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Marshall AG, Neikirk K, Afolabi J, Mwesigwa N, Shao B, Kirabo A, Reddy AK, Hinton A. Update on the Use of Pulse Wave Velocity to Measure Age-Related Vascular Changes. Curr Hypertens Rep 2024; 26:131-140. [PMID: 38159167 PMCID: PMC10955453 DOI: 10.1007/s11906-023-01285-x] [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] [Accepted: 11/08/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE OF REVIEW Pulse wave velocity (PWV) is an important and well-established measure of arterial stiffness that is strongly associated with aging. Age-related alterations in the elastic properties and integrity of arterial walls can lead to cardiovascular disease. PWV measurements play an important role in the early detection of these changes, as well as other cardiovascular disease risk factors, such as hypertension. This review provides a comprehensive summary of the current knowledge of the effects of aging on arterial stiffness, as measured by PWV. RECENT FINDINGS This review highlights recent findings showing the applicability of PWV analysis for investigating heart failure, hypertension, and other cardiovascular diseases, as well as cerebrovascular diseases and Alzheimer's disease. It also discusses the clinical implications of utilizing PWV to monitor treatment outcomes, various challenges in implementing PWV assessment in clinical practice, and the development of new technologies, including machine learning and artificial intelligence, which may improve the usefulness of PWV measurements in the future. Measuring arterial stiffness through PWV remains an important technique to study aging, especially as the technology continues to evolve. There is a clear need to leverage PWV to identify interventions that mitigate age-related increases in PWV, potentially improving CVD outcomes and promoting healthy vascular aging.
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Affiliation(s)
- Andrea G Marshall
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Kit Neikirk
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Jeremiah Afolabi
- Department of Medicine, Vanderbilt University Medical Center, 750 Robinson Research Building, 2200 Pierce Ave, Nashville, TN, 37232-0615, USA
| | - Naome Mwesigwa
- Department of Medicine, Vanderbilt University Medical Center, 750 Robinson Research Building, 2200 Pierce Ave, Nashville, TN, 37232-0615, USA
| | - Bryanna Shao
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Annet Kirabo
- Department of Medicine, Vanderbilt University Medical Center, 750 Robinson Research Building, 2200 Pierce Ave, Nashville, TN, 37232-0615, USA
| | - Anilkumar K Reddy
- Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
| | - Antentor Hinton
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA.
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Liao C, Chuang S, Cheng H, Lin C, Chen C. Aortic Characteristic Impedance and Suspected Mild Cognitive Impairment in a Community-Based Healthy Population. J Am Heart Assoc 2024; 13:e032268. [PMID: 38156549 PMCID: PMC10863810 DOI: 10.1161/jaha.123.032268] [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: 08/19/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Aging of the proximal aorta can lead to increased pressure and flow pulsatility in the cerebral microcirculation, which may cause cognitive impairment. This study investigated the association between aortic characteristic impedance (Zc), an indicator of regional stiffness of the proximal aorta, and suspected mild cognitive impairment (MCI), compared with carotid-femoral pulse wave velocity (CFPWV). METHODS AND RESULTS A total of 1461 healthy community residents (46.4% men; age range, 35-96 years [mean±SD, 59.9±11.8 years]) without a history of cardiovascular events or stroke were included in the study. Zc was estimated using applanation tonometry and echocardiography. Cognitive function was assessed using the Mini-Mental State Examination. Education-adjusted cut points were used to define suspected MCI. Subjects with suspected MCI (n=493 [33.7%]) had significantly higher Zc and CFPWV than those without. In multivariable analysis, both Zc and CFPWV were inversely associated with Mini-Mental State Examination score. Zc (odds ratio per 1 SD, 1.22 [95% CI, 1.09-1.37] and CFPWV (odds ratio per 1 SD, 1.18 [95% CI, 1.01-1.38]) was also significantly associated with suspected MCI, after adjusting for age, sex, education level, mean arterial pressure, hypertension, diabetes, low-density lipoprotein cholesterol, and smoking status. In joint analysis, Zc was significantly associated with suspected MCI, but CFPWV was not. In the age subgroups of <50 years and 50 to 70 years, only Zc was significantly associated with suspected MCI. CONCLUSIONS This study found that Zc was significantly associated with Mini-Mental State Examination score and suspected MCI, especially in younger and middle-aged adults. These findings suggest that Zc may be a useful biomarker for identifying individuals at risk for MCI.
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Affiliation(s)
- Chao‐Feng Liao
- Institute of Public Health, National Yang Ming Chiao Tung University College of MedicineTaipeiTaiwan, R.O.C.
| | - Shao‐Yuan Chuang
- Institute of Population Health Science, National Health Research InstituteMiaoliTaiwan, R.O.C.
| | - Hao‐Min Cheng
- Program of Interdisciplinary MedicineNational Yang Ming Chiao Tung University College of MedicineTaipeiTaiwan, R.O.C.
- Division of Faculty Development, Department of Medical EducationTaipei Veterans General HospitalTaipeiTaiwan, R.O.C.
| | - Chen‐Hua Lin
- Institute of Public Health, National Yang Ming Chiao Tung University College of MedicineTaipeiTaiwan, R.O.C.
| | - Chen‐Huan Chen
- Institute of Public Health, National Yang Ming Chiao Tung University College of MedicineTaipeiTaiwan, R.O.C.
