Arterial Stiffness In Adults Research Articles

Association between leisure-time physical activity and arterial stiffness in adults of the ELSA-Brasil study: a mediation analysis.

We aimed at defining the direct and the mediated pathways for the association between leisure-time physical activity (LTPA) and carotid-to-femoral pulse wave velocity (cf-PWV), and also to identify whether these effects are influenced by sex and age. Cross-sectional data from 13 718 adults (35-74 years) were obtained at the baseline of the ELSA-Brasil study. The cf-PWV was obtained by measuring the pulse transit time and the distance traveled by the pulse between the carotid and the femoral, as well as clinical and anthropometric parameters were measured. The levels of LTPA were determined by applying the long form of the International Physical Activity Questionnaire (IPAQ). Classical cardiovascular risk factors were independently associated with cf-PWV. Path analysis showed that increased levels of LTPA were directly associated with lower cf-PWV in both men and women ( β : -0.123 ± 0.03 vs. 0.065 ± 0.029, P for sex = 0.165), except for diabetes. Also, the mediated effect of LTPA on SBP and DBPs, heart rate, BMI, and fasting glucose, was associated with lower cf-PWV in men and women ( β : -0.113 ± 0.016 vs. -0.104 ± 0.016, P for sex = 0.692), except for diabetes. When age was tested as a moderator, the direct effect did not change significantly according to participants' age, regardless of sex. However, the mediated effect increases in both men and women over 50 years. Our findings support that LTPA in adults reduces cf-PWV by acting in different ways according to age. Physical activity in older individuals improves cardiometabolic risk factors and thus mitigates the stiffening of large arteries.

Physical activity and sedentary behaviour in relation to body composition, estimated insulin sensitivity and arterial stiffness in adults with type 1 diabetes

AimsTo examine the association of daily PA levels and sedentary behaviour with body composition, estimated insulin sensitivity, and arterial stiffness in adults with type 1 diabetes (T1D). MethodsCross-sectional study in adults with T1D (n = 54). PA levels (daily steps, and time in moderate-to-vigorous intensity PA (MVPA)) and sedentary behaviour were measured using accelerometry for 7 days (McRoberts® DynaPort MoveMonitor). Cardiopulmonary exercise test for VO2max. Anthropometrics were collected, and body composition (total and % of fat mass (FMtot, FM%), total and % of lean mass (LMtot, LM%), and estimated visceral adipose tissue (VAT)) volume was assessed with dual energy X-ray-absorptiometry (DXA). Estimates of insulin sensitivity were determined (estimated glucose disposal rate (eGDR) and total daily insulin dose). Arterial stiffness was assessed with carotid-femoral pulse wave velocity (cf-PWV (m/s); SphygmoCor®). ResultsLower 10-years HbA1c associated moderately with all PA measures. Favourable moderate associations were also found between PA measures and BMI, waist, VAT but not FM and LM. PA measures were favourably associated with a lower total daily insulin dose and higher eGDR. All PA parameters associated moderately with cf-PWV however not independent from traditional risk factors. VO2max was inversely associated with cf-PWV independent of age, T1D duration and 24-hour mean blood pressure. ConclusionsHigher levels of PA, lower sedentary behaviour and greater exercise capacity are favourably associated with long-term glycaemic control, body composition, insulin dosage, estimated insulin sensitivity and arterial stiffness in adults with T1D. Therefore, regular PA and limiting sedentary time should be encouraged to improve metabolic and cardiovascular health in this population. Future longitudinal studies should explore mutual interactions and synergistic effects of PA on these outcomes.

Arterial stiffness in adults with Long COVID in sub-Saharan Africa.

