Lower Arterial Stiffness Research Articles

Association between physical activity performed at different intensities and cardiovascular health in patients with peripheral artery disease: an observational study.

We examined the sedentary behavior and physical activity of 260 patients with peripheral artery disease. Women engaged in more light physical activity than men did. Light physical activity was associated with lower arterial stiffness in men only, while no significant associations were found between sedentary behavior, moderate-vigorous physical activity, and cardiovascular outcomes. ◼ Women with peripheral artery disease exhibited higher blood pressure and arterial stiffness than men. ◼ Low levels of physical activity, particularly moderate to vigorous activity, were observed in individuals with peripheral artery disease. To analyze the association between the time spent in sedentary behavior and physical activity of different intensities with cardiovascular health in men and women with peripheral artery disease. Two hundred and sixty patients with peripheral artery disease and claudication symptoms (65.7% men; 66±1 years; ankle brachial index 0.57±0.18) were evaluated. Physical activity and sedentary behavior were assessed using an accelerometer. Physical activity was classified into light and moderate-vigorous intensities. The cardiovascular outcomes included blood pressure (oscillometric method), cardiac autonomic modulation (heart rate variability), and arterial stiffness (pulse wave velocity). Women spent more time engaged in light physical activity than men (341±14 min/day versus 306±9 min/day; p=0.040, respectively). There was no significant difference in the time spent on sedentary behavior and moderate-vigorous physical activity. Women had a higher systolic blood pressure (p=0.025), higher augmentation index (p<0.001), and lower sympathovagal balance (p=0.047) than men. Pulse wave velocity was only negatively associated with light physical activity (β= -4.66; 95%CI= -8.57; -0.76) in men. Light and moderate-vigorous physical activity and sedentary behavior were not associated with other cardiovascular outcomes. Higher levels of light physical activity were associated with lower arterial stiffness in men with peripheral artery disease.

Abstract P447: Impact of Altered Receptor Expression On the Cardiovascular Response to Estrogen

Premenopausal women benefit from estrogen's protective effects, including lower arterial stiffness than men of the same age. Despite estrogen's protective role, menopausal hormone therapy showed no cardiovascular benefits in the Women's Health Initiative. One theory is that the response to menopausal hormone therapy is modulated by the presence of pre-existing cardiovascular disease. Estrogen signals through nuclear estrogen receptors ERα and ERβ, and the membrane-bound G protein-coupled estrogen receptor (GPER). Our lab has shown that GPER induces protective cardiovascular effects including decreased blood pressure, protection from renal damage, and attenuation of arterial remodeling. In this study, we hypothesized that GPER deletion would attenuate the protective vascular effects of estrogen after menopause. Female C57Bl/6J wildtype (wt) and global GPER knockout (ko) mice underwent ovariectomy (OVX) at 46 weeks of age and concurrently administered estrogen (E) or vehicle (Veh). Angiotensin II (Ang II; 700 ng/kg/day) infusion was used to induce hypertension either four weeks prior (Ang-E) or at the time of OVX (E-Ang) to evaluate the impact of cardiovascular diseases preceding or coinciding with menopause. Blood pressure was measured by tail-cuff plethysmography and arterial stiffness was assessed by pulse wave velocity (PWV). Statistical analysis was performed using one-way ANOVA. Ang II induced a similar level of hypertension in wt and ko mice and was not impacted by E or timing. In wt mice, PWV was significantly higher in Veh-treated compared with E-treated hypertensive animals, independent of timing (P&lt;0.001). In contrast, PWV was not impacted by E in GPER ko mice (P=0.99). In conclusion, we found that E did not affect the hypertensive response to Ang II in both wt and GPER ko mice. GPER deletion reduced estrogen’s protection from arterial stiffening. Whether Ang II preceded or coincided with menopause did not alter the effects of E. These studies are important for determining whether cardiovascular status should be a factor when considering menopausal hormone therapy.

Greater Adherence to Life's Essential 8 for Cardiovascular Health Is Associated With Lower Arterial Stiffness in Survivors of Cancer.