- Department of MedicineNational Yang Ming Chiao Tung University College of MedicineTaipeiTaiwan, R.O.C.
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Lindseth KT, Gerdts E, Midtbø H, Pristaj N, Cramariuc D, Einarsen E. Myocardial Work in Middle-Aged Adults with Overweight and Obesity: Associations with Sex and Central Arterial Stiffness. J Clin Med 2023; 12:5676. [PMID: 37685743 PMCID: PMC10488455 DOI: 10.3390/jcm12175676] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 08/15/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
We explored global myocardial work index (GWI), a novel measure of myocardial function that integrates left ventricular (LV) hemodynamic load, in relation to sex and increased body mass index (BMI). We used data from 467 individuals (61% women, average age 47 ± 9 years and BMI 31.2 kg/m2) without known cardiac disease. Central arterial function was analysed by applanation tonometry. GWI was calculated from global longitudinal strain (GLS) and post-echocardiography supine blood pressure (BP). Covariables of GWI were identified in linear regression analyses. Women had higher BMI, aortic augmentation pressure (12 ± 7 vs. 8 ± 6 mmHg), LV GLS (20.0 ± 2.8 vs. 18.8 ± 2.8%), and GWI (2126 ± 385 vs. 2047 ± 389 mmHg%) than men (all p < 0.05). In univariable analyses, higher GWI was associated with female sex, higher age, systolic BP, LV wall stress, LV ejection fraction, left atrial size, LV ejection time, and with lower waist circumference (all p < 0.05). In multivariable analysis, adjusting for these correlates, female sex remained independently associated with higher GWI (β = 0.13, p = 0.007). After additional adjustment for aortic augmentation pressure or central pulse pressure, this association became non-significant. In conclusion, the higher GWI in women compared to men was mainly explained by increased LV workload due to higher aortic augmentation pressure in women.
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Affiliation(s)
- Katrine Tryti Lindseth
- Center for Research on Cardiac Disease in Women, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway; (K.T.L.)
| | - Eva Gerdts
- Center for Research on Cardiac Disease in Women, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway; (K.T.L.)
| | - Helga Midtbø
- Department of Heart Disease, Haukeland University Hospital, 5021 Bergen, Norway; (H.M.); (D.C.)
| | - Nadia Pristaj
- Center for Research on Cardiac Disease in Women, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway; (K.T.L.)
| | - Dana Cramariuc
- Department of Heart Disease, Haukeland University Hospital, 5021 Bergen, Norway; (H.M.); (D.C.)
| | - Eigir Einarsen
- Department of Medicine, Nordland Hospital Trust, Vesterålen Hospital, 8450 Stokmarknes, Norway;
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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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Bruno RM, Varbiro S, Pucci G, Nemcsik J, Lønnebakken MT, Kublickiene K, Schluchter H, Park C, Mozos I, Guala A, Hametner B, Seeland U, Boutouyrie P. Vascular function in hypertension: does gender dimension matter? J Hum Hypertens 2023; 37:634-643. [PMID: 37061653 DOI: 10.1038/s41371-023-00826-w] [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: 07/28/2022] [Revised: 02/27/2023] [Accepted: 03/27/2023] [Indexed: 04/17/2023]
Abstract
Blood pressure and vascular ageing trajectories differ between men and women. These differences develop due to sex-related factors, attributable to sex chromosomes or sex hormones, and due to gender-related factors, mainly related to different sociocultural behaviors. The present review summarizes the relevant facts regarding gender-related differences in vascular function in hypertension. Among sex-related factors, endogenous 17ß-estradiol plays a key role in protecting pre-menopausal women from vascular ageing. However, as vascular ageing (preceding and inducing hypertension) has a steeper increase in women than in men starting already from the third decade, it is likely that gender-related factors play a prominent role, especially in the young. Among gender-related factors, psychological stress (including that one related to gender-based violence and discrimination), depression, some psychological traits, but also low socioeconomic status, are more common in women than men, and their impact on vascular ageing is likely to be greater in women. Men, on the contrary, are more exposed to the vascular adverse consequences of alcohol consumption, as well as of social deprivation, while "toxic masculinity" traits may result in lower adherence to lifestyle and preventive strategies. Unhealthy diet habits are more prevalent in men and smoking is equally prevalent in the two sexes, but have a disproportional negative effect on women's vascular health. In conclusion, given the major and complex role of gender-related factors in driving vascular alterations and blood pressure patterns, gender dimension should be systematically integrated into future research on vascular function and hypertension and to tailor cardiovascular prevention strategies.
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Affiliation(s)
- Rosa-Maria Bruno
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France.
