Differences In Arterial Stiffness Research Articles

Arterial stiffness characterization of patients with different ACS-causing plaque morphologies quantified by optical coherence tomography

Abstract Background Optical coherence tomography (OCT) has refined acute coronary syndrome (ACS)-management by enabling in-depth characterization of culprit lesions. Differentiating between plaques with ruptured (RFC) and intact fibrous cap (IFC) has shaped clinical decision making. However, the systemic vascular changes associated with different plaque morphologies remain unexplored. Purpose To investigate arterial stiffness among different ACS-causing plaque morphologies (RFC vs. IFC) and its prognostic value post-ACS. Methods We conducted a secondary analysis of a prospective registry study, including patients who underwent OCT-characterization of the ACS-causing culprit lesion and received arterial stiffness assessment 90 days post-index event. The association between arterial stiffness parameters, such as pulse wave velocity (PWV), aortic pulse pressure (APP), heart rate-corrected augmentation index (AIx@75) and plaque morphologies was assessed using logistic regression, adjusted for age, sex, hypertension, presence of diabetes mellitus, smoking status, LDL-C and discharge medications (ACE-inhibitors/ARBs, beta blockers, calcium-channel blockers and diuretics). A multiparameter model additionally included intima-media-thickness and all arterial stiffness metrics. Cox regression, further adjusted for stroke history, prior percutaneous coronary intervention or stable coronary artery disease and Killip class, evaluated the link between arterial stiffness parameters and major adverse cardiovascular events plus (MACE+). Results In total, 110 patients with arterial stiffness and OCT data were included. Of these, 78 (70.9%) patients had RFC- and 32 (29.1%) IFC-ACS. The median age was 61.5 years and 80.0% of patients were male. Patients with RFC- had significantly higher PWV (8.35 vs. 7.50 m/s, p=0.015) compared to IFC-ACS. Both groups received similar regimens of antihypertensive, diuretic and lipid-lowering pharmacological therapy at discharge (p>0.1). After multivariable adjustment, increased PWV (4th Quartile [Q4] vs. 1st Quartile [Q1] Adjusted Hazard Ratio [aHR]: 1.38 [95% Confidence Interval (CI) 1.02-1.88], p=0.043) was associated with RFC- while high APP was significantly associated with IFC-ACS as the underlying plaque morphology (Q4 vs. Q1 aHR: 0.65 [95% CI 0.48-0.87], p=0.005) (Figure 1). Furthermore, per one-unit increment in APP we observed a 10% increase in risk for MACE+ in patients with RFC-ACS (aHR: 1.10 [95% CI 1.02-1.19], p=0.016) but not IFC-ACS (aHR: 0.95 [95% CI 0.82-1.11], p=0.54). No risk modification with increases in PWV and AIx@75 were observed, regardless of underlying plaque pathology (p>0.05). Conclusion There are distinct differences in arterial stiffness between patients with RFC- and IFC-ACS. These results underscore the value of a patient-specific approach that integrates invasive and non-invasive vascular characterization for identifying high-risk individuals and guiding therapy to enhance clinical outcomes.

The Impact of Sex and Arterial Stiffness Interactions on the Outcome after an Acute Ischemic Stroke: A Retrospective Cohort Study.

Background/Objectives: Arterial stiffness (AS) is an independent predictor of cardiovascular events and is associated with a poor prognosis. While AS may represent a novel therapeutic target, recent evidence shows that it is sexually dimorphic. The aim of this study was to evaluate relative sex differences in arterial stiffness and their possible impact on the outcome of acute ischemic stroke. Methods: We retrospectively evaluated a cohort of adult patients with the following inclusion criteria: acute ischemic stroke, which occurred within 24 h from the onset of symptoms, confirmed through neuroimaging examinations, additional evaluations including extracranial and transcranial arterial ultrasound examinations, transthoracic echocardiography, a 12-lead resting ECG, and continuous 24 h in-hospital blood pressure monitoring. Based on the 24 h blood pressure monitoring, the following parameters were evaluated: systolic blood pressure, diastolic blood pressure, mean blood pressure, pulse pressure, and arterial stiffness index (ASI). The modified Rankin scale (mRS) was assessed at 90 days to evaluate the 3-month clinical outcome, defining an unfavorable outcome as an mRS score ≥ 3. To assess the factors associated with unfavorable outcomes, a stepwise logistic regression model was performed on the total sample size, and the analyses were replicated after stratifying by sex. Results: A total of 334 patients (176 males, 158 females) were included in the analysis. There was a significant sex-dependent impact of ASI on the 90-day unfavorable Rankin score (mRS score ≥ 3) as only men had a reduced likelihood of favorable outcomes with increasing arterial stiffness (OR:1.54, 95% CI: 1.06-2.23; P-interaction = 0.023). Conclusions: The influence of ASI on the 3-month functional outcome after acute ischemic stroke is at least in part sex-related, suggesting that, in males, higher ASI values are associated with a worse outcome.

Differences in carotid to femoral pulse wave velocity and carotid intima media thickness between vegetarian and omnivorous diets in healthy subjects: a systematic review and meta-analysis.