Survivors of cancer have elevated risk of cardiovascular disease, likely stemming from the negative impact of anticancer therapies on vascular function. Arterial stiffness is a strong indicator of vascular function and independent predictor of cardiovascular disease. The American Heart Association recommends Life's Essential 8 for optimal cardiovascular health. It is currently unknown, however, whether greater adherence to Life's Essential 8 is associated with low arterial stiffness in survivors of cancer. This cross-sectional study included 172 older adult (≥65 years) survivors of cancer (74±6 years; 58% female). Life's Essential 8 100-point cardiovascular health score, with higher scores indicative of better cardiovascular health, was calculated based on 8 components: diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure. Participants were classified as having low (<60), moderate (60-79), or high (≥80) cardiovascular health. Pulse wave velocity (PWV) was used to assess arterial stiffness; with high arterial stiffness defined as a pulse wave velocity ≥10 m/s. The mean cardiovascular health score was 72±11 and 40 survivors (23%) had high arterial stiffness. Compared with low cardiovascular health, the odds ratio of high arterial stiffness was 0.12 (95% CI, 0.03-0.50) and 0.02 (95% CI, 0.003-0.18) for moderate and high cardiovascular health, respectively. Every 10-point increase in the cardiovascular health score was associated with a 0.43 m/s reduction in pulse wave velocity (P<0.001). Greater adherence to the American Heart Association's Life's Essential 8 was associated with lower prevalence of high arterial stiffness in older adult survivors of cancer. Prospective studies with larger samples are needed.

Central and peripheral cardiovascular responses after acute dietary nitrate supplementation in post-menopausal women

The transition to menopause is accompanied by augmented cardiovascular disease risk, partially attributed to reduced nitric oxide (NO) bioavailability. Despite a lower arterial stiffness than men, postmenopausal women are susceptible to increased aortic pulsatile hemodynamic load because of greater pressure wave reflection and vascular dysfunction. Increasing bioavailable NO with dietary nitrate has shown promise to reduce aortic (aSBP) and brachial (bSBP) systolic pressure healthy postmenopausal women. However, there are limited reports comparing hypertensive (HTN) and normotensive (NTN) postmenopausal women regarding wave separation analysis and vascular function following dietary nitrate supplementation. This study investigated if acute dietary nitrate supplementation would improve aortic hemodynamics, wave reflection characteristics, vascular stiffness, and vasodilatory function. We hypothesized that dietary nitrate would lower pulse wave velocity in hypertensives, lower aortic and brachial blood pressures and forward and backward wave magnitude and increase microvascular, but not macrovascular function in both groups. Fourteen postmenopausal women (n=7 HTN; n=7 NTN) participated in a two-day randomized crossover study design with dietary nitrate (nitrate rich, NR) or a placebo control (NP). Central and peripheral hemodynamics and carotid-femoral pulse wave velocity (cfPWV) were performed with a SphygmoCOR Excel, simultaneous resting macro- and- microvascular function was assessed using flow-mediated vasodilation (FMD) and post occlusive reactive hyperemia (PORH) using near-infrared spectroscopy. aSBP was reduced significantly following NR supplement within groups (HTN: NP 126±2 NR 120±1mmHg) and NTN group (NP 110± 1 NR 104±3mmHg p&lt;0.05). Forward pulse height HTN (NP 29±1.4 NR 26.3±1.4mmHg) NTN (NP 25.6±0.9 NR 24±2.7mmHg) and reflected pulse height HTN (NP 18.2±0.08 NR 17.2±0.4mmHg) NTN (NP 17.7±0.2 NR 15.7±1.07mmHg) were not different. cfPWV was faster in the HTN group and slowed with a NR supplement (HTN: NP 8.2±0.29 NR 7.4±0.31m/s; NTN NP 7.1±0.23 NR 6.6±0.62m/s p&lt;0.05). A significant interaction for %FMD was found (HTN: NP 7.3±0.8 NR 6.2±0.8%; NTN NP 6.6±0.7 NR 9.4±0.7%). Further, we found no difference in the NIRS derived microvascular function measurements (HTN: NP 1.9±0.2 NR 1.7±0.3%/s; NTN NP 1.6±0.1 NR 1.4±0.2%/s p&gt;0.05). These data indicate that dietary nitrate consumption led to a substantial reduction in aortic hemodynamics and reduced pulse wave velocity regardless of hypertension status. Interestingly, macrovascular, but not microvascular vasodilatory function was improved in the NTN women only. Dietary nitrate supplementation appears to have differential effects when considering HTN and NTN postmenopausal women. Supported with funds from The University of Wisconsin-La Crosse RSEL graduate grant. This is the full abstract presented at the American Physiology Summit 2024 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.

Abstract P236: Association Between Perceived Discrimination and Arterial Stiffness in Non-Hispanic Black Adults