- Pharmacology Unit, Hôpital Européen Georges Pompidou, Paris, France.
| | - Szabolcs Varbiro
- Workgroup for Science Management, Doctoral School, Semmelweis University, Budapest, Hungary
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Giacomo Pucci
- Internal Medicine Unit, "Santa Maria" Terni Hospital and Department of Medicine and Surgery-University of Perugia, Perugia, Italy
| | - János Nemcsik
- Department of Family Medicine and Health Service of Zuglo (ZESZ), Semmelweis University, Budapest, Hungary
| | - Mai Tone Lønnebakken
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Karolina Kublickiene
- Institution for Clinical Science, Intervention and Technology, Department of Renal Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Helena Schluchter
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Chloe Park
- MRC Unit for Lifelong Health and Ageing at UCL, UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Ioana Mozos
- Department of Functional Sciences-Pathophysiology, Center for Translational Research and Systems Medicine, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Andrea Guala
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
| | - Bernhard Hametner
- AIT Austrian Institute of Technology, Center for Health & Bioresources, Vienna, Austria
| | - Ute Seeland
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitaetsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Pierre Boutouyrie
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
- Pharmacology Unit, Hôpital Européen Georges Pompidou, Paris, France
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Mitchell GF, Rong J, Larson MG, Cooper LL, Xanthakis V, Benjamin EJ, Hamburg NM, Vasan RS. Longitudinal Hemodynamic Correlates of and Sex Differences in the Evolution of Blood Pressure Across the Adult Lifespan: The Framingham Heart Study. J Am Heart Assoc 2023:e027329. [PMID: 37318016 DOI: 10.1161/jaha.122.027329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 05/24/2023] [Indexed: 06/16/2023]
Abstract
Background Systolic blood pressure increases with age after midlife, particularly in women, and contributes to development of wide pulse pressure hypertension in middle-aged and older adults. Relative contributions of aortic stiffness and premature wave reflection to increases in pulse pressure remain controversial. Methods and Results We evaluated visit-specific values and change in key correlates of pulse pressure, aortic characteristic impedance, forward and backward wave amplitude, and global reflection coefficient, at 3 sequential examinations of the Framingham Generation 3 (N=4082), Omni-2 (N=410), and New Offspring Spouse (N=103) cohorts (53% women). Data were analyzed using repeated-measures linear mixed models adjusted for age, sex, and risk factor exposures. Pulse pressure increased markedly with age after midlife (age and age-squared terms, P<0.0001), particularly in women (age slope 3.1±0.2 mm Hg/decade higher in women, P<0.0001). In sex-specific models, change in pulse pressure was closely related (all P<0.0001) to baseline (6.7±0.2 and 7.3±0.2 mm Hg/SD in men and women, respectively) and change (11.8±0.1 and 11.7±0.1 mm Hg/SD) in forward wave amplitude, whereas relations with baseline (2.1±0.15 and 2.0±0.14 mm Hg/SD) and change (4.0±0.13 and 3.4±0.11 mm Hg/SD) in global reflection coefficient were weaker. Global reflection coefficient fell as aortic characteristic impedance increased (P<0.0001), consistent with the hypothesis that impedance matching reduces relative wave reflection in the arterial system. Conclusions Proximal aortic stiffening, as assessed by higher aortic characteristic impedance and larger forward wave amplitude, is strongly associated with longitudinal increase in pulse pressure, especially in women, whereas wave reflection has more modest relations.
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Affiliation(s)
| | - Jian Rong
- Boston University and NHLBI's Framingham Study Framingham MA
| | - Martin G Larson
- Boston University and NHLBI's Framingham Study Framingham MA
- Department of Biostatistics Boston University School of Public Health Boston MA
| | | | - Vanessa Xanthakis
- Cardiovascular Engineering Inc. Norwood MA
- Boston University and NHLBI's Framingham Study Framingham MA
| | - Emelia J Benjamin
- Boston University and NHLBI's Framingham Study Framingham MA
- Cardiology and Preventive Medicine Sections, Department of Medicine Boston University Chobanian and Avedisian School of Medicine, Boston Medical Center Boston MA
- Department of Epidemiology Boston University School of Public Health Boston MA
- Evans Department of Medicine Boston MA
- Whitaker Cardiovascular Institute Boston University Chobanian and Avedisian School of Medicine Boston MA
| | - Naomi M Hamburg
- Evans Department of Medicine Boston MA
- Whitaker Cardiovascular Institute Boston University Chobanian and Avedisian School of Medicine Boston MA
| | - Ramachandran S Vasan
- Boston University and NHLBI's Framingham Study Framingham MA
- Cardiology and Preventive Medicine Sections, Department of Medicine Boston University Chobanian and Avedisian School of Medicine, Boston Medical Center Boston MA
- Department of Epidemiology Boston University School of Public Health Boston MA
- Evans Department of Medicine Boston MA
- Whitaker Cardiovascular Institute Boston University Chobanian and Avedisian School of Medicine Boston MA
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Jiang YQ, Zhang HR, Liu BN, Li TW, Jiang JF, Tian W. Ascending aorta dilatation reduces the influence of elevated pulse pressure on left ventricular hypertrophy: findings from a Chinese elderly hypertensive population. J Geriatr Cardiol 2023; 20:100-108. [PMID: 36910245 PMCID: PMC9992952 DOI: 10.26599/1671-5411.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
OBJECTIVE To determine the role of ascending aorta dilatation in the relationship between pulse pressure (PP) and left ventricular (LV) hypertrophy. METHODS A total of 1556 Chinese elderly hypertensive patients were retrospectively studied. Transthoracic echocardiography was used to obtain the aortic and cardiac structure measurements. In addition, brachial blood pressure was measured, and total arterial compliance, systemic vascular resistance, arterial elastance, and end-systolic LV elastance were calculated. The participants were divided into four groups according to the status of ascending aortic diameter and PP. RESULTS LV mass index increased in succession in the four groups, i.e., the group with the normal aorta and lower PP, with the normal aorta and higher PP, with aortic dilatation and lower PP, and with aortic dilatation and higher PP (P trend < 0.001). Total arterial compliance-1, arterial elastance, and end-systolic LV elastance were slightly higher in the individuals with normal aorta compared to those with aortic dilatation, regardless of PP being lower or higher (P < 0.01). Compared to the group with the normal aorta and lower PP, individuals with aortic dilatation had a significantly increased multivariable adjusted risk of LV hypertrophy, and higher PP further exacerbated this risk [aortic dilatation with lower PP (OR = 1.75, 95% CI: 1.01-3.04) and aortic dilatation with higher PP (OR = 3.42, 95% CI: 2.03-5.77)]. In the relation between PP and LV mass index (β = 0.095, P < 0.001), -41.3% of the total effect was attributable to mediation by ascending aortic diameter (P < 0.0001). CONCLUSIONS In Chinese elderly patients with hypertension, ascending aorta dilatation could reduce the influence of elevated PP on LV hypertrophy.