Background: Arterial stiffness and atherosclerosis are known risk factors for cardiovascular morbidity and mortality. Vegetarian diets have been associated with cardiovascular benefits, including improvements in metabolic parameters. However, the impact of a vegetarian diet on cardiovascular parameters, specifically arterial stiffness and atherosclerosis, in healthy individuals remains unclear. Thus, this study aims to analyze differences in arterial stiffness and atherosclerosis between vegetarian and omnivorous diets in healthy subjects. Methods: A systematic review and meta-analysis were conducted following established guidelines. PubMed, Scopus, Web of Science, and Cochrane Library databases were searched for studies examining the association between vegetarian and omnivorous diets with arterial stiffness and atherosclerosis. Cross-sectional studies reporting carotid to femoral pulse wave velocity (cf-PWv) as a measure of arterial stiffness and carotid intima media thickness (c-IMT) as a measure of atherosclerosis were included. Data were synthesized using random effects models, and sensitivity analyses, meta-regressions, and assessment of publication bias were performed. Results: Ten studies were included in the systematic review, and seven studies were included in the meta-analysis. The pooled analysis demonstrated that individuals following a vegetarian diet had differences in the levels of arterial stiffness (cf-PWv) compared to those following an omnivorous diet (MD: -0.43 m s-1; 95% CI: -0.63, -0.23). Similarly, atherosclerosis (c-IMT) was found to be different in individuals adhering to a vegetarian dietary pattern (MD = -29.86 mm; 95% CI: -58.41, -1.32). Conclusions: Our findings suggest that a vegetarian diet is associated with improved arterial stiffness and reduced atherosclerosis in healthy individuals. These results support the inclusion of a well-balanced vegetarian dietary pattern in the prevention and management of cardiovascular diseases. However, further research is needed to explore the effects of a vegetarian diet on arterial health in diverse populations and to assess long-term cardiovascular outcomes.

Adverse pregnancy outcomes and renal-vascular function in the early years after delivery.

Adverse pregnancy outcomes (APOs: hypertensive disorders, gestational diabetes, preterm birth, and placental disorders) are associated with cardiovascular disease risk or blood volume abnormalities. Traditional risk factors might not identify highest risk people in the early years after APO deliveries. Test the hypothesis that vascular function is worse, and plasma volume-regulating renal hormones are lower after delivery in people who did versus did not have an APO. Adult participants 6 mo-3 years postdelivery of a singleton infant participated in this cross-sectional study. Exclusion criteria included current smoking, current use of certain medications, and diabetes outside of pregnancy. Differences in measurements between participants with versus without APOs were determined with t tests or Wilcoxon tests. Associations of renal hormones with APO history were assessed with linear regression, adjusted for age, race, body mass index (BMI), and sodium consumption. Of 86 participants, 38 (44%) had an APO history. Those with APOs were more likely to identify as Black and had a higher BMI, 34.0 kg/m2 [interquartile range (IQR), 24.6, 39.3] versus 24.2 kg/m2 [IQR, 21.2, 31.3], P < 0.05. Most brachial and all aortic blood pressures were higher in those with APOs: median aortic blood pressure was 102/74 versus 96/68 mmHg, P ≤ 0.05. There were no differences in arterial stiffness or endothelial function between groups. Aldosterone was lower (54 [IQR, 28-84] vs. 80 [IQR, 39-150] pmol/L) in participants with past APOs. Blood pressures were higher, and aldosterone was lower in participants with past APOs. Associations of aldosterone with APO history persisted after adjustment. Neither renin nor aldosterone were related to vascular function.NEW & NOTEWORTHY Adverse pregnancy outcomes (APOs) are associated with cardiovascular disease (CVD) risk. Traditional CVD risk factors may not fully capture excess CVD risk soon after APOs. Vascular dysfunction and plasma volume irregularities may be detectable. We found people with APOs had worse blood pressures, higher BMI, and lower aldosterone levels versus those without APOs in the early years after delivery. Vascular function was similar between groups. Future research should assess vascular function and renal hormones at multiple timepoints during the perinatal period.

Abstract 055: Estrogen And Smooth Muscle Cell Estrogen Receptor Alpha Modulate Arterial Stiffness