Severe acute coronavirus-2 (SARS-CoV-2) infection has been associated with endothelial damage, and impaired nitric oxide production, which results in arterial stiffness and increased risk of cardiovascular disease. Long COVID is a term used to describe the persistence or the development of new symptoms that can occur after an acute infection. Little is known about the association between arterial stiffness and Long COVID. An observational, cross-sectional study in which arterial stiffness was measured with pulse wave velocity (PWV) was carried out in 74 participants between 19 and 40 years old (53 with Long COVID, 21 age and gender-matched controls). Data was collected from participants between 1 and 9 months after acute COVID-19 infection using the Complior analyze unit protocol. The Long COVID group had higher carotid-radial-PWV (crPWV) than controls (10 m/s interquartile range [IQR] 8.5-11.2 m/s) versus 8.8 m/s (IQR 7.7-9.2 m/s) as was their carotid-radial-arterial stiffness index (crASI) (2.26 cm/ms (IQR 1.9-2.56 cm/ms) vs. 2.01 cm/ms (IQR 1.82-2.27 cm/ms); p < 0.05) in both. They also had more type-A waveforms, indicating increased arterial stiffening. Peripheral arterial stiffness was higher in adults with Long COVID than in controls who were never infected with SARS-CoV-2 as noted by the elevated levels of crPWV and crASI among adults with Long COVID.

Home- vs gym-based exercise delivery modes of two multicomponent intensity training regimes on cardiorespiratory fitness and arterial stiffness in adults with intellectual and developmental disability during the COVID-19 pandemic - a randomized controlled trial.

Background: We compared the effects of home- vs gym-based delivery modes of two 8-week supervised multicomponent intensity training regimes on cardiorespiratory fitness and arterial stiffness in 17 adults with intellectual and developmental disability during the COVID-19 pandemic. Methods: Participants were assigned to sprint interval training or continuous aerobic training, both incorporating resistance training. The intervention started with 8-weeks of online training (M1-M2), 1-month of detraining, plus 8-weeks of gym-based training (M3-M4). Results: Peak oxygen uptake decreased from M1-M2 and increased from M2-M4. Central arterial stiffness decreased between M1-M2, and M1-M4, along with peripheral arterial stiffness. Central systolic blood pressure decreased from M1-M2 only with sprint interval training. Conclusion: Home-based training minimized the negative impact of the lockdown on central arterial stiffness and central blood pressure, but it did not match the benefits on cardiorespiratory fitness and peripheral arterial stiffness of a gym-based intervention, irrespective of the multicomponent intensity training regime. Registered in ClinicalTrials.gov NCT05701943.

In Utero and Early-Childhood Exposure to the Great Chinese Famine and Adult Arterial Stiffness: A Cross-Sectional Study.

In Utero and Early-Childhood Exposure to the Great Chinese Famine and Adult Arterial Stiffness: A Cross-Sectional Study.

Impaired Cardiovagal Activity as a Link Between Hyperglycemia and Arterial Stiffness in Adults With Type 2 Diabetes Mellitus Among an Eastern Indian Population: A Cross-sectional Study

ObjectivesCardiac autonomic neuropathy (CAN) is one of the most common yet overlooked complications of type 2 diabetes mellitus (T2DM). Individuals with T2DM with CAN have a 5-fold higher rate of cardiovascular morbidity and mortality. The presence of CAN in T2DM could potentially lead to arterial stiffness. However, only sparse data are available suggesting any association between autonomic dysfunction and arterial stiffness in T2DM. MethodsWe recruited 80 people with T2DM and 74 healthy controls for our study. Heart rate variability (HRV) testing was performed to assess autonomic function. Assessment of arterial stiffness was done by measuring the brachial pulse wave velocity (baPWV) and augmentation index (AI). ResultsThe time-domain parameters were significantly decreased (p<0.001) and frequency-domain parameters, such as total power and high-frequency band expressed as a normalized unit, were found to be significantly reduced in people with T2DM (p<0.001). Both baPWV and AI were significantly higher in people with T2DM compared with healthy controls (p<0.001). We observed a moderate correlation between standard deviation of normal to normal interval (SDNN) and baPWV (r=−0.437, p=0.002) and AI (r=−0.403, p=0.002). A multiple linear regression model showed an association between SDNN and arterial stiffness parameters, such as baPWV and AI, which were statistically significant (p<0.05) in a fully adjusted model that included the conventional risk factors for atherosclerosis. ConclusionsImpaired cardiovagal activity is an independent risk factor for the development of arterial stiffness. Incorporation of HRV testing into the diabetes management protocol would have potential benefits for identifying individuals at high risk of developing cardiovascular events. Hence, preventive measures can be taken as early as possible to improve patient outcomes.

The Effect of Folic Acid Supplementation on Endothelial Function and Arterial Stiffness Markers in Adults: A Systematic Review and Meta-Analysis.