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Affiliation(s)
- Yu-Qi Jiang
- Department of Geriatrics, the First Hospital of China Medical University, Shenyang, China
| | - Huan-Rui Zhang
- Department of Geriatrics, the First Hospital of China Medical University, Shenyang, China
| | - Bo-Nan Liu
- Department of Geriatrics, the First Hospital of China Medical University, Shenyang, China
| | - Tian-Wen Li
- Department of Geriatrics, the First Hospital of China Medical University, Shenyang, China
| | - Jun-Feng Jiang
- Department of Geriatrics, the First Hospital of China Medical University, Shenyang, China
| | - Wen Tian
- Department of Geriatrics, the First Hospital of China Medical University, Shenyang, China
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8
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Sun J, Zhang Z, Fei Y, Gao Y, Li Z, Gao S, Wang Y, Liu J, Tu J, Wang H, Wang J, Ning X, Zhao W, Zhang W. Determinants of arterial elastic function in middle-aged and elderly people: A population-based cross-sectional study from a low-income population in China. Front Cardiovasc Med 2023; 10:1037227. [PMID: 36844726 PMCID: PMC9949891 DOI: 10.3389/fcvm.2023.1037227] [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: 10/04/2022] [Accepted: 01/25/2023] [Indexed: 02/11/2023] Open
Abstract
Background Arterial stiffness is closely associated with the occurrence of many cardiovascular and cerebrovascular diseases. However, the risk factors and mechanisms related to arterial stiffness development have only been partially elucidated. We aimed to describe arterial elastic function and its influencing factors in middle-aged and elderly people in rural China. Methods This was a cross-sectional study conducted among residents, aged ≥45 years, of Tianjin, China, between April and July 2015. Data regarding participant demographics, medical history, lifestyle, and physical examination results were collected and assessed the association with arterial elastic function using linear regression. Results Of the 3,519 participants, 1,457 were male (41.4%). Brachial artery distensibility (BAD) decreased by 0.5%/mmHg with every 10-year increment in age. The mean BAD value was 0.864%/mmHg lower in women than in men. With each unit increase in mean arterial pressure, the BAD decreased by 0.042%/mmHg. In patients with hypertension or diabetes, the BAD decreased by 0.726 and 0.183%/mmHg, respectively, compared with those without hypertension or diabetes. For each unit increase in triglyceride (TG) level, the mean BAD increased by 0.043%/mmHg. With each increase in body mass index (BMI) category, the BAD increased by 0.113%/mmHg. Brachial artery compliance (BAC) decreased by 0.007 ml/mmHg with each 10-year increase in age, and brachial artery resistance (BAR) increased by 30.237 dyn s-1 cm-5. The mean BAC in women was 0.036 ml/mmHg lower and the mean BAR was 155.231 dyn s-1 cm-5 higher in women than in men. In individuals with hypertension, the mean BAC decreased by 0.009 ml/mmHg and the mean BAR increased by 26.169 dyn s-1 cm-5. With each increase in BMI category, the mean BAC increased by 0.005 ml/mmHg and the mean BAR decreased by 31.345 dyn s-1 cm-5. For each unit increase in TG level, the mean BAC increased by 0.001 ml/mmHg. Conclusion These findings indicate that age, sex, mean arterial pressure, BMI, diabetes, hypertension, and TG level are independently associated with the components of peripheral arterial elasticity. Understanding the factors influencing arterial stiffness is important for developing interventions to minimize arterial aging and cardiovascular and cerebrovascular diseases caused by arterial aging.