Background: Arterial stiffness increases with age and contributes to cardiovascular disease. Although sex differences in arterial stiffness are clinically observed, the underlying mechanisms are unknown. Specifically, the role of estrogen (E2) and estrogen receptor alpha (ERα) in sex-dependent differences in arterial stiffness have not been defined. We hypothesize that E2 and ERα contribute to sex differences in arterial stiffness. Methods/Results: We measured aortic pulse wave velocity, an index of arterial stiffness, at 3, 12, and 18 months old, in male and female mice. Arterial stiffness increased in males at 12 and 18m but was delayed until 18m in females (p&lt;0.05). Circulating E2 decreased with age in females (p&lt;0.05), suggesting a link between estrogens and arterial stiffness. In young female mice, arterial stiffness increased with ovariectomy (OVX) versus sham surgery but was restored in OVX mice plus E2 pellet (p&lt;0.05). Aortic gene expression for the vasoprotective angiotensin II type 2 receptor (AT2R) decreased with OVX versus sham and was restored in OVX mice plus E2 pellet (p&lt;0.05). These data suggest a link between arterial stiffness, E2, and AT2R. We therefore created novel SMC-specific ERα knockout (SMC-ERα-KO) mice to assess the role of SMC-ERα in sex differences in arterial stiffness. Differences in arterial stiffness with age persist in ERα-intact mice, but 18m SMC-ERα-KO males and females exhibited less stiffness vs. age-matched ERα-intact littermates (p&lt;0.05). Trends persist in repeat PWV measures at 12 and 16-18m in individual males and females. Blood pressure (via telemetry) did not differ between 18m intact and KO males or females (p=0.73). In young ERα-intact females, OVX increased stiffness and decreased aortic AT2R expression, while OVX had no effect in SMC-ERα-KO females (all p&lt;0.05), supporting a role for E2 and SMC-ERα in arterial stiffness. Conclusion: These data suggest that estrogen contributes to sex differences in arterial stiffness and that with advancing age, SMC-ERα is unliganded due to the loss of estrogen and contributes to arterial stiffness in females, potentially via alterations in vascular AT2R function. These results also suggest a detrimental role for SMC-ERα in aging-associated arterial stiffness in males.

Association between psychosocial work-related factors at midlife and arterial stiffness at older age in a prospective cohort of 1736 white-collar workers

ObjectiveArterial stiffness and exposure to psychosocial work-related factors increase the risk of developing cardiovascular disease. However, little is known about the relationship between psychosocial work-related factors and arterial stiffness. We...

Central and local arterial stiffness in White Europeans compared to age-, sex-, and BMI-matched South Asians.

Ethnicity impacts cardiovascular disease (CVD) risk, and South Asians demonstrate a higher risk than White Europeans. Arterial stiffness is known to contribute to CVD, and differences in arterial stiffness between ethnicities could explain the disparity in CVD risk. We compared central and local arterial stiffness between White Europeans and South Asians and investigated which factors are associated with arterial stiffness. Data were collected from cohorts of White Europeans (the Netherlands) and South Asians (India). We matched cohorts on individual level using age, sex, and body mass index (BMI). Arterial stiffness was measured with ARTSENS® Plus. Central stiffness was expressed as carotid-femoral pulse wave velocity (cf-PWV, m/s), and local carotid stiffness was quantified using the carotid stiffness index (Beta) and pressure-strain elastic modulus (Epsilon, kPa). We compared arterial stiffness between cohorts and used multivariable linear regression to identify factors related to stiffness. We included n = 121 participants per cohort (age 53±10 years, 55% male, BMI 24 kg/m2). Cf-PWV was lower in White Europeans compared to South Asians (6.8±1.9 vs. 8.2±1.8 m/s, p<0.001), but no differences were found for local stiffness parameters Beta (5.4±2.4 vs. 5.8±2.3, p = 0.17) and Epsilon (72±35 vs. 70±31 kPa, p = 0.56). Age (standardized β, 95% confidence interval: 0.28, 0.17-0.39), systolic blood pressure (0.32, 0.21-0.43), and South Asian ethnicity (0.46, 0.35-0.57) were associated with cf-PWV; associations were similar between cohorts (p>0.05 for interaction). Systolic blood pressure was associated with carotid stiffness in both cohorts, whereas age was associated to carotid stiffness only in South Asians and BMI only in White Europeans. Ethnicity is associated with central but not local arterial stiffness. Conversely, ethnicity seems to modify associations between CVD risk factors and local but not central arterial stiffness. This suggests that ethnicity interacts with arterial stiffness measures and the association of these measures with CVD risk factors.

Arterial stiffness and the reallocation of time between device-measured 24-hour movement behaviours: A compositional data analysis

Background and aimsArterial stiffness predicts cardiovascular morbidity and mortality. We aimed to quantify the differences in arterial stiffness associated with reallocating time between 24-h movement behaviours. MethodsThis observational cross-sectional study included Luxembourg residents aged 25-79y who each provided ≥4 valid days of triaxial accelerometry (n = 1001). Covariable adjusted compositional isotemporal substitution models were used to examine if theoretical reallocations of time between device-measured sedentariness, the sleep period, light physical activity (PA), and moderate-to-vigorous PA (MVPA) were associated with the percentage difference in carotid-femoral pulse wave velocity (cfPWV). We further investigated if replacing sedentary time accumulated in prolonged (≥30 min) with non-prolonged (<30 min) bouts was associated with arterial stiffness. The results are presented as 30 min time exchanges (β (95% confidence interval)). ResultsBeneficial associations with lower cfPWV were observed when reallocating time to MVPA from the sleep period (−1.38 (−2.63 to −0.12) %), sedentary time (−1.70 (−2.76 to −0.62) %), and light PA (−2.51 (−4.55 to −0.43) %), respectively. Larger associations in the opposite direction were observed when reallocating MVPA to the same behaviours (for example, replacing MVPA with sedentary time: 2.50 (0.85–4.18) %). Replacing prolonged with non-prolonged sedentary time was not associated with cfPWV (−0.27 (−0.86 to 0.32) %). In short sleepers, reallocating sedentary time to the sleep period was favourable (−1.96 (−3.74 to −0.15) %). ConclusionsIncreasing or at least maintaining MVPA appears to be important for arterial health in adults. Extending sleep in habitually short sleepers, specifically by redistributing sedentary time, may also be important.

