Reimagining the Value of Brachial-Ankle Pulse Wave Velocity as a Biomarker of Cardiovascular Disease Risk-A Call to Action on Behalf of VascAgeNet

Empagliflozin Leads to Faster Improvement in Arterial Stiffness Compared to Dapagliflozin: A Double-Blind Clinical

(1) Background: Arterial stiffness, often measured by carotid-femoral pulse wave velocity (cf-PWV), is crucial in cardiovascular disease. Dapagliflozin has shown rapid effects on arterial stiffness, but there is limited evidence of empagliflozin's acute effects, especially in type 2 diabetes (T2D) patients. This study evaluated the acute effects of empagliflozin and dapagliflozin on arterial stiffness and blood pressure (BP). (2) Methods: A one-week double-blind randomized trial involved 30 T2D patients on stable metformin therapy. Participants received empagliflozin (25 mg/day), dapagliflozin (10 mg/day), or a placebo. Arterial stiffness was assessed via cf-PWV, and BP was measured with an automated sphygmomanometer. (3) Results: Both SGLT2 inhibitors significantly reduced cf-PWV compared to the placebo after one week (p < 0.05), with dapagliflozin showing a more pronounced effect. No significant differences were observed in BP changes. (4) Conclusion: Short-term treatment with SGLT2 inhibitors acutely reduces arterial stiffness in T2D patients, with empagliflozin demonstrating a stronger effect, supporting the potential vascular benefits of SGLT2 inhibitors beyond glucose control.

Patients with Higher Pulse Wave Velocity Are More Likely to Develop a More Severe Form of Knee Osteoarthritis: Implications for Cardiovascular Risk

Background/Objectives: Knee osteoarthritis (KOA) is a progressive degenerative joint disease characterised by low-grade inflammation and is associated with increased cardiovascular (CV) risk and arterial stiffness. Pulse wave velocity (PWV) is a quantitative measure of arterial stiffness and an important tool for detecting subclinical arterial calcification and CV risk. This study aimed to determine whether PWV can distinguish radiographically mild KOA (Kellgren-Lawrence grades 1-2) from severe KAO (Kellgren-Lawrence grades 3-4) in terms of CV risk factors. Methods: A total of 223 postmenopausal women with KOA participated in this cross-sectional study. Assessments included anthropometry, laboratory analyses, blood pressure and PWV measurements, a 6 min walk test, pain evaluation using a visual analogue scale (VAS), and completion of the International Physical Activity Questionnaire (IPAQ). Results: PWV was significantly higher in the severe KOA group (10.53 m/s vs. 8.78 m/s, p < 0.001). A cut-off value of 8.4 m/s effectively distinguished between severe and mild forms of KOA (AUC = 0.798, p = 0.001). OA grade, pain, age, waist circumference, WHR, SCORE 2/SCORE 2OP, systolic blood pressure, serum glucose, HbA1c, uric acid, creatinine, and erythrocyte sedimentation rate were increased in the group with PWV > 8.4 m/s, compared to the group with PWV ≤ 8.4 m/s. Conversely, eGFR, the 6 min walk test and physical activity of patients were reduced in the group with PWV > 8.4 m/s. A patient with a PWV > 8.4 m/s has a 1.77 times higher chance of developing a more severe form of the disease than a patient with a lower PWV. Conclusions: Patients with a higher PWV are more likely to develop a more severe form of KOA, which is associated with increased cardiovascular risk.

Acute effect of lower-limb peristaltic pulse external pneumatic compression on segmental arterial stiffness in healthy young adults