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Affiliation(s)
- Jiayi Sun
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhen Zhang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yunhan Fei
- Department of Emergency, Tianjin Huanhu Hospital, Tianjin, China,Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin, China
| | - Yannan Gao
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zejian Li
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Shuai Gao
- School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Yunfan Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jie Liu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, Tianjin, China,Institute of Clinical Epidemiology and Evidence-Based Medicine, Tianjin Jizhou People’s Hospital, Tianjin, China
| | - Haiying Wang
- Department of Cardiology, Tianjin Jizhou People’s Hospital, Tianjin, China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education, Tianjin, China,Institute of Clinical Epidemiology and Evidence-Based Medicine, Tianjin Jizhou People’s Hospital, Tianjin, China
| | - Xianjia Ning
- Institute of Clinical Epidemiology and Evidence-Based Medicine, Tianjin Jizhou People’s Hospital, Tianjin, China,*Correspondence: Xianjia Ning,
| | - Wenjuan Zhao
- Department of Emergency, Tianjin Huanhu Hospital, Tianjin, China,Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin, China,Wenjuan Zhao,
| | - Wenjuan Zhang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China,Wenjuan Zhang,
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9
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Keehn L, Mangino M, Spector T, Chowienczyk P, Cecelja M. Relation of Pulse Wave Velocity to Contemporaneous and Historical Blood Pressure in Female Twins. Hypertension 2023; 80:361-369. [PMID: 36408690 PMCID: PMC9847690 DOI: 10.1161/hypertensionaha.122.19311] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND An association between blood pressure and aortic stiffness is well known, but ambiguity remains as to whether one precedes the other. This study aimed to investigate the association of aortic stiffness with contemporaneous versus historic blood pressure and direction of causality between aortic stiffening and hypertension in female twins. METHODS Aortic stiffness, measured by carotid-femoral pulse wave velocity (PWV), and mean arterial pressure (MAP) was recorded in 2037 female TwinsUK participants (mean age: 62.4±9.7 years) at a single time point. A subset of 947 participants had repeat PWV and MAP measures (mean interval 5.5±1.7 years) with additional historic MAP (mean interval 6.6±3.3 years before baseline). RESULTS Cross-sectional multivariable linear regression analysis confirmed PWV significantly associated with age and MAP. In longitudinal analysis, annual progression of PWV was not associated with historic MAP (standardized beta coefficient [β]=-0.02, P=0.698), weakly associated with baseline MAP (β=0.09, P=0.049) but strongly associated with progression (from baseline to most recent measurement) of MAP (β= 0.26, P<0.001). Progression of MAP associated with both baseline and progression of PWV (β=0.13, P=0.003 and β=0.24, P<0.001, respectively). CONCLUSIONS Progression of aortic stiffness associates more strongly with contemporaneous MAP compared with historic MAP. In contrast, progression of MAP is associated with prior arterial stiffness. These findings suggest a bidirectional relationship between arterial stiffness and blood pressure, and that lowering blood pressure may prevent a cycle of arterial stiffening and hypertension.
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Affiliation(s)
- Louise Keehn
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital (L.K., P.C., M.C.)
| | - Massimo Mangino
- NIHR Biomedical Research Centre at Guy’s and St Thomas’ Foundation Trust, London (M.M.)
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas Hospital (M.M., T.S.)
| | - Tim Spector
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas Hospital (M.M., T.S.)
| | - Phil Chowienczyk
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital (L.K., P.C., M.C.)
| | - Marina Cecelja
- Department of Clinical Pharmacology, King’s College London British Heart Foundation Centre, St Thomas’ Hospital (L.K., P.C., M.C.)
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10
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Lin L, Cao B, Chen W, Li J, Zhang Y, Guo VY. Association of Adverse Childhood Experiences and Social Isolation With Later-Life Cognitive Function Among Adults in China. JAMA Netw Open 2022; 5:e2241714. [PMID: 36367722 PMCID: PMC9652754 DOI: 10.1001/jamanetworkopen.2022.41714] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
IMPORTANCE Studies investigating the association of threat-related and deprivation-related adverse childhood experiences (ACEs) with later-life cognitive decline are lacking. OBJECTIVES To evaluate the independent association of threat-related and deprivation-related ACEs with cognitive decline over time among middle-aged and older Chinese adults and to examine the modifying role of social isolation in such associations. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study used cognitive data from the China Health and Retirement Longitudinal Study (CHARLS) baseline survey that was administered between June 1, 2011, and March 31, 2012, and the CHARLS follow-up survey administered between July 1 and September 30, 2015. The life history survey with information of ACEs was additionally administered between June 1 and December 31, 2014. Statistical analysis was performed from March 1 to July 31, 2022. The study population consisted of middle-aged and older adults (age range, 45-97 years) with complete data on ACEs and 2 cognitive assessments and without cognitive impairment at baseline. EXPOSURES Five threat-related ACEs (ie, physical abuse, household substance abuse, domestic violence, unsafe neighborhood, and bullying) and 5 deprivation-related ACEs (ie, emotional neglect, household mental illness, incarcerated household member, parental separation or divorce, and parental death) before 17 years of age were queried by questionnaires. The cumulative scores of the 2 ACE dimensions were calculated and grouped into 3 categories as 0, 1, and 2 or more in main analyses. MAIN OUTCOMES AND MEASURES Cognitive function was measured by episodic memory and executive function. Global cognition was further calculated as the total score of these 2 dimensions. The raw scores of each cognitive test were standardized to z scores using baseline means and SDs. Linear mixed-effects models were constructed to examine the association between 2 dimensions of ACEs and the rate of annual cognitive decline. The modifying role of baseline social isolation in such associations was assessed with 3-way interaction tests. RESULTS Of the 6466 participants included in main analyses, 3301 (51.1%) were men and the mean (SD) age was 57.2 (8.3) years. Compared