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Burden SJ, Alshehri R, Lamata P, Poston L, Taylor PD. Maternal obesity and offspring cardiovascular remodelling - the effect of preconception and antenatal lifestyle interventions: a systematic review. Int J Obes (Lond) 2024; 48:1045-1064. [PMID: 38898228 PMCID: PMC11281905 DOI: 10.1038/s41366-024-01536-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/02/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Preconception or antenatal lifestyle interventions in women with obesity may prevent adverse cardiovascular outcomes in the child, including cardiac remodelling. We undertook a systematic review of the existing data to examine the impact of randomised controlled trials of lifestyle interventions in pregnant women with obesity on offspring cardiac remodelling and related parameters of cardiovascular health. METHODS This review was registered with PROSPERO (CRD42023454762) and aligns with PRISMA guidelines. PubMed, Embase, and previous reviews were systematically searched. Follow-up studies from randomised trials of lifestyle interventions in pregnant women with obesity, which included offspring cardiac remodelling or related cardiovascular parameters as outcome measures, were included based on pre-defined inclusion criteria. RESULTS Eight studies from five randomised controlled trials were included after screening 3252 articles. Interventions included antenatal exercise (n = 2), diet and physical activity (n = 2), and preconception diet and physical activity (n = 1). Children were <2-months to 3-7-years-old, with sample sizes ranging between n = 18-404. Reduced cardiac remodelling, with reduced interventricular septal wall thickness, was consistently reported. Some studies identified improved systolic and diastolic function and a reduced resting heart rate. Risk of bias analyses rated all studies as 'fair' (some risk of bias). A high loss-to-follow-up was a common limitation. CONCLUSION Although there is some evidence to suggest that lifestyle interventions in women with obesity may limit offspring cardiac remodelling, further high-quality longitudinal studies with larger sample sizes are required to confirm these observations and to determine whether these changes persist to adulthood. Child offspring cardiovascular health benefits of preconception and antenatal lifestyle interventions in women with obesity.
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Affiliation(s)
- Samuel J Burden
- Department of Women and Children's Health, School of Life Course & Population Sciences, King's College London, London, UK.
| | - Rahaf Alshehri
- Cardiovascular Medicine and Science Research, School of Cardiovascular and Metabolic Medicine & Sciences, King's College London, London, UK
| | - Pablo Lamata
- Biomedical Engineering, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Lucilla Poston
- Department of Women and Children's Health, School of Life Course & Population Sciences, King's College London, London, UK
| | - Paul D Taylor
- Department of Women and Children's Health, School of Life Course & Population Sciences, King's College London, London, UK
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Jalanko P, Bond B, Laukkanen JA, Brage S, Ekelund U, Laitinen T, Määttä S, Kähönen M, Haapala EA, Lakka TA. Association between arterial health and cognition in adolescents: The PANIC study. Physiol Rep 2024; 12:e16024. [PMID: 38697946 PMCID: PMC11065692 DOI: 10.14814/phy2.16024] [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: 12/13/2023] [Revised: 03/11/2024] [Accepted: 04/11/2024] [Indexed: 05/05/2024] Open
Abstract
We investigated the associations of the measures of arterial health with cognition in adolescents and whether physical activity (PA) or sedentary time (ST) confounds these associations. One hundred sixteen adolescents (71 boys) aged 15.9 ± 0.4 participated in the study. PA and ST were assessed using a combined accelerometer/heart rate monitor. Overall cognition was computed from the results of psychomotor function, attention, working memory, and paired-associate learning tests. Pulse wave velocity was measured by impedance cardiography, carotid intima-media thickness, and carotid artery distensibility by carotid ultrasonography. Systolic and diastolic blood pressure (SBP and DBP) were measured using an aneroid sphygmomanometer. SBP was inversely associated with overall cognition (standardized regression coefficient [β] = -0.216, 95% confidence interval (CI) -0.406 to -0.027, p = 0.025). Pulse wave velocity (β = -0.199, 95% CI -0.382 to -0.017, p = 0.033) was inversely associated with working memory task accuracy. SBP was directly associated with reaction time in the attention (β = 0.256, 95% CI 0.069 to 0.443, p = 0.008) and errors in the paired-associate learning tasks (β = 0.308, 95% CI 0.126 to 0.489, p = 0.001). Blood pressure was inversely associated with overall cognition. PA or ST did not confound the associations. Results suggest that preventing high blood pressure is important for promoting cognition in adolescents.
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Affiliation(s)
- Petri Jalanko
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
- Helsinki Clinic for Sports and Exercise MedicineFoundation for Sports and Exercise MedicineHelsinkiFinland
| | - Bert Bond
- Children's Health and Exercise Research Centre, Sport and Health Science, College of Life and Environmental SciencesUniversity of ExeterExeterUK
| | - Jari A. Laukkanen
- Department of Medicine, Institute of Clinical MedicineUniversity of Eastern FinlandKuopioFinland
- Department of MedicineCentral Finland Health Care District Hospital DistrictJyväskyläFinland
| | - Soren Brage
- MRC Epidemiology UnitUniversity of Cambridge School of Clinical MedicineCambridgeUK
| | - Ulf Ekelund
- Department of Sports MedicineNorwegian School of Sport SciencesOsloNorway
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear ImagingUniversity of Eastern Finland and Kuopio University HospitalKuopioFinland
| | - Sara Määttä
- Department of Clinical NeurophysiologyKuopio University HospitalKuopioFinland
| | - Mika Kähönen
- Department of Clinical PhysiologyTampere University Hospital and Faculty of Medicine and Health Technology, Tampere UniversityTampereFinland
| | - Eero A. Haapala
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
- Institute of Biomedicine, School of MedicineUniversity of Eastern FinlandKuopioFinland
| | - Timo A. Lakka
- Department of Clinical Physiology and Nuclear ImagingUniversity of Eastern Finland and Kuopio University HospitalKuopioFinland
- Institute of Biomedicine, School of MedicineUniversity of Eastern FinlandKuopioFinland
- Foundation for Research in Health Exercise and NutritionKuopio Research Institute of Exercise MedicineKuopioFinland
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Desai SA, Mirza UA, Mueller PJ. Influence of sex and sedentary conditions on sympathetic burst characteristics in prepubertal, postpubertal, and young adult rats. J Appl Physiol (1985) 2024; 136:1170-1181. [PMID: 38511214 DOI: 10.1152/japplphysiol.00649.2023] [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: 09/08/2023] [Revised: 03/07/2024] [Accepted: 03/15/2024] [Indexed: 03/22/2024] Open
Abstract
Recent evidence indicates that sex-based differences in cardiovascular disease (CVD) begin early in life, particularly when associated with risk factors such as a sedentary lifestyle. CVD is associated with elevated sympathetic nerve activity (SNA), quantified as increased SNA burst activity in humans. Whether burst characteristics are influenced by sex or sedentary conditions at younger ages is unknown. The purpose of our study is to compare SNA bursts in active and sedentary female and male rats at ages including prepuberty and young adulthood. We hypothesized that burst characteristics and blood pressure are higher under sedentary conditions and lower in female rats compared with males. We analyzed splanchnic SNA (SpSNA) recordings from Inactin-anesthetized male and female rats at 4-, 8-, and 16-wk of age. Physically active and sedentary rats were each housed in separate, environmentally controlled chambers where physically active rats had free access to an in-cage running wheel. Sympathetic bursts were obtained by rectifying and integrating the raw SpSNA signal. Burst frequency, burst height, and burst width were calculated using the Peak Parameters extension in LabChart. Our results showed that sedentary conditions produced a greater burst width in 8- and 16-wk-old rats compared with 4-wk-old rats in both males and females (P < 0.001 for both). Burst frequency and incidence were both higher in 16-wk-old males compared with 16-wk-old females (P < 0.001 for both). Our results suggest that there are sedentary lifestyle- and sex-related mechanisms that impact sympathetic regulation of blood pressure at ages that range from prepuberty into young adulthood.NEW & NOTEWORTHY The mechanisms of decreased incidence of cardiovascular disease (CVD) in reproductive-age women compared with age-matched men are unknown. The strong association between elevated sympathetic activity and CVD led us to characterize splanchnic sympathetic bursts in female and male rats. Prepubescent males and females exhibited narrower sympathetic bursts, whereas young adult males had higher resting burst frequency compared with age-matched females. Sex-based regulation of sympathetic activity suggests a need for sex-dependent therapeutic strategies to combat CVD.
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Affiliation(s)
- Shivansh A Desai
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Umme Aiman Mirza
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, United States
| | - Patrick J Mueller
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, United States
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Crosier R, Lopez Laporte MA, Unni RR, Coutinho T. Female-Specific Considerations in Aortic Health and Disease. CJC Open 2024; 6:391-406. [PMID: 38487044 PMCID: PMC10935703 DOI: 10.1016/j.cjco.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/06/2023] [Indexed: 03/17/2024] Open
Abstract
The aorta plays a central role in the modulation of blood flow to supply end organs and to optimize the workload of the left ventricle. The constant interaction of the arterial wall with protective and deleterious circulating factors, and the cumulative exposure to ventriculoarterial pulsatile load, with its associated intimal-medial changes, are important players in the complex process of vascular aging. Vascular aging is also modulated by biomolecular processes such as oxidative stress, genomic instability, and cellular senescence. Concomitantly with well-established cardiometabolic and sex-specific risk factors and environmental stressors, arterial stiffness is associated with cardiovascular disease, which remains the leading cause of morbidity and mortality in women worldwide. Sexual dimorphisms in aortic health and disease are increasingly recognized and explain-at least in part-some of the observable sex differences in cardiovascular disease, which will be explored in this review. Specifically, we will discuss how biological sex affects arterial health and vascular aging and the implications this has for development of certain cardiovascular diseases uniquely or predominantly affecting women. We will then expand on sex differences in thoracic and abdominal aortic aneurysms, with special considerations for aortopathies in pregnancy.
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Affiliation(s)
- Rebecca Crosier
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | | | - Rudy R. Unni
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Thais Coutinho
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Ma G, Li J, Xie J, Li Y, Xu K, He Y, Yang J, Du H, Liu X. Pulse pressure and its association with body composition among Chinese men and women without diagnosed hypertension: the China Kadoorie Biobank. J Hypertens 2023; 41:1802-1810. [PMID: 37682069 PMCID: PMC10552820 DOI: 10.1097/hjh.0000000000003549] [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: 05/17/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Wide brachial pulse pressure (PP) has been associated with cardiovascular events, while its population distribution and association with body composition were poorly characterized in large populations. METHODS We evaluated the age and sex distributions of PP and its associations with body composition using baseline data from the China Kadoorie Biobank. A total of 434 200 participants without diagnosed hypertension were included in the analysis. Wide PP was defined as PP above 65 mmHg. Body composition variables, including BMI, waist circumference, waist-to-hip ratio (WHR), fat mass index (FMI), fat-free mass index (FFMI), and body fat percentage (BF%), were obtained from bioelectrical impedance analysis. RESULTS Overall, 14.3% of the participants had wide PP. Older age was consistently associated with wider PP in women but only after the andropause stage in men. The independent associations of BMI with wide PP were stronger than other body composition measures. The adjusted differences (men/women, mmHg) in PP per standard deviation (SD) increase in BMI (1.55/1.47) were higher than other body composition (BF%: 0.32/0.64, waist circumference: 0.33/0.39; WHR: 0.49/0.42). In addition, sex differences were observed. In men, the per SD difference in PP was higher for FFMI than for FMI (0.91 vs. 0.67, P < 0.05), whereas in women, it was higher for FMI than for FFMI (1.01 vs. 0.72, P < 0.05). CONCLUSION Our nationwide population-based study presented the sex-specific distribution of PP over age and identified differential associations of PP with fat and fat-free mass in men and women.
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Affiliation(s)
- Guoqing Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Junqi Li
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Jiawen Xie
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Yunfeng Li
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Kun Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Yafang He
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Jiaomei Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Huaidong Du
- Medical Research Council Population Health Research Unit at the University of Oxford
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Xin Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
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Mihuta MS, Paul C, Borlea A, Roi CM, Velea-Barta OA, Mozos I, Stoian D. Unveiling the Silent Danger of Childhood Obesity: Non-Invasive Biomarkers Such as Carotid Intima-Media Thickness, Arterial Stiffness Surrogate Markers, and Blood Pressure Are Useful in Detecting Early Vascular Alterations in Obese Children. Biomedicines 2023; 11:1841. [PMID: 37509481 PMCID: PMC10376407 DOI: 10.3390/biomedicines11071841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/17/2023] [Accepted: 06/23/2023] [Indexed: 07/30/2023] Open
Abstract
Obese children present a higher cardio-metabolic risk. Measuring vascular biomarkers that assess the evolution of arterial stiffness, subclinical atherosclerosis, and hypertension in such patients could be helpful in the long term. We studied 84 children, aged from 6 to 18 years: 50 obese subjects, versus 34 of normal weight. Clinical examination involved: BMI, waist circumference, waist-to-height ratio, and detection of the presence of acanthosis nigricans and irregular menstrual cycles (the latter in adolescent girls). The carotid intima-media thickness (CIMT) was measured with the Aixplorer MACH 30 echography device. The pulse wave velocity (PWV), augmentation index (AIx), and peripheral and central blood pressures (i.e., SBP, DBP, cSBP, cDBP, and cPP) were acquired through a Mobil-O-Graph device. Obese subjects underwent body composition analysis with a Tanita BC-418. Blood tests were: HOMA-IR, lipid panel, uric acid, and 25-OH vitamin D. All vascular biomarkers presented increased values in obese subjects versus controls. The following cut-off values were significant in detecting obesity: for PWV > 4.6 m/s, cSBP > 106 mmHg for the <12-year-olds, PWV > 4.5 m/s and cSBP > 115 mmHg for the 12-15-year-olds, and PWV > 5 m/s, cSBP > 123 mmHg for the >15-year-olds. AIx is higher in obese children, regardless of their insulin resistance status. Waist circumference and waist-to-height ratio correlate to all vascular parameters. HOMA-IR is an independent predictor for all vascular parameters except CIMT. Cut-off values for PWV of >4.8 m/s, SBP > 125 mmHg, and a cSBP > 117 mmHg predicted the presence of acanthosis nigricans. Obese girls with irregular menses displayed significantly higher PWV, SBP, and DPB. Elevated levels of uric acid, LDL-c, non-LDL-c, triglycerides, and transaminases, and low levels of HDL-c and 25-OH vitamin D correlated with higher arterial stiffness and CIMT values. We conclude that CIMT and the markers of arterial stiffness are useful in the early detection of vascular damage in obese children.