Although an acute bout of peristaltic pulse external pneumatic compression (EPC) of the lower extremities can improve vascular function, its effect on arterial stiffness remains unclear. This study aimed to investigate the acute effect of lower-limb peristaltic pulse EPC on segmental arterial stiffness. Nineteen healthy young adults (12 males and 7 females) (age: 20 ± 1 years) were allocated to undergo two experimental trials using a randomized crossover design. EPC treatment delivered at 70-80 mmHg (EPC trial) or non-compressed sham treatment (sham trial) was performed for 30 min. At baseline (Pre) and after the 30-min treatment (Post), arterial stiffness indices, including the heart-brachial pulse wave velocity (PWV) (hbPWV), brachial-ankle PWV (baPWV), heart-ankle PWV (haPWV), and the cardio-ankle vascular index (CAVI) were measured simultaneously. All parameters in the EPC trial exhibited a significant decrease (p < 0.05) at Post compared to Pre, including hbPWV, baPWV, haPWV, and CAVI. However, no such changes were observed in the sham trial. The study findings demonstrate that a single 30-min bout of lower-limb peristaltic pulse EPC can decrease arterial stiffness in healthy young adults. The observed EPC-induced decrease in arterial stiffness in various segments suggests that the beneficial vascular effect could be elicited systemically.

Acute Psychological Stress and Pulse Wave Velocity: Meta-Analysis and Recommendations for Future Research

Repeated exposures to acute psychological stress may be associated with cardiovascular disease (CVD) risk, but the mechanisms underlying this relationship are not fully understood. The objective of this meta-analysis was to determine the effect of acute psychological stress on central pulse wave velocity (PWV) compared to pre-stress (baseline) levels in adults free of overt CVD. Electronic databases (PubMed, SPORTDiscus, and Google Scholar) were queried from inception to July 2024. Reference lists of eligible studies and previous relevant reviews were also screened. Studies were included if: (i) a noninvasive measure of PWV was used that included a central (aortic) arterial segment; (ii) participants were adults (≥ 18 years) free of overt CVD; and (iii) the acute stressor was purely psychological in nature. Appraisal and Synthesis Methods: Effect sizes were calculated as standardized mean differences (SMD) and pooled using a random-effects model. The magnitude of effect was adjudicated as trivial (< 0.2), small (0.2), moderate (0.5), or large (0.8). A total of 11,689 studies were identified, from which 7 studies (11 effects, N = 162 participants) were eligible for inclusion. Moderate Acute psychological stress induced a moderate (SMD: 0.51, p < 0.0001; 95% CI: 0.34, 0.68) increase (detrimental) in central PWV, and there was insubstantial heterogeneity between studies (Cochran's Q (10) = 2.62 (p = 0.99)). The small overall number of studies as well as key differences in study methodologies limit the ability to elucidate the magnitude and consistency of stress-induced increases in PWV. Nonetheless, the present findings suggest that acute psychological stress induces significant increases in central PWV among adults free of overt CVD. The acute PWV response to psychological stress likely contributes to elevated CVD risk over time.

Sex and resting heart rate influence the relation between arterial stiffness and cardiac structure and function - insights from the general population

Arterial stiffness, a risk factor for cardiovascular disease, can be measured using pulse wave velocity (PWV) and augmentation index (AIx). We studied sex-specific associations between carotid-femoral PWV (cfPWV), brachial-ankle PWV (baPWV), aortic PWV (aoPWV), aortic (aoAIx), and brachial (baAIx) AIx with echocardiographic parameters. Data of 1150 participants of the Study of Health in Pomerania (SHIP-Trend 1; 530 men; median age 53 years; inter quartile range (IQR) 44 to 64) were used. Echocardiography assessed common structural and functional cardiac parameters. PWV and AIx were measured using the Vascular Explorer. Multivariable linear regression models were applied. In men, a higher brAIx was related to a greater right ventricular diameter (RV) (β 0.037; CI 0.003 to 0.148). A one m/s higher baPWV was associated with a smaller RV (β -0.037; CI -0.168 to -0.021) and right ventricular outflow tract (RVOT; β -0.029; CI -0.141 to -0.026). In men, a higher aoAIx (β 0.028; CI 0.01 to 0.122) and brAIx (β 0.029; CI 0.017 to 0.13) were associated with a greater RVOT. In women, a one m/s higher aoPWV (β 0.025; CI 0.006 to 0.105) was associated with a larger RV and a one m/s higher baPWV (β -0.031; CI -0.124 to -0.001) was inversely related to RVOT. In women, PWV associated with right ventricular dimensions, while in men, baPWV and AIx were related to right ventricular parameters. This suggests potentially sex-specific relations between PWV and cardiac structure and function.

