering-induced PTT changes was consecutive with a monotonous trend under all PTT definitions. The age groups with maximum and minimum filtering-induced PTT changes depended on the definition. In all subjects, the PTT defined by maximum peak of PPG had the minimum filtering-induced PTT changes (mean: 16.16 ms and 5.65% for PTT difference and relative difference). The changes of PTT defined by maximum first PPG derivative had the strongest linear relationship with age (R-squared: 0.47 and 0.46 for PTT difference relative difference). Conclusion: The filtering-induced PTT changes are significantly influenced by age and PTT definition. These factors deserve further consideration to improve the accuracy of PPG-based cuffless blood pressure measurement using wearable sensors.
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Affiliation(s)
- Shangdi Liao
- Department of Electronic and Electrical Engineering, Southern University of Science and Technology, Shenzhen, China
| | - Haipeng Liu
- Research Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Wan-Hua Lin
- Chinese Academy of Sciences Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology, Shenzhen, China
| | - Dingchang Zheng
- Research Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Fei Chen
- Department of Electronic and Electrical Engineering, Southern University of Science and Technology, Shenzhen, China
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17
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Königstein K, Klenk C, Sonnenberg J, Streese L. Editorial: Lifestyle and vascular ageing. Front Sports Act Living 2023; 5:1249268. [PMID: 37521102 PMCID: PMC10374331 DOI: 10.3389/fspor.2023.1249268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 07/06/2023] [Indexed: 08/01/2023] Open
Affiliation(s)
- Karsten Königstein
- Division Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Christopher Klenk
- Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jannik Sonnenberg
- Department of Medicine B, Gastroenterology and Hepatology, University Hospital Münster, Münster, Germany
| | - Lukas Streese
- Faculty of Health Care, Niederrhein University of Applied Sciences, Krefeld, Germany
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18
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Vear NK, Moon Y, Mielke GI, Skinner TL, Coombes JS, McCarthy AL, Abbott CR, Bailey TG. Efficacy of exercise training for improving vascular dysfunction in people with cancer: a systematic review with meta-analyses. J Cancer Surviv 2023:10.1007/s11764-023-01372-7. [PMID: 37079184 DOI: 10.1007/s11764-023-01372-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/23/2023] [Indexed: 04/21/2023]
Abstract
PURPOSE Cancer treatments exert vascular toxic effects that can lead to the development of cardiovascular disease. Exercise training has the potential to prevent or reduce cancer treatment-induced damage to vascular structure and function. This systematic review with meta-analyses aimed to determine the isolated effects of exercise training on vascular outcomes in people with cancer. METHODS Seven electronic databases were searched on 20 September 2021 to identify randomised controlled trials, quasi-randomised trials, pilot and cohort studies. Included studies implemented a structured exercise intervention and assessed vascular structure and/or function in people during or following cancer treatment. Meta-analyses examined the effects of exercise training on endothelial function (via brachial artery flow-mediated dilation) and arterial stiffness (via pulse wave velocity). Methodological quality was assessed using the Cochrane Quality Assessment tool and modified Newcastle-Ottawa Quality Appraisal tool. Grading of Recommendations, Assessment, Development and Evaluations framework was used to assess the certainty of evidence. RESULTS Ten studies (discussed across 11 articles) met the inclusion criteria. Methodological quality of the included studies was moderate (71% average). Exercise improved vascular function when compared to control (standardised mean difference = 0.34, 95% CI (0.01, 0.67); p = 0.044: studies = 5, participants = 171), but not pulse wave velocity (standardised mean difference = - 0.64, 95% CI (- 1.29, 0.02); p = 0.056: studies = 4, participants = 333). The certainty of evidence was moderate for flow-mediated dilation and low for pulse wave velocity. CONCLUSIONS Compared to usual care, exercise training significantly improves flow-mediated dilation (endothelial function) but not pulse wave analysis, in people treated for cancer. IMPLICATIONS FOR CANCER SURVIVORS Exercise may improve vascular health in individuals during and following cancer treatment.
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Affiliation(s)
- Natalie K Vear
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia.
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia.
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia.
| | - Yubin Moon
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia
| | - Gregore I Mielke
- School of Public Health, The University of Queensland, Herston, Queensland, 4006, Australia
| | - Tina L Skinner
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
| | - Jeff S Coombes
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
| | - Alexandra L McCarthy
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia
- Mater Research Institute, Level 3, Aubigny Place, Raymond Terrace, South Brisbane, Queensland, 4101, Australia
| | - Claudia R Abbott
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia
| | - Tom G Bailey
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
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19
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Hobson S, Arefin S, Witasp A, Hernandez L, Kublickiene K, Shiels PG, Stenvinkel P. Accelerated Vascular Aging in Chronic Kidney Disease: The Potential for Novel Therapies. Circ Res 2023; 132:950-969. [PMID: 37053277 DOI: 10.1161/circresaha.122.321751] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
The pathophysiology of vascular disease is linked to accelerated biological aging and a combination of genetic, lifestyle, biological, and environmental risk factors. Within the scenario of uncontrolled artery wall aging processes, CKD (chronic kidney disease) stands out as a valid model for detailed structural, functional, and molecular studies of this process. The cardiorenal syndrome relates to the detrimental bidirectional interplay between the kidney and the cardiovascular system. In addition to established risk factors, this group of patients is subjected to a plethora of other emerging vascular risk factors, such as inflammation, oxidative stress, mitochondrial dysfunction, vitamin K deficiency, cellular senescence, somatic mutations, epigenetic modifications, and increased apoptosis. A better understanding of the molecular mechanisms through which the uremic milieu triggers and maintains early vascular aging processes, has provided important new clues on inflammatory pathways and emerging risk factors alike, and to the altered behavior of cells in the arterial wall. Advances in the understanding of the biology of uremic early vascular aging opens avenues to novel pharmacological and nutritional therapeutic interventions. Such strategies hold promise to improve future prevention and treatment of early vascular aging not only in CKD but also in the elderly general population.
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Affiliation(s)
- S Hobson
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (S.H., S.A., A.W., L.H., K.K., P.S.)
| | - S Arefin
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (S.H., S.A., A.W., L.H., K.K., P.S.)
| | - A Witasp
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (S.H., S.A., A.W., L.H., K.K., P.S.)
| | - L Hernandez
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (S.H., S.A., A.W., L.H., K.K., P.S.)
| | - K Kublickiene
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (S.H., S.A., A.W., L.H., K.K., P.S.)
| | - P G Shiels
- School of Molecular Biosciences, MVLS, University of Glasgow, United Kingdom (P.G.S.)
| | - P Stenvinkel
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (S.H., S.A., A.W., L.H., K.K., P.S.)
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20
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Abstract
Vascular age is determined by functional and structural changes in the arterial wall. When measured by its proxy, pulse wave velocity, it has been shown to predict cardiovascular and total mortality. Disconcordance between chronological and vascular age might represent better or worse vascular health. Cell senescence is caused by oxidative stress and sustained cell replication. Senescent cells acquire senescence-associated secretory phenotype. Oxidative stress, endothelial dysfunction, dysregulation of coagulation and leucocyte infiltration are observed in the aging endothelium. All of these mechanisms lead to increased vascular calcification and stiffness. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can involve the vascular endothelium. It enters cells using angiotensin-converting enzyme 2 (ACE-2) receptors, which are abundant in endothelial cells. The damage this virus does to the endothelium can be direct or indirect. Indirect damage is caused by hyperinflammation. Direct damage results from effects on ACE-2 receptors. The reduction of ACE-2 levels seen during coronavirus disease 2019 (COVID-19) infection might cause vasoconstriction and oxidative stress. COVID-19 and vascular aging share some pathways. Due to the novelty of the virus, there is an urgent need for studies that investigate its long-term effects on vascular health.
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Affiliation(s)
- Ignas Badaras
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania,Ignas Badaras, Faculty of Medicine, Vilnius
University, M. K. Ciurlionio g. 21/27, LT-03101, Vilnius 01513, Lithuania.
| | - Agnė Laučytė-Cibulskienė
- Department of Nephrology, Skåne University
Hospital, Malmö, Sweden,Department of Clinical Sciences, Lund University, Malmö, Sweden
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21
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du Toit WL, Kruger R, Gafane-Matemane LF, Schutte AE, Louw R, Mels CMC. Markers of arterial stiffness and urinary metabolomics in young adults with early cardiovascular risk: the African-PREDICT study. Metabolomics 2023; 19:28. [PMID: 36988718 PMCID: PMC10060307 DOI: 10.1007/s11306-023-01987-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 03/04/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION Increased exposure to risk factors in the young and healthy contributes to arterial changes, which may be accompanied by an altered metabolism. OBJECTIVES To increase our understanding of early metabolic alterations and how they associate with markers of arterial stiffness, we profiled urinary metabolites in young adults with cardiovascular disease (CVD) risk factor(s) and in a control group without CVD risk factors. METHODS We included healthy black and white women and men (N = 1202), aged 20-30 years with a detailed CVD risk factor profile, reflecting obesity, physical inactivity, smoking, excessive alcohol intake, masked hypertension, hyperglycemia, dyslipidemia and low socio-economic status, forming the CVD risk group (N = 1036) and the control group (N = 166). Markers of arterial stiffness, central systolic blood pressure (BP) and pulse wave velocity were measured. A targeted metabolomics approach was followed by measuring amino acids and acylcarnitines using a liquid chromatography-tandem mass spectrometry method. RESULTS In the CVD risk group, central systolic BP (adjusted for age, sex, ethnicity) was negatively associated with histidine, arginine, asparagine, serine, glutamine, dimethylglycine, threonine, GABA, proline, methionine, pyroglutamic acid, aspartic acid, glutamic acid, branched chain amino acids (BCAAs) and butyrylcarnitine (all P ≤ 0.048). In the same group, pulse wave velocity (adjusted for age, sex, ethnicity, mean arterial pressure) was negatively associated with histidine, lysine, threonine, 2-aminoadipic acid, BCAAs and aromatic amino acids (AAAs) (all P ≤ 0.044). In the control group, central systolic BP was negatively associated with pyroglutamic acid, glutamic acid and dodecanoylcarnitine (all P ≤ 0.033). CONCLUSION In a group with increased CVD risk, markers of arterial stiffness were negatively associated with metabolites related to AAA and BCAA as well as energy metabolism and oxidative stress. Our findings may suggest that metabolic adaptations may be at play in response to increased CVD risk to maintain cardiovascular integrity.
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Affiliation(s)
- Wessel L du Toit
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
| | - Ruan Kruger
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Lebo F Gafane-Matemane
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Aletta E Schutte
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
- School of Population Health, University of New South Wales, Sydney, Australia
- The George Institute for Global Health, Sydney, Australia
| | - Roan Louw
- Human Metabolomics, North-West University, Potchefstroom Campus, Potchefstroom, South Africa
| | - Catharina M C Mels
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa.