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Affiliation(s)
- Monica Simina Mihuta
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Corina Paul
- Department of Pediatrics, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Andreea Borlea
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- 2nd Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Cristina Mihaela Roi
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Oana-Alexandra Velea-Barta
- 3rd Department of Odontotherapy and Endodontics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ioana Mozos
- Department of Functional Sciences-Pathophysiology, Center for Translational Research and Systems Medicine, Victor Babes University of Medicine and Pharmacy, 300173 Timisoara, Romania
| | - Dana Stoian
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- 2nd Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Shen K, Li G, Chemori A, Hayashibe M. Self-organizing neural network for reproducing human postural mode alternation through deep reinforcement learning. Sci Rep 2023; 13:8966. [PMID: 37268710 DOI: 10.1038/s41598-023-35886-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/25/2023] [Indexed: 06/04/2023] Open
Abstract
A self-organized phenomenon in postural coordination is essential for understanding the auto-switching mechanism of in-phase and anti-phase postural coordination modes during standing and related supra-postural activities. Previously, a model-based approach was proposed to reproduce such self-organized phenomenon. However, if we set this problem including the process of how we establish the internal predictive model in our central nervous system, the learning process is critical to be considered for establishing a neural network for managing adaptive postural control. Particularly when body characteristics may change due to growth or aging or are initially unknown for infants, a learning capability can improve the hyper-adaptivity of human motor control for maintaining postural stability and saving energy in daily living. This study attempted to generate a self-organizing neural network that can adaptively coordinate the postural mode without assuming a prior body model regarding body dynamics and kinematics. Postural coordination modes are reproduced in head-target tracking tasks through a deep reinforcement learning algorithm. The transitions between the postural coordination types, i.e. in-phase and anti-phase coordination modes, could be reproduced by changing the task condition of the head tracking target, by changing the frequencies of the moving target. These modes are considered emergent phenomena existing in human head tracking tasks. Various evaluation indices, such as correlation, and relative phase of hip and ankle joint, are analyzed to verify the self-organizing neural network performance to produce the postural coordination transition between the in-phase and anti-phase modes. In addition, after learning, the neural network can also adapt to continuous task condition changes and even to unlearned body mass conditions keeping consistent in-phase and anti-phase mode alternation.
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Affiliation(s)
- Keli Shen
- Department of Robotics, Graduate School of Engineering, Tohoku University, Sendai, Japan
| | - Guanda Li
- Department of Robotics, Graduate School of Engineering, Tohoku University, Sendai, Japan
| | - Ahmed Chemori
- LIRMM, University of Montpellier, CNRS, Montpellier, France
| | - Mitsuhiro Hayashibe
- Department of Robotics, Graduate School of Engineering, Tohoku University, Sendai, Japan.
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D’Agata MN, Matias AA, Witman MA. We like to move it, move it: A perspective on performing passive leg movement as a non-invasive assessment of vascular function in pediatric populations. Front Physiol 2023; 14:1165800. [PMID: 37179828 PMCID: PMC10169695 DOI: 10.3389/fphys.2023.1165800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/03/2023] [Indexed: 05/15/2023] Open
Abstract
The passive leg movement (PLM) technique is a non-invasive assessment of lower-limb vascular function. PLM is methodologically simple to perform and utilizes Doppler ultrasound to determine leg blood flow (LBF) through the common femoral artery at rest and in response to passive movement of the lower leg. LBF responses to PLM have been reported to be mostly nitric oxide (NO)-mediated when performed in young adults. Moreover, PLM-induced LBF responses, as well as the NO contribution to PLM-induced LBF responses, are reduced with age and in various diseased populations, demonstrating the clinical utility of this non-invasive test. However, no PLM studies to date have included children or adolescents. Since its conception in 2015, our laboratory has performed PLM on hundreds of individuals including a large cohort of children and adolescents. Thus, the purpose of this perspective article is threefold: 1) to uniquely discuss the feasibility of performing PLM in children and adolescents, 2) to report PLM-induced LBF values from our laboratory in 7-17-year-olds, and 3) to discuss considerations for making comparisons among pediatric populations. Based on our experiences performing PLM in children and adolescents (among various other age groups), it is our perspective that PLM can feasibly be performed in this population. Further, data from our laboratory may be used to provide context for typical PLM-induced LBF values that could be observed in children and adolescents, as well as across the lifespan.
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Affiliation(s)
| | | | - Melissa A. Witman
- Vascular Function in Chronic Disease Research Laboratory, Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States
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Agbaje AO, Zachariah JP, Bamsa O, Odili AN, Tuomainen TP. Cumulative insulin resistance and hyperglycemia with arterial stiffness and carotid IMT progression in 1,779 adolescents: a 9-yr longitudinal cohort study. Am J Physiol Endocrinol Metab 2023; 324:E268-E278. [PMID: 36753290 PMCID: PMC10010917 DOI: 10.1152/ajpendo.00008.2023] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/09/2023]
Abstract
In pediatric population with diabetes and obesity, insulin resistance (HOMA-IR) has been associated with worsening vascular outcomes, however, the cumulative role of HOMA-IR, hyperglycemia, and hyperinsulinemia on repeatedly measured vascular outcomes in asymptomatic youth is unknown. We examined the longitudinal associations of fasting glucose, insulin, and HOMA-IR with carotid-femoral pulse wave velocity (cfPWV) and carotid intima-media thickness (cIMT). From the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, UK 1,779, 15-yr-old participants were followed up for 9 yr. Glucose, insulin, and HOMA-IR assessed at 15, 17, and 24 yr and sex-specifically dichotomized as ≥75th percentile, indicating high category and <75th percentile as reference. cfPWV and cIMT were measured at ages 17 and 24 yr. Associations were examined using linear mixed-effect models adjusted for cardiometabolic and lifestyle covariates. Among 1,779 participants [49.9% female], glucose, insulin, and HOMA-IR had a J- or U-shaped increase from ages 15 through 24 yr. The cumulative exposures to hyperinsulinemia effect estimate -0.019 mU/L; [95% CI -0.019 to -0.002; P = 0.033] and high HOMA-IR: -0.021; [-0.039 to -0.004; P = 0.019] from 15 to 24 yr of age were negatively associated with the 7-yr cfPWV progression. Only cumulative hyperinsulinemia and high HOMA-IR from ages 15 to 17 yr but not from ages 17 to 24 yr was associated with decreased cfPWV progression. There were no associations between cumulative hyperglycemia and cfPWV or cIMT progression. Hyperinsulinemia and HOMA-IR were not associated with cIMT progression. In conclusion, late adolescence may be an optimal timing for intervention targeted at sustaining the protective effect of the decline of insulin and insulin resistance on arterial stiffness progression.NEW & NOTEWORTHY Fasting plasma glucose, insulin, and insulin resistance had a J- or U-shaped increase from 15 to 24 yr with the base of the curve at age 17 yr. Cumulative high insulin and high insulin resistance from 15 to 24 yr were negatively associated with arterial stiffness progression from ages 17 to 24 yr. Age 17 yr may be an optimal timing for intervention targeted at sustaining the protective effect of the decline of insulin and insulin resistance on arterial stiffness progression.
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Affiliation(s)
- Andrew O Agbaje
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Justin P Zachariah
- Section of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, United States
| | | | - Augustine N Odili
- Department of Epidemiology, Circulatory Health Research Laboratory, College of Health Sciences, University of Abuja, Abuja, Nigeria
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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Mihuta MS, Stoian D, Borlea A, Roi CM, Velea-Barta OA, Mozos I, Paul C. Evaluating the Arterial Stiffness as a Useful Tool in the Management of Obese Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020183. [PMID: 36832311 PMCID: PMC9955158 DOI: 10.3390/children10020183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/28/2022] [Accepted: 01/15/2023] [Indexed: 01/20/2023]
Abstract
Childhood obesity speeds up the development of arterial stiffness and progressively increases the values of arterial pressure. The purpose of this study is to investigate the value of using pulse wave analysis (PWA) to measure arterial stiffness as a sign of vascular wall impairment in obese children. The research was focused on 60 subjects: 33 obese and 27 normal-weight. Ages ranged from 6 to 18 years old. PWA includes parameters such as pulse wave velocity (PWV), augmentation index (AIx), peripheral and central blood pressure (SBP, DBP, cSBP, cDBP), heart rate, and central pulse pressure (cPP). The device used was a Mobil-O-Graph. Blood parameters were taken from the subject's medical history, not older than 6 months. A high BMI and a large waist circumference are linked to a high PWV. The levels of LDL-c, triglycerides (TG), non-HDL-c, TG/HDL-c ratio, and total cholesterol-HDL-c ratio significantly correlate to PWV, SBP, and cSBP. Alanine aminotransferase is a reliable predictor of PWV, AIx, SBP, DBP, and cDBP, while aspartate aminotransferase is a significant predictor of AIx, mean arterial pressure (MAP), cSBP, and cPP. 25-OH-Vitamin D negatively correlates with PWV, SBP, and MAP and significantly predicts the MAP. Cortisol and TSH levels are not significant to arterial stiffness in obese children without specific comorbidities and neither is fasting glucose in obese children without impaired glucose tolerance. We conclude that PWA contributes valuable data regarding patients' vascular health and should be considered a reliable tool in the management of obese children.
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Affiliation(s)
- Monica Simina Mihuta
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Dana Stoian
- 2nd Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Correspondence:
| | - Andreea Borlea
- 2nd Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Cristina Mihaela Roi
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Oana-Alexandra Velea-Barta
- 3rd Department of Odontotherapy and Endodontics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ioana Mozos
- Department of Functional Sciences—Pathophysiology, Center for Translational Research and Systems Medicine, Victor Babes University of Medicine and Pharmacy, 300173 Timisoara, Romania
| | - Corina Paul
- Department of Pediatrics, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
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11
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Rogers SC, Ko YA, Quyyumi AA, Hajjar I. Differential Sex-Specific Effects of Angiotensin-Converting Enzyme Inhibition and Angiotensin Receptor Blocker Therapy on Arterial Function in Hypertension: CALIBREX Trial. Hypertension 2022; 79:2316-2327. [PMID: 35916128 DOI: 10.1161/hypertensionaha.122.19105] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Increased arterial stiffness is associated with adverse cardiovascular outcomes. We studied the sex-specific impact of angiotensin antagonists on vascular function in hypertension with the hypothesis that their effects on arterial stiffness may be variable in men and women. METHODS In 141 hypertensive participants with mild cognitive impairment (age 65.9±7.7, 57% female), candesartan (up to 32 mg, n=77) or lisinopril (up to 40 mg, n=64) were administered to achieve blood pressure <140/90 mm Hg. Pulse wave velocity, central pulse pressure, and central augmentation index were measured using applanation tonometry (SphygmoCor, Australia). Multivariate linear regression and mixed model analyses were performed using intention-to-treat and per protocol analyses for those completing the study. RESULTS Blood pressure reduction was similar among candesartan and lisinopril groups. Compared with candesartan, lisinopril therapy resulted in lower pulse wave velocity (0.5±0.8 versus -0.7±0.4 m/s, respectively; P=0.003) and central pulse pressure (-1±3 versus -7±4 mm Hg; P=0.03) after 1 year. There was a significant interaction by sex whereby the improvements in pulse wave velocity and central pulse pressure with lisinopril compared with candesartan were only observed in women. In contrast, there was greater improvement in augmentation index with candesartan compared with lisinopril (-4±7% versus -1.5±8%; P=0.05), with no sex differences. CONCLUSIONS Despite equipotent antihypertensive effects, lisinopril was more effective than candesartan at lowering arterial stiffness in women. In contrast, candesartan was more effective than lisinopril in improving pulse wave reflections in both sexes. These findings demonstrate differential sex-specific effects of renin-angiotensin system antagonists on arterial function in hypertension that may contribute to long-term cardiovascular and neurocognitive outcomes in this population.
