Determination Of Arterial Stiffness Research Articles

Arterial hypertension and stiffness in women of different age groups and reproductive status

Objective: study of the relationship between arterial hypertension and arterial stiffness in women to identify potential markers of target organ damage and therapeutic targets of antihypertensive therapy.Materials and methods: the study involved 161 women who were divided into three groups depending on age and reproductive function. Group 1 consisted of 52 women aged 18 to 30; group 2 – 54 women aged 31 years before menopause; 3rd group – 55 women in the postmenopausal period. All women were questioned, clinical examination, determination of anthropometric data, measurement of carotid-femoral pulse wave velocity, determination of arterial stiffness by volumetric sphygmography, 24-hour blood pressure monitoring with assessment of aortic stiffness and characteristics of the central pulse wave.Results: 24-hour blood pressure monitoring revealed arterial hypertension in 38 (34,8%) women: 15 (27,8%) women in the 2nd group and 23 (41,8%) women in the 3rd group. Correlation analysis revealed the most significant correlations between the presence of arterial hypertension (R=0,45-0,71; p<<0,01) with central aortic pressure, double product index and average daily aortic pulse wave velocity in the aorta (PWVao), regardless of the state reproductive function. For women of reproductive age with arterial hypertension, the ambulatory vascular stiffness index (AASI: R=0,36; p=0,01) is more significant, while in the menopausal period, the arterial stiffness index (ASI: R=0,33; p=0,01). Correlation analysis did not reveal significant relationships between carotid-femoral pulse wave velocity and cardio-ankle vascular index (CAVI) with arterial hypertension in women of the 2nd and 3rd groups. The relationship between carotid-femoral pulse wave velocity and arterial hypertension in women was confirmed by analysis of variance (p=0,007).Conclusion: Central aortic pressure, carotid-femoral pulse wave velocity, AASI, ASI, PWVao – direct and indirect indicators of arterial stiffness – are interconnected with the presence of arterial hypertension in women of reproductive and menopausal age. In this regard, these indicators are potential markers of target organ damage in arterial hypertension.

Obstetric and gynecological history and arterial stiffness in women of different age groups

Aim. To study the correlation between the features of obstetric and gynecological anamnesis with indicators of arterial stiffness in women of different age groups to assess additional risk factors for the development of cardiovascular diseases.
 Materials and methods. The single centre study involved women aged 18 to 65 years. The surveyed 161 women were divided into three groups: 1st group 52 young women from 18 to 30 years old; 2nd group 54 women from 31 years old to the onset of menopause; 3rd group 55 postmenopausal women. The 1 and 2nd groups included women with preserved reproductive function. All women underwent a questionnaire survey, clinical examination, determination of anthropometric data, measurement of cfPWV, determination of arterial stiffness by volume sphygmography, 24-hour blood pressure monitoring with assessment of aortic stiffness and characteristics of the central pulse wave.
 Results. In group 1, the early age of menarche was associated with an increase in the rate of morning rise in SBP (r=-0.46, p=0.002) and a decrease in SEVR (r=0.33, p=0.03); the use of combined oral contraceptives correlates with an increase in the Weissler coefficient PEP/ET (R=0.3, p=0.03) and amplification of pulse pressure PPA (R=0.29, p=0.04). A history of 1 or 2 pregnancies is associated with a decrease in arterial stiffness. At the same time, 3 or more pregnancies in the anamnesis create the prerequisites for the formation of arterial stiffness. The early onset of pregnancy pathologies, namely, starting from the 1st or 2nd trimester of pregnancy, is associated with a violation of the characteristics of the reflected wave at a young age and the formation of arterial stiffness in the menopausal period. History of abortions was associated with PWVao (R=0.45, p=0.002), ASI (R=0.43, p=0.002) in group 2. History of miscarriages is associated with SEVR (R=0.52, p=0.00005) and SEVR to HR75 (R=0.27, p=0.04) in the menopausal period.
 Conclusion. Pathology of pregnancy, three or more pregnancies in history, early age of menarche, taking combined oral contraceptives, abortions and miscarriages in history are associated with an increase in arterial stiffness in the future, which predisposes women to the development of CVD and should be taken into account for preventive purposes.