Motor Skills, Heart Rate Variability, and Arterial Stiffness in Children with Autism Spectrum Disorder.

The prevalence of autism spectrum disorder (ASD) among children has been recently increasing. The severity of symptoms greatly varies between individuals with ASD, ranging from relatively mild to extremely severe. It is important to have a clearer understanding of the possible adverse consequences resulting from this disorder, such as delayed motor development, autonomic dysregulation, and arterial stiffness. Thus, the objective of this study was to investigate differences in motor skills, heart rate variability (HRV), and arterial stiffness between children with ASD and typically developing children. In this study, the school-aged children with mild symptoms of ASD (n = 17, 11.1 ± 1.0 years old) and typically developing peers (n = 15, 11.0 ± 0.5 years old) were recruited. Motor skills, HRV, and arterial stiffness were measured in these two groups. Motor skills were evaluated by the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition. Moreover, HRV was measured through a short-term recording using the Polar heart rate monitor, and arterial stiffness was assessed by non-invasive computerized oscillometry. Compared with the typically developing group, children with ASD displayed significant deficits in some areas of motor skills, including manual coordination, strength and agility, and total motor composite. Moreover, children with ASD exhibited significantly reduced HRV, including time- and frequency-domain measures. However, the results did not demonstrate any statistically significant differences in arterial stiffness between the groups. Our findings demonstrated the presence of motor skill deficits and autonomic dysregulation in children with ASD.

Sex differences in arterial stiffness and sympathetic activity in older CKD patients

Chronic kidney disease (CKD) is characterized by sympathetic nervous system overactivity that contributes to increased arterial stiffness and cardiovascular risk. While premenopausal females are relatively protected from cardiovascular disease in healthy individuals, older postmenopausal females without kidney disease have similar degrees of sympathetic overactivity, vascular stiffness and cardiovascular risk compared to older age-matched males in the general population. However, in the CKD population, cardiovascular mortality risk remains higher in older males compared to age-matched females and whether sex differences in neural and vascular function exist in older CKD patients is unknown. Therefore, we tested the hypothesis that compared to older females, older males with CKD have higher baseline sympathetic activity that is related to increased arterial stiffness. In 207 CKD patients (N=90 females, 62 ± 9 years; and N=117 males, 60 ± 9 years), we measured resting sympathetic nerve activity directed to muscle (MSNA) by microneurography at the peroneal nerve. At a separate visit, arterial stiffness was determined by carotid-to-femoral pulse wave velocity (PWV) using transcutaneous Doppler flow velocity (SphygmoCor®). Office blood pressure (BP) and 24-hour ambulatory BP monitoring (ABPM; Spacelabs) were performed using standard techniques. Resting MSNA was higher in males versus females with CKD (43 ± 10 vs 31 ± 14 bursts/min; p= 0.039). Both office and 24-hour ambulatory diastolic BP (79 ± 11 vs 67 ± 14 mmHg, p&lt;0.001) and mean arterial pressure (96 ± 10 vs 88 ± 13 mmHg, p&lt;0.001) were also higher in males versus females. PWV was not different between male and female groups (p= 0.157). There was no association between PWV and resting MSNA in males, while in females, there was an inverse relationship between PWV and MSNA burst frequency (r2=0.271; p=0.039) and burst incidence (r2=0.310; p=0.025). Older male CKD patients have higher resting MSNA, office and ambulatory BP compared to older females with CKD. In contrast, there were no differences in arterial stiffness measured as PWV between sexes. In males, increased MSNA was not associated with increased arterial stiffness, while MSNA was negatively correlated with PWV in females. Sex differences in neural and vascular function may impact cardiovascular outcomes in older patients with CKD. Supported by NIH grants R01HL135183, R33AT010457. 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.

Sex differences in middle cerebral artery reactivity and hemodynamics in 6-month-old Sprague-Dawley rats independent from systemic arterial stiffness or blood pressure