Introduction: Racial discrimination is a chronic stressor that may contribute to cardiovascular disease (CVD) disparities in non-Hispanic Black (NHB) adults. Compared to non-Hispanic White adults, NHB adults experience greater perceived discrimination (PD), chronic perceived stress (PS), and burden of CVD risk. However, associations between PD, PS, and CVD risk, measured as arterial stiffness (AS), have not been tested in a population-based study of NHB adults in the US, limiting our understanding of whether and how CVD prevention initiatives should target PD and PS. Purpose: Determine the association between PD and AS, and whether this association is modified by biological sex and mediated by PS. Hypothesis: We hypothesized a direct association between PD and AS and that associations will be stronger in females and mediated by PS. Methods: Study sample included 594 NHB adults with complete data who participated in the Jackson Heart (JHS) and Atherosclerosis Risk in Communities (ARIC) studies’ shared cohort. PD (lifetime, everyday, and burden of lifetime discrimination) and PS were measured at JHS baseline (2000-2004). AS was measured at ARIC Visit 5 (2011-2013). PD and PS were coded as continuous variables. Effect modification was evaluated by including an interaction term between sex and PD in fully adjusted models. Mediation was assessed via the natural indirect effects from the CAUSALmed procedure. Models were adjusted for age, sex, body mass index (BMI), blood pressure medication, diabetes status, and mean arterial pressure (MAP). Results: Participants had a mean [95% confidence interval (95%CI)] age of 64.7 [64.3, 65.1] years, BMI of 30.1 [29.7, 30.6] kg/m 2 ; 69% (410 of 594) were female, 24% (143 of 594) had diabetes, and 70% (416 of 594) had hypertension. Mean [95%CI] total scores for everyday, lifetime, and burden of lifetime PD were 1.96 [1.89, 2.03], 2.97 [2.81, 3.14], and 2.28 [2.21, 2.34], respectively. Mean [95%CI] AS, measured as pulse wave velocity, was 12.42 [12.15, 12.70] m/s. A 1-unit increase in lifetime PD score was associated with a decrease in AS ( β =- 0.30 [-0.57, -0.02] m/s ). The association remained after adjusting for demographics and clinical characteristics ( β= -0.29 [-0.55, 0.02] m/s ), but was no longer statistically significant when including MAP ( β= -0.21 [-0.46, 0.05] m/s ). There were non-significant associations between everyday PD and burden of lifetime PD and AS. There was no evidence of effect modification by sex or mediation by PS. Conclusion: Higher lifetime PD, but not everyday PD or burden of lifetime PD, was associated with lower AS in crude models. However, the association was attenuated to non-significance when adjusted for MAP, suggesting the association between PD and AS may be pressure-dependent. Future studies characterizing PD’s role in CVD risk development in other geographical regions and NHB populations.

Mediating effect of fat mass, lean mass, blood pressure and insulin resistance on the associations of accelerometer-based sedentary time and physical activity with arterial stiffness, carotid IMT and carotid elasticity in 1574 adolescents

This study examined the mediating effect of total body fat mass, lean mass, blood pressure (BP) and insulin resistance on the associations of sedentary time (ST), light physical activity (LPA) and moderate-to-vigorous PA (MVPA) with carotid-femoral pulse wave velocity (cfPWV), carotid intima-media thickness (cIMT) and carotid elasticity in 1574 adolescents from the Avon Longitudinal Study of Parents and Children birth cohort, UK. ST, LPA and MVPA were assessed with ActiGraph accelerometer. ST and LPA were sex-categorised in tertiles as low (reference), moderate and high, while MVPA was categorised as <40 min/day (reference), 40–<60 min/day and ≥60 min/day. cfPWV, cIMT and carotid elasticity were measured with Vicorder and ultrasound. Fat mass and lean mass were assessed with dual-energy X-ray absorptiometry and homeostatic model assessment of insulin resistance (HOMA-IR) was computed. Mediation analyses structural equation models and linear mixed-effect models adjusted for cardiometabolic and lifestyle factors were conducted. Among 1574 adolescents [56.2% female; mean (SD) age 15.4 (0.24) years], 41% males and 17% females accumulated ≥60 min/day of MVPA. Higher ST was associated with lower cIMT partly mediated by lean mass. Higher LPA (standardized β = −0.057; [95% CI −0.101 to −0.013; p = 0.014]) and the highest LPA tertile were associated with lower cfPWV. BP had no significant mediating effect movement behaviour relations with vascular indices. Lean mass partially mediated associations of higher MVPA with higher cIMT (0.012; [0.007–0.002; p = 0.001], 25.5% mediation) and higher carotid elasticity (0.025; [0.014–0.039; p = 0.001], 28.1% mediation). HOMA-IR mediated the associations of higher MVPA with higher carotid elasticity (7.7% mediation). Engaging in ≥60 min/day of MVPA was associated with higher carotid elasticity. In conclusion, higher LPA was associated with lower arterial stiffness, but higher MVPA was associated with thicker carotid wall explained by higher lean mass.

Intermittent supplementation with fisetin improves arterial function in old mice by decreasing cellular senescence.