Transforming growth factor, arterial stiffness and vascular aging in patients with uncontrolled arterial hypertension

Abstract Introduction Arterial stiffness and vascular aging is associated with a risk factors for cardiovascular complications in hypertension. It is known that, transforming growth factor β1 (TGF-β1), a pleiotropic cytokine, enhances proliferation and growth of smooth muscle cells, as well as the accumulation of extracellular matrix, that is, the processes underlying vascular remodeling in hypertension. But still there is no data about influence off TGF-β1 on arterial stiffness and vascular aging. Purpose The aim of our study was to identify the relationship between TGF-β1, arterial stiffness and vascular age in patients with uncontrolled arterial hypertension Materials and methods The study included 140 patients: 30 people with uncontrolled hypertension (UAH), 80 people with controlled hypertension (CAH) and 30 people in the control group. All patients underwent determination of arterial stiffness, vascular age using cardio-ankle vascular index (CAVI) by means of volumetric sphygmography and TGF-β1 concentration level. Results The TGF-β1 level was 19,2 [17,2; 24,7] ng/ml in the CAH group. In the UAH group – 22,6 [20,6; 25,6] ng/ml. In the control group - 17.4 [11,8; 19,3] ng/ml. Value of the CAVI was 9,2 [8,5; 9,9] in UAH group, 7.8 [7,0; 8,5] in CAH group and 7 [6,5; 7,5] in control group. The maximum and minimum values vascular age were observed in the group UAH 71,5 [64; 74] and control group 54 [44; 59], respectively (p<0,05), in the CAH group there was an intermediate value of the vascular age 59 [49; 69] (p<0,05). There was significant difference between vascular and passport age in CAH and UAH groups (p<0,05) and no significant difference between passport and vascular age in control group (p>0,05). The correlation analysis revealed a significant relationship between the TGF-β1 level and CAVI for patients with hypertension (CAH r=0,777; UAH r=0,753; p<0.05). Positive correlation was also revealed between TGF-β1 and vascular age in UAH group (r=0,657) and CAH (r=0,649) p<0,05. Conclusion An increase in the concentration of TGF-β1, vascular age and an increase of arterial stiffness were revealed in patients of the UAH group in comparison with the other groups. The relationship between TGF-β1, vascular age and arterial stiffness was also found in patients with arterial hypertension. Funding Acknowledgement Type of funding sources: None.

Evaluarea rigidității vasculare secundare calcificărilor vasculare la pacienţii dializaţi ambulator

Arterial stiffness provides an indirect picture of vascular calcifications in terms of the effect they have on the systemic circulation and consequently on the heart. The present study sought to demonstrate the usefulness of outpatient investigation of vascular calcifications in dialysis patients using pulse wave velocity (PWV) determination. The aim of the study was to determine arterial resistance in patients with chronic dialysis kidney disease. The average study period was 48.5 ± 19.0 (SD) months. The study included 203 patients on dialysis with BCRT. The determination of arterial stiffness was measured at an interval of one hour after the dialysis session. The study highlighted the presence of an increased cardiovascular risk related to the presence of vascular calcifications without being able to establish a direct linear and causal link between their presence, location and the risk of cardiovascular events. The importance of highlighting calcifications and the consequences they generate means the possibility of influencing the main elements that can generate acute cardiovascular events. The results obtained and the correlations performed give an overview of the pathology studied, providing premises for therapeutic influence and risk assessment.