Effects of Exercise Program on Mental, Pulmonary, and Cardiovascular Health of Elderly Men with Acquired Severe Physical Disabilities: A Retrospective Study

Background/Objectives: Physical activity is recommended for people with physical disabilities and is beneficial not only for physical health but also for mental health. This study aimed to evaluate the quality of life (QoL), pulmonary health, and cardiovascular health among a group of older men with physical disabilities who participated in an exercise program. Methods: This study included 23 participants in the exercise group (EG) as an experimental group and 23 in the culture group (CG) as a control group. All participants were ≥65 years, with one or more physical disabilities, and used wheelchairs or crutches for mobility. The participants were each provided with the exercise program for 8 weeks. Assessments included a QoL, pulmonary function test, brachial-ankle pulse wave velocity (baPWV), and factors of metabolic syndrome. The exercise program consisted of aerobics, strength training using dumbbells and tubes, and mat exercises for three days a week for 8 weeks. The culture program included singing, drawing, and writing. Results: The interaction effects by time and group showed that EG had a superior change compared to CG in QoL (physical function, pain, fatigue, social), forced vital capacity, baPWV, triglycerides, and high-density lipoprotein cholesterol (p < 0.05). Conclusions: Participation in the exercise program positively influenced mental, pulmonary, and cardiovascular health in older men with physical disabilities. Our research results will provide useful information for rehabilitation and social security research to improve the health of elderly people with physical disabilities.

Association between brachial-ankle pulse wave velocity, obesity-related indices, and the 10-year incident risk score of atherosclerotic cardiovascular disease: The rural Chinese cohort study

BACKGROUND AND AIMS

Although existing evidence suggests that arterial stiffness and obesity impact cardiovascular health, limited studies have been conducted to explore the association between brachial-ankle pulse wave velocity (baPWV), obesity-related indices, and the risk of atherosclerotic cardiovascular disease (ASCVD).

METHODS AND RESULTS

The study participants were among those who completed the baPWV measurement at the second follow-up examination (during 2018-2020) of the Rural Chinese Cohort Study. Logistic regression models were employed to calculate odds ratios (ORs) and 95 % confidence intervals (CIs) of the 10-year incident risk score of ASCVD associated with baPWV and obesity-related indices. Mediation analysis was applied to investigate the role of baPWV in the obesity-induced 10-year incident risk score of ASCVD. A total of 1589 individuals, including 573 men and 1016 women, were included in the study. In logistic regression analyses, the highest quartile levels of baPWV and obesity-related indices all significantly increased the 10-year incident risk score of ASCVD compared to their corresponding lowest quartiles. The ORs (95%CIs) of ASCVD 10-year incident risk score risk were 4.21(2.55-6.94) for baPWV, 4.43(2.69-7.29) for METS-VF, 7.20(4.09-12.66) for CVAI, 3.38(2.12-5.38) for CI, and 2.40(1.54-3.75) for ABSI. The indirect effect of baPWV accounted for 5.85 %, 7.92 %, 14.56 %, and 5.08 % of the total effects for METS-VF, CVAI, CI, and ABSI, respectively.

CONCLUSION

This study found that elevated levels of both baPWV and obesity-related indices were associated with a higher 10-year incident risk score of ASCVD. Additionally, baPWV partially mediated the obesity-related increase in 10-year incident risk score of ASCVD.

The BG Study Part 1 (Bergisch Gladbach): Development of a Prototype Coronary Artery Disease Risk Score Incorporating Peripheral Vascular Parameters-Preliminary Insights for Future CAD Risk Prediction Models in Vascular Patients