Cellular senescence and the senescence-associated secretory phenotype (SASP) contribute to age-related arterial dysfunction, in part, by promoting oxidative stress and inflammation, which reduce the bioavailability of the vasodilatory molecule nitric oxide (NO). In the present study, we assessed the efficacy of fisetin, a natural compound, as a senolytic to reduce vascular cell senescence and SASP factors and improve arterial function in old mice. We found that fisetin decreased cellular senescence in human endothelial cell culture. In old mice, vascular cell senescence and SASP-related inflammation were lower 1 week after the final dose of oral intermittent (1 week on-2 weeks off-1 weeks on dosing) fisetin supplementation. Old fisetin-supplemented mice had higher endothelial function. Leveraging old p16-3MR mice, a transgenic model allowing genetic clearance of p16INK4A -positive senescent cells, we found that exvivo removal of senescent cells from arteries isolated from vehicle- but not fisetin-treated mice increased endothelium-dependent dilation, demonstrating that fisetin improved endothelial function through senolysis. Enhanced endothelial function with fisetin was mediated by increased NO bioavailability and reduced cellular- and mitochondrial-related oxidative stress. Arterial stiffness was lower in fisetin-treated mice. Exvivo genetic senolysis in aorta rings from p16-3MR mice did not further reduce mechanical wall stiffness in fisetin-treated mice, demonstrating lower arterial stiffness after fisetin was due to senolysis. Lower arterial stiffness with fisetin was accompanied by favorable arterial wall remodeling. The findings from this study identify fisetin as promising therapy for clinical translation to target excess cell senescence to treat age-related arterial dysfunction.

Association Between Physical Activity and Arterial Stiffness in Patients with Type 2 Diabetes in Ningbo, China: A Cross-Sectional Study.

The study aimed to investigate the association between physical activity and arterial stiffness in patients with type 2 diabetes mellitus (T2DM) in Ningbo, China. A cross-sectional study was conducted using the Metabolic Management Center (MMC) dataset of The First Affiliated Hospital of Ningbo University from 1st March 2018 to 28th February 2023. 4444 adults with T2DM were included in the study. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ)-Short and was categorized into high, moderate, and low. Arterial stiffness was defined as brachial-ankle pulse wave velocity (baPWV) ≥1800cm/s or common carotid artery intima-media thickness (CCA IMT) ≥1mm. Multiple logistic regression analyses were performed to identify the association between physical activity and arterial stiffness. 6.5%, 47.0%, and 46.5% of patients with T2DM had high, moderate, and low physical activity, respectively. 18.8% and 17.5% of patients had arterial stiffness based on baPWV and CCA IMT, respectively. The odds of arterial stiffness (based on baPWV) were lower in patients having moderate to high physical activity (OR 0.82, 95% CI 0.68 to 0.98 and OR 0.58, 95% CI 0.39 to 0.87, respectively). The odds of arterial stiffness (based on CCA IMT) were found to be lower in patients having high physical activity (OR 0.49, 95% CI 0.33 to 0.74). Higher physical activity was found to be associated with lower arterial stiffness in patients with T2DM in Ningbo, China. This was a cross-sectional study, and there is a need to conduct longitudinal studies on this topic.

Greater Adherence To Life’s Essential 8 Is Associated With Lower Arterial Stiffness In Cancer Survivors

Greater Adherence To Life’s Essential 8 Is Associated With Lower Arterial Stiffness In Cancer Survivors

Effects of Physical Activity in the High School Curriculum on Cardiovascular Health, Cognitive and Physical Performance.

Cardiovascular health at a young age has implications for preventing cardiovascular disease, and it is associated with improved physical and cognitive performance during the aging process. Sports are well known to prevent cardiovascular disease; however, school-based interventions have mostly been neglected. This cross-sectional study aimed to compare groups of high school students, stratified by the amount of physical activity in their high school curriculum and downtime. Comparisons concerning physical and cognitive performance and arterial stiffness were made. A total of 63 senior-year students were investigated. Arterial stiffness was assessed using the oscillometric technique with ArteriographTM detection. Three-kilometer and pendulum runs were conducted as typical training loads. Cognitive performance was evaluated via the visual and verbal memory and number connection tests. Regarding cognitive skills, extracurricular physical activity improved the number connection test in male participants (p = 0.004). For physical performance, female students with a sports-focused curriculum were faster in the 3 km run (p < 0.001). Concerning arterial stiffness, the measurements yielded a lower mean arterial pressure (p = 0.015) and aortic pulse wave velocity (p = 0.04) in male students with a sports-focused curriculum. In summary, extracurricular physical activity and enrollment in a sports-focused curriculum may be associated with lower cardiovascular risk due to lower arterial stiffness and better physical and cognitive abilities.

Insights Into Vascular Physiology From Sleep Photoplethysmography.