Abstract P055: Smooth Muscle Cell-specific Conditional Knockout Of Lysine (K)-specific Demethylase 6a Causes Endothelial Dysfunction, Increased Blood Pressure And Arterial Stiffness

Arterial stiffening is the progressive loss of elasticity of the large vessels resulting from age. Increased arterial stiffening has been correlated with hypertension and other cardiovascular co-morbidities. KDM6A is a histone 3 lysine demethylase whose activity increases expression of target genes via removal of silencing methylation marks on lysine 27 of histone 3 (H3K27). The precise role of H3K27me3, or its absence in aortic vascular smooth muscle cells (VSMCs), remains to be investigated. The objectives of this study were to determine the effects of loss of KDM6A on arterial stiffness, blood pressure, and vascular cell function. We generated VSMC-specific Kdm6a knockout mice of C57BL/6 background and confirmed knockout by western blot. Knockout of Kdm6a resulted in increased resting systolic blood pressure and pulse wave velocity in male mice. Pulse wave velocity (PWV) is the gold-standard method for determination of arterial stiffness. PWVs of the knockout mice were significantly increased compared to controls four weeks after Kdm6a knockout (Controls 2.62 + 0.69 mm/ms; KO 3.13 + 0.30 mm/ms; P=0.0228). Systolic blood pressure was directly obtained for each mouse via carotid cannulation. The systolic blood pressures of knockout mice were significantly increased. Mesenteric arteries were isolated from three control and three Kdm6a knockout mice and mounted onto a wire myograph. Vessels were pre-constricted with norepinephrine and vasodilation was measured by treatment with increasing doses of acetylcholine and sodium nitroprusside to assess endothelial and VSMC function. Interestingly, despite Kdm6a knockout in VSMCs, vasodilation of VSMCs was not different between control and knockout arteries, but relaxation in response to acetylcholine, which stimulates the release of nitric oxide from endothelial cells, was decreased. This suggests endothelial dysfunction. These results indicate that loss of KDM6A in VSMCs leads to elevated systolic blood pressure and arterial stiffness.

Antihypertensive and Vasoprotective Effects of Combined Pharmacotherapy in Patients with Arterial Hypertension and Prediabetes

Aim To evaluate effects of different types of combination drug therapy on indexes of 24-h blood pressure monitoring (24-h BPM), arterial stiffness, and central aortic pressure (CAP) in patients with arterial hypertension (AH) and prediabetes.Materials and methods The study included 120 patients with AH and prediabetes. After randomization using envelopes, three treatment groups were formed: group 1, patients receiving perindopril, indapamide SR, and metformin (n=40); group 2, patients receiving perindopril, moxonidin, and metformin (n=40); and group 3, patients receiving perindopril, indapamide SR, and amlodipine (n=40). 24-h BPM, determination of arterial stiffness, and measurement of CAP were performed for all patients.Results After 24 weeks of treatment, patients of all groups showed statistically significant improvements of most indexes of 24-h BPM, arterial stiffness, and CAP. In groups 2 and 3, the treatment was associated with significantly more pronounced beneficial changes in 24-BPM, arterial stiffness, and CAP compared to group 1. Antihypertensive and vasoprotective effects of the perindopril+moxonidin+metformin and perindopril+indopamide SR+amlodipine combinations were comparable.Conclusion The observed statistically significant antihypertensive and vasoprotective effects of the perindopril+moxonidin+metformin combination along with its known positive metabolic effect allow recommendation of this combination therapy to patients with AH and prediabetes as an effective strategy for BP control.

Assessment of Risk Factors of Cardiovascular Diseases and Arterial Stiffness in Women of Different Ages

Objective:A comprehensive study of the prevalence and structure of risk factors (RF) of cardiovascular diseases (CVD), the daily dynamics of central aortic pressure and arterial stiffness in healthy women of different age groups.Materials and methods:the study involved 161 women aged 18 to 65 years with one or more CVD RF. All volunteers underwent a survey, 24-hour blood pressure monitoring with determination of arterial stiffness and daily dynamics of central aortic pressure, determination of carotid-femoral pulse wave velocity (cfPWV) and vascular stiffness by volume sphygmography.Results:the examined were divided into 3 groups: 1 group of 52 women of young age from 18 to 30 years (23.8 Ѓ} 5.3 years); 2 group of 54 women from 31 years before the onset of menopause (41 Ѓ} 5.9 years); group 3 — 54 women in the postmenopausal period (55.4 Ѓ} 5.8 years). High prevalence of modifiable CVD RF among women of various ages was revealed: smoking, non-compliance with dietary recommendations, lack of physical activity. Obstetric and gynecological pathologies prevail in younger age groups. In group 1 the studied parameters correspond to normal in most parameters. Significant differences in central and peripheral pressure, arterial stiffness indicators, with the exception of cfPWV, were identified in group 2 in comparison with young women. A comparative analysis of groups 2 and 3 showed a significant difference and worsening of indicators characterizing the degree of development of arterial stiffness, the contribution of the reflected wave and the associated dysfunction of the left ventricle.Conclusion:a comprehensive study of arterial stiffness allows you to identify subclinical changes in the vascular wall and evaluate their progression in women of different age groups.