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
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22
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Spikes TA, Alam AB, Lewis TT, Gwen Windham B, Kucharska-Newton A, Alonso A. Association of socioeconomic status with arterial stiffness in older African American and White adults: The ARIC study cohort. Am J Prev Cardiol 2023; 13:100469. [PMID: 36798726 PMCID: PMC9926086 DOI: 10.1016/j.ajpc.2023.100469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 01/10/2023] [Accepted: 01/21/2023] [Indexed: 01/27/2023] Open
Abstract
Objective To examine the cross-sectional associations of individual measures of SES-educational attainment and household income-and the joint effects of SES with PWV, as well as the SES-race interaction, in a cohort of older African American and White adults. Methods Data from the Atherosclerosis Risk in Communities (ARIC) Study were used to evaluate the cross-sectional associations of individual and joint SES [education and income] and carotid femoral pulse wave velocity (cfPWV), a subclinical marker of arterial stiffness, and the interaction of SES and race using adjusted multivariable linear regression models in a cohort of 3342 men and women aged 67-89 years free of CVD in 2011-2013. Results Participants were 64% female, 23% African American, mean cfPWV (12.3±3.5-African American and 11.6±3.9-White participants). Post-graduate education compared to less than high school was significantly associated with lower cfPWV (less stiffness) in African American (β = -1.28 m/s; 95% CI, -1.97, -0.59) but not in White (β = -0.69 m/s; 95% CI, -1.39, 0.01) participants. Income ≥$50K as compared to <$25K, was associated with lower cfPWV both in African American (β = -0.82 m/s; 95% CI, -1.42, -0.22) and White (β = -0.76 m/s; 95% CI, -1.19, -0.32) participants. The interaction of race and individual measures of SES on cfPWV in African American and White adults were not statistically significant (p-value >0.10). Conclusions Higher SES was cross-sectionally associated with lower arterial stiffness in this cohort; the data did not support differences by race. Prospective studies of SES and cfPWV are needed to efficiently compare larger racially and regionally diverse populations with a wider range of socioeconomic profiles to better identify subgroup CVD risk.
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Affiliation(s)
- Telisa A. Spikes
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd. Office# 428, Atlanta, GA 30322, United States
- Corresponding author.
| | - Aniqa B. Alam
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Tené T. Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - B. Gwen Windham
- Department of Medicine, University of Mississippi, United States
| | - Anna Kucharska-Newton
- Gillings School of Global Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- College of Public Health, University of Kentucky, Lexington, KY, United States
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
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23
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Li J, Gao J, Zhang X, Cui L, Hou J, Gao B, Wu S, Lu C. The Relationship between Vascular Aging Phenotypes and Renal Damage among Individuals with Type 2 Diabetes. Cardiorenal Med 2023; 13:91-100. [PMID: 36843125 DOI: 10.1159/000526345] [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: 04/27/2022] [Accepted: 07/15/2022] [Indexed: 02/26/2023] Open
Abstract
OBJECTIVE The aim of this study was to investigate the relationship between vascular aging (VA) phenotypes and renal damage in type 2 diabetic population. METHODS In this cross-sectional study, we included 8,141 individuals with type 2 diabetes who participated in the Kailuan Study during 2010-2018 and completed the brachial-ankle pulse wave velocity (baPWV) assessment for arterial stiffness, an indicator for VA. The age- and sex-specific 10th and 90th percentiles of baPWV based on a reference cohort were used as cutoffs to define supernormal VA (SUPERNOVA, baPWV<10th percentiles), normal VA (NVA, baPWV 10th to 90th percentiles), and early VA (EVA, baPWV>90th percentiles). The estimated glomerular filtration rate (eGFR) and proteinuria levels were used to assess renal damage, including isolated proteinuria, isolated kidney function decline (eGFR<60 mL/min/1.73 m2), and proteinuria combined with kidney function decline. Multivariable logistic regression analysis was used to analyze the relationship between VA phenotypes and diabetic kidney damage. RESULTS The prevalences of isolated proteinuria, isolated kidney function decline, and proteinuria combined with kidney function decline were 17.0%, 12.2%, and 5.4%, respectively. Compared with NVA, SUPERNOVA was associated with 34% lower odds (95% confidence interval [CI]: 0.46-0.96) of isolated proteinuria after adjusting for age, sex, and other potential confounders. EVA was associated with higher odds of all three types of kidney damage; the adjusted odds ratio (95% CI) was 1.42 (1.20-1.67) for proteinuria, 1.24 (1.01-1.51) for kidney function decline, and 1.56 (1.18-2.06) for proteinuria combined with kidney function decline. CONCLUSIONS VA phenotypes are associated with renal damage, especially isolated proteinuria. SUPERNOVA was associated with lower odds of isolated proteinuria and EVA was associated with higher odds of proteinuria and kidney function decline.
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Affiliation(s)
- Junjuan Li
- First Central Clinical College of Tianjin Medical University, Tianjin, China
- Department of Cardiology, Tianjin First Central Hospital, Tianjin, China
- Department of Nephrology, Kailuan General Hospital, Tangshan, China
| | - Jingli Gao
- Department of Intensive medicine, Kailuan General Hospital, Tangshan, China
| | - Xinyuan Zhang
- Department of Nutritional Sciences, Pennsylvania State University, State College, Philadelphia, Pennsylvania, USA
| | - Liufu Cui
- Department of Rheumatology and Immunology, Kailuan General Hospital, Tangshan, China
| | - Jinhong Hou
- Department of Nephrology, Kailuan General Hospital, Tangshan, China
| | - Bixia Gao
- Renal Division, Department of Medicine, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of health of China, and Key Laboratory of Chronic Kidney disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Chengzhi Lu
- First Central Clinical College of Tianjin Medical University, Tianjin, China
- Department of Cardiology, Tianjin First Central Hospital, Tianjin, China
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24
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Podrug M, Šunjić B, Koren P, Đogaš V, Mudnić I, Boban M, Jerončić A. What Is the Smallest Change in Pulse Wave Velocity Measurements That Can Be Attributed to Clinical Changes in Arterial Stiffness with Certainty: A Randomized Cross-Over Study. J Cardiovasc Dev Dis 2023; 10:jcdd10020044. [PMID: 36826540 PMCID: PMC9962359 DOI: 10.3390/jcdd10020044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/22/2023] [Accepted: 01/23/2023] [Indexed: 01/27/2023] Open
Abstract
Pulse wave velocity (PWV), a direct measure of arterial stiffness, is a promising biomarker of cardiovascular risk and a cardiovascular surrogate outcome. The resolution for detecting its smallest clinically significant change is dependent on the expected reproducibility, but there is currently no consensus on this. We estimated the PWV reproducibility in a range of intra-subject values that were observed over a 2 week period in a broad range of participants and under clinically relevant experimental conditions (two observers, morning/afternoon sessions, and number of visits) using SphygmoCor and Arteriograph devices. Each participant was recorded 12 times with each device over three visits, one week apart, and two morning and two afternoon recordings were taken per visit. The factors affecting reproducibility and the discrepancies between the consecutive PWV measurements for each device were also examined using multilevel mixed-effect models. We show that current PWV estimation guidance recommending 2 + 1 measurements is suboptimal because the PWV range was outside of the 1 m/s threshold for most of the participants, which is proposed as a minimal clinically important difference. The best reproducibility was yielded with median of four measurements and a 1.1 m/s threshold. Although PWV reproducibility and repeatability are frequently used interchangeably in studies, we demonstrated that despite their relative measures of variability (e.g., coefficient of variation) being comparable, their ranges revealed a clinically significant difference between them. We also found that different physiological variables were predictors of the discrepancy between the consecutive measurements made by the two devices, which is likely due to their distinct modes of operation. The evidence base for PWV reproducibility is limited, and more research is needed to deepen our understanding of the variation in arterial stiffness over time, as well as fluctuations within a population group and in an intervention setting.
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Affiliation(s)
- Mario Podrug
- Laboratory of Vascular Aging, University of Split School of Medicine, 21000 Split, Croatia
- Department of Health Studies, University of Split, 21000 Split, Croatia
| | - Borna Šunjić
- Laboratory of Vascular Aging, University of Split School of Medicine, 21000 Split, Croatia
- Department of Health Studies, University of Split, 21000 Split, Croatia
| | - Pjero Koren
- Laboratory of Vascular Aging, University of Split School of Medicine, 21000 Split, Croatia
- Department of Psychological Medicine, University of Split School of Medicine, 21000 Split, Croatia
| | - Varja Đogaš
- Department of Psychological Medicine, University of Split School of Medicine, 21000 Split, Croatia
| | - Ivana Mudnić
- Department of Basic and Clinical Pharmacology, University of Split School of Medicine, 21000 Split, Croatia
| | - Mladen Boban
- Department of Basic and Clinical Pharmacology, University of Split School of Medicine, 21000 Split, Croatia
| | - Ana Jerončić
- Laboratory of Vascular Aging, University of Split School of Medicine, 21000 Split, Croatia
- Department of Research in Biomedicine and Health, University of Split School of Medicine, 21000 Split, Croatia
- Correspondence:
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25
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Podrug M, Šunjić B, Bekavac A, Koren P, Đogaš V, Mudnić I, Boban M, Jerončić A. The effects of experimental, meteorological, and physiological factors on short-term repeated pulse wave velocity measurements, and measurement difficulties: A randomized crossover study with two devices. Front Cardiovasc Med 2023; 9:993971. [PMID: 36712242 PMCID: PMC9873998 DOI: 10.3389/fcvm.2022.993971] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023] Open
Abstract
Background Large longitudinal studies with repeated pulse wave velocity (PWV) measurements, a direct measure of arterial stiffness, are required to realize the full potential of arterial stiffness in clinical practice. To facilitate such studies it is important to increase the power of a study by reducing within-subject variability of PWV, and to ease the use of a PWV device in clinical settings by minimizing PWV measurement difficulties. Methods We systematically investigated experimental setting and meteorological conditions, as well as physiological factors and participant characteristics, to determine whether and to what extent they affected: between- and within-subjects variability of PWV recordings, and measurement difficulties of a particular device. We conducted a 2-week longitudinal block-randomized cross-over study with two blinded observers and two commonly used devices: applanation tonometry SphygmoCor CvMS and oscillometric Arteriograph to assess carotid-femoral (cfPWV) or aortic (PWVao) PWV, respectively. Our sample had uniform and wide-spread distribution of age, blood pressures, hypertensive status and BMI. Each participant (N = 35) was recorded 12 times over 3 visiting days, 7 days apart. On each day, recordings were made twice in the morning (7-10 a.m.) and afternoon (16-18 p.m.). Data were analyzed using multilevel mixed-effects models, separately for each device. Results In addition to age and mean arterial pressure (MAP) that strongly affected both cfPWV and PWVao, other significant factors appeared to indicate a measurement approach. cfPWV as a more direct measure of arterial stiffness was additionally affected by hypertension status, outdoor temperature, interaction of MAP with outdoor temperature and the order of visit, with MAP within-subject variability contributing on average 0.27 m/s to difference in repeated measurements at 5°C and 0.004 m/s at 25°C. PWVao measurements derived at a single brachial site were more dependent on age than cfPWV and also depended on personal characteristics such as height and sex, and heart rate; with within-subject MAP variability adding on average 0.23 m/s to the difference in repeated measures. We also found that female sex significantly increased, and recording in afternoon vs. morning significantly decreased measurement difficulties of both devices. Conclusion We identified factors affecting PWV recordings and measurement-difficulties and propose how to improve PWV measuring protocols.