Folic acid might improve endothelial function, but the results are inconclusive. This systematic review evaluated the effect of folic acid supplementation on endothelial parameters and arterial stiffness in adults. The study protocol was registered with the PROSPERO database (CRD42021290195). The PubMed, Web of Sciences, Cochrane and Scopus databases were searched to identify English-language randomised controlled trials of the effect of folate supplementation on arterial stiffness and endothelial function markers in adults. There were significant differences between the effect of folic acid and placebo on flow-mediated dilation (random-effects model, standardized mean differences (SMD): 0.888, 95% confidence interval (CI): 0.447, 1.329, p < 0.001) and monocyte chemotactic protein 1 (random-effects model, SMD: -1.364, 95% CI: -2.164, -0.563, p < 0.001), but there was no significant difference in the central pulse wave velocity (fixed-effects model, SMD: -0.069, 95% CI: -0.264, 0.125, p = 0.485) and peripheral pulse wave velocity (fixed-effects model, SMD: -0.093, 95% CI: -0.263, 0.077, p = 0.284). In conclusion, folic acid might have a favourable effect on endothelial function but may not affect arterial stiffness. Further studies are needed to confirm these results.

Blood pressure levels within normotensive range are independently associated with increased risk of arterial stiffness in adults without hypertension or prehypertension

Background and aimsHigh blood pressure (BP) indices, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP) predict cardiovascular diseases and mortality. However, the association of these BP indices with arterial stiffness (AS) in the normotensive population (BP < 120/80 mmHg) remains unclear. Methods and resultsStudy participants who underwent health checkups at a tertiary referred center were recruited between November 2018 to December 2019. 2129 participants were enrolled after excluding those aged <18 years old, with elevated BP, history of hypertension, cardiovascular disease, and stroke, or with incomplete data. The brachial-ankle pulse wave velocity (baPWV) values were examined for evaluation of AS. Participants with higher blood pressure indices had significantly higher baPWV. Multiple linear regression revealed that all BP indices were positively associated with baPWV. According to the binary logistic regression analysis, participants in the higher SBP and MAP quartiles were significantly related to AS. The odds ratio (OR) for SBP Q2, Q3 and Q4 vs. Q1 were 6.06, 10.06 and 17.78 whereas the OR for MAP Q2, Q3 and Q4 vs. Q1 were: 5.07, 5.28 and 10.34. For DBP and PP, only participants belonging to the highest quartile were associated with AS(OR for DBP Q4 vs. Q1: 2.51; PP Q4 vs Q1: 1.94). ConclusionsBP indices were linearly related to the baPWV. Normotensive participants with higher quartiles of SBP, DBP, MAP, and PP, remained associated with increased AS. The SBP and MAP levels exhibited a more prominent relationship with AS.

Association of time-restricted feeding, arterial age, and arterial stiffness in adults with metabolic syndrome.

Time-restricted feeding (TRF) is a kind of intermittent fasting defined as eating and drinking only during a certain number of hours in a day. It has been suggested that intermittent fasting may improve cardiovascular risk factors. This study evaluated the association of TRF and arterial stiffness, using pulse wave velocity (PWV), pulse wave analysis, and arterial age in metabolic syndrome participants. A cohort study was carried out among metabolic syndrome adults who were followed over the Ramadan fasting period (used as a model of TRF since food was only allowed for about 8 h/day). The subjects were divided into Ramadan fasting and Ramadan nonfasting groups. The aortic PWV and central aortic pressure waveform were measured. Central systolic pressure, central pulse pressure, and indices of arterial compliance, such as augmentation pressure and augmentation index (AIx), were determined from waveform analysis. Ninety-five adults (31.57% female, age: 45.46 ± 9.10 years) with metabolic syndrome (based on the International Diabetes Federation definition) participated in this study. Ramadan fasting and Ramadan nonfasting groups were including 80 and 15 individuals respectively. A significant reduction was seen in PWV (0.29 m/s), central systolic pressure (4.03 mmHg), central pulse pressure (2.43 mmHg), central augmentation pressure (1.88 mmHg), and central AIx (2.47) in the Ramadan fasting group (p = 0.014, p < 0.001, p = 0.001, p = 0.003, and p = 0.036 respectively). There were no significant changes in these indices among the Ramadan nonfasting group. This study suggested that TRF reduces arterial age and improves arterial stiffness among people with metabolic syndrome. This might be considered a beneficial nutrition strategy for extending healthspan (and perhaps longevity).