Assessment of Risk Factors of Cardiovascular Diseases and Arterial Stiffness in Women of Different Ages

Objective: A comprehensive study of the prevalence and structure of risk factors (RF) of cardiovascular diseases (CVD), the daily dynamics of central aortic pressure and arterial stiffness in healthy women of different age groups.Materials and methods: the study involved 161 women aged 18 to 65 years with one or more CVD RF. All volunteers underwent a survey, 24-hour blood pressure monitoring with determination of arterial stiffness and daily dynamics of central aortic pressure, determination of carotid-femoral pulse wave velocity (cfPWV) and vascular stiffness by volume sphygmography.Results: the examined were divided into 3 groups: 1 group of 52 women of young age from 18 to 30 years (23.8 Ѓ} 5.3 years); 2 group of 54 women from 31 years before the onset of menopause (41 Ѓ} 5.9 years); group 3 — 54 women in the postmenopausal period (55.4 Ѓ} 5.8 years). High prevalence of modifiable CVD RF among women of various ages was revealed: smoking, non-compliance with dietary recommendations, lack of physical activity. Obstetric and gynecological pathologies prevail in younger age groups. In group 1 the studied parameters correspond to normal in most parameters. Significant differences in central and peripheral pressure, arterial stiffness indicators, with the exception of cfPWV, were identified in group 2 in comparison with young women. A comparative analysis of groups 2 and 3 showed a significant difference and worsening of indicators characterizing the degree of development of arterial stiffness, the contribution of the reflected wave and the associated dysfunction of the left ventricle.Conclusion: a comprehensive study of arterial stiffness allows you to identify subclinical changes in the vascular wall and evaluate their progression in women of different age groups.

Chronic Kidney Disease and Pulse Wave Velocity: A Narrative Review.

Chronic kidney disease (CKD) is associated with excess cardiovascular mortality, resulting from both traditional and nontraditional, CKD-specific, cardiovascular risk factors. Nontraditional risk factors include the entity Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD) which is characterised by disorders of bone and mineral metabolism, including biochemical abnormalities of hyperphosphatemia and hyperparathyroidism, renal osteodystrophy, and vascular calcification. Increased arterial stiffness in the CKD population can be attributed amongst other influences to progression of vascular calcification, with significant resultant contribution to the cardiovascular disease burden. Pulse wave velocity (PWV) measured over the carotid-femoral arterial segments is the noninvasive gold-standard technique for measurement of aortic stiffness and has been suggested as a surrogate cardiovascular end-point. A PWV value of 10 m/s or greater has been recommended as a suitable cut-off for an increased risk of cardiovascular mortality. CKD is a risk factor for an excessive rate of increase in aortic stiffness, reflected by increases in PWV, and increased aortic PWV in CKD shows faster progression than for individuals with normal kidney function. Patients with varying stages of CKD, as well as those on dialysis or with a kidney transplant, have different biological milieu which influence aortic stiffness and associated changes in PWV. This review discusses the pathophysiology of arterial stiffness with CKD and outlines the literature on PWV across the spectrum of CKD, highlighting that determination of arterial stiffness using aortic PWV can be a useful diagnostic and prognostic tool for assessing cardiovascular disease in the CKD population.