Photoplethysmography (PPG) in consumer sleep trackers is now widely available and used to assess heart rate variability (HRV) for sleep staging. However, PPG waveform changes during sleep can also inform about vascular elasticity in healthy persons who constitute a majority of users. To assess its potential value, we traced the evolution of PPG-pulse waveform during sleep alongside measurements of HRV and blood pressure. Seventy eight healthy adults (50% male, median (range) age: 29.5 (23.0, 43.8)) underwent overnight polysomnography (PSG) with fingertip PPG, ambulatory blood pressure monitoring (ABPM) and electrocardiography (ECG). Selected PPG features that reflect arterial stiffness: systolic to diastolic distance (∆T_norm), normalized rising slope (Rslope) and normalized reflection index (RI) were derived using a custom-built algorithm. Pulse arrival time (PAT) was calculated using ECG and PPG signals. The effect of sleep stage on these measures of arterial elasticity and how this pattern of sleep stage evolution differed with participant age were investigated. Blood pressure, heart rate and PAT were reduced with deeper non-REM sleep but these changes were unaffected by the age range tested. After adjusting for lowered heart rate, ∆T_norm, Rslope and RI showed significant effects of sleep stage, whereby deeper sleep was associated with lower arterial stiffness. Age was significantly correlated with the amount of sleep-related change in ∆T_norm, Rslope and RI, and remained a significant predictor of RI after adjustment for sex, body mass index, office blood pressure and sleep efficiency. The current findings indicate that the magnitude of sleep-related change in PPG waveform can provide useful information about vascular elasticity and age effects on this in healthy adults.

Association of Dietary Potassium Intake With Abdominal Aortic Calcification and Pulse Pressure in US Adults

Arterial calcification contributes to cardiovascular mortality. Based on a recent animal study, we hypothesized that higher dietary potassium intake was associated with less abdominal aortic calcification (AAC) and lower arterial stiffness among adults in the United States. Cross-sectional analyses were performed on participants over 40years old from the National Health and Nutrition Examination Survey 2013-2014. Dietary potassium intake was categorized into quartiles (Q1: <1911, Q2: 1911-2461, Q3: 2462-3119, and Q4: >3119mg/d). Primary outcome AAC was quantified using the Kauppila scoring system. AAC scores were categorized into no AAC (AAC=0, reference group), mild/moderate (AAC >0 to≤6), and severe AAC (AAC >6). Pulse pressure was used as a surrogate for arterial stiffness and examined as a secondary outcome. Among 2,418 participants, there was not a linear association between dietary potassium intake and AAC. Higher dietary potassium intake was associated with less severe AAC when comparing dietary potassium intake in Q2 with Q1 (odds ratio 0.55; 95% confidence interval: 0.34 to 0.92; P=.03). Higher dietary potassium intake was significantly associated with lower pulse pressure (P=.007): per 1000mg/d higher dietary potassium intake, pulse pressure was 1.47mmHg lower in the fully adjusted model. Compared to participants with dietary potassium intake in Q1, pulse pressure was 2.84mmHg lower in Q4 (P=.04). We did not find a linear association between dietary potassium intake and AAC. Dietary potassium intake was negatively associated with pulse pressure.

Patients with CKD Secondary to Glomerular Disorders have Lower Arterial Stiffness, as Compared to Hypertensive and Diabetic CKD

BackgroundChronic kidney disease (CKD) manifested as reduced GFR and/or albuminuria, has been known to accelerate arterial stiffness and early vascular aging (EVA). Diabetes, hypertension, and glomerular disorders are the leading causes of CKD and renal failure.The question which etiology contributes more to this vascular phenomenon-hypertensive and diabetic CKD or CKD secondary to immune-mediated glomerulonephritis—remained unclear.ObjectiveTo compare pulse wave velocity (PWV), a marker of arterial stiffness, between CKD patients of different etiologies: hypertensive and diabetic nephrosclerosis. vs. CKD secondary to glomerular disorders.MethodsClinical data were collected on 56 patients followed at the Nephrology and Hypertension Institute in Samson Assuta Ashdod University Hospital. All patients had at least one visit at our Nephrology clinics prior to recruitment. All patients with a glomerular disorder had a clinical-pathological diagnosis based on a recent kidney biopsy.Pulse wave velocity (PWV) was measured using a validated Sphygmocor XCEL® device. Univariate and multivariate analyses were performed to compare PWV between hypertensive/diabetic CKD and CKD secondary to glomerular disorders.ResultsPWV was significantly higher in the hypertensive/diabetic CKD group, compared to the CKD-GN group, with an average of. 12.2 m/s vs 8.3 m/s, respectively (p < 0.001).In a multivariate linear regression model, having CKD secondary to glomerulonephritis was associated with a significantly lower PWV (B = − 3.262, p < 0.001), compared with CKD secondary to hypertension and diabetes, with adjustment of age, creatinine, and comorbidities.ConclusionCKD Patients secondary to glomerulonephritis, have lower PWV when compared to CKD patients with diabetes and/or hypertension, even after adjusting for age, renal function, and the presence of comorbidities. It is intriguing to further study the possible protective role of immunosuppression on the arterial properties of CKD patients.