Neighbourhood deprivation in childhood and adulthood and risk of arterial stiffness: the Cardiovascular Risk in Young Finns study

Purpose: Individual socioeconomic status is associated with increased arterial stiffness, but limited data are available on the relations of neighbourhood deprivation with this vascular measure. We prospectively examined whether neighbourhood deprivation in childhood and adulthood predicts arterial stiffness indicated by pulse wave velocity (PWV). Materials and methods: The study population comprised 1,761 participants aged 3-18 years at baseline (1980) from the longitudinal Cardiovascular Risk in Young Finns cohort study. PWV was measured in 2007 by whole-body impedance cardiography at ages 30-45 years. Cumulative lifetime neighbourhood deprivation was assessed using data from socioeconomic circumstances in participants’ lifetime residential neighbourhoods, categorised as low versus high deprivation. Results: High deprivation in childhood and adulthood was associated with higher PWV in adulthood after adjustment for age, sex, and place of birth (mean difference = 0.57 m/s, 95%CI = 0.26-0.88, P for trend = 0.0004). This association was attenuated but remained statistically significant after further adjustment for childhood parental socioeconomic status and adulthood individual socioeconomic status (mean difference = 0.37 m/s, 95%CI = 0.05-0.70, P for trend 0.048). Also, low individual socioeconomic status in adulthood was associated with higher PWV when adjusted for age, sex, place of birth, parental socioeconomic status in childhood, and lifetime neighbourhood deprivation (mean difference = 0.54 m/s, 95%CI = 0.23-0.84, P for trend 0.0001). Conclusion: These findings suggest that lifetime neighbourhood deprivation and low adulthood socioeconomic status are independent risk factors for increased arterial stiffness in adulthood.

Hemodynamic response to different contractile speeds of resistance exercise in adults with sarcopenic obesity

This study aimed to compare the effects of high-speed and low-speed resistance exercise on hemodynamics in adults with sarcopenic obesity. We hypothesized that high-speed resistance exercise induces greater/longer cardiovascular stress than low-speed resistance exercise. Forty-five individuals with sarcopenic obesity (64.0±6.0 years) were randomized to the low-speed resistance exercise group (LSRE; n=24) and the high-speed resistance exercise group (HSRE; n=21). All participants performed one-session of resistance exercises [squatting, chest press, and upright row; 3 sets of 10 repetitions at 60% of 1 repeated maximum]. Participants in the LSRE group performed the exercises with a 4:4 second concentric-eccentric contraction cycle controlled by a metronome while participants in the HSRE group performed the exercise with a 1:4 second concentric-eccentric contraction cycle. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and arterial stiffness (brachial-ankle pulse wave velocity; baPWV) were determined before exercise (resting), immediately after exercise (P0), 15-min after exercise (P15), and 30-min after exercise (P30). Two-way repeated measure analysis of variance was used to examine the effect of different contractile speeds of resistance exercise on outcome variables. The significant level was set at 0.05. We found that the HR at P0 was higher than the resting values for both groups, with 10.9 bpm and 14.0 bpm of increases for the LSRE group and HSRE group, respectively. HR was back to the resting level at P15 in the LSRE group; however, HR was back to the resting level until P30 in the HSRE group. For both groups, SBP was significantly higher at P0 compared to resting (12.5 mmHg of increase for the LSRE group and 11.9 mmHg of increase for the HSRE group) and back to the resting level at P15. PWV at P0 was higher than the resting and back to the resting level at P15 in the LSRE group. PWV levels did not change with exercise in the HSRE group (p&gt;0.05). DBP did not change significantly with exercise in both groups (p&gt;0.05). In conclusion, the influence of HSRE on HR is longer than that of LSRE. LSRE, but not HSRE, results in transient changes in arterial stiffness in adults with sarcopenic obesity. This study was supported by the Ministry of Science and Technology, Taiwan [grant numbers: MOST-109-2314-B-010 -036 -MY3 (Chen, C.N.)]. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Weight loss associated with low-energy diets with different glycaemic loads does not improve arterial stiffness: a randomised clinical trial.