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Affiliation(s)
- Mario Podrug
- Laboratory of Vascular Aging, University of Split School of Medicine, Split, Croatia,University Department of Health Studies, University of Split, Split, Croatia
| | - Borna Šunjić
- Laboratory of Vascular Aging, University of Split School of Medicine, Split, Croatia,University Department of Health Studies, University of Split, Split, Croatia
| | - Anamarija Bekavac
- PhD Study Programme, University of Split School of Medicine, Split, Croatia
| | - Pjero Koren
- Laboratory of Vascular Aging, University of Split School of Medicine, Split, Croatia,Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
| | - Varja Đogaš
- Department of Psychological Medicine, University of Split School of Medicine, Split, Croatia
| | - Ivana Mudnić
- Department of Basic and Clinical Pharmacology, University of Split School of Medicine, Split, Croatia
| | - Mladen Boban
- Department of Basic and Clinical Pharmacology, University of Split School of Medicine, Split, Croatia
| | - Ana Jerončić
- Laboratory of Vascular Aging, University of Split School of Medicine, Split, Croatia,Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia,*Correspondence: Ana Jerončić,
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26
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Forcada P, Vilela-Martin JF. Evaluation of Central Hemodynamics in the Diagnosis and Treatment of Hypertension. Curr Cardiol Rev 2023; 19:1-4. [PMID: 37171002 PMCID: PMC10636802 DOI: 10.2174/1573403x19666230511145035] [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: 06/23/2022] [Revised: 04/11/2023] [Accepted: 04/11/2023] [Indexed: 05/13/2023] Open
Affiliation(s)
- Pedro Forcada
- Department of Cardiology, Universidad Austral, Pilar, Argentina
- University of Buenos Aires, Buenos Aires, Argentina
| | - Jose F. Vilela-Martin
- Adjunct Professor at the State Medical School in Sao Jose do Rio Preto (FAMERP), Sao Paulo,Brazil
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27
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Lahera Juliá V, Lahera García AM. ARTERIAL AGEING AND ATHEROSCLEROTIC RISK: NEW PERSPECTIVES. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2023; 35:32-34. [PMID: 36746562 DOI: 10.1016/j.arteri.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Vicente Lahera Juliá
- Departamento de Fisiología. Facultad de Medicina. Universidad Complutense de Madrid
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28
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Park JB, Avolio A. Arteriosclerosis and Atherosclerosis Assessment in Clinical Practice: Methods and Significance. Pulse (Basel) 2023; 11:1-8. [PMID: 37404379 PMCID: PMC10315159 DOI: 10.1159/000530616] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 03/24/2023] [Indexed: 07/06/2023] Open
Abstract
Alongside cancer, cardiovascular disease (CVD) exhibits the highest rates of morbidity and mortality globally, in western society as well as in Asian countries. Aging is a serious problem for the Asian population as progression toward a super-aged society is moving at a remarkably high rate. This increased rate of aging leads to increased CVD risk and, consequently, high CVD incidence. However, aging is not the only deleterious factor of vascular problems; hypertension, hypercholesterolemia, diabetes mellitus, and kidney disease may induce atherosclerosis and arteriosclerosis (i.e., arterial stiffening), and the progression of these diseases ultimately leads to cardiovascular, cerebrovascular, chronic kidney, or peripheral artery disease. Despite the existence of several guidelines on the treatment of risk factors such as hypertension and CVD, there is still an ongoing debate regarding the clinical need for assessment of arteriosclerosis and atherosclerosis, which act as a bridge between cardiovascular risk factors and CVD. In other words, although arteriosclerosis and atherosclerosis are essential to our understanding of vascular diseases, the need for additional tests beyond the conventional diagnosis method remains disputed. This is presumably due to insufficient discussion on how to apply such tests in clinical practice. This study aimed to fill this gap.
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Affiliation(s)
- Jeong Bae Park
- JB Lab and Clinic and Department of Precision Medicine and Biostatistics, Yonsei University, Wonju College of Medicine, Seoul, Republic of Korea
| | - Alberto Avolio
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
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29
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Tsentidou G, Moraitou D, Tsolaki M, Masoura E, Papaliagkas V. Trajectories of Cognitive Impairment in Adults Bearing Vascular Risk Factors, with or without Diagnosis of Mild Cognitive Impairment: Findings from a Longitudinal Study Assessing Executive Functions, Memory, and Social Cognition. Diagnostics (Basel) 2022; 12:diagnostics12123017. [PMID: 36553024 PMCID: PMC9777412 DOI: 10.3390/diagnostics12123017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022] Open
Abstract
With the aging of the population, a key concern of both societies and health services is to keep the population cognitively healthy until the maximum age limit. It is a well-known fact that vascular aging has a negative effect on the cognitive skills of adults, putting them at greater risk of developing dementia. The present longitudinal study aimed to evaluate the main dimensions of cognition in two pathological groups with different health profiles: a group of adults with vascular risk factors (VRF) (n = 35) and a group of adults with vascular risk factors and mild cognitive impairment (VRF + MCI) (n = 35). The two groups were matched in age, education, and gender. They were assessed with extensive neuropsychological testing at three different times with a distance of about 8 months between them; the assessment regarded executive functions, memory capacity, and Theory of Mind abilities. The analyses carried out were (a) mixed-measures ANOVA, (b) repeated measures ANOVA, and (c) ANOVA. The findings showed that global cognitive status and short-term memory are the main cognitive abilities that decline in community dwelling people bearing VRF. Hence, this group of adults should be examined at least every 2 years for this decline. As regards people with both VRF and MCI, it seems that the assessment of Theory of Mind abilities can better capture their further impairment. Global cognitive status, task/rule switching function, and long-term memory (delayed verbal recall) were revealed as the abilities that clearly and steadily differentiate VRF people with and without MCI.
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Affiliation(s)
- Glykeria Tsentidou
- Laboratoty of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI), AUTh, 541 24 Thessaloniki, Greece
- Correspondence: ; Tel.: +30-6983140302
| | - Despina Moraitou
- Laboratoty of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI), AUTh, 541 24 Thessaloniki, Greece
- Greek Association of Alzheimer’s Disease and Related Disorders, 546 43 Thessaloniki, Greece
| | - Magdalini Tsolaki
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI), AUTh, 541 24 Thessaloniki, Greece
- Greek Association of Alzheimer’s Disease and Related Disorders, 546 43 Thessaloniki, Greece
| | - Elvira Masoura
- Laboratoty of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Vasileios Papaliagkas
- Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 574 00 Sindos, Greece
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30
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Genetic Variants of the TERT Gene and Telomere Length in Obstructive Sleep Apnea. Biomedicines 2022; 10:biomedicines10112755. [PMID: 36359275 PMCID: PMC9688013 DOI: 10.3390/biomedicines10112755] [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: 09/19/2022] [Revised: 10/20/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction: Obstructive sleep apnea (OSA) is a worldwide breathing disorder that has been diagnosed globally in almost 1 billion individuals aged 30−69 years. It is characterized by repeated upper airway collapses during sleep. Telomerase reverse transcriptase (TERT) is involved in the prevention of telomere shortening. This prospective, observational study aimed to investigate the relationship between single nucleotide polymorphisms (SNPs) of TERT and the severity of OSA, taking into account hypertension and diabetes prevalence. Methods: A total of 149 patients with OSA were diagnosed using one-night video-polysomnography based on the American Academy of Sleep Medicine guidelines. The TERT SNPs and telomere length (TL) were detected using real-time quantitative polymerase chain reaction. Results: Statistical analysis showed that there is no relationship between the rs2853669 and rs2736100 polymorphisms of TERT, and the severity of OSA (p > 0.05). Moreover, no relationship between TL and the severity of OSA was observed. The G allele in the locus of rs2736100 TERT was associated with hypertension prevalence and was more prevalent in hypertensives patients (46.00% vs. 24.49%, p = 0.011). The prevalence of hypertension was higher in patients with the C allele in the locus of rs2853669 than in patients without this allele (50.79% vs. 30.23%, p = 0.010). Moreover, a lower prevalence of diabetes was observed in homozygotes of rs2736100 TERT than in heterozygotes (5.63% vs. 15.38%, p = 0.039). Conclusion: This study showed no relationship between OSA and TERT SNPs. However, SNPs of the TERT gene (rs2736100 and rs2853669) were found to affect arterial hypertension and diabetes prevalence.
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Song Q, Ling Q, Bai J, Zhang H, Bu P, Chen F, Wu S, Zhang W, Chen M, Cai J. Influence of baseline arterial stiffness on effects of intensive compared with standard blood pressure control: a post hoc analysis of the STEP trial. BMC Med 2022; 20:358. [PMID: 36261812 PMCID: PMC9583479 DOI: 10.1186/s12916-022-02556-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/08/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The benefits and risks of intensive versus standard systolic blood pressure (SBP) treatment in older patients with arterial stiffness (AS) remains unclear. This study aims to investigate the interaction between the baseline AS and SBP treatments on cardiovascular outcomes. METHODS In this post hoc analysis of the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial, we involved 6865 participants with complete data regarding baseline brachial-ankle pulse wave velocity (baPWV). Patients were categorized by baseline AS status (AS, baPWV ≥ 1800 cm/s; non-AS, baPWV < 1800 cm/s). The primary outcome was a composite of cardiovascular events. The secondary outcomes were stroke, acute coronary syndrome (ACS), major cardiovascular events (MACE), and all-cause death. Cox regression was used to calculate hazard ratios for the outcomes. RESULTS During a mean follow-up of 2.69 years, a total of 248 primary outcome events and 81 all-cause deaths occurred. The hazard ratios for the primary outcome were 0.76 (95% confidence interval (CI), 0.54-1.09) and 0.63 (95% CI, 0.43-0.92) in the AS and non-AS groups, respectively (P for interaction = 0.43), and that for stroke was 0.58 (95% CI, 0.33-1.02) and 0.48 (95% CI, 0.23-0.99) in the AS and non-AS groups, respectively (P for interaction = 0.68). Effects of intensive SBP treatment on safety outcomes and all-cause death were also similar in the two groups (P for interaction > 0.05 for all). CONCLUSIONS In the STEP trial, the beneficial effects of intensive SBP treatment were similar among those in the AS group and the non-AS group at baseline. TRIAL REGISTRATION STEP ClinicalTrials.gov number, NCT03015311. Registered 2 January 2017.