with no exposures, experience of 1 deprivation-related ACE was associated with faster cognitive decline in global cognition (β = -0.012 [95% CI, -0.022 to -0.002] SD/y) and executive function (β = -0.010 [95% CI, -0.020 to -0.00002] SD/y), whereas individuals with at least 2 childhood deprivations had faster cognitive declines in all cognitive tests (β = -0.035 [95% CI, -0.050 to -0.019] SD/y for global cognition; β = -0.047 [95% CI, -0.068 to -0.025] SD/y for episodic memory; β = -0.019 [95% CI, -0.034 to -0.004] SD/y for executive function). However, such an association was not observed for threat-related ACEs. In addition, baseline social isolation was a significant modifier in the associations between deprivation-related ACEs and cognitive declines in global cognition (β = -0.033 [95% CI, -0.061 to -0.005] SD/y; P = .02 for 3-way interaction) and executive function (β = -0.032 [95% CI, -0.059 to -0.005] SD/y; P = .02 for 3-way interaction). CONCLUSIONS AND RELEVANCE Deprivation-related ACEs, but not threat-related ACEs, were associated with faster decline in later-life cognitive function, whereas social isolation could modify such detrimental impact. These findings highlight the potential benefits of promoting social integration in maintaining later-life cognitive function among individuals who have experienced childhood deprivation.
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Affiliation(s)
- Li Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Bing Cao
- Department of Neurosurgery, Wu Tsai Neuroscience Institute, Stanford University School of Medicine, Stanford, California
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jinghua Li
- Department of Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuying Zhang
- Department of Child Healthcare, Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Vivian Yawei Guo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
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11
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Gerdts E, Sudano I, Brouwers S, Borghi C, Bruno RM, Ceconi C, Cornelissen V, Diévart F, Ferrini M, Kahan T, Løchen ML, Maas AHEM, Mahfoud F, Mihailidou AS, Moholdt T, Parati G, de Simone G. Sex differences in arterial hypertension. Eur Heart J 2022; 43:4777-4788. [PMID: 36136303 PMCID: PMC9726450 DOI: 10.1093/eurheartj/ehac470] [Citation(s) in RCA: 56] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/17/2022] [Accepted: 08/11/2022] [Indexed: 01/12/2023] Open
Abstract
There is strong evidence that sex chromosomes and sex hormones influence blood pressure (BP) regulation, distribution of cardiovascular (CV) risk factors and co-morbidities differentially in females and males with essential arterial hypertension. The risk for CV disease increases at a lower BP level in females than in males, suggesting that sex-specific thresholds for diagnosis of hypertension may be reasonable. However, due to paucity of data, in particularly from specifically designed clinical trials, it is not yet known whether hypertension should be differently managed in females and males, including treatment goals and choice and dosages of antihypertensive drugs. Accordingly, this consensus document was conceived to provide a comprehensive overview of current knowledge on sex differences in essential hypertension including BP development over the life course, development of hypertension, pathophysiologic mechanisms regulating BP, interaction of BP with CV risk factors and co-morbidities, hypertension-mediated organ damage in the heart and the arteries, impact on incident CV disease, and differences in the effect of antihypertensive treatment. The consensus document also highlights areas where focused research is needed to advance sex-specific prevention and management of hypertension.
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Affiliation(s)
| | - Isabella Sudano
- University Hospital Zurich University Heart Center, Cardiology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Sofie Brouwers
- Department of Cardiology, Cardiovascular Center Aalst, OLV Clinic Aalst, Aalst, Belgium,Department of Experimental Pharmacology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Rosa Maria Bruno
- Université de Paris Cité, Inserm, PARCC, Paris, France,Service de Pharamcologie, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
| | - Claudio Ceconi
- University of Cardiologia, ASST Garda, Desenzano del Garda, Italy
| | | | | | - Marc Ferrini
- Department of Cardiology and Vascular Pathology, CH Saint Joseph and Saint Luc, Lyon, France
| | - Thomas Kahan
- Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Stockholm, Sweden
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Felix Mahfoud
- Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, Saarland University Hospital, Homburg/Saar, Germany
| | - Anastasia S Mihailidou
- Department of Cardiology and Kolling Institute, Royal North Shore Hospital, St Leonards, UK,Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Trine Moholdt
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gianfranco Parati
- Department of Cardiac, Neural and Metabolic Sciences, Instituto Auxologico Italiano, IRCCS, Milan, Italy,Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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12
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Zócalo Y, Bia D. Central Pressure Waveform-Derived Indexes Obtained From Carotid and Radial Tonometry and Brachial Oscillometry in Healthy Subjects (2–84 Y): Age-, Height-, and Sex-Related Profiles and Analysis of Indexes Agreement. Front Physiol 2022; 12:774390. [PMID: 35126173 PMCID: PMC8811372 DOI: 10.3389/fphys.2021.774390] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 12/22/2021] [Indexed: 12/11/2022] Open
Abstract
Aortic blood pressure (aoBP) waveform-derived indexes could provide valuable (prognostic) information over and above cardiovascular risk factors (CRFs). To obtain aoBP waveform-characteristics, several (i) techniques, (ii) recording sites, (iii) pressure-only waveform analysis mathematical approaches [e.g., pulse wave analysis (PWA), wave separation analysis (WSA)], and (iv) indexes [augmentation pressure and index (AP and AIx), forward (Pf) and backward (Pb) components of aoBP, reflection magnitude (RM), and reflection index (Rix)], were proposed. An accurate clinical use of these indexes requires knowing their physiological age-related profiles and the expected values for a specific subject. There are no works that have characterized waveform-derived indexes profiles in large populations considering: (i) as a continuous, data from different age stages (childhood, adolescence, and adulthood), (ii) complementary indexes, (iii) data obtained from different techniques and approaches, and (iv) analyzing potential sex- and body height (BH)-related differences. In addition, (v) there is a lack of normative data (reference intervals, RIs) for waveform-derived indexes.