We evaluated the effects of two low-energy diets with different glycaemic loads on arterial stiffness in adults with excess weight. This was a 45-day parallel-group, randomised clinical trial including seventy-five participants (20-59 years; BMI 32 kg/m2). They were assigned to two similar low-energy diets (reduction of ∼750 kcal.d-1) with macronutrient composition (55 % carbohydrates, 20 % proteins and 25 % lipids) but different glycaemic loads: high-glycaemic load (HGL 171 g.d-1; n 36) or low-glycaemic load (LGL 67 g.d-1; n 39). We evaluated: arterial stiffness (pulse wave velocity, PWV); augmentation index (AIx@75); reflection coefficient; fasting blood glucose; fasting lipid profile; blood pressure and body composition. We found no improvements in PWV (P = 0·690) and AIx@75 (P = 0·083) in both diet groups, but there was a decrease in the reflection coefficient in the LGL group (P = 0·003) compared with baseline. The LGL diet group showed reductions in body weight (Δ -4·9 kg; P = 0·001), BMI (Δ -1·6 kg/m2; P = 0·001), waist circumference (Δ -3·1 cm; P = 0·001), body fat (Δ -1·8 %; P = 0·034), as well as TAG (Δ -14·7 mg/dl; P = 0·016) and VLDL (Δ -2·8 mg/dl; P = 0·020). The HGL diet group showed a reduction in total cholesterol (Δ -14·6 mg/dl; P = 0·001), LDL (Δ -9·3 mg/dl; P = 0·029) but a reduction in HDL (Δ -3·7 mg/dl; P = 0·002). In conclusion, a 45-day intervention with low-energy HGL or LGL diets in adults with excess weight was not effective to improve arterial stiffness. However, the LGL diet intervention was associated with a reduction of reflection coefficient and improvements in body composition, TAG and VLDL levels.

Exploring mechanisms of blood pressure regulation in response to device-guided and non-device-guided slow breathing: A mini review.

Hypertension is a widespread disease that, if persistent, increases the risks of coronary heart disease mortality and morbidity. Slow breathing is a recommended blood pressure-lowering strategy though the mechanisms mediating its effects are unknown. This review aims to evaluate autonomic and vascular function as potential mediators driving BP adaptive responses with slow breathing. We searched EBSCO host, Web of Science, Cochrane Central Register of Controlled Trials, and PubMed using key words for optimized search results. Nineteen studies were included in this review (11 device-guided; 8 non-device-guided breathing). Though some studies showed increased vagally mediated components of heart rate variability during slow breathing, results from acute and long-term studies were incongruent. Increases in baroreflex sensitivity (BRS) following a single device-guided slow breathing bout were noted in normotensive and hypertensive adults. Long-term (4weeks to 3months) effects of slow breathing on BRS were absent. Device-guided breathing resulted in immediate reductions in muscle sympathetic nerve activity (MSNA) in normo- and hyper-tensive adults though results from long-term studies yielded inconsistent findings. Non-device-guided slow breathing posed acute and chronic effects on vascular function with reductions in arterial stiffness in adults with type I diabetes and increases in microvascular endothelial function in adults with irritable bowel syndrome. Non-device guided breathing also reduced pro-inflammatory cytokines in healthy and hypertensive adults in acute and chronic studies. No adverse effects or non-adherence to treatment were noted in these trials. Device-guided slow breathing is a feasible and effective modality in improving BRS, HRV, and arterial stiffness though its long-term effects are obscure. Though less evidence exists supporting the efficacy of non-device-guided slow breathing, acute and chronic studies demonstrate improvements in vascular function and inflammatory cytokines. More studies are needed to further explore the long-term effects of slow breathing in general and non-device-guided breathing in particular.

Arterial Stiffness and Chronic Kidney Disease Progression in Children.