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Affiliation(s)
- Qirui Song
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Rd. 167, Xicheng District, Beijing, 100037, China
| | - Qianhui Ling
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Rd. 167, Xicheng District, Beijing, 100037, China
| | - Jingjing Bai
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Rd. 167, Xicheng District, Beijing, 100037, China
| | - Hongwei Zhang
- The Hospital of Shunyi District Beijing, Beijing, 101300, China
| | - Peili Bu
- Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Fang Chen
- The First People's Hospital of Yinchuan, Yinchuan, 750000, Ningxia, China
| | - Shouling Wu
- Kailuan General Hospital, Tangshan, 063000, Hebei, China
| | - Weili Zhang
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Rd. 167, Xicheng District, Beijing, 100037, China
| | - Mulei Chen
- Heart Center and Beijing Key Laboratory of Hypertension, Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Gongtinanlu Rd. 8, Chaoyang District, Beijing, 100020, China.
| | - Jun Cai
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Rd. 167, Xicheng District, Beijing, 100037, China.
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Bruno RM, Pépin JL, Empana JP, Yang RY, Vercamer V, Jouhaud P, Escourrou P, Boutouyrie P. Home monitoring of arterial pulse-wave velocity during COVID-19 total or partial lockdown using connected smart scales . EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2022; 3:362-372. [PMID: 36712157 PMCID: PMC9384477 DOI: 10.1093/ehjdh/ztac027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 04/06/2022] [Accepted: 05/16/2022] [Indexed: 11/19/2022]
Abstract
Aims To investigate the impact of coronavirus disease 2019 lockdown on trajectories of arterial pulse-wave velocity in a large population of users of connected smart scales that provide reliable measurements of pulse-wave velocity. Methods and results Pulse-wave velocity recordings obtained by Withings Heart Health & Body Composition Wi-Fi Smart Scale users before and during lockdown were analysed. We compared two demonstrative countries: France, where strict lockdown rules were enforced (n = 26 196) and Germany, where lockdown was partial (n = 26 847). Subgroup analysis was conducted in users of activity trackers and home blood pressure monitors. Linear growth curve modelling and trajectory clustering analyses were performed. During lockdown, a significant reduction in vascular stiffness, weight, blood pressure, and physical activity was observed in the overall population. Pulse-wave velocity reduction was greater in France than in Germany, corresponding to 5.2 month reduction in vascular age. In the French population, three clusters of stiffness trajectories were identified: decreasing (21.1%), stable (60.6%), and increasing pulse-wave velocity clusters (18.2%). Decreasing and increasing clusters both had higher pulse-wave velocity and vascular age before lockdown compared with the stable cluster. Only the decreasing cluster showed a significant weight reduction (-400 g), whereas living alone was associated with increasing pulse-wave velocity cluster. No clusters were identified in the German population. Conclusions During total lockdown in France, a reduction in pulse-wave velocity in a significant proportion of French users of connected smart bathroom scales occurred. The impact on long-term cardiovascular health remains to be established.
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Affiliation(s)
- Rosa Maria Bruno
- Corresponding author. Tel: +33 1 5398 7967, Fax: +33 1 5609 3991,
| | - Jean Louis Pépin
- HP2 Laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France,EFCR Laboratory, Grenoble Alpes University Hospital, Grenoble, France
| | | | | | | | | | - Pierre Escourrou
- Centre Interdisciplnaire du Sommeil, 20 rue St SaënsParis 15, France,Université Paris Saclay, Paris, France
| | - Pierre Boutouyrie
- Université Paris Cité, Inserm, PARCC, F-75015 Paris, France,Pharmacology Unit, AP-HP, Hôpital Européen Georges Pompidou, F-75015 Paris, France
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Oliveira AC, Cunha PMGM, Vitorino PVDO, Souza ALL, Deus GD, Feitosa A, Barbosa ECD, Gomes MM, Jardim PCBV, Barroso WKS. Vascular Aging and Arterial Stiffness. Arq Bras Cardiol 2022; 119:604-615. [PMID: 36287415 PMCID: PMC9563886 DOI: 10.36660/abc.20210708] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 05/11/2022] [Indexed: 11/18/2022] Open
Abstract
O envelhecimento biológico é reflexo da interação entre genética, idade cronológica e fatores externos; é a base para novos conceitos em envelhecimento vascular, cuja progressão é determinada pela diferença entre idade biológica e cronológica. Do ponto de vista estrutural, os efeitos do envelhecimento vascular são mais evidentes na camada média das grandes artérias elásticas e resultam em aumento da rigidez arterial, da dilatação do lúmen e da espessura da parede. Esses efeitos são descritos no continuum de envelhecimento cardiovascular (proposto por Dzau em 2010) em que as etapas progressivas de lesões da microvasculatura de coração, rins e cérebro, têm início a partir do processo de envelhecimento. O aumento da rigidez arterial pode ser verificado de forma não invasiva por vários métodos. Os eventos cardiovasculares têm sido tradicionalmente previstos utilizando escores que combinam fatores de risco convencionais para aterosclerose. No continuum cardiovascular clássico (Dzau, 2006), é desafiador avaliar o peso exato da contribuição de cada fator de risco; entretanto, por refletir o dano precoce e cumulativo desses fatores de riscos cardiovascular, a rigidez arterial reflete o verdadeiro dano à parede arterial. Este artigo fornece uma visão geral dos mecanismos da fisiopatogenia, alterações estruturais das artérias e consequências hemodinâmicas do envelhecimento arterial; métodos não invasivos para a avaliação da rigidez arterial e da medida central da pressão arterial; o continuum de envelhecimento cardiovascular, e aplicação do conceito de rigidez arterial na estratificação de risco cardiovascular.
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Affiliation(s)
| | | | | | - Ana Luiza Lima Souza
- Universidade Federal de Goiás , Liga de Hipertensão , Goiânia , GO - Brasil.,Universidade Federal de Goiás - Programa de Pós-Graduação em Ciências da Saúde , Goiânia , GO - Brasil
| | - Gilcimar Divino Deus
- Pontifícia Universidade Católica de Goiás - Escola de Ciências Exatas e da Computação , Goiânia , GO - Brasil
| | - Audes Feitosa
- Universidade de Pernambuco , Recife , PE - Brasil.,Universidade Católica de Pernambuco , Recife , PE - Brasil
| | | | - Marco Mota Gomes
- Centro Universitario CESMAC - Hospital do Coração , Maceió , AL - Brasil
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Dorogovtsev VN, Yankevich DS, Petrova MV, Torshin VI, Severin AE, Borisov IV, Podolskaya JA, Grechko AV. Detection of Preclinical Orthostatic Disorders in Young African and European Adults Using the Head-Up Tilt Test with a Standardized Hydrostatic Column Height: A Pilot Study. Biomedicines 2022; 10:biomedicines10092156. [PMID: 36140257 PMCID: PMC9496141 DOI: 10.3390/biomedicines10092156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/29/2022] [Accepted: 08/29/2022] [Indexed: 11/16/2022] Open
Abstract
Arterial hypertension (AH) remains the most common disease. One possible way to improve the effectiveness of the primary prevention of AH is to identify and control the preclinical orthostatic disturbances that precede the development of AH. The aim of the study was to determine the feasibility of a new protocol for the head-up tilt test (HUTT) with a standardized hydrostatic column height for the detection of asymptomatic orthostatic circulatory disorders and their racial differences in young African and European adults. Methods. In total, 80 young healthy adults (40 African and 40 European) aged 20–23 years performed the HUTT with a standardized hydrostatic column height of 133 cm. The hemodynamic parameters were recorded using a Task Force Monitor (3040i). The cardio-ankle vascular index (CAVI) was measured using a VaSera VS-2000 volumetric sphygmograph. Results. The baseline and orthostatic hemodynamic changes in both racial groups were within normal limits. Orthostatic circulatory disturbances were not detected in 70% of the European participants and 65% of the African participants; however, preclinical orthostatic hypertension, which precedes AH, was detected using the new HUTT protocol in 32.5% of the African participants and 20% of the European participants. The baseline CAVI was higher in the European group compared to the African group. Conclusion. The results of this study showed the feasibility of the detection of preclinical orthostatic disturbances in young adults and the detection of their racial differences using the HUTT protocol, providing the use of a standard gravity load. Further study on the evolution of preclinical orthostatic disturbances and their relation to increased vascular stiffness is necessary among large samples.
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Affiliation(s)
- Victor N. Dorogovtsev
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 107031 Moscow, Russia
- Correspondence:
| | - Dmitry S. Yankevich
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 107031 Moscow, Russia
| | - Marina V. Petrova
- Department of Anesthesiology and Resuscitation with Medical Rehabilitation Courses, Peoples’ Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya Street, 117198 Moscow, Russia
| | - Vladimir I. Torshin
- Department of Normal Physiology, and Department of Anesthesiology and Resuscitation with Medical Rehabilitation Courses, Peoples’ Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya Street, 117198 Moscow, Russia
| | - Aleksander E. Severin
- Department of Normal Physiology, and Department of Anesthesiology and Resuscitation with Medical Rehabilitation Courses, Peoples’ Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya Street, 117198 Moscow, Russia
| | - Ilya V. Borisov
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 107031 Moscow, Russia
| | - Julia A. Podolskaya
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 107031 Moscow, Russia
| | - Andrey V. Grechko
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, 107031 Moscow, Russia
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Comparison between Carotid Distensibility-Based Vascular Age and Risk-Based Vascular Age in Middle-Aged Population Free of Cardiovascular Disease. J Clin Med 2022; 11:jcm11164931. [PMID: 36013170 PMCID: PMC9410254 DOI: 10.3390/jcm11164931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 12/05/2022] Open
Abstract
The concept of vascular age (VA) was proposed to provide patients with an understandable explanation of cardiovascular (CV) risk and to improve the performance of prediction models. The present study compared risk-based VA derived from Framingham Risk Score (FRS) and Systematic Coronary Risk Estimation (SCORE) models with value-based VA derived from the measurement of the common carotid artery (CCA) distensibility coefficient (DC), and it assessed the impact of DC-based VA on risk reclassification. In 528 middle-aged individuals apparently free of CV disease, DC was measured by radiofrequency-based arterial wall tracking that was previously utilised to establish sex- and age-specific reference values in a healthy population. DC-based VA represented the median value (50th percentile) for given sex in the reference population. FRS-based and SCORE-based VA was calculated as recommended. We observed a good agreement between DC-based and FRS-based VA, with a mean difference of 0.46 ± 12.2 years (p = 0.29), while the mean difference between DC-based and SCORE-based VA was higher (3.07 ± 12.7 years, p < 0.0001). When only nondiabetic individuals free of antihypertensive therapy were considered (n = 341), the mean difference dropped to 0.70 ± 12.8 years (p = 0.24). Substitution of chronological age with DC-based VA in FRS and SCORE models led to a reclassification of 28% and 49% of individuals, respectively, to the higher risk category. Our data suggest that the SCORE prediction model, in which diabetes and antihypertensive treatment are not considered, should be used as a screening tool only in healthy individuals. The use of VA derived from CCA distensibility measurements could improve the performance of risk prediction models, even that of the FRS model, as it might integrate risk prediction with additional risk factors participating in vascular ageing, unique to each individual. Prospective studies are needed to validate the role of DC-based VA in risk prediction.