Background: Peripheral vascular parameters may provide valuable insights into coronary artery disease (CAD) risk stratification. This study aimed to develop a CAD risk score by integrating carotid duplex velocities, ankle-brachial index (ABI), and clinical history into a point-based model. Methods: We analyzed data from 902 cardiology patients, of whom 592 (65.6%) had confirmed CAD based on coronary angiography. Peripheral vascular assessments included carotid duplex ultrasonography and ABI measurements. Predictors were identified through multivariate logistic regression, addressing multicollinearity and interaction effects. A point-based scoring system was developed using statistically significant variables and evaluated via receiver operating characteristic (ROC) analysis. Results: Key predictors included external carotid artery velocities, ABI, carotid stenosis, chronic kidney disease (CKD) stage, smoking history, diabetes, hypertension, and age. The scoring system demonstrated moderate discriminative ability (AUC: 0.683) and high sensitivity (97%) for detecting CAD-positive cases but lower specificity (11%) for CAD-negative cases. Patients were stratified into risk categories, with an optimal threshold of ≥7 points maximizing the F1 score. Conclusions: This novel scoring system highlights the clinical relevance of integrating peripheral vascular assessments into CAD risk models. While its high sensitivity ensures robust detection of CAD-positive patients, future multicenter studies are needed to improve specificity and validate its broader clinical utility.

The Effects of Endurance Training and High-Intensity Resistance Training on Pulse Wave Velocity and QT Dispersion

Objectives: This study aimed to examine the effects of endurance and high-intensity resistance training on arterial stiffness and ventricular repolarization in elite athletes. Methods: A total of 50 male athletes from different sports disciplines (volleyball, football, judo, and wrestling) and a sedentary group of 30 males participated in this study. Data collected from all participants included age, height, body weight, cardiovascular hemodynamic parameters, arterial stiffness parameters, and ECG measurements. Results: There was no significant age difference between the athlete group (20.42 ± 1.903 years) and the control group (20.97 ± 1.771 years) (p > 0.05). However, body mass index (BMI) values in the control group (24.83 ± 2.22 kg/m2) were significantly different from those in the athlete group (22.39 ± 2.663 kg/m2) (p < 0.05). Significant differences were found between the athlete and control groups in QT dispersion, systolic blood pressure, pulse pressure, and central pulse pressure values (p < 0.05), while similar results were obtained for arterial stiffness parameters (p > 0.05). Conclusions: The lack of a difference in pulse wave velocity and augmentation index (AIx) values between the athletes and the control group suggests that athletes do not bear additional risks regarding arterial stiffness. However, increased systolic blood pressure, pulse pressure, and central pulse pressure, among the hemodynamic parameters, indicate potential variations in vascular wall compliance and hemodynamic responses in the cardiovascular system. The increase in QT dispersion suggests that athletes may exhibit a heterogeneous repolarization process and an elevated risk of ventricular arrhythmias compared to the general population.

Lung Cancer Biomarkers Associated with Increased Peripheral Arterial Stiffness in Middle-aged Chinese Adults

AIMS

Previous evidence suggests that serum lung cancer biomarkers are associated with inflammatory conditions; however, their relationship with peripheral arterial stiffness remains unclear. Therefore, the present study investigated the relationship between serum lung cancer biomarkers and peripheral arterial stiffness in middle-aged Chinese adults.

METHODS

In total, 3878 middle-aged Chinese adults were enrolled in this study. Increased peripheral arterial stiffness was assessed using the brachial-ankle pulse wave velocity and ankle-brachial index. Univariate and multivariate logistic regression analyses were used to determine the independent effects of serum lung cancer biomarkers on the risk of increased peripheral arterial stiffness. A receiver operating characteristic curve analysis was used to assess the diagnostic ability of serum lung cancer biomarkers in distinguishing increased peripheral arterial stiffness.

RESULTS

Serum levels of carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), cytokeratin-19 fragment 21-1, and pro-gastrin-releasing peptide were higher in subjects with increased peripheral arterial stiffness than in those without (P＜0.05). After adjusting for other risk factors, serum CEA and NSE levels were found to be independently associated with increased peripheral arterial stiffness. The corresponding adjusted odds ratios (ORs) for increased peripheral arterial stiffness in CEA level quartiles were 1.00, 1.57, 2.15, and 6.13. The ORs for increased peripheral arterial stiffness in the quartiles of NSE levels were 1.00, 4.92, 6.65, and 8.01.