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Affiliation(s)
- Steven C Rogers
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute (S.C.R., Y.-A.K., A.A.Q.), Emory University School of Medicine, Atlanta, GA
| | - Yi-An Ko
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute (S.C.R., Y.-A.K., A.A.Q.), Emory University School of Medicine, Atlanta, GA
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA (Y.-A.K.)
| | - Arshed A Quyyumi
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute (S.C.R., Y.-A.K., A.A.Q.), Emory University School of Medicine, Atlanta, GA
| | - Ihab Hajjar
- Department of Neurology (I.H.), Emory University School of Medicine, Atlanta, GA
- Division of General Medicine and Geriatrics, Department of Medicine (I.H.), Emory University School of Medicine, Atlanta, GA
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12
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Connecting Aortic Stiffness to Vascular Contraction: Does Sex Matter? Int J Mol Sci 2022; 23:ijms231911314. [PMID: 36232616 PMCID: PMC9569837 DOI: 10.3390/ijms231911314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 09/18/2022] [Accepted: 09/21/2022] [Indexed: 11/17/2022] Open
Abstract
This study was designed to connect aortic stiffness to vascular contraction in young male and female Wistar rats. We hypothesized that female animals display reduced intrinsic media-layer stiffness, which associates with improved vascular function. Atomic force microscopy (AFM)-based nanoindentation analysis was used to derive stiffness (Young’s modulus) in biaxially (i.e., longitudinal and circumferential) unloaded aortic rings. Reactivity studies compatible with uniaxial loading (i.e., circumferential) were used to assess vascular responses to a selective α1 adrenergic receptor agonist in the presence or absence of extracellular calcium. Elastin and collagen levels were indirectly evaluated with fluorescence microscopy and a picrosirius red staining kit, respectively. We report that male and female Wistar rats display similar AFM-derived aortic media-layer stiffness, even though female animals withstand higher aortic intima-media thickness-to-diameter ratio than males. Female animals also present reduced phenylephrine-induced aortic force development in concentration-response and time-force curves. Specifically, we observed impaired force displacement in both parts of the contraction curve (Aphasic and Atonic) in experiments conducted with and without extracellular calcium. Additionally, collagen levels were lower in female animals without significant elastin content and fragmentation changes. In summary, sex-related functional differences in isolated aortas appear to be related to dissimilarities in the dynamics of vascular reactivity and extracellular matrix composition rather than a direct response to a shift in intrinsic media-layer stiffness.
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13
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A Systematic Review of the Associations of Adiposity and Cardiorespiratory Fitness With Arterial Structure and Function in Nonclinical Children and Adolescents. Pediatr Exerc Sci 2022:1-12. [PMID: 36150705 DOI: 10.1123/pes.2022-0029] [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: 02/16/2022] [Revised: 08/02/2022] [Accepted: 08/07/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE To summarize the evidence on associations of adiposity and cardiorespiratory fitness (CRF) with arterial structure and function in nonclinical children and adolescents. METHODS Two researchers conducted a search in 5 electronic databases in April 2022 to find studies in nonclinical youth (age 5-17.9 y) reporting multivariable associations. Studies were eligible if adiposity and/or CRF were used as the predictor and arterial structure and/or function was the outcome. The Quality Assessment Tool for Quantitative Studies was used to assess methodological quality for experimental studies, and a modified version was used for observational studies. RESULTS Ninety-nine studies (72.7% cross-sectional) were included. Ninety-four assessed associations between adiposity and arterial outcomes, most using overall body proportion (n = 71), abdominal (n = 52), or whole-body adiposity (n = 40). Most evidence was inconsistent or nonsignificant, but 59 studies suggested higher abdominal adiposity and worse body proportion were associated with adverse arterial outcomes. Twenty-one assessed associations between CRF and arterial outcomes, with findings inconsistent. Most evidence was rated weak in quality. CONCLUSION While high adiposity may contribute to poor arterial outcomes, evidence is limited regarding CRF. Future studies should disentangle these associations by studying youth with healthy adiposity but poor CRF, or vice versa, using longitudinal or experimental study designs.
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14
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Mihuta MS, Paul C, Borlea A, Cepeha CM, Velea IP, Mozos I, Stoian D. The Oscillometric Pulse Wave Analysis Is Useful in Evaluating the Arterial Stiffness of Obese Children with Relevant Cardiometabolic Risks. J Clin Med 2022; 11:jcm11175078. [PMID: 36079009 PMCID: PMC9457050 DOI: 10.3390/jcm11175078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/27/2022] [Accepted: 08/28/2022] [Indexed: 11/16/2022] Open
Abstract
Early detection of all complications of childhood obesity is imperative in order to minimize effects. Obesity causes vascular disruptions, including early increased arterial stiffness and high blood pressure. This study’s aim is to assess the reliability of pulse wave analysis (PWA) in obese children and how additional risk factors influence the evaluated parameters. We analyzed 55 children aged 6–18 years old by measuring their pulse wave velocity (PWV), augmentation index (AIx), peripheral blood pressure (SBP, DBP), heart rate, central blood pressure (cSBP, cDBP) and central pulse pressure (cPP). We used the oscillometric IEM Mobil-O-Graph and performed a single-point brachial measurement. The subjects were divided into two groups: obese (n = 30) and normal-weight (n = 25) and were clinically and anamnestically assessed. BMI and waist circumference are significantly correlated to higher values for PWV, SBP, DBP, cSBP, and cDBP. Weight significantly predicts PWV, SBP, DBP and cPP. The risk factors that significantly influence the PWA and BP values are: a cardiometabolically risky pregnancy (higher PWV, AIx, SBP), active and passive smoking (higher PWV, SBP, cSBP, cDBP), sleep deprivation (higher PWV, SBP, cSBP) and sedentariness (higher PWV, AIx, peripheral and central BP). We conclude that obese children with specific additional cardiometabolic risk factors present increased arterial stiffness and higher blood pressure values.
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Affiliation(s)
- Monica Simina Mihuta
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Corina Paul
- Department of Pediatrics, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Correspondence:
| | - Andreea Borlea
- 2nd Department of Internal Medicine, Victor Babeș University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Cristina Mihaela Cepeha
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Iulian Puiu Velea
- Department of Pediatrics, Pius Brinzeu Emergency County Hospital, 300723 Timisoara, Romania
| | - Ioana Mozos
- Department of Functional Sciences—Pathophysiology, Center for Translational Research and Systems Medicine, Victor Babeş University of Medicine and Pharmacy, 300173 Timisoara, Romania
| | - Dana Stoian
- 2nd Department of Internal Medicine, Victor Babeș University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
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15
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Gaynor-Metzinger SHA, Triplett NT, Meucci M, Fasczewski KS, Flinchum DH, Collier SR. Central arterial stiffness, wave reflection, and heart rate variability following 4-week high-intensity resistance training intervention in young active women. Eur J Appl Physiol 2022; 122:2283-2293. [DOI: 10.1007/s00421-022-05003-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 06/28/2022] [Indexed: 12/22/2022]
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16
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Mizrak I, Asserhøj LL, Lund MAV, Greisen GO, Clausen TD, Main KM, Vejlstrup NG, Jensen RB, Pinborg A, Madsen PL. Aortic distensibility is equal in prepubertal girls and boys and increases with puberty in girls. Am J Physiol Heart Circ Physiol 2022; 323:H312-H321. [PMID: 35687504 DOI: 10.1152/ajpheart.00097.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Windkessel function is governed by conductance artery compliance that is associated with cardiovascular disease in adults independently of other risk factors. Sex-related differences in conductance artery compliance partly explain the sex-related differences in risk of cardiovascular disease. Studies on sex-related differences in conductance artery function in prepubertal children are few and inconclusive. This study determined conductance artery compliance and cardiac function by magnetic resonance imaging in 150 healthy children (75 girls) aged 7-10 years. Any sex-related difference in conductance artery function was determined with correction for other potential predictors in multivariable linear regression models. Our data showed that ascending (crude mean difference 1.11 95% CI (0.22; 2.01)) and descending (crude mean difference 1.10 95% CI (0.09; 1.91)) aortic distensibility were higher in girls, but differences disappeared after adjustment for pubertal status and other identified potential predictors. Systolic and diastolic blood pressure, cardiac output, left ventricle (LV) systolic function, and total peripheral resistance did not differ between the sexes. In girls, heart rate was 7 bpm higher, whereas pulse pressure (by 2 mmHg), and LV end-diastolic volume index (by 7 mL) and stroke volume (by 5 mL) were lower. LV peak filling rate indexed to LV end-diastolic volume was 0.5 s-1 higher in girls. In conclusion, prepubertal girls and boys have equal conductance artery function. Thus, the well-known sex difference in adult conductance artery function seems to develop after the onset of puberty with girls initially increasing aortic distensibility.
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Affiliation(s)
- Ikram Mizrak
- Department of Cardiology, Herlev-Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Fertility Department, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Louise L Asserhøj
- Fertility Department, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Growth and Reproduction, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,International Center for Research and Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Morten A V Lund
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gorm O Greisen
- Department of Neonatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Tine D Clausen
- Department of Gynecology and Obstetrics, North Zealand Hospital, Copenhagen University Hospital, Hilleroed, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Katharina M Main
- Department of Growth and Reproduction, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,International Center for Research and Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Niels G Vejlstrup
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Rikke B Jensen
- Department of Growth and Reproduction, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,International Center for Research and Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anja Pinborg
- Fertility Department, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Per L Madsen
- Department of Cardiology, Herlev-Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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17
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Pierce GL, Coutinho TA, DuBose LE, Donato AJ. Is It Good to Have a Stiff Aorta with Aging? Causes and Consequences. Physiology (Bethesda) 2022; 37:154-173. [PMID: 34779281 PMCID: PMC8977146 DOI: 10.1152/physiol.00035.2021] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/28/2021] [Accepted: 11/08/2021] [Indexed: 01/09/2023] Open
Abstract
Aortic stiffness increases with advancing age, more than doubling during the human life span, and is a robust predictor of cardiovascular disease (CVD) clinical events independent of traditional risk factors. The aorta increases in diameter and length to accommodate growing body size and cardiac output in youth, but in middle and older age the aorta continues to remodel to a larger diameter, thinning the pool of permanent elastin fibers, increasing intramural wall stress and resulting in the transfer of load bearing onto stiffer collagen fibers. Whereas aortic stiffening in early middle age may be a compensatory mechanism to normalize intramural wall stress and therefore theoretically "good" early in the life span, the negative clinical consequences of accelerated aortic stiffening beyond middle age far outweigh any earlier physiological benefit. Indeed, aortic stiffness and the loss of the "windkessel effect" with advancing age result in elevated pulsatile pressure and flow in downstream microvasculature that is associated with subclinical damage to high-flow, low-resistance organs such as brain, kidney, retina, and heart. The mechanisms of aortic stiffness include alterations in extracellular matrix proteins (collagen deposition, elastin fragmentation), increased arterial tone (oxidative stress and inflammation-related reduced vasodilators and augmented vasoconstrictors; enhanced sympathetic activity), arterial calcification, vascular smooth muscle cell stiffness, and extracellular matrix glycosaminoglycans. Given the rapidly aging population of the United States, aortic stiffening will likely contribute to substantial CVD burden over the next 2-3 decades unless new therapeutic targets and interventions are identified to prevent the potential avalanche of clinical sequelae related to age-related aortic stiffness.
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Affiliation(s)
- Gary L Pierce
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa
- Abboud Cardiovascular Research Center, University of Iowa, Iowa City, Iowa
- Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa
| | - Thais A Coutinho
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Divisions of Cardiology and Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Lyndsey E DuBose
- Division of Geriatrics, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Anthony J Donato
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
- Department of Biochemistry, University of Utah, Salt Lake City, Utah
- Geriatric Research Education and Clinical Center, VA Salt Lake City, Salt Lake City, Utah
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18
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Tai CC, Chen YL, Kalfirt L, Masodsai K, Su CT, Yang AL. Differences between Elite Male and Female Badminton Athletes Regarding Heart Rate Variability, Arterial Stiffness, and Aerobic Capacity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063206. [PMID: 35328902 PMCID: PMC8956041 DOI: 10.3390/ijerph19063206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 11/17/2022]
Abstract
Cardiovascular health and aerobic capacity play crucial roles in determining the performance of athletes in the highly competitive sport of badminton. Few studies have directly compared heart rate variability (HRV), arterial stiffness, and aerobic capacity between male and female athletes, especially among badminton athletes. This study investigated sex differences in HRV, arterial stiffness, and aerobic capacity in badminton athletes. Elite badminton athletes were recruited and divided into male (n = 20, 21.0 ± 1.8 years old) and female (n = 16, 21.2 ± 2.3 years old) groups. Both groups performed an incremental treadmill running test for the evaluation of maximal oxygen consumption (V.O2max), anaerobic threshold, and time to exhaustion. They started exercising at a treadmill speed of 2.7 km/h and an inclination of 10% gradient for 3 min, and the speed and inclination were gradually increased every 3 min until they were exhausted or fatigued volitionally. HRV was examined using the Polar heart rate monitor over a period of 5 min at rest in the supine position. Subsequently, the index of arterial stiffness was examined under the same condition. Our results revealed significant differences between the male and female athletes in V.O2max (men: 60.38 ± 8.98 mL/kg/min, women: 48.13 ± 7.72 mL/kg/min, p < 0.05), anaerobic threshold (men: 41.50 ± 7.26 mL/kg/min, women: 32.51 ± 6.19 mL/kg/min, p < 0.05), time to exhaustion (men: 902.15 ± 120.15 s, women: 780.56 ± 67.63 s, p < 0.05), systolic blood pressure (men: 125.27 ± 7.76 mmHg, women: 107.16 ± 11.09 mmHg, p < 0.05), and arterial stiffness index (men: 63.56 ± 12.55, women: 53.83 ± 8.03, p < 0.05). However, no significant differences in HRV measures were observed between the two groups. These findings suggested that the male badminton athletes demonstrated significantly higher aerobic capacity than did the female athletes, but there were no significant differences in HRV measures. The female athletes exhibited superior arterial function, compared with their male counterparts.