LONG TERM EFFECT OF RENAL DENERVATION ON 24 HOUR ABPM AND BLOOD PRESSURE LOAD IS LARGELY DEPENDENT OF BASELINE ARTERIAL STIFFNESS

Objective: The aim of the study was to evaluate the long term effect of renal sympathetic denervation (RSD) on 24h ambulatory blood pressure measurement (ABPM) and blood pressure load (BP load) in patients with resistant hypertension depending of the baseline arterial stiffness status. Design and method: Consecutive patients with resistant hypertension who underwent RSD workout at the University Hospital Saint Anna, Sofia, ESH Excellence center of hypertension, were included. RSD was performed on the grounds of resistant hypertension defined as mean daytime systolic BP &gt;135 mmHg or diastolic BP &gt;85 mmHg in 24-hr ambulatory blood pressure measurement (ABPM) despite the intake of at least three antihypertensive agents, including a diuretic. Cardio ankle vascular index (CAVI) was measured using the VaSera system (Fukuda Denshi Co, Japan). RSD was performed with the Symplicity Flex™ catheter (Medtronic, Minneapolis, MN, USA) according to a standardized protocol. Results: The study included 32 patients with treatment-resistant hypertension and performed successful RSD. CAVI was measured before the intervention and the results of the procedure on 24h daytime, nighttime and 24 blood pressure and systolic and diastolic BP load were evaluated by serial ABPM measurements. A long-term effect of the RSD, reported as a reduction in 24-hour systolic blood pressure above 10 mmHg at month 12, was found in 22 patients (68.8%). Despite similar baseline out-of-office and office blood pressure and concomitant antihypertensive therapy, patients with lower arterial stiffness had a more significant blood pressure effect of renal denervation, a result that persisted within 12 months of follow-up. Along with reduction of all ABPM parameters more profound and clinically meaningful change of BP load during daytime, nighttime and 24h period was also noticed in this group of patients. (Table 1) Conclusions: The long term effect of renal denervation on 24h ABPM and BP load is largely dependent of baseline arterial stiffness. The results of the present study justify the incorporation of arterial stiffness evaluation in clinical decision workout of the procedure.

EFFECTS OF TRIATHLON TRAINING ON HEMODYNAMIC RESPONSES AND VASCULAR FUNCTION: THE ATHLAS STUDY

Objective: Regular and moderate endurance exercise has beneficial effects on the cardiovascular system. Triathlon is a rigorous endurance multisport that requires a higher level of training. Chronic consequences on cardiovascular system of such a high cardiovascular demand have not yet been highlighted. In this study, we assessed the effect of triathlon training and racing on the cardiovascular system in experienced triathletes. Design and method: ATHLAS is a prospective controlled study comparing 34 male recreational long-distance triathletes aged 19 to 39 years (Tri) with 29 healthy insufficiently active of the same age (Ctrl). All volunteers completed three visits throughout an annual sports season: at baseline during the off-season (in winter), at peak of physical performance during races period (in spring/summer), and during active rest in post-season (in autumn). At each visit, peripheral blood pressure was measured, and applanation tonometry was performed to evaluate arterial stiffness by carotid-femoral pulse wave velocity (cfPWV) and myocardial perfusion using the subendocardial viability ratio (SEVR). Results: At baseline, Tri had higher systolic blood pressure (SBP) and pulse pressure (PP) than Ctrl (respectively, 131.1±8.9 vs 125.7±10.4 mmHg; and 56.5±12.8 vs 48.9±6.5 mmHg, p&lt;0.05) but lower cfPWV (6.29 ±0.15 vs 6.95 ±0.16 m/sec, p&lt;0.01). SEVR was increased in Tri indicating better myocardial perfusion (mean difference of 34.42%, p = 0.03). At peak of performance in Tri, SBP and PP were decreased (respectively, mean difference of 3.63 mmHg, and 3.36 mmHg, p&lt;0.05), and returning to baseline levels in active rest. Tri cfPWV and SEVR were not influenced by training phases. In Ctrl group, SBP, PP and cfPWV exhibited seasonal variation with lower levels in spring/summer (p&lt; 0.05). Conclusions: Triathlon training and racing have beneficial effects on arterial stiffness and myocardial perfusion regardless of time of season. In triathletes, increased SBP despite lower arterial stiffness (cfPWV) reflects adaptation of the athlete's heart with a high cardiac output. These results will require further study to determine whether high blood pressure could lead to negative cardiovascular impact in the long term.