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36
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Gómez-Sánchez L, Rodríguez-Sánchez E, Ramos R, Marti R, Gómez-Sánchez M, Lugones-Sánchez C, Tamayo-Morales O, Sánchez SG, Rigo F, García-Ortiz L, Gómez-Marcos MA, Ramos R, Ramos R, Martí R, Parramon D, Ponjoan A, Quesada M, Garcia-Gil M, Sidera M, Camós L, Montesinos F, Montoya I, López C, Agell A, Pagès N, Gil I, Maria-Castro A, Rigo F, Frontera G, Rotger A, Feuerbach N, Pons S, Garcia N, Guillaumet J, Llull M, Gutierrez M, Agudo-Conde C, Gómez-Sanchez L, Castaño-Sanchez C, Rodriguez-Martín C, Sanchez-Salgado B, de Cabo-Laso A, Gómez-Sánchez M, Rodriguez-Sanchez E, MaderueloFernandez JA, Ramos-Delgado E, Patino-Alonso C, Recio-Rod-riguez JI, Gomez-Marcos MA, Garcia-Ortiz L. Association of physical activity with vascular aging in a population with intermediate cardiovascular risk, analysis by sex: MARK study. Biol Sex Differ 2022; 13:46. [PMID: 35987700 PMCID: PMC9392339 DOI: 10.1186/s13293-022-00456-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 08/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this study was to analyze the association of physical activity and its intensity with arterial stiffness and vascular aging and differences by sex in a Spanish population with intermediate cardiovascular risk. Methods Cross-sectional study. A total of 2475 individuals aged 35–75 years participated in the study. Brachial–ankle pulse wave velocity (baPWV) was measured using a VaSera VS-1500® device. Based on the age and sex percentile presented by the participants, the latter were classified as follows: those with a percentile above 90 and presenting established cardiovascular disease were classified as early vascular aging (EVA); those with a percentile between 10 and 90 were classified as normal vascular aging (NVA) and those with a percentile below 10 were classified as healthy vascular aging (HVA). Physical activity was analyzed through the short version of the Minnesota Leisure Time Physical Activity Questionnaire (MLTPAQ). Results The mean age of the participants was 61.34 ± 7.70 years, with 61.60% men. Of the total sample, 86% were sedentary (83% men vs 90% women). The total physical activity showed a negative association with baPWV (β = − 0.045; 95% CI − 0.080 to − 0.009). Intense physical activity showed a negative relationship with baPWV (β = − 0.084; 95% CI − 0.136 to − 0.032). The OR of the total physical activity and the intense physical activity carried out by the subjects classified as NVA with respect to those classified as HVA was OR = 0.946; (95% CI 0.898 to 0.997) and OR = 0.903; (95% CI 0.840 to 0.971), and of those classified as EVA it was OR = 0.916; (95% CI 0.852 to 0.986) and OR = 0.905; (95% CI 0.818 to 1.000). No association was found with moderate- or low-intensity physical activity. Conclusions The results of this study suggest that, when intense physical activity is performed, the probability of presenting vascular aging is lower. In the analysis by sex, this association is only observed in men. Supplementary Information The online version contains supplementary material available at 10.1186/s13293-022-00456-w. This study is the first to find a negative association between total physical activity and arterial stiffness and vascular aging in adults with intermediate cardiovascular risk. This study also shows that the association of physical activity with arterial stiffness and vascular aging in adults with intermediate cardiovascular risk varies depending on its intensity, with a negative association being found only with intense physical activity. In the analysis by sex, the results found suggest that the association is greater in men.
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Cao Q, Li M, Wang T, Chen Y, Dai M, Zhang D, Xu Y, Xu M, Lu J, Wang W, Ning G, Bi Y, Zhao Z. Association of Early and Supernormal Vascular Aging categories with cardiovascular disease in the Chinese population. Front Cardiovasc Med 2022; 9:895792. [PMID: 36035913 PMCID: PMC9403083 DOI: 10.3389/fcvm.2022.895792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/25/2022] [Indexed: 11/24/2022] Open
Abstract
Background Early Vascular Aging and Supernormal Vascular Aging are two extreme phenotypes of vascular aging, and people in the two categories demonstrate distinct clinical characteristics and cardiovascular prognosis. However, the clinical implication of vascular aging categories in the Asian or Chinese population has not been investigated. We aimed to investigate the association between vascular aging categories and cardiovascular events in a Chinese cohort. Methods We explored the association of vascular aging categories with incident cardiovascular disease in a community cohort in Shanghai, China, which included 10,375 participants following up for 4.5 years. Vascular age was predicted by a multivariable linear regression model including classical risk factors and brachial-ankle pulse wave velocity. Early and Supernormal vascular aging groups were defined by 10% and 90% percentiles of Δ-age, which was calculated as chronological minus vascular age. Results We found that cardiovascular risk significantly increased in Early [hazard ratio (HR), 1.597 (95% CI, 1.043–2.445)] and decreased in Supernormal [HR, 0.729 (95% CI, 0.539–0.986)] vascular aging individuals, comparing with normal vascular aging subjects. The associations were independent of the Framingham risk score. Early vascular aging individuals also showed an elevated risk of total mortality [HR, 2.614 (95% CI, 1.302–5.249)]. Further, the associations of vascular aging categories with cardiovascular risk were much stronger in females than in males. Vascular aging categories with different cutoff levels expressed as percentiles (10th, 20th, and 25th) of Δ-age showed similar associations with cardiovascular risk. Conclusions In conclusion, the vascular aging categories could identify people with different levels of cardiovascular risk in the Chinese population, particularly in women.
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Affiliation(s)
- Qiuyu Cao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mian Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tiange Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuhong Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Meng Dai
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Di Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jieli Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Yufang Bi,
| | - Zhiyun Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Zhiyun Zhao,
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Kim B, Lee CJ, Won HH, Lee SH. Genetic Variants Associated with Supernormal Coronary Arteries. J Atheroscler Thromb 2022; 30:467-480. [PMID: 35793981 PMCID: PMC10164599 DOI: 10.5551/jat.63554] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
AIMS Genetic and medical insights from studies on cardioprotective phenotypes aid the development of novel therapeutics. This study identified genetic variants associated with supernormal coronary arteries using genome-wide association study data and the corresponding genes based on expression quantitative trait loci (eQTL). METHODS Study participants were selected from two Korean cohorts according to inclusion criteria that included males with high cardiovascular risk (Framingham risk score ≥ 14, 10-year risk ≥ 16%) but with normal coronary arteries (supernormal group) or coronary artery disease (control group). After screening 12,309 individuals, males meeting the supernormal phenotype (n=72) and age-matched controls (n=94) were enrolled. Genetic variants associated with the supernormal phenotype were identified using Firth's logistic regression, and eQTL was used to evaluate whether the identified variants influence the expression of particular genes in human tissues. RESULTS Approximately 5 million autosomal variants were tested for association with the supernormal phenotype, and 10 independent loci suggestive of supernormal coronary arteries (p<5.0 ×10 -5) were identified. The lead variants were seven intergenic single-nucleotide polymorphisms (SNPs), including one near PBX1, and three intronic SNPs, including one in PPFIA4. Of these variants or their proxies, rs9630089, rs6427989, and rs4984694 were associated with expression levels of SLIT1 and ARHGAP19, PPFIA4, and METTL26 in human tissues, respectively. These eQTL results supported their potential biological relevance. CONCLUSIONS This study identified genetic variants and eQTL genes associated with supernormal coronary arteries. These results suggest candidate genes representing potential therapeutic targets for coronary artery disease.
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Affiliation(s)
- Beomsu Kim
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center
| | - Chan Joo Lee
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine
| | - Hong-Hee Won
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center
| | - Sang-Hak Lee
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine
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Rodríguez-Vargas GS, Santos-Moreno P, Rubio-Rubio JA, Bautista-Niño PK, Echeverri D, Gutiérrez-Castañeda LD, Sierra-Matamoros F, Navarrete S, Aparicio A, Saenz L, Rojas-Villarraga A. Vascular Age, Metabolic Panel, Cardiovascular Risk and Inflammaging in Patients With Rheumatoid Arthritis Compared With Patients With Osteoarthritis. Front Cardiovasc Med 2022; 9:894577. [PMID: 35865390 PMCID: PMC9295407 DOI: 10.3389/fcvm.2022.894577] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/08/2022] [Indexed: 12/14/2022] Open
Abstract
IntroductionThe risk of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) is 1.5–2 times higher than the general population. The fundamental risk factor for CVD is age, related to alterations at the arterial level. The aim of the study was to compare vascular age (VA) in RA patients under a strict treat-to-target (T2T) strategy with Osteoarthritis (OA) patients without strict follow up and to assess the influence of inflammaging (chronic, sterile, low-grade inflammation related to aging) and metabolic markers on VA.Materials and MethodsThis was an analytical cross-sectional study. Patients with RA (under a strict a T2T strategy) and OA patients without strict clinical follow-up were included. Patients with a history of uncontrolled hypertension, CVD, and/or current smoking were excluded. Sociodemographic, physical activity, and toxic exposure data were obtained. Waist-hip ratio and body mass index (BMI) were measured. DAS-28 (RA) and inflammatory markers, lipid profile, and glycaemia were analyzed. Pulse wave velocity (PWV) was measured (oscillometric method, Arteriograph-TensioMed®). VA was calculated based on PWV. Eleven components of inflammaging [six interleukins, three metalloproteinases (MMP), and two tissue inhibitors of metalloproteinases (TIMP)] were evaluated (Luminex® system). Univariate and bivariate analyzes (Mann Whitney U and chi-square) and correlations (Spearmans Rho) were done to compare the two groups.ResultsA total of 106 patients (74% women) were included, 52/RA and 54/OA. The mean age was 57 (Interquartile range - IQR 9 years). The BMI, waist circumference, and weight were higher in patients with OA (p < 0.001). RA patients had low disease activity (DAS-28-CRP). There were no differences in VA, inflammaging nor in PWV between the two groups. VA had a positive, but weak correlation, with age and LDL. In group of RA, VA was higher in those who did not receive methotrexate (p = 0.013). LDL levels correlated with MMP1, TIMP1, and TIMP2.ConclusionsWhen comparing RA patients with low levels of disease activity with OA patients with poor metabolic control, there are no differences in VA. Furthermore, methotrexate also influences VA in RA patients. This shows that implemented therapies may have an impact on not only the inflammatory state of the joint but also CVD risk.