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Affiliation(s)
- Ching-Chieh Tai
- Graduate Institute of Sports Training, University of Taipei, Taipei 11153, Taiwan; (C.-C.T.); (Y.-L.C.)
| | - Yi-Liang Chen
- Graduate Institute of Sports Training, University of Taipei, Taipei 11153, Taiwan; (C.-C.T.); (Y.-L.C.)
| | - Ludek Kalfirt
- Institute of Sports Sciences, University of Taipei, Taipei 11153, Taiwan;
| | - Kunanya Masodsai
- Faculty of Sports Science, Chulalongkorn University, Bangkok 10330, Thailand;
| | - Chia-Ting Su
- Department of Occupational Therapy, College of Medicine, Fu Jen Catholic University, New Taipei City 24205, Taiwan;
| | - Ai-Lun Yang
- Institute of Sports Sciences, University of Taipei, Taipei 11153, Taiwan;
- Correspondence: ; Tel.: +886-228-718-288 (ext. 5815)
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19
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Marshall ZA, Mackintosh KA, McNarry MA. Investigating the influence of physical activity composition on arterial stiffness in youth. Eur J Sport Sci 2022; 23:617-624. [PMID: 35135413 DOI: 10.1080/17461391.2022.2039304] [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: 01/10/2023]
Abstract
Physical activity is beneficial for arterial health in children but less is known about how all daily movement behaviours influence arterial stiffening. Compositional analysis can account for the co-dependent nature of these behaviours and therefore was employed to explore how the movement composition influences arterial health. Augmentation index (AIx) and pulse wave velocity were measured cross-sectionally in healthy children (n = 129; 12.4 ± 1.6 years). Time spent in sedentary, light physical activity (LPA), moderate-to-vigorous physical activity (MVPA) and asleep were derived from seven-day hip-worn accelerometry. The relative effects of individual behaviours and the overall movement composition on arterial stiffness were explored utilising compositional analysis, with predictive modelling used to predict effects of the substituting time between behaviours. Girls (n = 45, 12.1 ± 1.5yrs, 20.5 ± 3.6kg·m-2) had a higher AIx (+ 3.94; p < 0.05) and accrued physical activity predominantly in LPA, whereas boys (n = 56, 12.6 ± 1.7yrs, 20.6 ± 4.0kg·m-2) accrued physical activity predominantly in MVPA. Individual behaviours and the movement composition were not significant predictors of any measure of arterial stiffness (P > 0.05), and the reallocation of 20-minutes between behaviours did not elicit significant change in arterial stiffness, irrespective of sex (P > 0.05). The reallocation of time to MVPA from any other behaviour did not predict an improvement in arterial stiffness. This highlights the high potential dose of MVPA required to improve arterial health and the complex nature of the determinants of arterial stiffness. HighlightsMovement behaviours in isolation nor combination predicted arterial stiffness in youth.The reallocation of behaviours from any other behaviour to MVPA did not affect arterial stiffness in youth.Arterial stiffness is a complex, multidimensional health parameter that does not appear to be primarily determined by physical activity levels or intensity.
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Affiliation(s)
- Zoë A Marshall
- Applied, Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, UK
| | - Kelly A Mackintosh
- Applied, Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, UK
| | - Melitta A McNarry
- Applied, Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, UK
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20
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Koch SE, de Kort BJ, Holshuijsen N, Brouwer HFM, van der Valk DC, Dankers PYW, van Luijk JAKR, Hooijmans CR, de Vries RBM, Bouten CVC, Smits AIPM. Animal studies for the evaluation of in situ tissue-engineered vascular grafts - a systematic review, evidence map, and meta-analysis. NPJ Regen Med 2022; 7:17. [PMID: 35197483 PMCID: PMC8866508 DOI: 10.1038/s41536-022-00211-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/11/2022] [Indexed: 12/12/2022] Open
Abstract
Vascular in situ tissue engineering (TE) is an approach that uses bioresorbable grafts to induce endogenous regeneration of damaged blood vessels. The evaluation of newly developed in situ TE vascular grafts heavily relies on animal experiments. However, no standard for in vivo models or study design has been defined, hampering inter-study comparisons and translational efficiency. To provide input for formulating such standard, the goal of this study was to map all animal experiments for vascular in situ TE using off-the-shelf available, resorbable synthetic vascular grafts. A literature search (PubMed, Embase) yielded 15,896 studies, of which 182 studies met the inclusion criteria (n = 5,101 animals). The reports displayed a wide variety of study designs, animal models, and biomaterials. Meta-analysis on graft patency with subgroup analysis for species, age, sex, implantation site, and follow-up time demonstrated model-specific variations. This study identifies possibilities for improved design and reporting of animal experiments to increase translational value.
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Affiliation(s)
- Suzanne E Koch
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Bente J de Kort
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Noud Holshuijsen
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Hannah F M Brouwer
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Dewy C van der Valk
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Patricia Y W Dankers
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Judith A K R van Luijk
- SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE), Department for Health Evidence, Radboud Institute for Health Sciences, Radboud UMC, Nijmegen, The Netherlands
| | - Carlijn R Hooijmans
- SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE), Department for Health Evidence, Radboud Institute for Health Sciences, Radboud UMC, Nijmegen, The Netherlands
| | - Rob B M de Vries
- SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE), Department for Health Evidence, Radboud Institute for Health Sciences, Radboud UMC, Nijmegen, The Netherlands
| | - Carlijn V C Bouten
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Anthal I P M Smits
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands. .,Institute for Complex Molecular Systems (ICMS), Eindhoven University of Technology, Eindhoven, The Netherlands.
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21
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Lau ES, Panah LG, Zern EK, Liu EE, Farrell R, Schoenike MW, Namasivayam M, Churchill TW, Curreri L, Malhotra R, Nayor M, Lewis GD, Ho JE. Arterial Stiffness and Vascular Load in HFpEF: Differences Among Women and Men. J Card Fail 2022; 28:202-211. [PMID: 34955334 PMCID: PMC8840989 DOI: 10.1016/j.cardfail.2021.10.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Mechanisms underlying sex differences in heart failure with preserved ejection fraction (HFpEF) are poorly understood. We sought to examine sex differences in measures of arterial stiffness and the association of arterial stiffness measures with left ventricular hemodynamic responses to exercise in men and women. METHODS We studied 83 men (mean age 62 years) and 107 women (mean age 59 years) with HFpEF who underwent cardiopulmonary exercise testing with invasive hemodynamic monitoring and arterial stiffness measurement (augmentation pressure [AP], augmentation index [AIx], and aortic pulse pressure [AoPP]). Sex differences were compared using multivariable linear regression. We examined the association of arterial stiffness with abnormal left ventricular diastolic response to exercise, defined as a rise in pulmonary capillary wedge pressure relative to cardiac output (∆PCWP/∆CO) ≥ 2 mmHg/L/min by using logistic regression models. RESULTS Women with HFpEF had increased arterial stiffness compared with men. AP was nearly 10 mmHg higher, and AIx was more than 10% higher in women compared with men (P < 0.0001 for both). Arterial stiffness measures were associated with a greater pulmonary capillary wedge pressure response to exercise, particularly among women. A 1-standard deviation higher AP was associated with > 3-fold increased odds of abnormal diastolic exercise response (AP: OR 3.16, 95% CI 1.34-7.42; P = 0.008 [women] vs OR 2.07, 95% CI 0.95-5.49; P = 0.15 [men]) with similar findings for AIx and AoPP. CONCLUSIONS Arterial stiffness measures are significantly higher in women with HFpEF than in men and are associated with abnormally steep increases in pulmonary capillary wedge pressure with exercise, particularly in women. Arterial stiffness may preferentially contribute to abnormal diastolic function during exercise in women with HFpEF compared with men.
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22
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Kwak S, Kim HL, Lim WH, Seo JB, Kim SH, Zo JH, Kim MA. Sex-specific associations of brachial-ankle pulse wave velocity with adverse cardiac remodeling and long-term cardiovascular outcome. J Hypertens 2022; 40:364-373. [PMID: 34611109 DOI: 10.1097/hjh.0000000000003021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND It remains unclear whether the cardiovascular consequences of arterial stiffness differ by sex. This study aimed to investigate the sex-specific association of brachial-ankle pulse wave velocity (baPWV) with adverse cardiac remodeling and cardiovascular outcome. METHOD We studied 11 767 patients (57.6% men) with cardiovascular risk factors, whose baPWV was measured. The primary endpoint was composite cardiovascular events. Restricted cubic spline (RCS) analyses were performed to delineate the association of baPWV with echocardiography parameters and risks of cardiovascular events. RESULTS RCS curves showed that structural/functional echocardiography parameters gradually worsened with increasing baPWV more prominently in women than in men. The prevalence of left ventricular hypertrophy and diastolic dysfunction increases with baPWV increase more steeply in women (P-for-interaction by sex <0.001). During the median follow-up of 3.64 years (interquartile interval, 1.56-5.38 years), 350 cardiovascular events (3.0%) and 155 deaths (1.3%) occurred. Cumulative cardiovascular events and deaths were significantly higher in patients with elevated baPWV in both sexes (P < 0.001). Cox analyses showed that the increase in baPWV was associated with the higher risks of cardiovascular events and deaths more strongly in women [cardiovascular events: men, adjusted hazard ratio 1.10, 95% confidence interval (1.08-1.13), P < 0.001; women, adjusted hazard ratio 1.18, 95% confidence interval (1.13-1.24), P < 0.001 by 100 cm/s increase in baPWV; P-for-interaction by sex = 0.022]. CONCLUSION The detrimental effects of baPWV on adverse cardiac remodeling and cardiovascular outcome were stronger in women than in men. The prognostic information provided by baPWV may be particularly crucial for women.
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Affiliation(s)
- Soongu Kwak
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Boramae Medical Center, Seoul, South Korea
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23
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Vatner SF, Zhang J, Vyzas C, Mishra K, Graham RM, Vatner DE. Vascular Stiffness in Aging and Disease. Front Physiol 2021; 12:762437. [PMID: 34950048 PMCID: PMC8688960 DOI: 10.3389/fphys.2021.762437] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 10/26/2021] [Indexed: 01/01/2023] Open
Abstract
The goal of this review is to provide further understanding of increased vascular stiffness with aging, and how it contributes to the adverse effects of major human diseases. Differences in stiffness down the aortic tree are discussed, a topic requiring further research, because most prior work only examined one location in the aorta. It is also important to understand the divergent effects of increased aortic stiffness between males and females, principally due to the protective role of female sex hormones prior to menopause. Another goal is to review human and non-human primate data and contrast them with data in rodents. This is particularly important for understanding sex differences in vascular stiffness with aging as well as the changes in vascular stiffness before and after menopause in females, as this is controversial. This area of research necessitates studies in humans and non-human primates, since rodents do not go through menopause. The most important mechanism studied as a cause of age-related increases in vascular stiffness is an alteration in the vascular extracellular matrix resulting from an increase in collagen and decrease in elastin. However, there are other mechanisms mediating increased vascular stiffness, such as collagen and elastin disarray, calcium deposition, endothelial dysfunction, and the number of vascular smooth muscle cells (VSMCs). Populations with increased longevity, who live in areas called “Blue Zones,” are also discussed as they provide additional insights into mechanisms that protect against age-related increases in vascular stiffness. Such increases in vascular stiffness are important in mediating the adverse effects of major cardiovascular diseases, including atherosclerosis, hypertension and diabetes, but require further research into their mechanisms and treatment.
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Affiliation(s)
- Stephen F Vatner
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
| | - Jie Zhang
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
| | - Christina Vyzas
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
| | - Kalee Mishra
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
| | - Robert M Graham
- Victor Chang Cardiac Research Institute, University of New South Wales, Darlinghurst, NSW, Australia
| | - Dorothy E Vatner
- Department of Cell Biology and Molecular Medicine, Rutgers University - New Jersey Medical School, Newark, NJ, United States
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24
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Ballenger BK, Hunter GR, Fisher G. Vascular hemodynamics and blood pressure differences between young and older women. Clin Hypertens 2021; 27:25. [PMID: 34776005 PMCID: PMC8591875 DOI: 10.1186/s40885-021-00181-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 09/25/2021] [Indexed: 11/30/2022] Open
Abstract
Background Cardiovascular disease is one of the main causes of death in the United States, and hypertension is a primary risk factor. Therefore, the primary causes of hypertension need to be identified so they may be addressed for treatment. The purpose of this study was to compare blood pressure with hemodynamic values and identify factors that may explain blood pressure differences between a cohort of healthy normotensive younger and older women. Methods Participants were 49 young (age: 33.8 ± 5.9) and 103 old (age: 65.8 ± 4) who were non-hypertensive, had no previous history of heart disease or type 2 diabetes, body mass index less than 30 kg/m2, normal electrocardiography response at rest and during exercise, nonsmokers, and no use of medications known to affect cardiovascular or metabolic function. Body composition measured by dual-energy X-ray absorptiometry. Hemodynamic values measured by non-invasive pulse wave velocity through radial artery tonometry. Markers of inflammation measured through blood sample analysis. Results Significant differences exist between young and old groups in %fat (P < 0.001), systolic blood pressure (SBP) (P = 0.001), large artery elasticity (P = 0.005), small artery elasticity (P < 0.001), systemic vascular resistance (P = 0.004), total vascular impedance (P < 0.001), estimated cardiac output (P < 0.001), and tumor necrosis factor-⍺ (TNF-⍺) (P < 0.001). Using ANCOVA the difference in SBP between age groups was no longer significant after adjusting for small artery elasticity (P < 0.001) and TNF-⍺ (P = 0.041). Conclusions These data demonstrate that blood pressure and vascular hemodynamic measures differ significantly between young and old women independent of body composition. Furthermore, these differences may be explained by the inflammation marker TNF-⍺ and/or small artery elasticity.