Cerebrovascular disease (CVD) is a major risk factor for developing cognitive impairment. Young women are protected against CVD compared with older women or men, however the underlying mechanisms are not well understood. Greater peripheral arterial stiffness has been linked to increased cerebral flow pulsatility and cognitive impairment. In this study we determined whether sex differences in middle cerebral artery (MCA) reactivity are associated with changes in cerebral [MCA, intracranial internal carotid artery (ICA)] or systemic [common carotid artery (CCA), thoracic aorta (TAo)] arterial resistance and stiffness in six month-old Sprague-Dawley (SD) rats. No differences in systolic or diastolic blood pressures measured by tail-cuff method were observed between sexes. Heart rate was higher in the female versus male SD (438±9 vs. 343±10 bpm, p&lt;0.05, n=8-12). The pulsatility (PI) and resistance indexes (RI) of left MCA and left intracranial ICA were calculated as follows: PI=(Peak systolic velocity (Vs)-End-diastolic velocity (Vd))/Vmean, or RI=(Vs-Vd)/Vs (Vevo LAZR, FUJIFILM VisualSonics). Left MCA PI and RI indexes were lower in the female versus male SD (PI: 0.75±0.09 vs. 1.17±0.11; RI: 0.49±0.04 vs. 0.63±0.03, all p&lt;0.05; n=7-8), while no differences in left ICA blood flow (n=4-9) or resistance (n=7-10) were observed between sexes. There were no differences in arterial stiffness of TAo or left CCA evaluated by pulse wave velocity (PWV) measurements. To investigate vascular reactivity, left MCA segments were isolated and mounted on a wire Multi Myograph (DMT-USA). Data were acquired and analyzed with Powerlab 8 and LabChart v8 (ADInstruments). Female left MCA had lower contraction to potassium (K+: 0.6±0.1 vs. 1±0.2 mN/mm, p&lt;0.05), but similar maximal contraction (109±10 vs. 116±6 %KMAX, p&gt;0.05) and sensitivity (7.3±0.2 vs. 7.2±0.2, p&gt;0.05) to thromboxane A2 receptor agonist U46619. Pre-incubation with indomethacin lowered maximal response (97±5 vs. 116±6 %KMAX, p&lt;0.05) and sensitivity (6.8±0.1 vs. 7.2±0.2, p&lt;0.05) to U46619 in male MCA, with no effect in female MCA (Male: 109±9 vs. 113±7 %KMAX; Female: 7.3±0.2 vs. 7.3±0.2). MCA collagen deposition (by trichrome staining) was similar between sexes, however eNOS immunoreactivity tended to increase in the female versus male MCA (7.3±2 vs. 1.2±0.6; n=3-4, p=0.07). No sex differences in MCA COX-2 expression were found. In summary, lower PI and RI of MCA in 6-month-old females suggests decreased cerebrovascular resistance compared with age-matched male SD. Increased eNOS expression may contribute to the lower contraction observed in female MCA, whereas vasoconstrictor prostaglandins appear to have a greater role in male versus female MCA. Our results demonstrate sex differences in MCA vascular reactivity associated with a protective functional profile of MCA in 6-month-old female versus male SD rats independent from changes in systemic arterial stiffness or blood pressure. Studies were supported by the WFUSM CVSC Pilot Award and NIH 5R01HL155420. 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.

Sex-specific differences in arterial stiffness and endothelial function in untreated hyperlipidemia

Background: The ACC/AHA guidelines for management of blood pressure (BP) and blood cholesterol provide significant updates to the identification and intervention of strategies for mitigating CVD risk. However, opportunities remain for enhancement especially in consideration of concomitant disease states and in sex differences. Recent reports have demonstrated the efficacy of measurements of arterial stiffness in which sex differences have been established in predicting the progression or development of cardio-metabolic pathologies. Thus, the purpose of the present study was to investigate sex-specific differences of elevated BP on arterial stiffness in a hyperlipidemic population. Methods: A total of 29 individuals (9 men:M, 20 women:W) with elevated fasting blood LDL cholesterol were recruited and grouped based on resting systolic blood pressure (SBP), with values ≤ 120 mmHg categorized as “normotensive” (n=5 M, 11 W) and SBP values &gt; 120 mmHg as “elevated” BP (n=4 M, 9 W). Cardiovascular (CV) measures and blood samples for fasting LDL-cholesterol were collected before the clinical trial began thus, the data presented are baseline values. CV measurements included 24-hr ambulatory BP monitoring, endothelium-dependent vasodilator function via flow-mediated dilation (% FMD) test, and arterial stiffness determined via ultrasound of foot-to-foot transit time and velocity waveforms. Data are presented as (Mean ± SD) and significance was considered p&lt;0.05. Results: Age was not significantly different between normotensive vs. elevated BP groups (M; 47.4 ± 16.6 vs. 47 ± 12.7 years, p&gt;0.99), (W; 49 ±10.3 vs. 61.4 ± 8.6 years, p=0.12). LDL-cholesterol levels were not different between normotensive and elevated BP groups for men (p=0.38) or women (p=0.93). However, the normotensive group exhibited a greater change in % FMD vs. the elevated BP group (8.4 ± 3.2 vs. 5.9 ± 2.6%, p=0.022). Carotid-femoral pulse wave velocity (cfPWV) was significantly higher in the elevated BP group compared to normotensive (6 ± 1.3 vs. 7.7 ± 1.4 m/s, p=0.0016). When evaluating sex-specific differences, women had a higher % FMD in the normotensive group vs. elevated BP (9.5 ± 3.4 vs. 4.8 ± 1.7%, p=0.0037) whereas there was no difference in normotensive vs. elevated BP in men (p=0.99). Women with elevated BP also had greater elevations in cfPWV vs. normotensive women (6.2 ± 1.4 vs. 8.1 ± 1.6 m/s, p=0.022), while there was no difference in normotensive vs. elevated BP in men (p=0.68). Conclusion: Hyperlipidemic, but normotensive, women had greater blood vessel responses to FMD than hyperlipidemic women with elevated BP whereas there were no differences in men. Additionally, women with elevated BP had greater cfPWV than normotensive women, which implies greater arterial stiffness in those with elevated BP. These elevated BP measurements suggest a sex-specificity on arterial stiffness and endothelial function as changes were only seen in hyperlipidemic women but not hyperlipidemic men. California Strawberry Commission 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.