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13
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Vasan RS, Song RJ, Xanthakis V, Mitchell GF. Aortic Root Diameter and Arterial Stiffness: Conjoint Relations to the Incidence of Cardiovascular Disease in the Framingham Heart Study. Hypertension 2021; 78:1278-1286. [PMID: 34601969 PMCID: PMC8516742 DOI: 10.1161/hypertensionaha.121.17702] [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: 05/11/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Ramachandran S. Vasan
- Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, MA
- Framingham Heart Study, Framingham, MA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Rebecca J. Song
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Vanessa Xanthakis
- Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, MA
- Framingham Heart Study, Framingham, MA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
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14
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Seeland U, Nemcsik J, Lønnebakken MT, Kublickiene K, Schluchter H, Park C, Pucci G, Mozos I, Bruno RM. Sex and Gender Aspects in Vascular Ageing - Focus on Epidemiology, Pathophysiology, and Outcomes. Heart Lung Circ 2021; 30:1637-1646. [PMID: 34452844 DOI: 10.1016/j.hlc.2021.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 12/14/2022]
Abstract
Sex and gender are important modifiers of cardiovascular system physiology, pathophysiology, and disease development. The atherosclerosis process, together with the progressive loss of arterial elasticity with age, is a major factor influencing the development of overt cardiovascular, renal, and cerebrovascular disease. While differences between women and men in epidemiology and pathophysiology of vascular ageing are increasingly reported, sex-disaggregated data are still scarcely available for prospective studies. A better knowledge of sex differences in physiological ageing as well as in disease-related changes in vascular ageing trajectories is crucial to avoid misdiagnosis and mistreatment. This review presents key concepts and knowledge gaps identified in vascular ageing due to gonadal function, vascular physiology, pathophysiology, psychosocial factors, pregnancy, and prognostic relevance. Gender roles determine the effectiveness of any cardiovascular preventive strategy and acceptance for non-invasive or invasive diagnostics and therapeutics. Gender differences in health behaviour, also due to sociocultural norms conditioned by society, contribute to behaviours that may lead to premature arterial vascular ageing. These include differences in risk behaviours like smoking, diet, exercise, and in stress, but also conditions such as housing, noise pollution, poverty, disability, and any kind of stigmatisation. The VascAgeNet Gender Expert Group aims to advance the use of non-invasive vascular ageing measures in routine clinical settings by providing facts to fill in the gaps concerning sex and gender differences at each step of this process, and to search for solutions.
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Affiliation(s)
- Ute Seeland
- Institute of Physiology and Science-IT, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
| | - János Nemcsik
- Semmelweis University, Department of Family Medicine and Health Service of Zuglo (ZESZ), Budapest, Hungary
| | - Mai Tone Lønnebakken
- Department of Clinical Science, University of Bergen, Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Karolina Kublickiene
- Institution for Clinical Science, Intervention & Technology, Department of Renal Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Helena Schluchter
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Chloe Park
- MRC Unit for Lifelong Health and Ageing at UCL, UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Giacomo Pucci
- Unit of Internal Medicine, Terni University Hospital - Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Ioana Mozos
- Department of Functional Sciences - Pathophysiology, Center for Translational Research and Systems Medicine, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Rosa-Maria Bruno
- University of Paris and Assistance-Publique Hopitaux de Paris, Georges Pompidou European Hospital and Cardiovascular Research Center - PARCC INSERM, Paris, France
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15
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Cooper LL, Rong J, Larson MG, Benjamin EJ, Hamburg NM, Vasan RS, Mitchell GF. Discrepancies in Observed and Predicted Longitudinal Change in Central Hemodynamic Measures: The Framingham Heart Study. Hypertension 2021; 78:973-982. [PMID: 34365810 DOI: 10.1161/hypertensionaha.121.17558] [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
[Figure: see text].