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Affiliation(s)
- Brantley K Ballenger
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, 39762, USA.
| | - Gary R Hunter
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, 35233, USA
| | - Gordon Fisher
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, 35233, USA.,Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL, 35233, USA
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25
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Immuno-regenerative biomaterials for in situ cardiovascular tissue engineering - Do patient characteristics warrant precision engineering? Adv Drug Deliv Rev 2021; 178:113960. [PMID: 34481036 DOI: 10.1016/j.addr.2021.113960] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/20/2021] [Accepted: 08/30/2021] [Indexed: 02/07/2023]
Abstract
In situ tissue engineering using bioresorbable material implants - or scaffolds - that harness the patient's immune response while guiding neotissue formation at the site of implantation is emerging as a novel therapy to regenerate human tissues. For the cardiovascular system, the use of such implants, like blood vessels and heart valves, is gradually entering the stage of clinical translation. This opens up the question if and to what extent patient characteristics influence tissue outcomes, necessitating the precision engineering of scaffolds to guide patient-specific neo-tissue formation. Because of the current scarcity of human in vivo data, herein we review and evaluate in vitro and preclinical investigations to predict the potential role of patient-specific parameters like sex, age, ethnicity, hemodynamics, and a multifactorial disease profile, with special emphasis on their contribution to the inflammation-driven processes of in situ tissue engineering. We conclude that patient-specific conditions have a strong impact on key aspects of in situ cardiovascular tissue engineering, including inflammation, hemodynamic conditions, scaffold resorption, and tissue remodeling capacity, suggesting that a tailored approach may be required to engineer immuno-regenerative biomaterials for safe and predictive clinical applicability.
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26
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Nakamura N, Muraoka I. Effects of Greater Central Arterial Stiffness on Cardiovagal Baroreflex Sensitivity in Resistance-Trained Men. SPORTS MEDICINE-OPEN 2021; 7:77. [PMID: 34698951 PMCID: PMC8548489 DOI: 10.1186/s40798-021-00367-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 10/04/2021] [Indexed: 11/11/2022]
Abstract
Background Compared with age-matched untrained men, resistance-trained men who have undergone long duration training (> 2 years) at a high frequency (> 5 days/week) may be lower cardiovagal baroreflex sensitivity (BRS) because of central arterial stiffening. Therefore, the purpose of this study was to examine the effect of greater central arterial stiffness in resistance-trained men on cardiovagal BRS in a cross-sectional study to compare resistance-trained men with age-matched untrained men. Methods This cross-sectional study included resistance-trained men (n = 20; age: 22 ± 3; body mass index: 26.7 ± 2.2) and age-matched untrained men (control group: n = 20; age: 25 ± 2; body mass index: 23.7 ± 2.4). The β-stiffness index and arterial compliance were assessed at the right carotid artery using a combination of a brightness mode ultrasonography system for the carotid artery diameter and applanation tonometry for the carotid blood pressure. And, the cardiovagal BRS was estimated by the slope of the R–R interval and systolic blood pressure during Phase II and IV of Valsalva maneuver (VM). The participants maintained an expiratory mouth pressure of 40 mmHg for 15 s in the supine position. Results The β-Stiffness index was significantly higher in the resistance-trained group than in the control group (5.9 ± 1.4 vs. 4.4 ± 1.0 a.u., P < 0.01). In contrast, the resistance-trained group had significantly lower arterial compliance (0.15 ± 0.05 vs. 0.20 ± 0.04 mm2/mmHg, P < 0.01) and cardiovagal BRS during Phase IV of VM (9.0 ± 2.5 vs. 12.9 ± 5.4 ms/mmHg, P < 0.01) than the control group and. Moreover, cardiovagal BRS during Phase IV of VM was inversely and positively correlated with the β-stiffness index (r = − 0.59, P < 0.01) and arterial compliance (r = 0.64, P < 0.01), respectively. Conclusion Resistance-trained group had greater central arterial stiffness and lower cardiovagal BRS Phase IV compared with control group. Moreover, the central arterial stiffening was related to cardiovagal BRS Phase IV. These results suggest that greater central arterial stiffness in resistance-trained men may be associated with lower cardiovagal BRS. Trial Registration University hospital Medical Information Network (UMIN) in Japan, UMIN000038116. Registered on September 27, 2019.
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Affiliation(s)
- Nobuhiro Nakamura
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan. .,Faculty of Commerce, Yokohama College of Commerce, Yokohama, Kanagawa, Japan. .,Waseda Institute for Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan.
| | - Isao Muraoka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
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27
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Sex-Specific Impacts of Exercise on Cardiovascular Remodeling. J Clin Med 2021; 10:jcm10173833. [PMID: 34501285 PMCID: PMC8432130 DOI: 10.3390/jcm10173833] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/21/2021] [Accepted: 08/21/2021] [Indexed: 12/14/2022] Open
Abstract
Cardiovascular diseases (CVD) remain the leading cause of death in men and women. Biological sex plays a major role in cardiovascular physiology and pathological cardiovascular remodeling. Traditionally, pathological remodeling of cardiovascular system refers to the molecular, cellular, and morphological changes that result from insults, such as myocardial infarction or hypertension. Regular exercise training is known to induce physiological cardiovascular remodeling and beneficial functional adaptation of the cardiovascular apparatus. However, impact of exercise-induced cardiovascular remodeling and functional adaptation varies between males and females. This review aims to compare and contrast sex-specific manifestations of exercise-induced cardiovascular remodeling and functional adaptation. Specifically, we review (1) sex disparities in cardiovascular function, (2) influence of biological sex on exercise-induced cardiovascular remodeling and functional adaptation, and (3) sex-specific impacts of various types, intensities, and durations of exercise training on cardiovascular apparatus. The review highlights both animal and human studies in order to give an all-encompassing view of the exercise-induced sex differences in cardiovascular system and addresses the gaps in knowledge in the field.
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28
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Ganti V, Carek AM, Jung H, Srivatsa AV, Cherry D, Johnson LN, Inan OT. Enabling Wearable Pulse Transit Time-Based Blood Pressure Estimation for Medically Underserved Areas and Health Equity: Comprehensive Evaluation Study. JMIR Mhealth Uhealth 2021; 9:e27466. [PMID: 34338646 PMCID: PMC8369375 DOI: 10.2196/27466] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/10/2021] [Accepted: 05/10/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Noninvasive and cuffless approaches to monitor blood pressure (BP), in light of their convenience and accuracy, have paved the way toward remote screening and management of hypertension. However, existing noninvasive methodologies, which operate on mechanical, electrical, and optical sensing modalities, have not been thoroughly evaluated in demographically and racially diverse populations. Thus, the potential accuracy of these technologies in populations where they could have the greatest impact has not been sufficiently addressed. This presents challenges in clinical translation due to concerns about perpetuating existing health disparities. OBJECTIVE In this paper, we aim to present findings on the feasibility of a cuffless, wrist-worn, pulse transit time (PTT)-based device for monitoring BP in a diverse population. METHODS We recruited a diverse population through a collaborative effort with a nonprofit organization working with medically underserved areas in Georgia. We used our custom, multimodal, wrist-worn device to measure the PTT through seismocardiography, as the proximal timing reference, and photoplethysmography, as the distal timing reference. In addition, we created a novel data-driven beat-selection algorithm to reduce noise and improve the robustness of the method. We compared the wearable PTT measurements with those from a finger-cuff continuous BP device over the course of several perturbations used to modulate BP. RESULTS Our PTT-based wrist-worn device accurately monitored diastolic blood pressure (DBP) and mean arterial pressure (MAP) in a diverse population (N=44 participants) with a mean absolute difference of 2.90 mm Hg and 3.39 mm Hg for DBP and MAP, respectively, after calibration. Meanwhile, the mean absolute difference of our systolic BP estimation was 5.36 mm Hg, a grade B classification based on the Institute for Electronics and Electrical Engineers standard. We have further demonstrated the ability of our device to capture the commonly observed demographic differences in underlying arterial stiffness. CONCLUSIONS Accurate DBP and MAP estimation, along with grade B systolic BP estimation, using a convenient wearable device can empower users and facilitate remote BP monitoring in medically underserved areas, thus providing widespread hypertension screening and management for health equity.
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Affiliation(s)
- Venu Ganti
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Andrew M Carek
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Hewon Jung
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Adith V Srivatsa
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | | | | | - Omer T Inan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States
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29
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Climie RE, Park C, Avolio A, Mynard JP, Kruger R, Bruno RM. Vascular Ageing in Youth: A Call to Action. Heart Lung Circ 2021; 30:1613-1626. [PMID: 34275753 DOI: 10.1016/j.hlc.2021.06.516] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/31/2021] [Accepted: 06/06/2021] [Indexed: 12/18/2022]
Abstract
Extensive evidence shows that risk factors for cardiovascular disease (CVD) begin to develop early in life. Childhood obesity and elevated blood pressure (BP) have become overwhelmingly challenging, with 57% of today's children predicted to be obese by the age of 35 years, and global rates of hypertension in children and adolescents increasing by 75% from 2000 to 2015. Thus, there is an urgent need for tools that can assess early CVD risk in youth, which may lead to better risk stratification, preventative intervention, and personalised medicine. Vascular ageing (the deterioration in vascular structure and function) is a pivotal progenitor of health degeneration associated with elevated BP. Exposure to adverse environmental and genetic factors from fetal life promotes the development and accumulation of subclinical vascular changes that direct an individual towards a trajectory of early vascular ageing (EVA)-an independent predictor of target organ damage in the heart, brain, and kidneys. Therefore, characterising vascular ageing from youth may provide a window into cardiovascular risk later in life. However, vascular ageing measurements only have value when techniques are accurate/validated and when reliable thresholds are available for defining normal ranges and ranges that signal increased risk of disease. The aim of this paper is to summarise current evidence on the importance of vascular ageing assessment in youth and the impact of interventions to prevent or delay EVA, to highlight the need for standardisation and validation of measurement techniques in children and adolescents, and the importance of establishing reference values for vascular ageing measures in this population.
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Affiliation(s)
- R E Climie
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tas, Australia; Baker Heart and Diabetes Institute, Melbourne, Vic, Australia; Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), Paris, France.
| | - C Park
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, UCL, London, UK
| | - A Avolio
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - J P Mynard
- Heart Research, Murdoch Children's Research Institute, Melbourne, Vic, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Vic, Australia; Department of Biomedical Engineering, University of Melbourne, Melbourne, Vic, Australia; Department of Cardiology, Royal Children's Hospital, Melbourne, Vic, Australia
| | - R Kruger
- Hypertension in Africa Research Team (HART); North-West University, Potchefstroom, South Africa; MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - R-M Bruno
- Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), Paris, France. https://twitter.com/rosam_bruno
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30
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Jimenez V, Sanchez N, Clark ELM, Miller RL, Casamassima M, Verros M, Conte I, Ruiz-Jaquez M, Gulley LD, Johnson SA, Melby C, Lucas-Thompson RG, Shomaker LB. Associations of adverse childhood experiences with stress physiology and insulin resistance in adolescents at risk for adult obesity. Dev Psychobiol 2021; 63:e22127. [PMID: 33991342 DOI: 10.1002/dev.22127] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 02/27/2021] [Accepted: 04/08/2021] [Indexed: 12/19/2022]
Abstract
Adverse childhood experiences (ACEs) heighten the risk for adult obesity and cardiometabolic disease, but physiological factors underlying this connection are not well understood. We determined if ACEs were associated with physiological stress response and insulin resistance in adolescents at risk for adult obesity. Participants were 90 adolescents 12.0-17.5 years (50% female, 30% Hispanic/Latinx), at risk for adult obesity by virtue of above-average body mass index (BMI; kg/m2 ≥ 70th percentile) or parental obesity (BMI ≥ 30 kg/m2 ). ACEs were determined as presence (vs. absence) based upon the Schedule for Affective Disorders and Schizophrenia for School-Aged Children. Physiological stress response was measured as heart rate/blood pressure response to the Trier Social Stress Test. Homeostatic model assessment of insulin resistance was determined from fasting glucose/insulin. Sixty-one percent of adolescents reported positive ACE history. The presence of ACEs predicted greater heart rate (p < .001) and diastolic blood pressure (p = .02) response to stress, controlling for age, sex, race/ethnicity, puberty, and BMI standard score. Systolic blood pressure and insulin resistance did not differ by ACE history (p-values > .08). Findings suggest heightened sympathetic stress response in adolescence could be explanatory in how ACEs increase the risk for later cardiometabolic disease. Future studies should characterize ACEs in relationship to day-to-day variations in adolescents' stress physiology and glucose homeostasis.