CONCLUSIONS

Increased serum CEA and NSE levels are closely linked to increased peripheral arterial stiffness, and high serum CEA and NSE levels are potential risk markers for peripheral arterial stiffness in middle-aged Chinese adults.

Exploring the relationship between trunk flexibility and arterial stiffness measured by pulse wave velocity: A systematic review and meta-analysis

BACKGROUND

As individuals age, the risk of cardiovascular disease (CVD) increases, largely due to progressive stiffening of the arteries. This relationship underscores the critical need to monitor arterial stiffness as a predictor of CVD outcomes. While aerobic exercise has demonstrated benefits for vascular health, the influence of flexibility, particularly trunk flexibility, on arterial stiffness remains underexplored. Thus, this study aimed to analyse the overall relationship between trunk flexibility and arterial stiffness across different age groups (young, middle-aged, and older adults) and according to sex.

METHODS

A systematic review and meta-analysis were conducted following the MOOSE and JBI Manual for Evidence Synthesis on systematic reviews of etiology and risk guidelines. Searches in PubMed, Scopus, and Web of Science identified studies investigating the association between trunk flexibility and arterial stiffness measured by pulse wave velocity. Data extraction, quality assessment, and statistical analyses were performed following predefined criteria.

RESULTS

Five studies involving 2797 participants were included. Poor trunk flexibility was associated with increased arterial stiffness compared to high flexibility (pooled standardized mean difference = -0.27, 95% CI: -0.39, -0.14), with substantial heterogeneity observed. Subgroup analyses by sex and age revealed significant associations predominantly in men and older individuals. Sensitivity analyses confirmed the robustness of the findings, and meta-regression models showed no significant differences according to age, BMI, or blood pressure. No evidence of publication bias was found.

CONCLUSION

Poor trunk flexibility is linked to elevated arterial stiffness across diverse demographic groups, highlighting its potential as a surrogate marker for cardiovascular health. Physiological mechanisms involving connective tissue integrity and neural regulation may underpin this relationship. Understanding the role of flexibility in arterial health could inform targeted interventions to mitigate age-related increases in arterial stiffness and reduce cardiovascular disease risk. However, further research is needed to validate these findings and explore potential sex-specific differences.

Aortic-Femoral Stiffness Gradient and Cardiovascular Risk in Older Adults

BACKGROUND

The aortic-femoral arterial stiffness gradient, calculated as the ratio of lower-limb pulse-wave velocity (PWV) to central (aortic) PWV, is a promising tool for assessing cardiovascular disease (CVD) risk, but whether it predicts incident CVD is unknown.

METHODS

We examined the association of the aortic-femoral arterial stiffness gradient measures carotid-femoral stiffness gradient (femoral-ankle PWV divided by carotid-femoral PWV) and the heart-femoral stiffness gradient (femoral-ankle PWV divided by heart-femoral PWV), as well as PWV, with incident CVD (coronary disease, stroke, and heart failure) and all-cause mortality among 3109 participants of the Atherosclerosis Risk in Communities Study cohort (age, 75±5 years; carotid-femoral PWV, 11.5±3.0 m/s), free of CVD. Cox regression was used to estimate hazard ratios (HR) and 95% CIs.

RESULTS

Over a median 7.4-year follow-up, there were 322 cases of incident CVD and 410 deaths. In fully adjusted models, only top quartiles of carotid-femoral stiffness gradient (quartile 4: HR, 1.43 [95% CI, 1.03-1.97]; and quartile 3: HR, 1.49 [95% CI, 1.08-2.05]) and heart-femoral stiffness gradient (quartile 4: HR, 1.77 [95% CI, 1.27-2.48]; and quartile 3: HR, 1.41 [95% CI, 1.00-2.00]) were significantly associated with a greater risk of incident CVD. Only high aortic stiffness in combination with low lower-limb stiffness was significantly associated with incident CVD (HR, 1.46 [95% CI, 1.06-2.02]) compared with the referent low aortic stiffness and high lower-limb stiffness. No PWVs were significantly associated with incident CVD. No exposures were associated with all-cause mortality.