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Affiliation(s)
- Leroy L Cooper
- From the Biology Department, Vassar College, Poughkeepsie, NY (L.L.C.)
| | - Jian Rong
- Boston University and NHLBI's Framingham Study, MA (J.R., M.G.L., E.J.B., R.S.V.)
| | - Martin G Larson
- Boston University and NHLBI's Framingham Study, MA (J.R., M.G.L., E.J.B., R.S.V.).,Department of Mathematics and Statistics, Boston University, MA (M.G.L.)
| | - Emelia J Benjamin
- Boston University and NHLBI's Framingham Study, MA (J.R., M.G.L., E.J.B., R.S.V.).,Cardiology and Preventive Medicine Sections, Department of Medicine, Boston University School of Medicine, Boston, MA (E.J.B., R.S.V.).,Department of Epidemiology, Boston University School of Public Health (E.J.B., R.S.V.).,Evans Department of Medicine (E.J.B., N.M.H., R.S.V.), Boston University School of Medicine, Boston, MA.,Whitaker Cardiovascular Institute (E.J.B., N.M.H., R.S.V.), Boston University School of Medicine, Boston, MA
| | - Naomi M Hamburg
- Evans Department of Medicine (E.J.B., N.M.H., R.S.V.), Boston University School of Medicine, Boston, MA.,Whitaker Cardiovascular Institute (E.J.B., N.M.H., R.S.V.), Boston University School of Medicine, Boston, MA
| | - Ramachandran S Vasan
- Boston University and NHLBI's Framingham Study, MA (J.R., M.G.L., E.J.B., R.S.V.).,Cardiology and Preventive Medicine Sections, Department of Medicine, Boston University School of Medicine, Boston, MA (E.J.B., R.S.V.).,Department of Epidemiology, Boston University School of Public Health (E.J.B., R.S.V.).,Evans Department of Medicine (E.J.B., N.M.H., R.S.V.), Boston University School of Medicine, Boston, MA.,Whitaker Cardiovascular Institute (E.J.B., N.M.H., R.S.V.), Boston University School of Medicine, Boston, MA
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16
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Francesconi M, Martina MR, Armenia S, Buzzelli A, Di Franco G, Gemignani V, Bianchini E, Bruno RM. Technical Validation and Usability of a Portable Ultrasound-Based System for Carotid Assessment of Vascular Ageing: A Pilot Study. Heart Lung Circ 2021; 30:1734-1743. [PMID: 34366219 DOI: 10.1016/j.hlc.2021.06.530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/28/2021] [Accepted: 06/02/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The objective of this work was to investigate technical validation and usability of an innovative, technically simple, easy-to-use, and portable integrated system to assess carotid function and structure by ultrasound. METHODS The studied system integrated a hardware (the Interson SP-L01 embedded ultrasound probe [Interson, Pleasanton, CA, USA]) and a software measuring the instantaneous diameter of the carotid artery in real-time from B-mode ultrasound image sequences (Carotid Studio, by Quipu Srl [Pisa, Italy]). Technical validation was evaluated by intra-operator reproducibility of two measurements acquired by an expert operator, and agreement with state-of-the-art technique (Mylab25 by Esaote SpA [Genova, Italy], Carotid Studio 4.3 by Quipu Srl) was evaluated in laboratory settings in 12 healthy volunteers; usability of the portable integrated system was investigated by administering questionnaires to users and the results were reported with scores based on a five-point scale. RESULTS Twelve (12) healthy volunteers (five men, mean age 44.5±13.6 years, free of cardiovascular disease or risk factors), were recruited. Agreement with state-of-the-art technique was satisfactory, with no significant bias. Coefficient of variation (intra-operator reproducibility) was 3.2% (2.5% SD) for intima-media thickness, 0.9% (0.7% SD) for diameter, and 2.5% (2.2% SD) for distension. Usability questionnaires showed an overall positive judgement of the integrated system with respect to the traditional one, obtaining an average score greater than 4 (on a five-point scale). CONCLUSIONS A portable, innovative prototype to easily assess ultrasound carotid parameters of vascular ageing was successfully designed, developed, and demonstrated to be comparable with state-of-the art technique. Usability was also satisfactory.
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Affiliation(s)
- Martina Francesconi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Institute of Clinical Physiology, Italian National Research Council, Pisa, Italy
| | | | - Silvia Armenia
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Buzzelli
- Institute of Clinical Physiology, Italian National Research Council, Pisa, Italy
| | - Gregorio Di Franco
- General Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Vincenzo Gemignani
- Institute of Clinical Physiology, Italian National Research Council, Pisa, Italy
| | - Elisabetta Bianchini
- Institute of Clinical Physiology, Italian National Research Council, Pisa, Italy.
| | - Rosa Maria Bruno
- INSERM U970 Paris Cardiovascular Research Centre - PARCC, Université de Paris, and AP-HP, Pharmacology Unit, Hôpital Européen Georges Pompidou, Paris, France
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17
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Affiliation(s)
- Stéphane Laurent
- From the Department of Pharmacology, European Georges Pompidou Hospital, Assistance Publique - Hôpitaux de Paris, Paris Cardiovascular Research Center, PARCC-Inserm U970 and Paris University, France
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