Decentering and baroreflex sensitivity in adults with elevated blood pressure

Previous studies have linked the ability to decenter, a non-judgmental view of emotions, with lower arterial stiffness and better nocturnal blood pressure dipping in adults. It is unknown however if autonomic regulation of blood pressure is linked to decentering. Therefore, the purpose of this study was to determine if decentering ability is related to cardiovagal or sympathetic baroreflex sensitivity. Thirty-three adults (age 25±6 years; BMI 25±3 kg/m2) with resting blood pressure ≥120/80 mmHg volunteered for this study. All participants had a BMI &lt;30 kg/m2, and had no history of smoking, diabetes, or prescriptions for blood pressure or cardiac function. Participants completed an 11-item experiences questionnaire to evaluate decentering, and then were equipped for a supine autonomic evaluation. The autonomic evaluation included continuous recording of heart rate via 3-lead ECG, muscle sympathetic nerve activity (MSNA) via microneurography, and beat-to-beat blood pressure via finger photoplethysmography. Cardiovagal baroreflex sensitivity (n=33) included estimation of vagal activation by evaluating up-up relationships between systolic arterial pressure (SAP) and R-R intervals of the ECG. Vagal withdrawal was also estimated via the down-down relationships between SAP and R-R intervals. Spontaneous sympathetic baroreflex sensitivity (n=26) was evaluated by evaluating the relationship between changes in diastolic arterial pressure (DAP) in 3 mmHg bins vs. changes in MSNA burst incidence (i.e., bursts / 100 heart beats). Results from 2-tailed Pearson correlation analyses revealed that there was not a relationship between decentering and vagal activation (r=-0.07; p=0.71) or between decentering and vagal withdrawal (r=-0.28; p=0.12). Likewise, there was no relationship between decentering and sympathetic baroreflex sensitivity (r=0.10; p=0.64). Our findings suggest that there is not a clear link between decentering and autonomic regulation of blood pressure as estimated through both cardiovagal and baroreflex sensitivity. NIH (1R15HL140596-01); Nils K. Nelson Endowment Fund 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.

Association of socioeconomic status with arterial stiffness in older African American and White adults: The ARIC study cohort

ObjectiveTo examine the cross-sectional associations of individual measures of SES—educational attainment and household income—and the joint effects of SES with PWV, as well as the SES-race interaction, in a cohort of older African American and White adults. MethodsData from the Atherosclerosis Risk in Communities (ARIC) Study were used to evaluate the cross-sectional associations of individual and joint SES [education and income] and carotid femoral pulse wave velocity (cfPWV), a subclinical marker of arterial stiffness, and the interaction of SES and race using adjusted multivariable linear regression models in a cohort of 3342 men and women aged 67–89 years free of CVD in 2011–2013. ResultsParticipants were 64% female, 23% African American, mean cfPWV (12.3±3.5-African American and 11.6±3.9-White participants). Post-graduate education compared to less than high school was significantly associated with lower cfPWV (less stiffness) in African American (β = -1.28 m/s; 95% CI, -1.97, -0.59) but not in White (β = -0.69 m/s; 95% CI, -1.39, 0.01) participants. Income ≥$50K as compared to <$25K, was associated with lower cfPWV both in African American (β = -0.82 m/s; 95% CI, -1.42, -0.22) and White (β = -0.76 m/s; 95% CI, -1.19, -0.32) participants. The interaction of race and individual measures of SES on cfPWV in African American and White adults were not statistically significant (p-value >0.10). ConclusionsHigher SES was cross-sectionally associated with lower arterial stiffness in this cohort; the data did not support differences by race. Prospective studies of SES and cfPWV are needed to efficiently compare larger racially and regionally diverse populations with a wider range of socioeconomic profiles to better identify subgroup CVD risk.

PS-C12-9: CARDIO ANKLE VASCULAR INDEX AS A PREDICTOR OF SUCCESSFUL RENAL DENERVATION AND IMPROVED BP VARIABILITY IN SUBJECTS WITH RESISTANT HYPERTENSION

