Vascular ageing: main symptoms and mechanisms

Influence of Moxonidine and Bisoprolol on Morphofunctional Condition of Arterial Wall and Telomerase Activity in Postmenopausal Women with Arterial Hypertension and Osteopenia. The Results from a Moscow Randomized Study

PURPOSE

To compare the effect of 12 months of treatment with moxonidine or bisoprolol on telomerase activity (TA) and parameters characterizing the arterial wall state in postmenopausal women with arterial hypertension (AH) and osteopenia.

METHODS

An open-label randomized study with 114 postmenopausal women with hypertension and osteopenia; pulse wave velocity (PWV), intima-media thickness (IMT), and TA were analyzed initially and after 12 months of therapy with moxonidine (n = 57) or bisoprolol (n = 57).

RESULTS

Both medications effectively lowered blood pressure (BP) in both groups. After 12 months, the moxonidine group showed a significant increase in TA by 45.5% (from 0.87 to 1.15; p < 0.001), in contrast to the bisoprolol group, where TA decreased by 14.1% (from 0.89 to 0.74; p = 0.001). Within 12 months, in the moxonidine group, PWV decreased by 1.9% (from 10.35 ± 2.56 to 10.05 ± 2.29 m/s; p = 0.039), and in the bisoprolol group it increased by 5.8% (from 10.36 ± 2.47 to 11.26 ± 2.60 m/s; p < 0.001). In the moxonidine group, IMT increased by 3.5% on the right and 1.4% on the left, in the bisoprolol group - by 5.7% on the right and 4.2% on the left.

CONCLUSION

A 12-month treatment with moxonidine but not with bisoprolol in postmenopausal women with AH and osteoporosis was associated with a decrease of arterial stiffness seen as statistically significantly reduced PVW and with increased TA.

[Association of AGT, ACE, NOS3, TNF, MMP9, CYBA polymorphism with subclinical arterial wall changes]

Aim    Activation of the renin-angiotensin-aldosterone system, decreased nitric oxide production, chronic inflammation, and oxidative stress result in subclinical changes in the arterial wall, which favor the development of cardiovascular diseases (CVD). The effect of allelic gene variants that encode the proteins participating in pathogenetic pathways of age-associated diseases with subclinical changes in the arterial wall [increased pulse wave velocity (PWV), increased intima-media thickness, endothelial dysfunction (ED), presence of atherosclerotic plaques (ASP)] are understudied. This study analyzed the relationship between AGT, ACE, NOS3 TNF, MMP9, and CYBA gene polymorphism and the presence of subclinical changes in the arterial wall, including the dependence on risk factors for CVD, in arbitrarily healthy people of various age.Material and methods    The relationship of polymorphisms с.521С&gt;Т of AGT gene, Ins&gt;Del of AСE gene, с.894G&gt;T of NOS3 gene, - 238G&gt;A of TNF gene, - 1562С&gt;T of MMP9 gene, and c.214Т&gt;С of CYBA gene with indexes of changes in the arterial wall and risk factors for CVD was studied in 160 arbitrarily healthy people by building models of multiple logistic regression and also by analyzing frequencies of co-emergence of two signs with the Pearson chi-squared test (χ2) and Fisher exact test.Results    The DD-genotype of Ins&gt;Del ACE gene polymorphism was correlated with increased PWV (p=0.006; odds ratio (OR) =3.41, 95 % confidence interval (CI): 1.48-8.67) and ED (p=0.014; OR=2.60, 95 % CI: 1.22-5.68). The GG genotype of с.894G&gt;T NOS3 gene polymorphism was correlated with ED (p=0.0087; OR=2.65, 95 % CI: 1.26-5.72); the ТТ-genotype of с.894G&gt;T NOS3 gene polymorphism was correlated with ASP (p=0.033; OR=0.034, 95 % CI: 0.001-0.549).Conclusion    Polymorphic variants of AСE and NOS3 genes correlated with ED, increased arterial wall stiffness, and the presence of subclinical changes in the arterial wall.

[Possibilities of application of cardio-ankle vascular index in patients with cerebrovascular diseases]

This publication focuses on the feasibility of using the cardio-ankle vascular index (CAVI) in patients with cerebrovascular diseases. The authors consider the pathological conditions and risk factors of stroke associated with increased arterial stiffness, methods for its assessment, the advantages of using CAVI, the experience of using CAVI in patients with cardiovascular diseases, in particular, in neurological patients. The complexity of the application of CAVI in the Russian population, promising directions for determining the index in neurology as well as the importance of CAVI borderline indicators are shown. It is emphasized that stroke patients should be screened with a mandatory study of CAVI.

NEW ASPECTS OF MOXONIDINE USAGE IN FEMALE PATIENTS WITH ARTERIAL HYPERTENSION AND POSTMENOPAUSE

The review of a new data is provided related to novel aspects of moxonidine use in the patients with arterial hypertension. The main attention is paid to the problem of vascular ageing, telomere biology, insulin resistance and calcium-phosphorum homeostasis. The possible ways to influence this processes are discussed. 

GUT ENTEROBIOTA — A NEW PLAYER IN ATHEROSCLEROSIS PATHOGENESIS

The article provides a review of contemporary literature, which generalizes experimental and clinical data on the role of gut microbiota in atherosclerosis development. Gut microflora can be named a marker of the macroorganism condition, reacting on age-related, physiological, dietic, climatogeoraphic factors with its changes of qualitative and quantitative compounds. It was shown that L-carnitine and choline being received with food, are utilized by microflora to synthetize trimethylamine, which then rapidly oxydized by flavinmonooxygenase of liver to trimethylamin-N-oxide, that causes atherosclerosis development and increases risk of cardiovscular diseases.

INTERRELATION BETWEEN CARDIOVASCULAR RISK FACTORS AND TELOMERE BIOLOGY WITH THE SIGNS OF VASCULAR AGING

Aim.To study interrelationship between cardiovascular risk factors and cellular and vascular aging processes. Material and methods. Totally 136 patients were included having no signs of cardiovascular diseases, diabetes 2nd type and receiving no drug therapy, but with one or several risk factors for cardiovascular diseases (smoking, arterial hypertension, obesity, dyslipidemia, fasting hyperglycemia). The telomere length and telomerase activity was measured by polymerase chain reaction. The thickness of intima-media complex (TIMC) and presence of atherosclerotic plaques (ASP) were measured by duplex scanning of right and left carotid arteries. Pulse wave velocity (PWV) was measured by applanation tonometry. Biochemical tests done by standard.

Results.PWV significantly correlated with age, body mass index, glycosilated hemoglobin level, fasting glycemia and telomere length. Presence of ASP and increased TIMC significantly correlated with age, body mass index, arterial hypertension, dyslipidemia.Conclusion.Increase of arterial wall stiffness and subclinical atherosclerotic disease have different causes. The level of PWV more linked with carbohydrate metabolism disorder, and TIMC and ASP are linked with lipid disorders.