CKD has been linked to increased arterial stiffness in adults, but data in children with CKD remain conflicting. We aimed to investigate the longitudinal dynamics and determinants of pulse wave velocity in children with CKD and its association with CKD progression. We performed an analysis of the Cardiovascular Comorbidity in Children with Chronic Kidney Disease (4C) study, which prospectively followed children aged 6-17 years with CKD stages 3-5. Follow-up was censored at the time of KRT initiation. Two separate analyses were performed: with absolute pulse wave velocity (primary outcome) and with pulse wave velocity standardized to height (z score; restricted to participants ≤17 years) as a sensitivity analysis. In total, 667 patients with a mean baseline eGFR of 27 ml/min per 1.73 m2 were included. Pulse wave velocity above the 95th percentile was observed in 124 (20%) patients at baseline. Absolute pulse wave velocity increased gradually over the median follow-up of 2.7 (interquartile range, 0.7-4.4) years, whereas pulse wave velocity z score remained relatively stable. Absolute pulse wave velocity over time associated with time; older age; higher mean arterial pressure, LDL cholesterol, and albuminuria; and lower ferritin. Pulse wave velocity z score (n=628) was associated with the same variables and additionally, with higher diastolic BP z score, lower height z score, younger age, and girls. Of 628 patients, 369 reached the composite end point of CKD progression (50% eGFR loss, eGFR <10 ml/min per 1.73 m2, or the start of KRT) during a median follow-up of 2.4 (interquartile range, 0.9-4.6) years. Pulse wave velocity z score did not associate with CKD progression by univariable or multivariable proportional hazard analysis correcting for the established predictors eGFR, proteinuria, and BP. Pulse wave velocity is increased in children with CKD but does not associate with eGFR or CKD progression.

Uric acid and arterial stiffness in children and adolescents: Role of insulin resistance and blood pressure.

Several studies describe the association between serum uric acid (SUA) and arterial stiffness in adults. Uric acid contributes through several mechanisms to the increase in blood pressure (BP) and adversely affects the insulin signaling pathway. Moreover, SUA predict the development of hypertension and insulin resistance up to type 2 diabetes. Early arterial stiffening, estimated by carotid-femoral pulse wave velocity (PWV), may already be present in pediatric age. Aim of our study was to investigate the relationship between SUA and PWV in a pediatric population and its interaction with insulin resistance and BP. In 322 children and adolescents (56.2% male, mean age 11.3 [SD 2.8] years), we measured weight, height, waist circumference, BP and PWV. We also assayed SUA and estimated glomerular filtration rate (eGFR) and calculated HOMA-index as a marker of insulin resistance. Simple and multiple regression analyses were performed to assess variables associated with PWV. Mediation models were applied to identify the direct and indirect effects of individual variables on PWV. On univariate analysis, age (p < 0.001), waist circumference-to-height ratio (p = 0.036), systolic and diastolic BP (SBP and DBP) z-score (p < 0.001), heart rate (p = 0.028), SUA (p = 0.002), HOMA-index (p < 0.001), and eGFR (p = 0.014) were significantly associated with PWV. The multiple regression model showed that only age (p = 0.028), SBP z-score (p = 0.006), and heart rate (p = 0.001) were significantly associated with PWV. The results were superimposable when the DBP z-score replaced the SBP z-score in the model. Mediation models showed that the effect of eGFR on PWV was fully mediated by SUA (p = 0.015) and that the effect of SUA on PWV was totally mediated by HOMA-index (p < 0.001). Both SUA (p < 0.01) and HOMA-index (p < 0.01) had a significant association with higher SBP (DBP) z-scores. The double mediation model including both BP and HOMA-index showed that the SUA effect on PWV was totally mediated by both variables (p = 0.005, for HOMA-index, p = 0.004, for SBP z-score and p = 0.007, for combined effect). The results were superimposable when the DBP z-score replaced the SBP z-score in the model. In conclusion, insulin resistance and BP are both important mediators of the association between SUA and vascular stiffness in pediatric age.

The acute effect of maximal exercise on arterial stiffness in adults with and without intellectual and developmental disabilities.