CONCLUSIONS

The aortic-femoral arterial stiffness gradient may enhance CVD risk assessment in older adults in whom the predictive capacity of traditional risk factors and PWV are attenuated.

Systemic Arterial Stiffness and Choroidal Microvascular Insufficiency on the Structural Progression of Normal Tension Glaucoma

PURPOSE

To identify the role of systemic arterial stiffness and choroidal microvascular insufficiency on structural progression of normal-tension glaucoma (NTG).

DESIGN

Retrospective cohort study.

METHODS

A total of 107 early NTG eyes of 88 patients, who underwent pulse wave velocity (PWV) measurements and optical coherence tomography (OCT) angiography (OCT-A) at baseline, were categorized depending on the presence of peripapillary choroidal microvasculature dropout (MvD) and PWV. Differences in glaucomatous progression were analyzed. Structural progression rates were determined using the trend-based analysis of Cirrus OCT.

RESULTS

Thirty-two eyes displayed choroidal MvD (62.7 [95% CI 58.4-67.0] years old, 53.6% males), and 70 eyes did not show any MvD (59.9 (95% CI 57.1-62.6) years old, 53.3% males) at baseline. Patients were followed for 48.4 (95% CI 40.0-56.8) months. When they were further divided based on PWV (high PWV ≥ 1400 cm/sec), those with choroidal MvD and high PWV showed significantly faster thinning in macular ganglion cell-inner plexiform layer (GCIPL; P = .023). In comparison to those with low PWV and no MvD, eyes with high PWV and MvD in the peripapillary area were likely to show fast structural progression (≤-1.2 µm/year) in the macular GCIPL by odds of 6.019 (95% CI 1.619-38.531, P = .025).

CONCLUSIONS

In NTG eyes, GCIPL thinning was faster when choroidal MvD and high systemic arterial stiffness were present. The simultaneous presence of regional and systemic vascular insufficiency may be associated with rapid glaucoma structural progression in eyes with low baseline intraocular pressure.

Cross-sectional and longitudinal evaluation of heart-to-brachium pulse wave velocity for cardiovascular disease risk

Heart-brachium pulse wave velocity (hbPWV) is a promising measure of arterial stiffness including the proximal aorta. To characterize age-associated changes and the clinical utilities of hbPWV, we evaluated the impacts of age and cardiovascular disease (CVD) risks on hbPWV cross-sectionally (N = 7868) and longitudinally (N = 3710, followed by 9.1 ± 2.0 years). hbPWV were obtained using two validated equations for arterial path length (with and without considering age-related aortic elongations). Brachial-ankle pulse wave velocity (baPWV) was used as a comparative measure. Repeated-measures correlation (rmcorr) and regression analyses were used to characterize associations of PWVs with age and Framingham's general CVD risk score (FRS). In the cross-sectional study, hbPWVs derived by both equations showed stronger correlation with age (r = 0.746 ~ 0.796) and FRS (r = 0.714-0.749) than baPWV (r = 0.554 and r = 0.643). Furthermore, hbPWVs correlated with FRS even after controlling for age (r = 0.260 ~ 0.269, P < 0.0001). In the longitudinal study, hbPWVs demonstrated significantly higher rmcorr coefficient with age than baPWV (rrm=0.439-0.511 vs. 0.307, P < 0.0001). Across the adult lifespan, age-related increases in hbPWVs were almost consistent, starting from young adults, while baPWV displayed accelerated increases with age. A receiver operating characteristic curve analysis indicated that hbPWVs depicted more robust ability to stratify general CVD risk compared with baPWV (AUC = 0.896-0.913 vs. 0.833, P < 0.0001). The results of the follow-up study were consistent with the findings of the cross-sectional investigation. Our findings suggest that hbPWV undergoes a linear augmentation with age, commencing from an early adult life stage onward, rendering it a potential marker for discerning CVD risk.

Association between exposure to air pollution and arterial stiffness in participants with and without atherosclerotic cardiovascular disease

AIMS

To assess the association of air pollution exposure at different time scales with arterial stiffness in participants with and without atherosclerotic cardiovascular disease (ASCVD).