Exploring Racial and Ethnic Differences in Arterial Stiffness Among Youth and Young Adults With Type 1 Diabetes.

Background We examined arterial stiffness in individuals with type 1 diabetes, and explored whether differences between Hispanic, non-Hispanic Black (NHB), and non-Hispanic White (NHW) individuals were attributable to modifiable clinical and social factors. Methods and Results Participants (n=1162; 22% Hispanic, 18% NHB, and 60% NHW) completed 2 to 3 research visits from ≈10 months to ≈11 years post type1diabetesdiagnosis (mean ages of ≈9 to ≈20 years, respectively) providing data on socioeconomic factors, type1diabetescharacteristics, cardiovascular risk factors, health behaviors, quality of clinical care, and perception of clinical care. Arterial stiffness (carotid-femoral pulse wave velocity [PWV], m/s) was measured at ≈20 years of age. We analyzed differences in PWV by race and ethnicity, then explored the individual and combined impact of the clinical and social factors on these differences. PWV did not differ between Hispanic (adjusted mean 6.18 [SE 0.12]) and NHW (6.04 [0.11]) participants after adjustment for cardiovascular risks (P=0.06) and socioeconomic factors (P=0.12), or between Hispanic and NHB participants (6.36 [0.12]) after adjustment for all factors (P=0.08). PWV was higher in NHB versus NHW participants in all models (all P<0.001). Adjustment for modifiable factors reduced the difference in PWV by 15% for Hispanic versus NHW participants; by 25% for Hispanic versus NHB; and by 21% for NHB versus NHW. Conclusions Cardiovascular and socioeconomic factors explain one-quarter of the racial and ethnic differences in PWV of young people with type1diabetes, but NHB individualsstill experienced greater PWV. Exploration of pervasive inequities potentially driving these persistent differences is needed.

Sex differences in the risk of arterial stiffness among adults with different glycemic status and modifications by age.

Studies indicate lower, comparable, and higher cardiovascular risks in women vs men in normal glucose regulation (NGR), prediabetes, and diabetes, respectively. However, this sex difference is uncertain and aging might play a part. We aimed to estimate sex differences in arterial stiffness in NGR, prediabetes, or diabetes and the potential modifications by age. We used baseline data of 9618 participants aged ≥40 years in a large community-based cohort study in Shanghai. Glycemic status was determined by history of diabetes, fasting and 2-h post-load glucose levels, and hemoglobin A1c levels. Arterial stiffness was examined by brachial-ankle pulse wave velocity (ba-PWV). Multivariable linear regression analysis was conducted to examine the associations between sex and ba-PWV levels in glycemic and age categories. Before adjustment for age, women had lower, comparable, and higher ba-PWV vs men in the NGR, prediabetes, and diabetes groups, respectively. In participants aged 40-59 years, women were associated with lower ba-PWV levels in generally all glycemic strata after adjustment for age and other confounders. In participants aged ≥60 years, women were associated with significantly higher ba-PWV levels (β coefficient=71.5; 95% confidence interval=23.4, 119.7) and the sex difference was attenuated in the groups of prediabetes and diabetes with a borderline significant interaction between sex and glycemic status (p for interaction=.068). The sex difference in cardiovascular risks in adults with NGR, prediabetes, or diabetes was dependent on age. Our findings provide new evidence for prioritizing preventive treatment against atherosclerosis in men vs women with different glycemic status.

Subjects Conceived through Assisted Reproductive Technologies Display Normal Arterial Stiffness.

Multiple studies reported signs of vascular dysfunction in subjects conceived through assisted reproductive technologies (ART). The assessment of arterial stiffness in this cohort seems beneficial for risk stratification. Regional arterial stiffness of the abdominal aorta (AAO) and the common carotid arteries (CCA) was evaluated sonographically using two-dimensional speckle tracking in subjects conceived through ART and spontaneously conceived peers. Global arterial stiffness was assessed utilizing an oscillometric blood pressure device. The cohorts of 67 ART subjects and 86 spontaneously conceived peers (11.31 (8.10-18.20) years vs. 11.85 (8.72-18.27) years, p = 0.43) did not differ significantly in parameters of regional and global arterial stiffness. In the sub-analysis of study participants ≥10 years of age, markers of arterial stiffness did not display significant differences between both groups. However, a higher tendency of brachial systolic blood pressure was demonstrated in the ART cohort compared to the control group (120.18 ± 9.57 mmHg vs. 116.55 ± 8.05 mmHg, p = 0.050). The present study displayed no significant differences in arterial stiffness between ART subjects and spontaneously conceived peers. Moreover, this study suggests that arterial stiffness does not elevate more profoundly in ART subjects with increasing age. Further studies are required for a more detailed cardiovascular risk stratification of the ART cohort.