We compared central and peripheral arterial stiffness response patterns between persons with and without intellectual and developmental disabilities (IDD) of different age groups at rest and following a cardiopulmonary exercise test (CPET). Fifteen young adults with and without IDD, and 15 middle-aged adults without IDD performed a CPET. Central and peripheral arterial stiffness were measured at rest and following CPET using estimates of carotid-femoral (cfPWV), carotid-radial (crPWV), and carotid-ankle (cdPWV) pulse wave velocity derived from piezoelectric mechano-transducers. cfPWV remained unchanged following CPET in adults with and without IDD but increased in middle-aged adults (d=0.85; 95% CI: 0.27-1.42m·s-1, p=0.005), whereas cdPWV was similarly reduced (d= -0.77; 95% CI: -1.06 to -0.48m·s-1, p<0.001) in all groups. crPWV remained unchanged in all groups. These results were independent of exercise-related changes in mean arterial pressure. Overall group differences suggested that persons with IDD (d = -1.78; 95% CI: -3.20 to -0.37m·s-1, p=0.009) and without IDD (d = -1.84; 95% CI: -3.26 to -0.43m·s-1, p=0.007) had lower cfPWV than middle-aged adults. We found no evidence of early vascular aging and diminished vascular reserve following CPET in adults with IDD.

Blood Pressure Trajectories From Childhood to Youth and Arterial Stiffness in Adulthood: A 30-Year Longitudinal Follow-Up Study.

BackgroundThis study aimed to identify the subgroups of individuals sharing similar blood pressure (BP) trajectories from childhood to youth and explore the associations of these trajectories with arterial stiffness in adulthood.MethodsA group-based trajectory model was used to identify BP trajectories among 2,082 individuals in the Hanzhong adolescent hypertension cohort by using BP values repeatedly measured at four visits from childhood (6–15 years) to youth (14–23 years). The brachial–ankle pulse wave velocity (baPWV) was examined 30 years after the baseline survey. Mixed linear regression models were used to examine the associations of these trajectories with adult baPWV.ResultsAmong the 2,082 individuals, three trajectory groups of systolic BP were identified as follows: the low-level group (n = 889), medium-level group (n = 1,021), and high-level group (n = 172). The baPWV in adulthood was higher in medium-level and high-level groups compared with the low-level group (1271.4 ± 224.7 cm/s, 1366.1 ± 249.8 cm/s vs. 1190.1 ± 220.3 cm/s, all p < 0.001). After adjustment for potential confounding factors, the association between baPWV and systolic BP trajectories was statistically significant (adjusted β = 49.4 cm/s; p < 0.001 for the medium-level group and β = 107.6 cm/s; p < 0.001 for the high-level group compared with the low-level group). Similar results were obtained for the association of baPWV with the trajectories of diastolic BP and mean arterial pressure (MAP), except for pulse pressure.ConclusionOur investigation demonstrates different BP trajectories from childhood to youth and shows the trajectories of systolic BP, diastolic BP, and MAP are significant predictors of arterial stiffness in adulthood.

Effects of Maximal Exercise on Central and Peripheral Arterial Stiffness in Adults with and without Intellectual and Developmental Disabilities

Adults with Down‐Syndrome seem to be protected from early aging‐associated increases in arterial stiffness and to present blunted responses to maximal aerobic exercise in comparison to age‐matched controls, possibly underlying diminished vascular reserve. However, whether these arterial stiffness responses apply to adults with intellectual and developmental disabilities (IDD) in general remains unknown. We compared central and peripheral arterial stiffness response patterns between persons with and without IDD of different age groups following maximal aerobic exercise. We hypothesized that adults with IDD would show an attenuated arterial stiffness response to maximal aerobic exercise in comparison to young and middle‐aged adults without IDD. Thirty young adults with (n=15, age= 30 ± 7 years) and without (n=15, age= 27 ± 7 years) IDD, and 15 middle‐aged adults (age= 51 ± 4 years) without IDD performed a bout of maximal aerobic exercise. Central and peripheral arterial stiffness were measured at rest and following maximal aerobic exercise using applanation tonometry estimates of carotid‐femoral (cfPWV), carotid‐distal (cdPWV), and carotid‐radial (crPWV) pulse wave velocity, respectively. cfPWV was unchanged following maximal aerobic exercise in young adults with and without IDD (figure) but increased in middle‐aged adults (d= 0.85; 95% CI: 0.27 to 1.42 m.s‐1, p= 0.005), whereas cdPWV was reduced (d= ‐0.77; 95% CI: ‐1.06 to ‐0.48 m.s‐1, p&lt; 0.001) and crPWV unchanged in all three groups, independent of changes in mean arterial pressure. Overall group differences suggest that young adults with (d= ‐1.78; 95% CI: ‐3.20 to ‐0.37 m.s‐1, p= 0.009) and without(d= ‐1.84; 95% CI: ‐3.26 to ‐0.43 m.s‐1, p= 0.007) IDD had lower cfPWV than middle‐aged adults. We found no evidence of early vascular aging and or a diminished vascular reserve following maximal aerobic exercise in adults with IDD.