METHODS

We measured participants' arterial stiffness with brachial-ankle pulse wave velocity (baPWV) from October 2016 to January 2020. Concentrations of air pollutants including fine particles < 2.5 μm aerodynamic diameter (PM2.5), inhalable particles < 10 μm aerodynamic diameter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) measured by fixed ambient air monitoring stations were collected for short- (7-day) and long-term (365-day) exposure assessment. We used generalized estimating equations (GEEs) to analyze and further explored the modification effects between ASCVD and air pollutants.

RESULTS

Seven hundred sixty-five participants were finally included and four hunderd sixty (60.1%) participants had a history of ASCVD. Based on the partial regression coefficients (β) and 95% confidence intervals (95% CI) calculated from GEEs using linear regression, each 10 μg/m3 increase in long-term exposure to PM2.5 and PM10 was associated with 31.85 cm/s (95% CI, 17.97 to 45.73) and 35.93 cm/s (95% CI, 21.01 to 50.84) increase in baPWV. There was no association between short-term exposure to air pollution and arterial stiffness. Although no significant interaction effect was observed between air pollution and ASCVD, baPWV showed a greater increment in the subgroup without ASCVD.

CONCLUSION

Long-term exposure to air pollution is closely associated with higher arterial stiffness in participants with and without ASCVD. Reducing air pollution exposure is essential in the primary and secondary prevention of ASCVD.

Effect of low-dose terazosin on arterial stiffness improvement: A pilot study

Arterial stiffness, a prominent hallmark of ageing arteries, is a predictor of all-cause mortality. Strategies for promoting healthy vascular ageing are encouraged. Here we conducted a pilot study to evaluate the potential effects of low-dose Terazosin on arterial stiffness. We enrolled patients aged over 40 with elevated arterial stiffness, defined as a brachial-ankle pulse wave velocity (baPWV) ≥1400 cm/s, who were administered Terazosin (0.5 and 1.0 mg/day) from December 2020 to June 2023. Treatment responses were assessed every 3 months. Linear regression analysis was used to characterise the improvement. We matched cases who took Terazosin for 1 year with Terazosin-free controls using propensity score matching (PSM). Our findings demonstrate that Terazosin administration significantly affected arterial stiffness. (1) Arterial stiffness significantly improved (at least a 5% reduction in baPWV) in 50.0% of patients at 3 months, 48.6% at 6 months, 59.3% at 9 months, and 54.4% at 12 months, respectively. (2) Those with higher baseline baPWV and hypertension exhibited a significantly reduced risk of non-response. (3) Terazosin was associated with a reduction of baPWV at 1-year follow-up (linear regression: β = -165.16, p < 0.001). This pilot study offers valuable insights into the potential significance of Terazosin in improving arterial stiffness and paves the way for future randomised clinical trials in combating vascular ageing.

Osteocalcin: A Potential Marker of Peripheral Arterial Stiffness in Hypertensive Patients

Background and Objectives: Brachial-ankle pulse wave velocity (baPWV) is an established independent risk factor for cardiovascular events, cardiovascular mortality, and all-cause mortality. Osteocalcin (OC) is recognized to be associated with vascular function. The present study assessed the correlation between serum OC levels and peripheral arterial stiffness (PAS) measured through baPWV in hypertensive patients. Materials and Methods: Fasting blood samples were collected from 120 hypertensive participants. The serum total OC levels were measured using a commercial enzyme-linked immunosorbent assay kit, whereas the baPWV device was used to detect PAS. The PAS group had left or right baPWV > 18.0 m/s. Results: Among the hypertensive patients, 24 (20.0%) were classified into the PAS group. The PAS group exhibited a significantly older age (p = 0.011), higher prevalence of diabetes (p = 0.010), systolic blood pressure (p = 0.019), levels of serum fasting glucose (p = 0.003), blood urea nitrogen (p = 0.024), creatinine (p = 0.004), C-reactive protein (p = 0.007), OC (p = 0.002), and lower estimated glomerular filtration rate (p = 0.004) than the non-PAS group. Age (odds ratio [OR]: 1.076, 95% CI: 1.004-1.153, p = 0.037) and serum OC level (OR: 1.797, 95% confidence interval (CI): 1.077-3.000, p = 0.025) were independent factors linked to PAS in hypertensive patients in the multivariate logistic regression analysis. Conclusions: Serum OC levels and older age are positively associated with PAS in hypertensive patients.