Upper-Arm SBP Decline Associated with Repeated Cuff-Oscillometric Inflation Significantly Correlated with the Arterial Stiffness Index.

We evaluated the clinical significance of the new non-invasive vascular indices to explore their potential utility using repeated cuff-oscillometric inflation. In 250 consecutive outpatients, we performed a cross-sectional, retrospective, single-center, observational study to investigate sequential differences in arterial stiffness using blood pressure, arterial velocity pulse index (AVI), and arterial pressure volume index (API) with repeated measurements. Males accounted for 62.7% of the patients, and the mean age was 68.1 ± 12.1 years. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the first reading in repeated measurements were 133.07 ± 21.20 mmHg and 73.94 ± 13.56 mmHg, respectively. The mean AVI and API were 23.83 ± 8.30 and 31.12 ± 7.86, respectively. In each measurement of these parameters, although DBP and AVI did not show significant changes throughout repeated measurements, SBP and API decreased significantly according to the measurement orders. Furthermore, changes in SBP and API were significantly correlated in several of the models. In this study, it was concluded that upper-arm SBP decline associated with repeated cuff-oscillometric inflation was significantly correlated with the arterial stiffness index. The findings of this study will allow clinicians to easily recognize the progression of atherosclerosis through regular, routine practice. In conclusion, this study suggests that changes in repeated SBP measurements may be predictive of arterial stiffness and atherosclerosis.

Ambulatory Arterial Stiffness, Salivary Inflammation, And Physical Activity In Young Adults With And Without Covid-19

COVID-19 illness may cause a dysregulated systemic inflammatory response, leading to cardiovascular damage and an increased risk for cardiovascular disease (CVD). Physical activity (PA) is inversely associated with systemic inflammation and CVD risk and may be a cardioprotective lifestyle factor for individuals recovering from COVID-19. PURPOSE: 1) To compare CVD risk, assessed as arterial stiffness and systemic inflammatory levels, between young adults recovering from COVID-19 and uninfected controls, and 2) to explore PA as a mediator for the relationship of COVID-19 infection history with arterial stiffness and systemic inflammation. METHODS: Analyses were performed on 23 COVID-19 (15 females, 25.0 ± 8.9 years, 24.1 ± 3.5 kg/m2) and 32 control participants (18 females, 24.4 ± 6.5 years, 25.1 ± 3.5 kg/m2). Arterial stiffness was estimated as pulse wave velocity (PWV) during 24-hour ambulatory blood pressure monitoring with an oscillometric blood pressure device. Systemic inflammation was assessed as salivary C-reactive protein (CRP) levels using the passive drool method. PA was objectively measured via accelerometry and assessed as moderate-to-vigorous PA (MVPA). An independent samples t-test was used to compare measures of arterial stiffness and systemic inflammation between the COVID-19 and control groups. Mediation analysis was used to determine whether there was a significant indirect effect of COVID-19 infection history through MVPA on arterial stiffness and CRP levels. RESULTS: There were no significant differences (p > 0.05) between the SARS-CoV-2 and control groups in PWV (5.0 ± 0.5 m/s vs. 5.1 ± 0.5 m/s) or CRP levels (765.4 ± 672.9 pg/mL vs. 526.3 ± 674.8 pg/mL). Mediation analysis did not reveal a significant indirect effect of COVID-19 infection history through MVPA on arterial stiffness (estimate = 0.02, 95% CI = -0.05 - 0.24) or CRP levels (estimate = 0.03, 95% CI = -0.07 - 0.16). CONCLUSION: These results suggest there are no differences in arterial stiffness and systemic inflammation between young adults recovering from COVID-19 and uninfected controls, and that MVPA may not significantly mediate the relationship for COVID-19 infection history with arterial stiffness and systemic inflammation. Young adults recovering from COVID-19 may not have a heightened CVD risk compared to controls.

Abstract P070: Vascular Conditioning Exercise Acutely Enhances Endothelial Function In Young Adults