Arterial stiffness acute changes following aerobic exercise in males with and without hypertension.

While regular exercise exposure is considered the most effective therapy to reduce arterial stiffness, the effect of acute exercise training on arterial stiffness in adults with different blood pressure (BP) levels remains unclear. The authors aimed to investigate the effects of acute aerobic exercise on arterial stiffness in male with different BP levels. This cross‐sectional study utilized data for 1200 males aged 20–49 years from the Kailuan study cohort who participated in the fifth National Fitness Monitoring project. A total of 940 participants (621 in the non‐hypertensive group and 319 in the hypertensive group) aged 36.82 ± 7.76 who completed a twice‐quantitative cycle ergometer exercise and measure of brachial‐ankle pulse wave velocity (baPWV) at both the baseline and immediately after exercise were included in this study. The baPWV was decreased after acute aerobic exercise in the non‐hypertension and hypertension groups (Δ 40.29 [95% confidence interval [CI], −47.72 to −32.86] vs. Δ20.45 [95% CI, −31.32 to −9.58] cm/s). Participants without hypertension showed a greater decrease in baPWV (Δ 19.84 [95% CI, −33.83 to −5.84] cm/s) than participants with hypertension. Aerobic exercise had an acute positive effect on arterial stiffness. This study provides evidence of a greater reduction in arterial stiffness in individuals without hypertension than in those with hypertension.

Abstract P033: Higher Ambulatory Sbp Is Associated With Increasing Number Of Target Organ Abnormalities In Youth: The Ship Ahoy Study

Hypertension is associated with elevated left ventricular mass index (LVMI), cardiac dysfunction and increased arterial stiffness in adults which predict cardiovascular (CV) events. The extent to which elevated BP in youth is associated with subclinical CV target organ damage (TOD) is not known. We explored the relation between BP level and number of TOD abnormalities (nTOD). We measured clinic and ambulatory BP (ABP), anthropometrics, and nTOD in 244 adolescents (mean 15.5 + 1.8 years, 67% white, 60% male). Subjects were recruited as low-risk (L=98, SBP%&lt;80 th %), mid-risk (Mid=60, SBP% 80-&lt;90 th %); and high-risk (H=86, SBP% &gt;=90 th %) based on mean of 6 aneroid clinic BPs by age-, sex- and height-specific cut-points. 24-hour ABP was measured with an oscillometric device per pediatric guidelines. Four measures of TOD were: LVMI &gt; 38.6 g/m 2.7 ; LV systolic strain (Strain %) &gt; -18; LV diastolic function (E/e’) &gt; 8; pulse wave velocity (PWV) &gt; 5.8 m/sec. ANOVA was used to evaluate differences in CV risk factors and chi square for differences in nTOD across groups. Logistic regression models were used to determine if clinic and/or ABP was an independent predictor of nTOD after adjustment for age, sex, race, and BMI z-score. BP groups did not differ in BMI z-score. Clinic and ABP systolic and diastolic BP increased across BP groups. The distribution of nTOD was shifted towards higher BP group with most nTOD= 0 (47%) in the L and all (100%) nTOD = 4 in the H group (X 2 = 0.08) and became significant when L (clinic SBP&lt;75 th %) was compared to M+H (clinic SBP &gt; 80 th %; X 2 =0.04). Daytime ABP index (subject daytime systolic ABP/95 th % for daytime systolic ABP) and BMI z-score (both p &lt; 0.003) were significantly associated with nTOD in a model containing clinic SBP, age, sex and race (other covariates NS; full model p &lt; 0.0001, R 2 =0.22). We conclude that higher ABP is associated with a greater number of cardiac and vascular abnormalities in youth. ABP should be applied in youth with elevated BP to evaluate need for intensification of therapy to prevent CV TOD.