Seated Elliptical Exercise, But Not Periodic Standing, Alleviates Sitting-Induced Changes to Arterial Wave Reflections

PURPOSE

Sedentary behavior may contribute to increased central wave reflection due to associated peripheral vasoconstriction, yet its impact on central hemodynamics and the mitigating effects of interventional strategies have not been thoroughly investigated. We tested whether standing or seated elliptical breaks alleviate the deleterious effects of prolonged sitting on central wave reflections.

METHODS

Eighteen healthy adults (9 9 females, 25 ± 3 yr) completed three 3-h protocols on separate days: uninterrupted sitting, sitting with periodic standing, and sitting with periodic seated elliptical activity. Central wave reflection, central pulse wave velocity, and lower-limb pulse wave velocity were measured before and after each intervention.

RESULTS

Central relative wave reflection magnitude (RM) increased during sitting (0.31 ± 0.05 to 0.35 ± 0.05; P < 0.01) but did not change after standing (0.30 ± 0.05 to 0.32 ± 0.04; P = 0.19) or elliptical protocols (0.30 ± 0.05 to 0.30 ± 0.04; P > 0.99). The change in RM during prolonged sitting (ΔRM) was attenuated with elliptical activity (0.04 ± 0.05 vs 0.00 ± 0.03; P = 0.02) but not with periodic standing (0.04 ± 0.04 vs 0.02 ± 0.05; P = 0.54). In addition, augmentation index and central pulse wave velocity increased after sitting (both P < 0.01) and periodic standing (both P < 0.01) but were unchanged after elliptical activity. Lower limb pulse wave velocity did not change after sitting ( P = 0.73) or standing ( P = 0.21) but did decrease after elliptical activity ( P = 0.03).

CONCLUSIONS

Prolonged sitting without interruptions increased central wave reflection, whereas elliptical but not standing interruptions were able to ameliorate multiple sitting-induced vascular consequences. More work is required to examine the long-term effectiveness of interruption strategies, as well as the optimal type, frequency, and duration for reducing vascular risk associated with sedentary behaviors.

The 24-h activity cycle and cardiovascular outcomes: establishing biological plausibility using arterial stiffness as an intermediate outcome

This review proposes a biologically plausible working model for the relationship between the 24-h activity cycle (24-HAC) and cardiovascular disease. The 24-HAC encompasses moderate-to-vigorous physical activity (MVPA), light physical activity, sedentary behavior (SB), and sleep. MVPA confers the greatest relative cardioprotective effect, when considering MVPA represents just 2% of the day if physical activity guidelines (30 min/day) are met. While we have well-established guidelines for MVPA, those for the remaining activity behaviors are vague. The vague guidelines are attributable to our limited mechanistic understanding of the independent and additive effects of these behaviors on the cardiovascular system. Our proposed biological model places arterial stiffness, a measure of vascular aging, as the key intermediate outcome. Starting with prolonged exposure to SB or static standing, we propose that the reported transient increases in arterial stiffness are driven by a cascade of negative hemodynamic effects following venous pooling. The subsequent autonomic, metabolic, and hormonal changes further impair vascular function. Vascular dysfunction can be offset by using mechanistic-informed interruption strategies and by engaging in protective behaviors throughout the day. Physical activity, especially MVPA, can confer protection by chronically improving endothelial function and associated protective mechanisms. Conversely, poor sleep, especially in duration and quality, negatively affects hormonal, metabolic, autonomic, and hemodynamic variables that can confound the physiological responses to next-day activity behaviors. Our hope is that the proposed biologically plausible working model will assist in furthering our understanding of the effects of these complex, interrelated activity behaviors on the cardiovascular system.