Introduction: Vascular conditioning exercise (VCE), otherwise known as high-resistance inspiratory muscle strength training, is a potent non-pharmacological therapy to reduce blood pressure. When performed daily for 6 weeks, systolic blood pressure is reduced by ~6-10 mmHg on average, in part, by increasing nitric oxide-mediated endothelial dependent dilation (EDD). While the adaptations to long-term VCE have been described, the acute effects of VCE that may mediate the long-term vascular adaptations have not been thoroughly investigated. Hypothesis: We assessed the hypothesis that a single bout of VCE would increase EDD for at least 40 minutes after exercise completion, while arterial stiffness would not be affected. Methods: Nitric oxide-mediated EDD and ischemia-induced maximal shear rate were assessed with brachial artery flow-mediated dilation, and arterial stiffness was assessed via carotid-femoral pulse wave velocity. Assessments were performed before, 10 minutes after, and 40 minutes after a single bout of VCE (5 sets of 6 breaths at 50% of maximal inspiratory pressure with 1-minute rest intervals) or a time-matched rest interval in nine young adults (22.3 ± 2.6 years; 3 male, 6 female) using a randomized crossover design, with at least 48 hours between visits. Results: All values are mean difference ± SD. There were no differences between interventions in EDD at baseline (0.73 ± 3.7%; p =0.569). EDD was significantly higher 10 minutes post-VCE, relative to the rest intervention (3.28 ± 3.37%; p = 0.019), but there were no differences at 40 minutes post-intervention (0.01 ± 4.46%; p =0.992). Further, there were no differences in maximal shear rate between measurements (all p -values &gt;0.05), indicating the changes in EDD were not due to a modified hyperaemic response. Lastly, there were no differences in arterial stiffness (Baseline: 0.22 ± 0.75 m/s; Post-10: 0.26 ± 0.51 m/s; Post-40: 0.27 ± 0.33 m/s; all p -values &gt;0.05). Conclusions: A single bout of VCE transiently enhances EDD in healthy young adults, although this effect disappears within 40 minutes of exercise completion. This acute functional response to VCE can partially explain the large improvements in EDD that are seen in response to daily VCE performance over longer periods.

Inter-individual Variability In Passive Leg Movement-induced Hyperemia And Arterial Stiffness Across The Menstrual Cycle

There is variability in the impact of menstrual phase on arterial stiffness with some, but not all, studies reporting a decrease in arterial stiffness from the early follicular (EF; low estradiol) to the late follicular (LF; high estradiol) phase at the group or individual level. However, the mechanisms driving inter-study and inter-individual phase differences in arterial stiffness remain unknown. Vasorelaxation reduces arterial resistance and arterial stiffness. Variable increases in the endothelial-derived vasodilator nitric oxide with elevated LF estrogen may result in variable smooth muscle relaxation and thus variability in the impact of phase on arterial stiffness. It is speculated that inter-individual phase changes in nitric oxide dependent endothelial function will be related to inter-individual phase changes in arterial stiffness. PURPOSE: to investigate whether changes in endothelial function are related to changes in arterial stiffness across the menstrual cycle. METHODS: 11 premenopausal women (22±4 years) completed two visits; 1 in EF and 1 in LF phase. Salivary estradiol and leg endothelial function and arterial stiffness were tested during each visit. Endothelial function was quantified by the hyperemic response to passive leg movement (PLM) characterized by area under the curve leg blood flow (AUC LBF) and leg vascular conductance (AUC LVC) assessed via duplex ultrasound. Leg femoral-foot pulse wave velocity (PWV) was assessed via applanation tonometry. RESULTS: Estradiol increased from the EF to LF phase (p=0.014; EF=1.43±0.38, LF=1.60±0.43 pg/ml). At the group level, PWV decreased from the EF to LF phase (p=0.022; EF=7.98±1.48, LF=7.21±1.85 m/s). There were no group-level phase changes in AUC LBF (p=0.308; EF=132.50, LF=149.07 ml/min) or AUC LVC (p=0.344; EF=1.76±1.13, LF=1.96±1.06 ml/min/mmHg). Phase changes in PWV were not associated with phase changes in AUC LBF (r=0.171, p =0.616) or AUC LVC (r=0.247, p=0.464). CONCLUSION: Peripheral arterial stiffness decreased with a rise in estrogen in the LF phase, however, individual phase changes in arterial stiffness were not related to individual changes in endothelial function. Future research is needed to understand the mechanisms resulting in individual responses to fluctuations in endogenous estradiol. Funded by NSERC

Inter-arm differences in regional arterial stiffness and geometry lead to inter-arm systolic blood pressure differences: A modelling study

An inter-arm systolic blood pressure difference (ISBPD), if substantial in magnitude (typically defined as ≥10 mmHg), is a potential cardiovascular risk factor in adults, due to its association with cardiovascular events/mortality. A substantial ISBPD occurs in approximately 10% of the adult population, and, although associations with vascular disease and elevated stiffness have been reported, the mechanisms underlying ISBPD remain unknown. The aim of this study was to investigate whether inter-arm differences in segmental pulse wave velocity, cross-sectional area, or vascular bed compliance/resistance could give rise to substantial differences in brachial pressures between arms; for example, due to differences in pulse wave transmission and reflection. Using an established one-dimensional model of the major systemic arteries, pulse wave velocity (PWV) was uniformly increased or decreased in arteries of 1) the supra-aortic region leading up to the arm, 2) the brachial region, 3) the forearm, and 4) all of these (entire arm pathway); for the left arm, right arm, and both arms. Cross-sectional area and vascular bed compliance and resistance of the arms were similarly varied. Inter-arm differences in segmental PWV and cross-sectional area (but not bilateral changes) led to associated substantial inter-arm SBP differences, which were observed with changes to brachial, forearm and/or entire arm pathways and were related to altered transmission of forward waves and amplitude/timing of reflected waves. Vascular bed compliance and resistance had minimal influence. We conclude that inter-arm differences in arterial stiffness and geometry may contribute to inter-arm systolic blood pressure differences, warranting further investigation.