Objective: The aim of the study was to determine the clinical characteristics of patients with increased arterial stiffness (AS) undergoing renal sympathetic denervation (RSD) and to examine the role of cardio ankle vascular index (CAVI) measurement in predicting the outcome of RSD. Another task was to assess the effect on the indices of blood pressure variability. Design and method: Consecutive patients with resistant hypertension who underwent RSD workout at the University Hospital Saint Anna, Sofia, between January 2014 and December 2020 were included. CAVI was measured using the VaSera system (Fukuda Denshi Co, Japan). RSD was performed with the Symplicity Flex catheter (Medtronic, Minneapolis, MN, USA) according to a standardized protocol. Blood pressure variability was assessed by weighted 24 h BPV by ABPM. Results: The study included 62 patients with treatment resistant hypertension, after out of office blood pressure measurement and intensification of therapy, renal denervation was performed in 32 (51.6%). Patients with increased arterial stiffness, defined as CAVI &gt;median of 8.3, were older, with a larger waist circumference and previous cardiovascular events. A longterm effect of the RSD, reported as a reduction in 24-hour systolic blood pressure above 10 mmHg at month 12, was found in 22 patients (68.8%). The median of the observed reduction of the 24 hour systolic blood pressure was 16 mmHg at 95% confidence interval 9.1 to 21 mmHg. Despite similar baseline out of office and office blood pressure and concomitant antihypertensive therapy, patients with lower arterial stiffness had a more significant blood pressure effect of renal denervation, a result that persisted within 12 months of follow up. More profound and significant drop of BP variability was also noticed in this group of patients. In contrast, the effect of the procedure was clinically insignificant among patients with baseline CAVI values above 8.3. Difference in office and out of office BP between the baseline values and those at month 12 after RSD in patients with low arterial stiffness. Conclusions: These findings hold the promise that AS might be used as a selection criterion for RSD, thereby improving outcome following RSD.

Cross-sectional associations between short and mid-term blood pressure variability, cognition, and vascular stiffness in older adults

High blood pressure variability (BPV), particularly in older age, appears to be an independent risk factor for incident dementia. The current study aimed to investigate the association between different BPV measures (short- and mid-term BPV including circadian patterns) and cognitive functioning as well as vascular stiffness measures to better understand the role that BPV plays in cognitive impairment. 70 older adults (60-80-year-olds) without dementia completed a cognitive test battery and had their blood pressure (BP) assessed via a 24-hour ambulatory BP monitor (divided into sleep and wake for short-term BPV) and 4-day morning and evening home-based BP monitor (for day-to-day BPV). Arterial stiffness was evaluated via pulse wave analysis and pulse wave velocity (PWV) and cerebrovascular pulsatility was assessed via transcranial doppler sonography of the middle cerebral arteries. High systolic as well as diastolic short- and mid-term BPV were associated with poorer cognitive functioning, independent of the mean BP. Higher short-term BPV was associated with poorer attention and psychomotor speed, whilst day-to-day BPV was negatively linked with executive functioning. Circadian BP patterns (dipping and morning BP surge) showed no significant relationships with cognition after adjusting for covariates. Higher systolic short-term BPV was associated with higher arterial stiffness (PWV) and higher diastolic day-to-day BPV was linked with lower arterial stiffness. No significant associations between BPV measures and cerebrovascular pulsatility were present. High BPV, independently of the mean BP, is associated with lower cognitive performance and increased arterial stiffness in older adults without clinically-relevant cognitive impairment. This highlights the role of systolic and diastolic BPV as a potential early clinical marker for cognitive impairment.

Flavonifractor plautii Protects Against Elevated Arterial Stiffness.

Dysbiosis of gut microbiota plays a pivotal role in vascular dysfunction and microbial diversity was reported to be inversely correlated with arterial stiffness. However, the causal role of gut microbiota in the progression of arterial stiffness and the specific species along with the molecular mechanisms underlying this change remain largely unknown. Participants with elevated arterial stiffness and normal controls free of medication were matched for age and sex. The microbial composition and metabolic capacities between the 2 groups were compared with the integration of metagenomics and metabolomics. Subsequently, Ang II (angiotensin II)-induced and humanized mouse model were employed to evaluate the protective effect of Flavonifractor plautii (F plautii) and its main effector cis-aconitic acid. Human fecal metagenomic sequencing revealed a significantly high abundance and centrality of F plautii in normal controls, which was absent in the microbial community of subjects with elevated arterial stiffness. Moreover, blood pressure only mediated part of the effect of F plautii on lower arterial stiffness. The microbiome of normal controls exhibited an enhanced capacity for glycolysis and polysaccharide degradation, whereas, those of subjects with increased arterial stiffness were characterized by increased biosynthesis of fatty acids and aromatic amino acids. Integrative analysis with metabolomics profiling further suggested that increased cis-aconitic acid served as the main effector for the protective effect of F plautii against arterial stiffness. Replenishment with F plautii and cis-aconitic acid improved elastic fiber network and reversed increased pulse wave velocity through the suppression of MMP-2 (matrix metalloproteinase-2) and inhibition of MCP-1 (monocyte chemoattractant protein-1) and NF-κB (nuclear factor kappa-B) activation in both Ang II-induced and humanized model of arterial stiffness. Our translational study identifies a novel link between F plautii and arterial function and raises the possibility of sustaining vascular health by targeting gut microbiota.