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Affiliation(s)
- Gabriel-Santiago Rodríguez-Vargas
- Research Institute, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
- Rheumatology, Biomab - Center for Rheumatoid Arthritis, Bogotá, Colombia
- *Correspondence: Gabriel-Santiago Rodríguez-Vargas
| | | | | | | | - Darío Echeverri
- Cardiovascular Prevention Program, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia
| | - Luz-Dary Gutiérrez-Castañeda
- Research Institute, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
- Basic Sciences Laboratory, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
| | | | - Stephania Navarrete
- Basic Sciences Laboratory, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
| | - Anggie Aparicio
- Basic Sciences Laboratory, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá, Colombia
| | - Luis Saenz
- Cardiovascular Prevention Program, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia
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Jae SY, Lee KH, Kim HJ, Kunutsor SK, Heffernan KS, Climie RE, Bunsawat K, Kang M. Separate and Joint Associations of Cardiorespiratory Fitness and Healthy Vascular Aging With Subclinical Atherosclerosis in Men. Hypertension 2022; 79:1445-1454. [PMID: 35535602 DOI: 10.1161/hypertensionaha.122.19016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Achieving healthy vascular aging (HVA) is important for decelerating age-related cardiovascular disease risk. We evaluated the interplay between HVA, cardiorespiratory fitness (CRF), and subclinical atherosclerosis. METHODS We analyzed data on 3722 men who underwent cardiopulmonary exercise testing in a health examination program. HVA was defined as blood pressure <140/90 mm Hg without hypertension and brachial-ankle pulse wave velocity <1266 cm/s. CRF was directly measured by peak oxygen uptake. Subclinical atherosclerosis was defined as coronary artery calcification scores of >0 and ≥100 and a mean carotid artery intima-media thickness (CIMT) >75th percentile for each age group as well as >0.8 mm of CIMT. Separate and joint associations of HVA and CRF with subclinical atherosclerosis were evaluated. RESULTS Each 1 metabolic equivalent increment in CRF was associated with 23% higher odds for having HVA. HVA was associated with lower odds of coronary artery calcification but not CIMT. CRF modified the association between HVA and CIMT>0.8 mm (interaction: P=0.01); HVA was associated with lower odds of CIMT>0.8 mm in fit men with no significant association between HVA and CIMT>0.8 mm in unfit men. Compared with no HVA and being unfit, HVA and being fit was associated with lower odds of subclinical atherosclerosis, but there was no significant association between HVA and being unfit with subclinical atherosclerosis. CONCLUSIONS HVA and higher CRF are each associated with a lower risk of subclinical atherosclerosis in men. Higher CRF is associated with a higher prevalence of HVA and may modify the association between HVA and subclinical atherosclerosis.
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Affiliation(s)
- Sae Young Jae
- Department of Sport Science (S.Y.J., H.J.K.), University of Seoul, Republic of Korea.,Division of Urban Social Health, Graduate School of Urban Public Health (S.Y.J.), University of Seoul, Republic of Korea
| | - Kyung Hyun Lee
- Department of Digital Health, SAIHST, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (K.H.L., M.K.)
| | - Hyun Jeong Kim
- Department of Sport Science (S.Y.J., H.J.K.), University of Seoul, Republic of Korea
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, United Kingdom (S.K.K.).,Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, United Kingdom (S.K.K.)
| | | | - Rachel E Climie
- Menzies Institute for Medical Research, University of Tasmania, Hobart TAS, Australia (R.E.C.)
| | - Kanokwan Bunsawat
- Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City (K.B.).,Geriatric Research, Education, and Clinical Center, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah (K.B.)
| | - Mira Kang
- Department of Digital Health, SAIHST, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (K.H.L., M.K.).,Health Promotion Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (M.K.).,Digital Innovation Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Seoul, Republic of Korea (M.K.)
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Adam CA, Anghel R, Marcu DTM, Mitu O, Roca M, Mitu F. Impact of Sodium–Glucose Cotransporter 2 (SGLT2) Inhibitors on Arterial Stiffness and Vascular Aging—What Do We Know So Far? (A Narrative Review). Life (Basel) 2022; 12:life12060803. [PMID: 35743834 PMCID: PMC9224553 DOI: 10.3390/life12060803] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 11/23/2022] Open
Abstract
Vascular aging, early vascular aging or supernormal vascular aging are concepts used for estimating the cardiovascular risk at a certain age. From the famous line of Thomas Sydenham that “a man is as old as his arteries” to the present day, clinical studies in the field of molecular biology of the vasculature have demonstrated the active role of vascular endothelium in the onset of cardiovascular diseases. Arterial stiffness is an important cardiovascular risk factor associated with the occurrence of cardiovascular events and a high risk of morbidity and mortality, especially in the presence of diabetes. Sodium–glucose cotransporter 2 inhibitors decrease arterial stiffness and vascular resistance by decreasing endothelial cell activation, stimulating direct vasorelaxation and ameliorating endothelial dysfunction or expression of pro-atherogenic cells and molecules.
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Affiliation(s)
- Cristina Andreea Adam
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr. 14, 700661 Iaşi, Romania; (C.A.A.); (R.A.); (M.R.); (F.M.)
| | - Razvan Anghel
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr. 14, 700661 Iaşi, Romania; (C.A.A.); (R.A.); (M.R.); (F.M.)
- Department of Internal Medicine, University of Medicine and Pharmacy, Grigore T. Popa, University Street nr. 16, 700115 Iaşi, Romania
| | - Dragos Traian Marius Marcu
- Department of Internal Medicine, University of Medicine and Pharmacy, Grigore T. Popa, University Street nr. 16, 700115 Iaşi, Romania
- Correspondence: (D.T.M.M.); (O.M.)
| | - Ovidiu Mitu
- Department of Internal Medicine, University of Medicine and Pharmacy, Grigore T. Popa, University Street nr. 16, 700115 Iaşi, Romania
- Sf. Spiridon Clinical Emergency Hospital, Independence Boulevard nr. 1, 700111 Iasi, Romania
- Correspondence: (D.T.M.M.); (O.M.)
| | - Mihai Roca
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr. 14, 700661 Iaşi, Romania; (C.A.A.); (R.A.); (M.R.); (F.M.)
- Department of Internal Medicine, University of Medicine and Pharmacy, Grigore T. Popa, University Street nr. 16, 700115 Iaşi, Romania
| | - Florin Mitu
- Clinical Rehabilitation Hospital, Cardiovascular Rehabilitation Clinic, Pantelimon Halipa Street nr. 14, 700661 Iaşi, Romania; (C.A.A.); (R.A.); (M.R.); (F.M.)
- Department of Internal Medicine, University of Medicine and Pharmacy, Grigore T. Popa, University Street nr. 16, 700115 Iaşi, Romania
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Rotar O, Boyarinova M, Moguchaya E, Tolkunova K, Kolosov N, Rezapova V, Freylikhman O, Usoltsev D, Melnik O, Sergushichev A, Solntsev V, Kostareva A, Dubinina E, Voortman T, Stevens C, Daly MJ, Konradi A, Shlyakhto E, Artomov M. Case Report: Supernormal Vascular Aging in Leningrad Siege Survivors. Front Cardiovasc Med 2022; 9:843439. [PMID: 35677697 PMCID: PMC9170230 DOI: 10.3389/fcvm.2022.843439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 02/18/2022] [Indexed: 12/02/2022] Open
Abstract
Age-related changes in the vascular system play an important role in the biological age and lifespan of a person and maybe affected from an early age onward. One of the indicators of changes in the vascular system is arterial wall stiffness and its main measure, i.e., carotid-femoral pulse wave velocity (cfPWV). We examined arterial wall stiffness in a sample of 305 Leningrad Siege survivors to assess how hunger and stressful conditions during fetal development and early childhood affected the state of the cardiovascular system at a later age and what factors may neutralize the negative impact sustained in early childhood. Here, we presented an evaluation of two unique patients with supernormal vascular aging (SUPERNOVA) phenotype from this cohort and described the details of congruence between hereditary resistance and practiced lifestyle yielding slower biological aging rate.
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Affiliation(s)
- Oxana Rotar
- Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Maria Boyarinova
- Almazov National Medical Research Centre, Saint Petersburg, Russia
| | | | | | - Nikita Kolosov
- Almazov National Medical Research Centre, Saint Petersburg, Russia
- ITMO University, Saint Petersburg, Russia
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, United States
| | - Valeriia Rezapova
- Almazov National Medical Research Centre, Saint Petersburg, Russia
- ITMO University, Saint Petersburg, Russia
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, United States
| | - Olga Freylikhman
- Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Dmitrii Usoltsev
- Almazov National Medical Research Centre, Saint Petersburg, Russia
- ITMO University, Saint Petersburg, Russia
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, United States
| | - Olesya Melnik
- Almazov National Medical Research Centre, Saint Petersburg, Russia
| | | | | | - Anna Kostareva
- Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Elena Dubinina
- Herzen State Pedagogical University of Russia, Saint Petersburg, Russia
- V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, Saint Petersburg, Russia
| | - Trudy Voortman
- Erasmus Medical Center, Rotterdam, Netherlands
- Division of Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Christine Stevens
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, United States
| | - Mark J. Daly
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, United States
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, United States
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Alexandra Konradi
- Almazov National Medical Research Centre, Saint Petersburg, Russia
- ITMO University, Saint Petersburg, Russia
| | - Evgeny Shlyakhto
- Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Mykyta Artomov
- Almazov National Medical Research Centre, Saint Petersburg, Russia
- ITMO University, Saint Petersburg, Russia
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, United States
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, United States
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
- *Correspondence: Mykyta Artomov
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Gómez-Sánchez L, Gómez-Sánchez M, Rodríguez-Sánchez E, Patino-Alonso C, Alonso-Dominguez R, Sanchez-Aguadero N, Lugones-Sánchez C, Llamas-Ramos I, García-Ortiz L, Gómez-Marcos MA. Relationship of Different Anthropometric Indices with Vascular Ageing in an Adult Population without Cardiovascular Disease-EVA Study. J Clin Med 2022; 11:jcm11092671. [PMID: 35566797 PMCID: PMC9105296 DOI: 10.3390/jcm11092671] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/04/2022] [Accepted: 05/06/2022] [Indexed: 02/01/2023] Open
Abstract
The objectives of this study were to analyse the capacity of different anthropometric indices to predict vascular ageing and this association in Spanish adult population without cardiovascular disease. A total of 501 individuals without cardiovascular disease residing in the capital of Salamanca (Spain) were selected (mean age: 55.9 years, 50.3% women), through stratified random sampling by age and sex. Starting from anthropometric measurements such as weight, height, and waist circumference, hip circumference, or biochemical parameters, we could estimate different indices that reflected general obesity, abdominal obesity, and body fat distribution. Arterial stiffness was evaluated by measuring carotid-femoral pulse wave velocity (cf-PWV) using a SphygmoCor® device. Vascular ageing was defined in three steps: Step 1: the participants with vascular injury were classified as early vascular ageing (EVA); Step 2: classification of the participants using the 10 and 90 percentiles of cf-PWV in the study population by age and sex in EVA, healthy vascular ageing (HVA) and normal vascular ageing (NVA); Step 3: re-classification of participants with arterial hypertension or type 2 diabetes mellitus included in HVA as NVA. The total prevalence of HVA and EVA was 8.4% and 21.4%, respectively. All the analysed anthropometric indices, except waist/hip ratio (WHpR), were associated with vascular ageing. Thus, as the values of the different anthropometric indices increase, the probability of being classified with NVA and as EVA increases. The capacity of the anthropometric indices to identify people with HVA showed values of area under the curve (AUC) ≥ 0.60. The capacity to identify people with EVA, in total, showed values of AUC between 0.55 and 0.60. In conclusion, as the values of the anthropometric indices increased, the probability that the subjects presented EVA increased. However, the relationship of the new anthropometric indices with vascular ageing was not stronger than that of traditional parameters. Therefore, BMI and WC can be considered to be the most useful indices in clinical practice to identify people with vascular ageing in the general population.