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Affiliation(s)
- Virginia Jimenez
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Natalia Sanchez
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA.,Colorado School of Public Health, Aurora, Colorado, USA
| | - Emma L M Clark
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Reagan L Miller
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Milena Casamassima
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA.,Colorado School of Public Health, Aurora, Colorado, USA
| | - Megan Verros
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA.,Colorado School of Public Health, Aurora, Colorado, USA
| | - Isabella Conte
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Metztli Ruiz-Jaquez
- Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz Medical Campus/Children's Hospital Colorado, Aurora, Colorado, USA
| | - Lauren D Gulley
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA.,Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz Medical Campus/Children's Hospital Colorado, Aurora, Colorado, USA
| | - Sarah A Johnson
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, Colorado, USA
| | - Christopher Melby
- Colorado School of Public Health, Aurora, Colorado, USA.,Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, Colorado, USA
| | - Rachel G Lucas-Thompson
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA.,Colorado School of Public Health, Aurora, Colorado, USA
| | - Lauren B Shomaker
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA.,Colorado School of Public Health, Aurora, Colorado, USA.,Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz Medical Campus/Children's Hospital Colorado, Aurora, Colorado, USA
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31
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Fine J, Branan KL, Rodriguez AJ, Boonya-ananta T, Ajmal, Ramella-Roman JC, McShane MJ, Coté GL. Sources of Inaccuracy in Photoplethysmography for Continuous Cardiovascular Monitoring. BIOSENSORS 2021; 11:126. [PMID: 33923469 PMCID: PMC8073123 DOI: 10.3390/bios11040126] [Citation(s) in RCA: 91] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/30/2021] [Accepted: 04/09/2021] [Indexed: 12/14/2022]
Abstract
Photoplethysmography (PPG) is a low-cost, noninvasive optical technique that uses change in light transmission with changes in blood volume within tissue to provide information for cardiovascular health and fitness. As remote health and wearable medical devices become more prevalent, PPG devices are being developed as part of wearable systems to monitor parameters such as heart rate (HR) that do not require complex analysis of the PPG waveform. However, complex analyses of the PPG waveform yield valuable clinical information, such as: blood pressure, respiratory information, sympathetic nervous system activity, and heart rate variability. Systems aiming to derive such complex parameters do not always account for realistic sources of noise, as testing is performed within controlled parameter spaces. A wearable monitoring tool to be used beyond fitness and heart rate must account for noise sources originating from individual patient variations (e.g., skin tone, obesity, age, and gender), physiology (e.g., respiration, venous pulsation, body site of measurement, and body temperature), and external perturbations of the device itself (e.g., motion artifact, ambient light, and applied pressure to the skin). Here, we present a comprehensive review of the literature that aims to summarize these noise sources for future PPG device development for use in health monitoring.
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Affiliation(s)
- Jesse Fine
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (J.F.); (K.L.B.)
| | - Kimberly L. Branan
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (J.F.); (K.L.B.)
| | - Andres J. Rodriguez
- Department of Biomedical Engineering, Florida International University, Miami, FL 33174, USA; (A.J.R.); (T.B.-a.); (A.); (J.C.R.-R.)
| | - Tananant Boonya-ananta
- Department of Biomedical Engineering, Florida International University, Miami, FL 33174, USA; (A.J.R.); (T.B.-a.); (A.); (J.C.R.-R.)
| | - Ajmal
- Department of Biomedical Engineering, Florida International University, Miami, FL 33174, USA; (A.J.R.); (T.B.-a.); (A.); (J.C.R.-R.)
| | - Jessica C. Ramella-Roman
- Department of Biomedical Engineering, Florida International University, Miami, FL 33174, USA; (A.J.R.); (T.B.-a.); (A.); (J.C.R.-R.)
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Michael J. McShane
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (J.F.); (K.L.B.)
- Department of Materials Science and Engineering, Texas A&M University, College Station, TX 77843, USA
- Center for Remote Health Technologies and Systems, Texas A&M Engineering Experimentation Station, Texas A&M University, College Station, TX 77843, USA
| | - Gerard L. Coté
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (J.F.); (K.L.B.)
- Center for Remote Health Technologies and Systems, Texas A&M Engineering Experimentation Station, Texas A&M University, College Station, TX 77843, USA
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Shih YH, Howe CG, Scannell Bryan M, Shahriar M, Kibriya MG, Jasmine F, Sarwar G, Graziano JH, Persky VW, Jackson B, Ahsan H, Farzan SF, Argos M. Exposure to metal mixtures in relation to blood pressure among children 5-7 years old: An observational study in Bangladesh. Environ Epidemiol 2021; 5:e135. [PMID: 33778363 PMCID: PMC7939402 DOI: 10.1097/ee9.0000000000000135] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/15/2021] [Indexed: 02/07/2023] Open
Abstract
Hypertension in later life, a significant risk factor for cardiovascular disease, has been linked to elevated blood pressure in early life. Exposure to metals may influence childhood blood pressure; however, previous research is limited and has mainly focused on evaluating the toxicity of single metal exposures. This study evaluates the associations between exposure to metal mixtures and blood pressure among Bangladeshi children age 5-7 years. METHODS We investigated the associations of 17 toenail metal concentrations with blood pressure using linear regression models. Principal component analysis (PCA), weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) were conducted as secondary analyses. RESULTS Associations were observed for selenium with diastolic blood pressure (per doubling of exposure β = 2.91, 95% confidence interval [CI] = 1.08, 4.75), molybdenum with systolic (β = 0.33, 95% CI = 0.05, 0.61) and diastolic blood pressure (β = 0.39, 95% CI = 0.12, 0.66), tin with systolic blood pressure (β = -0.33, 95% CI = -0.60, -0.06), and mercury with systolic (β = -0.83, 95% CI = -1.49, -0.17) and diastolic blood pressure (β = -0.89, 95% CI = -1.53, -0.26). Chromium was associated with diastolic blood pressure among boys only (β = 1.10, 95% CI = 0.28, 1.92, P for interaction = 0.02), and copper was associated with diastolic blood pressure among girls only (β = -1.97, 95% CI = -3.63, -0.32, P for interaction = 0.01). These findings were largely robust to the secondary analyses that utilized mixture modeling approaches (PCA, WQS, and BKMR). CONCLUSIONS Future prospective studies are needed to investigate further the impact of early life exposure to metal mixtures on children's blood pressure trajectories and cardiovascular disease risk later in life.
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Affiliation(s)
- Yu-Hsuan Shih
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, Illinois
| | - Caitlin G. Howe
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Dartmouth College, Lebanon, New Hampshire
| | - Molly Scannell Bryan
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, Illinois
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Dartmouth College, Lebanon, New Hampshire
- Institute for Minority Health Research, College of Medicine, University of Illinois Chicago, Chicago, Illinois
- UChicago Research Bangladesh, Dhaka, Bangladesh
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York
- Trace Element Analysis Core Laboratory, Department of Earth Sciences, Dartmouth College, Hanover, New Hampshire
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | | | - Muhammad G. Kibriya
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois
| | - Farzana Jasmine
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois
| | | | - Joseph H. Graziano
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Victoria W. Persky
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, Illinois
| | - Brian Jackson
- Trace Element Analysis Core Laboratory, Department of Earth Sciences, Dartmouth College, Hanover, New Hampshire
| | - Habibul Ahsan
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois
| | - Shohreh F. Farzan
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Maria Argos
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, Illinois
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Enea C, Laffetas P, Pichon A, Delpech N. Arterial Stiffness and Hemodynamics in Young Women: The Effects of Oral Contraceptive Intake and Physical Habits. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073393. [PMID: 33805931 PMCID: PMC8037745 DOI: 10.3390/ijerph18073393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/01/2021] [Accepted: 03/23/2021] [Indexed: 12/17/2022]
Abstract
Oral contraceptive (OC) intake seems to be associated with increased central hemodynamics and arterial stiffness. Conversely, physical activity (PA) is known to induce benefits on vascular structure and function, suggesting that the negative effects of the OC pill could be counterbalanced by regular PA. The aim of this cross-sectional study was to determine (1) whether OC intake in young women is associated with higher values of hemodynamic parameters and arterial stiffness and (2) whether these negative effects could be counterbalanced by regular physical activity. Forty-nine young healthy women (21.9 years ± 2.1) were recruited and divided into 4 groups, depending on their hormonal status (OC users: OC+ or non-OC users: OC−) and their physical habits (active/inactive). Assessments of central hemodynamics (central blood pressure, Aix75) and pulse wave velocity (PWV) were performed using applanation tonometry. cBP was higher in OC+ vs. OC−, while PWV was similar between these two groups. No interaction between physical activity and hormonal status was observed for any of these variables. Nevertheless, PWV was lower in young active women compared with age-matched inactive women, suggesting that the positive effect of regular physical exercise on the cardiovascular system is already visible in the first years of women’s adulthood, whatever the hormonal status.
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Wang Z, Li W, Liu W, Tian J. Gender is a determinant of carotid artery stiffness independent of age and blood pressure. Br J Radiol 2021; 94:20200796. [PMID: 33476176 DOI: 10.1259/bjr.20200796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To identify the gender-specific differences in carotid artery structural and stiffening parameters by radiofrequency ultrasound (RFU) with an automatic arterial stiffness analyzing system. METHODS Seventy-two consecutive individuals (32 males and 40 females, age range from 36 to 62 years) with no history of significant cardiovascular diseases or carotid artery plaques were enrolled between September and December 2017. Quality intima-media thickness (QIMT) and quality arterial stiffness (QAS) parameters were automatically computed, including pulse wave velocity (PWV), vascular distension, compliance coefficient (CC), distensibility coefficient (DC), stiffness index α and β, augmentation pressure (AP), and augmentation index (AIx). Those parameters were compared between males and females. Multiple linear regression analysis was performed to assess the independent association between gender and RFU parameters. RESULTS The mean age had no difference between males and females (47.8 ± 3.3 vs 50.0 ± 8.5 years, p = 0.19). Females had higher systolic blood pressure (134.53 ± 9.65 vs 127.78 ± 6.12 mm Hg) and diastolic blood pressure (85.83 ± 3.94 vs 78.03 ± 5.22 mm Hg), greater carotid QIMT (598.73 ± 72.16 vs 550.84 ± 29.37 µm), advanced PWV (8.08 ± 1.60 vs 6.24 ± 0.70 m/s), higher stiffness index α (6.21 ± 1.94 vs 3.95 ± 0.78) and β (9.43 ± 3.17 vs 6.38 ± 0.78), higher AP (6.68 ± 2.24 vs 3.64 ± 1.22 mm Hg) and AIx (7.42 ± 2.08 vs 4.69 ± 1.26%), all p < 0.001. Multiple linear regression analysis demonstrated gender was independently associated with carotid structural and elastic parameters. CONCLUSION Gender independently impacts carotid structure and function, with females more vulnerable to the progression of arterial aging. Awareness of the gender differences on the risk stratification of carotid artery disease will benefit reliable assessments and specific management recommendations in clinical practice. ADVANCES IN KNOWLEDGE (1) RFU provides an μm-unit quality IMT measurement and multiple quality arterial stiffness parameters. (2) Gender is an independent determinant in both the arterial structural and elastic aspects, with females of stiffer arteries in low CVD risk individuals.
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Affiliation(s)
- Zhenzhen Wang
- Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wei Li
- Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wei Liu
- Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jiawei Tian
- Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Harbin, China
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Jósvai A, Török M, Mátrai M, Hetthéssy J, Monori-Kiss A, Makk J, Székács B, Nádasy GL, Várbíró S. Effects of Testosterone Deficiency and Angiotensin II-Induced Hypertension on the Biomechanics of Intramural Coronary Arteries. J Sex Med 2020; 17:2322-2330. [PMID: 33067160 DOI: 10.1016/j.jsxm.2020.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/14/2020] [Accepted: 09/12/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Andropause and hypertension also increase the risk of coronary artery damage. AIM To investigate the effect of testosterone deficiency and hypertension on intramural coronary vessels. METHODS 4 groups of 8-week-old Sprague-Dawley rats were studied: control male (Co, n=10), orchidectomized male (OCT, n=13), angiotensin (AII) hypertensive male (AII, n=10), and AII hypertensive and OCT (AII + OCT, n=8). Surgical orchidectomy was performed, and an osmotic minipump was inserted for chronic angiotensin II infusion (100 ng/min/kg). After 4 weeks, spontaneous tone and biomechanical properties of the intramural coronary resistance artery were investigated in vitro, by pressure microarteriography. OUTCOMES Morphology and biomechanics of the intramural coronaries were evaluated: the outer diameter, wall thickness-to-lumen diameter ratio, and tangential wall stress in the contracted and relaxed states. RESULTS The outer diameter was reduced in OCT and AII + OCT groups (on 50 mmHg 315 ± 20 Co; 237 ± 21 OCT; 291 ± 16 AII, and 166 ± 12 μm AII + OCT). The increased wall thickness-to-lumen diameter ratio resulted in lower tangential wall stress in AII + OCT rats (on 50 mmHg 19 ± 2 Co; 24 ± OCT; 26 ± 5 AII, and 9 ± 1 kPa AII + OCT). Spontaneous tone was increased in the hypertensive rats (AII and AII + OCT groups) (on 50 mmHg 7.7 ± 1.8 Co; 6.1 ± 1.4 OCT; 14.5 ± 3.0 AII, and 17.4 ± 4.1 % AII + OCT). CLINICAL IMPLICATIONS Andropause alone can be considered as a cardiovascular risk factor that will further exacerbate vascular damage in hypertension. STRENGTHS & LIMITATIONS A limitation of our study is that it was performed on relatively young rats, and the conclusions might not apply to coronary remodelling in older animals with slower adaptation processes. CONCLUSIONS Testosterone deficiency and hypertension damage the mechanical adaptation of the vessel wall additively: double noxa caused inward eutrophic remodeling and increased tone. Jósvai A, Török M, Mátrai M, et al. Effects of Testosterone Deficiency and Angiotensin II-Induced Hypertension on the Biomechanics of Intramural Coronary Arteries. J Sex Med 2020;17:2322-2330.