PP.37.17] PREVALENCE OF VARIABLES ASSOCIATED WITH ARTERIAL STIFFNESS IN COMMUNAL PHARMACIES OF THE VALENCIAN COMMUNITY (RIVALFAR-STUDY)

Objective: Although determination of arterial stiffness is included in ESH-Guidelines as subclinical target organ damage for monitoring patients, stiffness- related variables are rather unknown among medical doctors and pharmacists. This study aims to measure the prevalence of pulse wave velocity (PWV), central arterial pressure (BPc) and Augmentation Index (AIx) in persons attending a communal pharmacy for any reason. Design and method: Cross-sectional, observational, descriptive, non-interventional study in 32 communal pharmacies of the Valencian Community, belonging to SEFAC (Spanish Society of Communal Pharmacies), between November 2015 and April 2016. Stiffness-related variables were measured with a validated device (MOBIL-O-GRAPH, IEM®), according to ESH-recommendations, followed by a 10 items-containing questionnaire and measurement of the waist circumference. Results: During the first month, mean age of the 638 consecutive recruited patients was 56,5 years, the percentage of men was 38,6 %, with a global BMI of 28,5 kg/m2. Brachial and central BP were 127/80 and 116/81 mmHg, PWV and AI were 8,2 m/seg and 22,5 %, respectively. The proportion of patients with increased PWV, defined as an absolute value > 10 m/seg, was 19,6 %. when adjusting to six age-groups, prevalence was 24,1 %, with a concordance rate of both measurements of 75,9 %. Multivariate lineal regression confirmed age (beta = 0,13; CI: 0,125/0,130; p < 0.0001), and brachial BP (beta = 0,03; CI: 0,028/;0,032; p < 0.0001), as the 2 variables with the highest, independent association with PWV, followed by and obesity. In 69,1 % of the cases elevated PWV coincided with high BP values, but in 18,8 % of patients PWV was normal in spite of high BP and in 12,1 % of the cases BP was normal but PWV was pathological, indicating increased CV risk, not recognized by simple BP measurement. Conclusions: This pioneering large scale study measuring arterial stiffness in communal pharmacies shows their capability to contribute to the management of hypertensive patients by identifying subclinical organ lesions as vascular damage in almost one fourth of individuals attending a pharmacy for whatever reasons. Measuring PWV together with BP can therefore be recommended as a strategy to improve monitoring BP and promote adherence to treatment.

Evaluation of the Cardio-Ankle Vascular Index, a New Indicator of Arterial Stiffness Independent of Blood Pressure, in Obesity and Metabolic Syndrome

Aortic stiffness is predictive of cardiovascular diseases (CVD) and mortality in lifestyle-related diseases. The cardio-ankle vascular index (CAVI), a new index of arterial stiffness, was recently developed by measuring of pulse wave velocity (PWV) and blood pressure (BP). CAVI is adjusted for BP based on stiffness parameter beta and is less influenced by BP, suggesting its superiority over brachial-ankle PWV (baPWV). However, there are currently no reports on the usefulness of CAVI as an atherogenic index in obesity and metabolic syndrome (MS). Among the 325 obese Japanese outpatients enrolled in the multi-centered Japan Obesity and Metabolic Syndrome Study, 216 patients (67%) met the criteria of MS according to the modified National Cholesterol Education Program-Adult Treatment Panel III. CAVI values were significantly higher in MS than in non-MS patients, whereas there was no significant difference in body mass index, total cholesterol, and low-density lipoprotein-cholesterol between both groups. CAVI values were weakly correlated with BP but closely correlated with the severity of MS and MS-related parameters such as hypoadiponectinemia, relative to baPWV. Furthermore, weight-reduction therapy through diet and exercise over a 3-month period significantly decreased CAVI values in parallel with increasing adiponectin. This study demonstrates for the first time that CAVI is a good indicator of arterial stiffness. It is closely correlated with the severity of MS and CVD risks in obesity and independent of BP, and is thus superior to baPWV. Therefore, the determination of arterial stiffness by CAVI may be useful for evaluating and managing the CVD risks of MS patients.