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Affiliation(s)
- Leticia Gómez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
| | - Marta Gómez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Health Service of Castile and Leon (SACyL), 37007 Salamanca, Spain
- Department of Medicine, University of Salamanca, 37008 Salamanca, Spain
| | - Carmen Patino-Alonso
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Statistics Department, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain
| | - Rosario Alonso-Dominguez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, 37008 Salamanca, Spain
| | - Natalia Sanchez-Aguadero
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, 37008 Salamanca, Spain
| | - Cristina Lugones-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
| | - Ines Llamas-Ramos
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Health Service of Castile and Leon (SACyL), 37007 Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, 37008 Salamanca, Spain
| | - Luis García-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Health Service of Castile and Leon (SACyL), 37007 Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, 37008 Salamanca, Spain
| | - Manuel A. Gómez-Marcos
- Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain; (L.G.-S.); (M.G.-S.); (E.R.-S.); (C.P.-A.); (R.A.-D.); (N.S.-A.); (C.L.-S.); (I.L.-R.); (L.G.-O.)
- Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain
- Health Service of Castile and Leon (SACyL), 37007 Salamanca, Spain
- Department of Medicine, University of Salamanca, 37008 Salamanca, Spain
- Correspondence: ; Tel.: +34-923-124465
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Pierce GL, Coutinho TA, DuBose LE, Donato AJ. Is It Good to Have a Stiff Aorta with Aging? Causes and Consequences. Physiology (Bethesda) 2022; 37:154-173. [PMID: 34779281 PMCID: PMC8977146 DOI: 10.1152/physiol.00035.2021] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/28/2021] [Accepted: 11/08/2021] [Indexed: 01/09/2023] Open
Abstract
Aortic stiffness increases with advancing age, more than doubling during the human life span, and is a robust predictor of cardiovascular disease (CVD) clinical events independent of traditional risk factors. The aorta increases in diameter and length to accommodate growing body size and cardiac output in youth, but in middle and older age the aorta continues to remodel to a larger diameter, thinning the pool of permanent elastin fibers, increasing intramural wall stress and resulting in the transfer of load bearing onto stiffer collagen fibers. Whereas aortic stiffening in early middle age may be a compensatory mechanism to normalize intramural wall stress and therefore theoretically "good" early in the life span, the negative clinical consequences of accelerated aortic stiffening beyond middle age far outweigh any earlier physiological benefit. Indeed, aortic stiffness and the loss of the "windkessel effect" with advancing age result in elevated pulsatile pressure and flow in downstream microvasculature that is associated with subclinical damage to high-flow, low-resistance organs such as brain, kidney, retina, and heart. The mechanisms of aortic stiffness include alterations in extracellular matrix proteins (collagen deposition, elastin fragmentation), increased arterial tone (oxidative stress and inflammation-related reduced vasodilators and augmented vasoconstrictors; enhanced sympathetic activity), arterial calcification, vascular smooth muscle cell stiffness, and extracellular matrix glycosaminoglycans. Given the rapidly aging population of the United States, aortic stiffening will likely contribute to substantial CVD burden over the next 2-3 decades unless new therapeutic targets and interventions are identified to prevent the potential avalanche of clinical sequelae related to age-related aortic stiffness.
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Affiliation(s)
- Gary L Pierce
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa
- Abboud Cardiovascular Research Center, University of Iowa, Iowa City, Iowa
- Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa
| | - Thais A Coutinho
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Divisions of Cardiology and Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Lyndsey E DuBose
- Division of Geriatrics, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Anthony J Donato
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
- Department of Biochemistry, University of Utah, Salt Lake City, Utah
- Geriatric Research Education and Clinical Center, VA Salt Lake City, Salt Lake City, Utah
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Llamas-Ramos I, Llamas-Ramos R, Alonso-Domínguez R, Gómez-Sánchez L, Tamayo-Morales O, Lugones-Sánchez C, Rodríguez-Sánchez E, García-Ortiz L, Gómez-Marcos MA. Sedentary Behaviour and Its Relationship with Early Vascular Ageing in the General Spanish Population: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095450. [PMID: 35564843 PMCID: PMC9101612 DOI: 10.3390/ijerph19095450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 12/04/2022]
Abstract
Sedentary behaviour is associated with a greater predisposition to developing cardiovascular diseases. The aim of the study was to analyse the relationship between sedentary time and early vascular ageing. A total of 501 participants (49.70% men) were recruited through random sampling stratified by age group and sex. Vascular ageing was evaluated considering three criteria: (1) the vascular ageing index (VAI); (2) the carotid−femoral pulse wave velocity (cfPWV) 10th and 90th percentiles of the reference values in the European population by age; and (3) the Framingham’s heart age. The carotid intima−media thickness was measured using a Sonosite Micromaxx ultrasound, the presence of peripheral artery disease was assessed by calculating the ankle−brachial index using a VaSera VS-1500, and the cfPWV was measured with a SphygmoCor® device. Weekly sedentary hours were evaluated through a sitting time questionnaire. The average age of the population was 55.90 ± 14.24 years. The men spent more hours sitting per week (47.6 ± 16.6 vs. 36.8 ± 17.3 h/W), at work (16.7 ± 16.2 vs. 9.73 ± 14.9 h/W), and watching TV (21.6 ± 12.5 vs. 18.7 ± 11.9 h/W). In the logistic regression analysis, the individuals with early vascular aging (EVA), with respect to those with healthy vascular aging (HVA), spent more hours sitting per week (OR = 1.03 vs. OR = 1.02; p < 0.05) and watching TV (OR = 1.03 vs. OR = 1.03; p < 0.05), using the criteria of the European guideline and VAI, and more hours sitting when commuting (OR = 1.04; p < 0.05), using Framingham’s heart age to define EVA. The results of this study indicate that sedentary time is associated with early vascular ageing. Therefore, reducing sedentary time would improve vascular health.
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Affiliation(s)
- Inés Llamas-Ramos
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
- Department of Nursing and Physiotherapy, Universidad de Salamanca, 37007 Salamanca, Spain
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
- University Hospital of Salamanca, 37007 Salamanca, Spain
- Correspondence: ; Tel.: +34-663005052
| | - Rocío Llamas-Ramos
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
- Department of Nursing and Physiotherapy, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Rosario Alonso-Domínguez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
- Department of Nursing and Physiotherapy, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Leticia Gómez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
| | - Olaya Tamayo-Morales
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
| | - Cristina Lugones-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
| | - Emiliano Rodríguez-Sánchez
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
- Department of Medicine, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Luis García-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Manuel A. Gómez-Marcos
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), 37005 Salamanca, Spain; (R.L.-R.); (R.A.-D.); (L.G.-S.); (O.T.-M.); (C.L.-S.); (E.R.-S.); (L.G.-O.); (M.A.G.-M.)
- Health Service of Castilla and Leon (SACyL), 37005 Salamanca, Spain
- Department of Medicine, Universidad de Salamanca, 37007 Salamanca, Spain
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Paapstel K, Kals J. Metabolomics of Arterial Stiffness. Metabolites 2022; 12:370. [PMID: 35629874 PMCID: PMC9146333 DOI: 10.3390/metabo12050370] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 12/18/2022] Open
Abstract
Arterial stiffness (AS) is one of the earliest detectable signs of structural and functional alterations of the vessel wall and an independent predictor of cardiovascular events and death. The emerging field of metabolomics can be utilized to detect a wide spectrum of intermediates and products of metabolism in body fluids that can be involved in the pathogenesis of AS. Research over the past decade has reinforced this idea by linking AS to circulating acylcarnitines, glycerophospholipids, sphingolipids, and amino acids, among other metabolite species. Some of these metabolites influence AS through traditional cardiovascular risk factors (e.g., high blood pressure, high blood cholesterol, diabetes, smoking), while others seem to act independently through both known and unknown pathophysiological mechanisms. We propose the term 'arteriometabolomics' to indicate the research that applies metabolomics methods to study AS. The 'arteriometabolomics' approach has the potential to allow more personalized cardiovascular risk stratification, disease monitoring, and treatment selection. One of its major goals is to uncover the causal metabolic pathways of AS. Such pathways could represent valuable treatment targets in vascular ageing.