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Affiliation(s)
- Attila Jósvai
- Department of Neurosurgery, Hungarian Defence Forces Medical Centre, Budapest, Hungary.
| | - Marianna Török
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Máté Mátrai
- Institute of Clinical Experimental Research, Semmelweis University, Budapest, Hungary
| | - Judit Hetthéssy
- Department of Orthopedics, Semmelweis University, Budapest, Hungary
| | - Anna Monori-Kiss
- Institute of Clinical Experimental Research, Semmelweis University, Budapest, Hungary
| | - Jennifer Makk
- Institute of Clinical Experimental Research, Semmelweis University, Budapest, Hungary
| | - Béla Székács
- 2nd Department Internal Medicine, Department Section of Geriatrics, Szt Imre Teaching Hospital, Budapest, Hungary
| | - György L Nádasy
- Department of Physiology, Semmelweis University, Budapest, Hungary
| | - Szabolcs Várbíró
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
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Skrabal F, Weber T, Skrabal K, Windhaber J, Ehsas H, Stockinger N, Boyer J. Measurement of aortofemoral volume wave velocity during the routine 12-channel ECG: relation to age, physiological hemoglobin A 1C, triglycerides and SBP in healthy individuals. J Hypertens 2020; 38:1989-1999. [PMID: 32890275 DOI: 10.1097/hjh.0000000000002493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Measurements of pulse wave velocity are generally thought to be too impractical for clinical routine. This study aimed to develop a method that can be performed during routine 12-channel ECG. METHODS A 12-channel ECG simultaneously supplies arterial impedance plethysmographic signals from the extremities beside segmental multifrequency impedance measurements for obtaining body composition. The origin of the plethysmographic signal (volume wave) at the arms and legs was determined at the level of the elbows and the knees. The volume wave velocity (VWV) at the aorta and femoral arteries was calculated from the time difference of the plethysmographic signals between arms and legs. RESULTS Automated measurement of VWV was highly reproducible (r = 0.96). In 107 participants in perfect health, VWV in different models was positively related to age, physiological hemoglobin A 1C, triglycerides, normal standardized unattended blood pressure, but not to physiological low-density lipoprotein-cholesterol and high-density lipoprotein-cholesterol. Aortofemoral VWV was significantly higher in patients with established coronary artery disease than in healthy controls of the same age group (18.1 ± 5.8 vs. 11.9 ± 1.7 m/s, P < 0.001). VWV in study participants was higher than tonometrically determined pulse wave velocity as muscular arteries are included (13.2 ± 5.81 vs. 8.8 ± 2.98 m/s, n = 115, P < 0.001). CONCLUSION These background arterial impedance plethysmographic measurements for the measurement of VWV made simultaneously during 12-channel ECG show promise for large-scale, routine clinical assessment of large artery function.
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Affiliation(s)
- Falko Skrabal
- Institute of Cardiovascular & Metabolic Medicine, Graz
| | - Thomas Weber
- Cardiology Department, Klinikum Wels-Grieskirchen, Wels
| | | | - Jana Windhaber
- Department of Paediatric and Adolescent Surgery, Medical University Graz, Auenbruggerplatz, Graz, Austria
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Nowak KL, Farmer-Bailey H, Cadnapaphornchai MA, You Z, George D, Wang W, Jovanovich A, Soranno DE, Gitomer B, Chonchol M. Curcumin therapy to treat vascular dysfunction in children and young adults with autosomal dominant polycystic kidney disease: Design and baseline characteristics of participants. Contemp Clin Trials Commun 2020; 19:100635. [PMID: 33294724 PMCID: PMC7691667 DOI: 10.1016/j.conctc.2020.100635] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/29/2020] [Accepted: 08/09/2020] [Indexed: 02/07/2023] Open
Abstract
Although often considered to be a disease of adults, complications of autosomal dominant polycystic kidney disease (ADPKD) begin in childhood. While the hallmark of ADPKD is the development and continued growth of multiple renal cysts that ultimately result in loss of kidney function, cardiovascular complications are the leading cause of death among affected patients. Vascular dysfunction (endothelial dysfunction and large elastic artery stiffness) is evident very early in the course of the disease and appears to involve increased oxidative stress and inflammation. Treatment options to prevent cardiovascular disease in adults with ADPKD are limited, thus childhood may represent a key therapeutic window. Curcumin is a safe, naturally occurring polyphenol found in the Indian spice turmeric. This spice has a unique ability to activate transcription of key antioxidants, suppress inflammation, and reduce proliferation. Here we describe our ongoing randomized, placebo-controlled, double-blind clinical trial to assess the effect of curcumin therapy on vascular function and kidney growth in 68 children and young adults age 6–25 years with ADPKD. Baseline demographic, vascular, and kidney volume data are provided. This study has the potential to establish a novel, safe, and facile therapy for the treatment of arterial dysfunction, and possibly renal cystic disease, in an understudied population of children and young adults with ADPKD. Evaluating a strategy to intervene early in the course of ADPKD. Assessing two major contributors to arterial dysfunction and CVD risk in ADPKD. Curcumin is a novel nutraceutical that is an safe, naturally occurring, and facile. Using a translational approach is used to assess physiological mechanisms. Gaining exploratory evidence on the efficacy of curcumin to slow kidney growth.
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Affiliation(s)
- Kristen L. Nowak
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Corresponding author. Division of Renal Diseases and Hypertension, 12700 E 19th Ave C281, Aurora, CO, 80045, USA.
| | | | - Melissa A. Cadnapaphornchai
- Rocky Mountain Pediatric Kidney Center, Rocky Mountain Hospital for Children at Presbyterian St. Luke's Medical Center, Denver, CO, USA
| | - Zhiying You
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Diana George
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Wei Wang
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Anna Jovanovich
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Rocky Mountain Regional VA Medical Center, Aurora, CO, USA
| | - Danielle E. Soranno
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Children's Hospital Colorado, Aurora, CO, USA
| | | | - Michel Chonchol
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Coovadia Y, Adler TE, Steinback CD, Fraser GM, Usselman CW. Sex differences in dynamic blood pressure regulation: beat-by-beat responses to muscle sympathetic nerve activity. Am J Physiol Heart Circ Physiol 2020; 319:H531-H538. [PMID: 32734818 DOI: 10.1152/ajpheart.00245.2020] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
It has been suggested that sex differences in acute blood pressure fluctuations occur during the periods of time between bursts of muscle sympathetic nerve activity. Therefore, we tested the hypothesis that men experience more dynamic changes in mean arterial pressure (Finometer MIDI) than women during acute sympathoinhibition (i.e., slow breathing) in which bursts of sympathetic activity occur more infrequently than at rest. We tested healthy women (n = 9) and men (n = 9) of similar age (22 ± 2 vs. 23 ± 3 yr, P = 0.6). Custom software was used to calculate beat-by-beat changes in blood pressure following sympathetic burst and nonburst sequences (recorded using microneurography) during 10 min of supine rest and a 15-min bout of slow breathing. During slow breathing following nonburst sequences, women demonstrated smaller overall reductions in mean arterial pressure compared with men over the subsequent 15 cardiac cycles (P < 0.01). In addition, following a burst of sympathetic activity, women experienced greater overall increases in mean arterial pressure compared with men over the following 15 cardiac cycles (P < 0.01). Despite these differences, the peak and nadir changes in arterial pressure following burst and nonburst sequences were not different between the sexes (P = 0.45 and P = 0.48, burst and nonburst sequences, respectively). As such, these data suggest that women respond to a burst of sympathetic activity with more sustained increases in blood pressure than men, coupled with improved maintenance of blood pressure during acute periods of sympathetic quiescence. In other words, these findings suggest that men rely more on frequent bursts of sympathetic activity to acutely regulate arterial pressure than women.NEW & NOTEWORTHY We demonstrate that during acute sympathoinhibition, women demonstrate more sustained increases in blood pressure following sympathetic bursts of activity than men. Likewise, during prolonged sympathetic quiescence, blood pressure is less labile in women than men. This suggests that lower overall blood pressure in young women may not be mediated by smaller beat-by-beat changes in blood pressure in response to sympathetic outflow but may instead be mediated by a lower frequency of sympathetic bursts.
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Affiliation(s)
- Yasmine Coovadia
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Tessa E Adler
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Craig D Steinback
- Neurovascular Health Laboratory, Program for Pregnancy and Postpartum Health, Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada.,Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Graham M Fraser
- Division of BioMedical Sciences, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador
| | - Charlotte W Usselman
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada.,McGill Research Centre for Physical Activity and Health, McGill University, Montreal, Quebec, Canada
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Short Sleep Duration is Associated with Central Arterial Stiffness in Children Independent of Other Lifestyle Behaviors. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/s42978-020-00062-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Sun P, Chen X, Zeng Z, Li S, Wang J, Yu F, Liu S, Li H, Fernhall B. Sex differences in lower-limb arterial stiffness following acute aerobic exercise. Sci Sports 2020. [DOI: 10.1016/j.scispo.2019.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kruszyńska E, Łoboz-Rudnicka M, Palombo C, Vriz O, Kozakova M, Ołpińska B, Morizzo C, Łoboz-Grudzień K, Jaroch J. Carotid Artery Stiffness in Metabolic Syndrome: Sex Differences. Diabetes Metab Syndr Obes 2020; 13:3359-3369. [PMID: 33061497 PMCID: PMC7524178 DOI: 10.2147/dmso.s262192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/17/2020] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION The effect of metabolic syndrome (MS) on carotid stiffness (CS) in the context of gender is under research. OBJECTIVE We examined the relationship between the MS and CS in men (M) and women (W) and investigated if the impact of cardiovascular risk factors on CS is modulated by gender. PATIENTS AND METHODS The study included 419 subjects (mean age 54.3 years): 215 (51%) with MS (109 W and 106 M) and 204 (49%) without MS (98 W and 106 M). Carotid intima-media thickness (IMT) and CS parameters (beta stiffness index (beta), Peterson's elastic modulus (Ep), arterial compliance (AC) and one-point pulse wave velocity (PWV-beta)) were measured with the echo-tracking (eT) system. RESULTS ANCOVA demonstrated that MS was associated with elevated CS indices (p = 0.003 for beta and 0.025 for PWV-beta), although further sex-specific analysis revealed that this relationship was significant only in W (p = 0.021 for beta). Age was associated with CS in both M and W, pulse pressure (PP) and body mass index turned out to be determinants of CS solely in W, while the effect of mean arterial pressure (MAP) and heart rate was more pronounced in M. MANOVA performed in subjects with MS revealed that age and diabetes mellitus type 2 were determinants of CS in both sexes, diastolic blood pressure and MAP - solely in M and systolic blood pressure, PP and waist circumference - solely in W (the relationship between the waist circumference and AC was paradoxical). CONCLUSION The relationship between MS and CS is stronger in W than in M. In subjects with MS, various components of arterial pressure exert different sex-specific effects on CS - with the impact of the pulsative component of arterial pressure (PP) observed in W and the impact of the steady component (MAP) observed in M.
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Affiliation(s)
- Ewa Kruszyńska
- Cardiology Department, T. Marciniak Hospital, Emergency Medicine Center, Wrocław, Poland
| | - Maria Łoboz-Rudnicka
- Cardiology Department, T. Marciniak Hospital, Emergency Medicine Center, Wrocław, Poland
- Correspondence: Maria Łoboz-Rudnicka Email
| | - Carlo Palombo
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, School of Medicine, Pisa, Italy
| | - Olga Vriz
- Department of Cardiology and Emergency, San Antonio Hospital, Udine, Italy
| | - Michaela Kozakova
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Bogusława Ołpińska
- Cardiology Department, T. Marciniak Hospital, Emergency Medicine Center, Wrocław, Poland
| | - Carmela Morizzo
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, School of Medicine, Pisa, Italy
| | - Krystyna Łoboz-Grudzień
- Cardiology Department, T. Marciniak Hospital, Emergency Medicine Center, Wrocław, Poland
- Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
| | - Joanna Jaroch
- Cardiology Department, T. Marciniak Hospital, Emergency Medicine Center, Wrocław, Poland
- Faculty of Health Sciences, Wrocław Medical University, Wrocław, Poland
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Coupal KE, Heeney ND, Hockin BCD, Ronsley R, Armstrong K, Sanatani S, Claydon VE. Pubertal Hormonal Changes and the Autonomic Nervous System: Potential Role in Pediatric Orthostatic Intolerance. Front Neurosci 2019; 13:1197. [PMID: 31798399 PMCID: PMC6861527 DOI: 10.3389/fnins.2019.01197] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 10/22/2019] [Indexed: 12/22/2022] Open
Abstract
Puberty is initiated by hormonal changes in the adolescent body that trigger physical and behavioral changes to reach adult maturation. As these changes occur, some adolescents experience concerning pubertal symptoms that are associated with dysfunction of the autonomic nervous system (ANS). Vasovagal syncope (VVS) and Postural Orthostatic Tachycardia Syndrome (POTS) are common disorders of the ANS associated with puberty that are related to orthostatic intolerance and share similar symptoms. Compared to young males, young females have decreased orthostatic tolerance and a higher incidence of VVS and POTS. As puberty is linked to changes in specific sex and non-sex hormones, and hormonal therapy sometimes improves orthostatic symptoms in female VVS patients, it is possible that pubertal hormones play a role in the increased susceptibility of young females to autonomic dysfunction. The purpose of this paper is to review the key hormonal changes associated with female puberty, their effects on the ANS, and their potential role in predisposing some adolescent females to cardiovascular autonomic dysfunctions such as VVS and POTS. Increases in pubertal hormones such as estrogen, thyroid hormones, growth hormone, insulin, and insulin-like growth factor-1 promote vasodilatation and decrease blood volume. This may be exacerbated by higher levels of progesterone, which suppresses catecholamine secretion and sympathetic outflow. Abnormal heart rate increases in POTS patients may be exacerbated by pubertal increases in leptin, insulin, and thyroid hormones acting to increase sympathetic nervous system activity and/or catecholamine levels. Given the coincidental timing of female pubertal hormone surges and adolescent onset of VVS and POTS in young women, coupled with the known roles of these hormones in modulating cardiovascular homeostasis, it is likely that female pubertal hormones play a role in predisposing females to VVS and POTS during puberty. Further research is necessary to confirm the effects of female pubertal hormones on autonomic function, and their role in pubertal autonomic disorders such as VVS and POTS, in order to inform the treatment and management of these debilitating disorders.