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Affiliation(s)
- Kaido Paapstel
- Endothelial Research Centre, University of Tartu, 8 Puusepa Street, 51014 Tartu, Estonia;
- Department of Cardiology, Institute of Clinical Medicine, University of Tartu, 8 Puusepa Street, 51014 Tartu, Estonia
- Heart Clinic, Tartu University Hospital, 8 Puusepa Street, 51014 Tartu, Estonia
| | - Jaak Kals
- Endothelial Research Centre, University of Tartu, 8 Puusepa Street, 51014 Tartu, Estonia;
- Department of Surgery, Institute of Clinical Medicine, University of Tartu, 8 Puusepa Street, 51014 Tartu, Estonia
- Surgery Clinic, Tartu University Hospital, 8 Puusepa Street, 51014 Tartu, Estonia
- Department of Biochemistry, Institute of Biomedicine and Translational Medicine, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, 19 Ravila Street, 50411 Tartu, Estonia
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Eriksson JG, Salonen MK, von Bonsdorff MB, Wasenius N, Kajantie E, Kautiainen H, Mikkola TM. Adiposity-Related Predictors of Vascular Aging From a Life Course Perspective–Findings From the Helsinki Birth Cohort Study. Front Cardiovasc Med 2022; 9:865544. [PMID: 35498003 PMCID: PMC9047949 DOI: 10.3389/fcvm.2022.865544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/24/2022] [Indexed: 11/23/2022] Open
Abstract
The main objective of this study was to study predictors of vascular health with focus on adiposity-related factors. Glucose metabolism, blood lipids, inflammatory markers and body composition were assessed 15 years before assessment of vascular health which was assessed with pulse wave velocity (PWV) in 660 subjects born 1934–44. In a univariate analysis in women the strongest association with PWV was seen for age, systolic blood pressure, dysglycemia, dyslipidemia, inflammatory markers and body fat percentage measured in late midlife and PWV measured 15 years later. In men age, body mass index (BMI), systolic blood pressure, dysglycemia, and body fat percentage in late midlife were associated with PWV. One novel finding was that adiposity-related factors were strong predictors of vascular health, something not fully encapsulated in BMI, lean body mass or body fat percentage alone. A higher fat mass index was associated with worse vascular health, which was not ameliorated by a higher lean mass index. Our findings stress the importance to study body composition and fat and lean body mass simultaneously because of their close interaction with each other also in relation to vascular health.
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Affiliation(s)
- Johan G. Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Department of Obstetrics and Gynecology and Human Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- *Correspondence: Johan G. Eriksson
| | - Minna K. Salonen
- Folkhälsan Research Center, Helsinki, Finland
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Mikaela B. von Bonsdorff
- Folkhälsan Research Center, Helsinki, Finland
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Niko Wasenius
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Eero Kajantie
- Department of Public Health Solutions, Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Hannu Kautiainen
- Folkhälsan Research Center, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tuija M. Mikkola
- Folkhälsan Research Center, Helsinki, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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48
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Relationship between Arterial Stiffness and Renal Function Determined by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) Equations in a Chinese Cohort Undergoing Health Examination. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8218053. [PMID: 35321070 PMCID: PMC8938063 DOI: 10.1155/2022/8218053] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/26/2022] [Indexed: 12/02/2022]
Abstract
Background The association between arterial stiffness and cardiovascular risk in CKD and ESRD patients is well established. However, the relationship between renal function estimation and properties of large arteries is unclear due to the four different methods used to quantify glomerular filtration. This study investigated the relationship between carotid-femoral pulse wave velocity (c-fPWV), as a measure of arterial stiffness, and accepted metrics of renal function. Methods This cross-sectional study was conducted in 431 health examination individuals in China, enrolled from January 2017 to June 2019. c-fPWV and blood pressure were measured, and blood samples were obtained for all participants. Four different methods were used to determine the estimated glomerular filtration rate (eGFR) as described by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations: (i) CKD-EPISCr formula based on SCr, (ii) CKD-EPICysC formula based on CysC, (iii) CKD-EPISCr/CysC formula based on Cr and CysC, and (iv) MDRD. Results Of all of the study participants (average age 53.1 ± 13.0 years, 68.1% male), 23.7% had diabetes mellitus and 66.6% had hypertension. The average eGFR values determined by the CKD-EPISCr, CKD-EPICysC, CKD-EPISCr/CysC, and MDRD equations were 91.9 ± 15.6, 86.8 ± 21.4, 89.6 ± 18.3, and 90.7 ± 16.6 ml/min/1.73m2, respectively. c-fPWV was significantly and negatively correlated with eGFR determined by CKD-EPISCr (r = −0.336, P < 0.001), CKD-EPICysC (r = −0.385, P < 0.001), CKD-EPISCr/CysC (r = −0.378, P < 0.001), and MDRD (r = −0.219, P < .001) equations. After adjusting for confounding factors, c-fPWV remained significantly and negatively correlated with eGFR determined by the CKD-EPICysC equation (β = −0.105, P = 0.042) and significantly and positively correlated with age (β = 0.349, P ≤ 0.01), systolic pressure (β = 0.276, P ≤ 0.01), and hypoglycemic drugs (β = 0.101, P = 0.019). Conclusion In a health examination population in China, c-fPWV is negatively correlated with eGFR determined by four different equations; however, only the metric of eGFR determined by the equation for CKD-EPICysC showed an independent relation with c-fPWV.
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Evsevyeva MY, Eremin MV, Rostovtseva MV, Sergeeva OV, Rusidi AV, Kudryavtseva VD, Shchetinin EV. Preventive Screening of Young People from the Perspective of Vascular Aging Phenotypes: the Role of Body Weight. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2022. [DOI: 10.20996/1819-6446-2022-02-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim. To study the cardiovascular stiffness index CAVI in relation to main risk factors (RF) in young people from the point of their vascular aging phenotype and gender.Material and methods. 264 young people (93 boys and 171 girls) at age of 18 to 25 years were examined. Vascular screening was performed with evaluating of CAVI. All subjects were divided into tertile groups for this indicator, taking into account gender. Such interval analysis of gender- and age- homogeneous sample allows to identify carriers of the phenotypes of premature (upper CAVI-tercile), normal (middle CAVI-tercile), and favorable or healthy (low CAVI-tercile) vascular aging. The first of them is also called EVA (early vascular aging) syndrome. In these groups, the incidence of carriers of insufficient, normal body mass (BM) and overweight were estimated. In three groups formed by BM indicator, the parameters of CAVI, hemodynamic and metabolic status in response to changes in BM were determined.Results. Among of the presented RF, the correlation was significant for CAVI with a weight -0.428 (p<0.001) for R-CAVI, -0.453 (p<0.001) for L- CAVI, and even more significant with the BM index - at the level of -0.410 (p<0.001) for R-CAVI and -0.462 (p<0.001) for L-CAVI. This connection is found in boys. Among boys and girls with excessive BM, the most favorable vascular aging phenotype is observed 2.7 and 2.2 times more often than the EVA syndrome. In contrast, among girls with insufficient BM, a favorable vascular phenotype is detected almost twice rarely as compared with EVA syndrome. In similar group of boys, a healthy vascular phenotype is not observed at all. Among normal-weight boys and girls, the occurrence of the two extreme vascular phenotypes is almost identical. The arterial rigidity decrease on the background of BM increase occurs despite the сhanges of hemo- dynamic and metabolic indicators. This changes are especially pronounced in girls. The difference between the extreme weight categories in terms of R- CAVI and L-CAVI for boys was 1.4, while for girls it was only 0.3 for R-CAVI and 0.4 for L-CAVI.Conclusion. When carrying out preventive measures among young people, one should not limit oneself to evaluating only traditional RF. Based on the concept of vascular aging, angiological screening should be more widely implemented. It will allow for more individualized preventive interventions among young people in the future.
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Yan Y, Cao Y, Ma Q, Wang K, Liao Y, Sun Y, Chen C, Hu J, Zheng W, Chu C, Wang Y, Mu J. Long-Term Blood Pressure Exposure From Childhood and Early Vascular Aging in Midlife: A 30-Year Prospective Cohort Study. Angiology 2022; 73:869-876. [PMID: 35232270 DOI: 10.1177/00033197221082712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Early vascular aging (EVA) increases cardiovascular mortality, but its long-term determinants are unknown. We included 2098 participants with ≥4 blood pressure (BP) measurements from childhood to adulthood (from the Hanzhong Adolescent Hypertension Cohort study) to investigate the impact of child-to-adult cumulative BP exposure on EVA patterns in midlife. Participants with EVA had significantly higher long-term BP burden than those with normal vascular age in midlife despite being much younger. Child-to-adult cumulative burden and trends of systolic and diastolic BP were associated with vascular age (standardized regression coefficient [β] = .31 to .53; P < .001 for all). Higher cumulative systolic and diastolic BP exposure significantly increased the risk of EVA in midlife (odds ratio, OR=1.67 to 2.75, P < .05 for all). All associations were independent of socio-demographics and cardiovascular risk factors. Excluding participants who were receiving anti-hypertensive, antidiabetic, or lipid-lowering treatments did not substantially change the above associations. This study, for the first time, reported that high cumulative child-to-adult BP exposure accelerated the vascular aging process. Stabilizing BP across life course could be beneficial to vascular health in the long run.
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Affiliation(s)
- Yu Yan
- Department of Cardiology, First Affiliated Hospital of Medical School, 162798Xi'an Jiaotong University, Key Laboratory of Molecular Cardiology of Shaanxi Province, Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Shaanxi, China
| | - Yu Cao
- Department of Pediatrics, First Affiliated Hospital of Medical School, 162798Xi'an Jiaotong University, Xi'an, China
| | - Qiong Ma
- Department of Cardiology, First Affiliated Hospital of Medical School, 162798Xi'an Jiaotong University, Key Laboratory of Molecular Cardiology of Shaanxi Province, Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Shaanxi, China
| | - Keke Wang
- Department of Cardiology, First Affiliated Hospital of Medical School, 162798Xi'an Jiaotong University, Key Laboratory of Molecular Cardiology of Shaanxi Province, Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Shaanxi, China
| | - Yueyuan Liao
- Department of Cardiology, First Affiliated Hospital of Medical School, 162798Xi'an Jiaotong University, Key Laboratory of Molecular Cardiology of Shaanxi Province, Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Shaanxi, China
| | - Yue Sun
- Department of Cardiology, First Affiliated Hospital of Medical School, 162798Xi'an Jiaotong University, Key Laboratory of Molecular Cardiology of Shaanxi Province, Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Shaanxi, China
| | - Chen Chen
- Department of Cardiology, First Affiliated Hospital of Medical School, 162798Xi'an Jiaotong University, Key Laboratory of Molecular Cardiology of Shaanxi Province, Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Shaanxi, China
| | - Jiawen Hu
- Department of Cardiovascular Surgery, First Affiliated Hospital of Medical School, 162798Xi'an Jiaotong University, Xi'an, China
| | - Wenling Zheng
- Department of Cardiology, First Affiliated Hospital of Medical School, 162798Xi'an Jiaotong University, Key Laboratory of Molecular Cardiology of Shaanxi Province, Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Shaanxi, China
| | - Chao Chu
- Department of Cardiology, First Affiliated Hospital of Medical School, 162798Xi'an Jiaotong University, Key Laboratory of Molecular Cardiology of Shaanxi Province, Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Shaanxi, China
| | - Yang Wang
- Department of Cardiology, First Affiliated Hospital of Medical School, 162798Xi'an Jiaotong University, Key Laboratory of Molecular Cardiology of Shaanxi Province, Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Shaanxi, China
| | - Jianjun Mu
- Department of Cardiology, First Affiliated Hospital of Medical School, 162798Xi'an Jiaotong University, Key Laboratory of Molecular Cardiology of Shaanxi Province, Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Shaanxi, China
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