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Affiliation(s)
- Kassandra E Coupal
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Natalie D Heeney
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Brooke C D Hockin
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Rebecca Ronsley
- Department of Pediatrics, BC Children's Hospital, Vancouver, BC, Canada
| | - Kathryn Armstrong
- Children's Heart Centre, BC Children's Hospital, Vancouver, BC, Canada
| | | | - Victoria E Claydon
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
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Fhayli W, Boëté Q, Harki O, Briançon-Marjollet A, Jacob MP, Faury G. Rise and fall of elastic fibers from development to aging. Consequences on arterial structure-function and therapeutical perspectives. Matrix Biol 2019; 84:41-56. [PMID: 31493460 DOI: 10.1016/j.matbio.2019.08.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/03/2019] [Accepted: 08/26/2019] [Indexed: 12/12/2022]
Abstract
In the arteries of vertebrates, evolution has given rise to resilient macromolecular structures, elastin and elastic fibers, capable of sustaining an elevated blood pressure and smoothening the discontinuous blood flow and pressure generated by the heart. Elastic fibers are produced only during development and childhood, before being progressively degraded by mechanical stress and enzymatic activities during adulthood and aging. During this period, arterial elastic fiber calcification and loading of lipids also occur, all of these events conducting to arteriosclerosis. This leads to a progressive dysfunction of the large elastic arteries inducing elevated blood pressure as well as altered hemodynamics and organ perfusion, which induce more global malfunctions of the body during normal aging. Additionally, some arterial conditions occur more frequently with advancing age, such as atherosclerosis or aneurysms, which are called age-related diseases or pathological aging. The physiological or pathological degradation of elastic fibers and function of elastic arteries seemed to be rather inevitable over time. However, during the recent years, different molecules - including several ATP-dependent potassium channel openers, such as minoxidil - have been shown to re-induce elastin production and elastic fiber assembly, leading to improvements in the arterial structure and function or in organ perfusion. This review summarizes the changes in the arterial elastic fibers and structure from development until aging, and presents some of the potential pharmacotherapies leading to elastic fiber neosynthesis and arterial function improvement.
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Affiliation(s)
- Wassim Fhayli
- Univ. Grenoble Alpes, Inserm U1042, CHU Grenoble Alpes, HP2, 38000 Grenoble, France
| | - Quentin Boëté
- Univ. Grenoble Alpes, Inserm U1042, CHU Grenoble Alpes, HP2, 38000 Grenoble, France
| | - Olfa Harki
- Univ. Grenoble Alpes, Inserm U1042, CHU Grenoble Alpes, HP2, 38000 Grenoble, France
| | | | - Marie-Paule Jacob
- INSERM, U1148, and Hopital Bichat-Claude Bernard, 46 rue Henri Huchard, 75877 Paris, France
| | - Gilles Faury
- Univ. Grenoble Alpes, Inserm U1042, CHU Grenoble Alpes, HP2, 38000 Grenoble, France.
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DuPont JJ, Kenney RM, Patel AR, Jaffe IZ. Sex differences in mechanisms of arterial stiffness. Br J Pharmacol 2019; 176:4208-4225. [PMID: 30767200 DOI: 10.1111/bph.14624] [Citation(s) in RCA: 163] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 01/08/2019] [Accepted: 01/21/2019] [Indexed: 12/24/2022] Open
Abstract
Arterial stiffness progressively increases with aging and is an independent predictor of cardiovascular disease (CVD) risk. Evidence supports that there are sex differences in the time course of aging-related arterial stiffness and the associated CVD risk, which increases disproportionately in postmenopausal women. The association between arterial stiffness and mortality is almost twofold higher in women versus men. The differential clinical characteristics of the development of arterial stiffness between men and women indicate the involvement of sex-specific mechanisms. This review summarizes the current literature on sex differences in vascular stiffness induced by aging, obesity, hypertension, and sex-specific risk factors as well as the impact of hormonal status, diet, and exercise on vascular stiffness in males and females. An understanding of the mechanisms driving sex differences in vascular stiffness has the potential to identify novel sex-specific therapies to lessen CVD risk, the leading cause of death in males and females. LINKED ARTICLES: This article is part of a themed section on The Importance of Sex Differences in Pharmacology Research. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.21/issuetoc.
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Affiliation(s)
- Jennifer J DuPont
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, Massachusetts, United States of America
| | - Rachel M Kenney
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, Massachusetts, United States of America
| | - Ayan R Patel
- Division of Cardiology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts, United States of America
| | - Iris Z Jaffe
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, Massachusetts, United States of America.,Division of Cardiology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts, United States of America
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Associations of Cardiorespiratory Fitness and Adiposity With Arterial Stiffness and Arterial Dilatation Capacity in Response to a Bout of Exercise in Children. Pediatr Exerc Sci 2019; 31:238-247. [PMID: 30626267 DOI: 10.1123/pes.2018-0145] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Purpose: To investigate the associations of directly measured peak oxygen uptake ( V˙O2peak ) and body fat percentage (BF%) with arterial stiffness and arterial dilatation capacity in children. Methods: Findings are based on 329 children (177 boys and 152 girls) aged 8-11 years. V˙O2peak was assessed by a maximal cardiopulmonary exercise test on a cycle ergometer and scaled by lean body mass (LM). BF% and LM were measured by bioelectrical impedance. Stiffness index (measure of arterial stiffness) and change in reflection index (ΔRI, measure of arterial dilatation capacity) were assessed by pulse contour analysis. Data were analyzed by linear regression models. Results:V˙O2peak/LM was positively associated with ΔRI in boys adjusted for age and BF% (β = 0.169, P = .03). Further adjustments for systolic blood pressure, heart rate, and the study group had no effect on this association, but additional adjustment for clinical puberty attenuated it (β = 0.171, P = .07). BF% was inversely related to ΔRI in boys adjusted for age and V˙O2peak/LM (β = -0.171, P = .03). V˙O2peak or BF% was not associated with ΔRI in girls or with stiffness index in either boys or girls. Conclusion: Increasing cardiorespiratory fitness and decreasing adiposity may improve arterial health in childhood, especially among boys.
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Lentferink YE, Kromwijk LAJ, van der Aa MP, Knibbe CAJ, van der Vorst MMJ. Increased Arterial Stiffness in Adolescents With Obesity. Glob Pediatr Health 2019; 6:2333794X19831297. [PMID: 30828593 PMCID: PMC6390226 DOI: 10.1177/2333794x19831297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 12/08/2018] [Accepted: 12/14/2018] [Indexed: 01/09/2023] Open
Abstract
Increased arterial stiffness (AS) is an early sign of cardiovascular disease.
Influence of weight, puberty, and insulin resistance (IR) on AS in adolescents
is unclear. Therefore, this study compared AS, assessed with pulse wave velocity
(PWV) and augmentation index (AIx), of adolescents with and without obesity and
evaluated the influence of puberty and IR on AS. Sixty-two lean and 61
adolescents with obesity were included. Significantly higher PWV was observed in
adolescents with obesity (4.1 ms−1 [2.4 to 5.6 ms−1] vs
3.6 ms−1 [0.4 to 6.1 ms−1]; P = .01),
while AIx was not significant different. However, significantly higher AIx was
observed in adolescents with obesity and IR (3.0 [−17.5% to 28.5%] vs −3.0
[−19.0% to 13.0%]; P = .01). For Tanner stages, no differences
were observed. The higher PWV in adolescents with obesity and higher AIx in
adolescents with obesity and IR both indicate an increased AS. Consequently,
measurement of AS should be considered in adolescents with obesity and IR as
part of cardiovascular risk assessment.
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Chaudhari S, Cushen SC, Osikoya O, Jaini PA, Posey R, Mathis KW, Goulopoulou S. Mechanisms of Sex Disparities in Cardiovascular Function and Remodeling. Compr Physiol 2018; 9:375-411. [PMID: 30549017 DOI: 10.1002/cphy.c180003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Epidemiological studies demonstrate disparities between men and women in cardiovascular disease prevalence, clinical symptoms, treatments, and outcomes. Enrollment of women in clinical trials is lower than men, and experimental studies investigating molecular mechanisms and efficacy of certain therapeutics in cardiovascular disease have been primarily conducted in male animals. These practices bias data interpretation and limit the implication of research findings in female clinical populations. This review will focus on the biological origins of sex differences in cardiovascular physiology, health, and disease, with an emphasis on the sex hormones, estrogen and testosterone. First, we will briefly discuss epidemiological evidence of sex disparities in cardiovascular disease prevalence and clinical manifestation. Second, we will describe studies suggesting sexual dimorphism in normal cardiovascular function from fetal life to older age. Third, we will summarize and critically discuss the current literature regarding the molecular mechanisms underlying the effects of estrogens and androgens on cardiac and vascular physiology and the contribution of these hormones to sex differences in cardiovascular disease. Fourth, we will present cardiovascular disease risk factors that are positively associated with the female sex, and thus, contributing to increased cardiovascular risk in women. We conclude that inclusion of both men and women in the investigation of the role of estrogens and androgens in cardiovascular physiology will advance our understanding of the mechanisms underlying sex differences in cardiovascular disease. In addition, investigating the role of sex-specific factors in the development of cardiovascular disease will reduce sex and gender disparities in the treatment and diagnosis of cardiovascular disease. © 2019 American Physiological Society. Compr Physiol 9:375-411, 2019.
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Affiliation(s)
- Sarika Chaudhari
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Spencer C Cushen
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Oluwatobiloba Osikoya
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Paresh A Jaini
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Rachel Posey
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Keisa W Mathis
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Styliani Goulopoulou
- Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, Texas, USA
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Pediatric reference values for arterial stiffness parameters cardio-ankle vascular index and CAVI 0. ACTA ACUST UNITED AC 2018; 12:e35-e43. [PMID: 30420250 DOI: 10.1016/j.jash.2018.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 08/07/2018] [Accepted: 10/10/2018] [Indexed: 11/21/2022]
Abstract
The process of arteriosclerosis begins early in life, and cardiovascular risk factors identified in childhood tend to persist into adulthood. Cardio-ankle vascular index (CAVI), a recent parameter of arterial stiffness, is considered an independent predictor of cardiovascular risk. However, there are no studies reporting sex- and age-specific physiological values of CAVI in childhood. We aimed to establish reference values for CAVI and its blood pressure-corrected variant (CAVI0) in 500 healthy children and adolescents aged 7 to 19 years and to study potential relationships with anthropometric indices. Sex- and age-specific distributions of CAVI and CAVI0 values in healthy children and adolescents are presented. Boys aged 15-19 years had lower CAVI than girls, which could result from CAVI's slight blood pressure dependence. CAVI0 did not show such sex difference. Body roundness index-a novel parameter to quantify abdominal fat-was a strong anthropometric predictor of both CAVI and CAVI0. This is the first study providing pediatric age- and sex-specific reference values for arterial stiffness parameters CAVI and CAVI0. The presented data can contribute to the understanding of the evolution of these indices during childhood and adolescence. Under specific conditions, CAVI0 may offer more robust information about arterial stiffness than standard CAVI.
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Overweight and obese children with sleep disordered breathing have elevated arterial stiffness. Sleep Med 2018; 48:187-193. [DOI: 10.1016/j.sleep.2018.05.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 05/09/2018] [Accepted: 05/14/2018] [Indexed: 11/23/2022]
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50
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Ogola BO, Zimmerman MA, Clark GL, Abshire CM, Gentry KM, Miller KS, Lindsey SH. New insights into arterial stiffening: does sex matter? Am J Physiol Heart Circ Physiol 2018; 315:H1073-H1087. [PMID: 30028199 DOI: 10.1152/ajpheart.00132.2018] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This review discusses sexual dimorphism in arterial stiffening, disease pathology interactions, and the influence of sex on mechanisms and pathways. Arterial stiffness predicts cardiovascular mortality independent of blood pressure. Patients with increased arterial stiffness have a 48% higher risk for developing cardiovascular disease. Like other cardiovascular pathologies, arterial stiffness is sexually dimorphic. Young women have lower stiffness than aged-matched men, but this sex difference reverses during normal aging. Estrogen therapy does not attenuate progressive stiffening in postmenopausal women, indicating that currently prescribed drugs do not confer protection. Although remodeling of large arteries is a protective adaptation to higher wall stress, arterial stiffening increases afterload to the left ventricle and transmits higher pulsatile pressure to smaller arteries and target organs. Moreover, an increase in aortic stiffness may precede or exacerbate hypertension, particularly during aging. Additional studies are needed to elucidate the mechanisms by which females are protected from arterial stiffness to provide insight into its mechanisms and, ultimately, therapeutic targets for treating this pathology.
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Affiliation(s)
- Benard O Ogola
- Department of Pharmacology, Tulane University , New Orleans, Louisiana
| | | | - Gabrielle L Clark
- Department of Biomedical Engineering, Tulane University , New Orleans, Louisiana
| | - Caleb M Abshire
- Department of Pharmacology, Tulane University , New Orleans, Louisiana
| | - Kaylee M Gentry
- Department of Pharmacology, Tulane University , New Orleans, Louisiana
| | - Kristin S Miller
- Department of Biomedical Engineering, Tulane University , New Orleans, Louisiana
| | - Sarah H Lindsey
- Department of Pharmacology, Tulane University , New Orleans, Louisiana
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