Peripheral Systolic Blood Pressure Research Articles

THE ARTERIAL STIFFNESS AS RISK FACTOR FOR THE OCCURRENCE OF ARTERIAL HYPERTENSION IN POSTOPERATIVE CRITICALLY ILL PATIENTS

Objective: The aim of the present study is to investigate the predictive value of arterial stiffness in the occurrence of arterial hypertension in critically ill patients. Also, the study investigates the risk factors of arterial hypertension in ICU patients. Design and method: This is a prospective observational study. The study included postoperative patients who were admitted to the ICU. We collected demographic characteristics of the patients, their clinical characteristics (i.e. hemodynamic status), clinical severity (APACHE II, SOFA score), lifestyle data (i.e. smoking, alcohol, drugs), and medical history (diabetes mellitus, cardiovascular diseases). Arterial stiffness assessment is performed by recording and analyzing the pulse wave in postoperative patients during the first 24 hours of admission to the ICU. The Sphygmocor software was used for pulse wave analysis and IBM SPSS v.27.0 software was used for statistical analysis. Results: The sample of the study consisted of 74 patients. Most of them were males (70.3%) aged 59.3±18.6 yrs and the rest were females (29.7%) aged 63.3±16.9 yrs. Totally, 54.1% of patients had emergency surgery, 60.8% survived and discharged from ICU, 52.7% had arterial hypertension, 70.3% had diabetes mellitus, 58.1% were smoking, and 63.5% had hypercholesterolemia. The APACHE II score of patients was found 21.2±7.2 and the SOFA score 7.5±2.8 The value of peripheral systolic blood pressure (PSBP) was 138.7±19.4 mmHg, peripheral diastolic blood pressure (PDBP) was 67.1±13.2 mmHg, mean peripheral blood pressure (MPBP) was 90.7±14.6 mmHg, pulse pressure (PP) was 53.1±15.3 mmHg and AIX@75 was 22.3±13.1%. Older patients (69.1±14.9 vs. 52.7±17.3, p=0.001), patients with diabetes mellitus (92.3% vs. 7.7%, p=0.001), patients with hypercholesterolemia (92.3% vs. 7.7%, p=0.001), patients with higher value of Albumin (2.9±0.5 vs. 2.5±0.6, p=0.025), and patients with a higher value of AIX@75 (26.8±10.5 vs. 18.3±14.1, p=0.004) had statistically significant higher percentages of arterial hypertension. Higher AIX values are associated with a greater likelihood of arterial hypertension (OR: 1.027; 95%CI: 1.004-1.049, p=0.018). Conclusions: The arterial stiffness is an independent risk factor for arterial hypertension in postoperative critically ill patients.

Heartbeats and high scores: esports triggers cardiovascular and autonomic stress response.

Gaming is often labeled as sedentary behavior. However, competitive gaming, also known as esports, involves significant cognitive demands and may induce stress. This study aims to investigate whether the psychophysical demands during esports elicit a physiological stress response. Fourteen FIFA 21 and thirteen League of Legends players (23.3 ± 2.8 years) were recruited for the study. Heart rate (HR), root mean square of successive differences between normal heartbeats (RMSSD), peripheral and central blood pressure (BP), pulse wave velocity (PWV), and energy expenditure (EE) were assessed during supine rest, seated rest, and competitive FIFA or League of Legends matches. No significant group × condition interactions were observed for any of the outcomes. However, there were significant increases in mean HR (p < 0.001, = 0.383), RMSSD (p = 0.019, = 0.226), peripheral systolic BP (p < 0.001, = 0.588), peripheral diastolic BP (p = 0.005, = 0.272), central systolic BP (p = 0.005; = 0.369), central diastolic BP (p = 0.016, = 0.313), PWV (p = 0.004, = 0.333), and EE (p < 0.001, = 0.721) during both games compared to the seated rest condition. Despite the sedentary nature of esports, the psychophysical demands appear to elicit physiological responses. Interestingly, no significant differences were found between the different game genres.

Subpopulations of regulatory T cells are associated with subclinical atherosclerotic plaques, levels of LDL, and cardiorespiratory fitness in the elderly

BackgroundAtherosclerosis forms the pathological basis for the development of cardiovascular disease. Since pathological processes initially develop without clinically relevant symptoms, the identification of early markers in the subclinical stage plays an important role for initiating early interventions. There is evidence that regulatory T cells (Tregs) are involved in the development of atherosclerosis. Therefore, the present study aimed to identify and investigate associations with Tregs and their subsets in a cohort of healthy elderly individuals with and without subclinical atherosclerotic plaques (SAP). In addition, various lifestyle and risk factors, such as cardiorespiratory fitness, were investigated as associated signatures. MethodsA cross-sectional study was performed in 79 participants (male: n = 50; age = 63.6 ± 3.7 years; body mass index = 24.9 ± 3.1 kg/m²; mean ± SD) who had no previous diagnosis of chronic disease and were not taking medication. Ultrasound of the carotids to identify SAP, cardiovascular function measurement for vascular assessment and a cardiorespiratory fitness test to determine peak oxygen uptake were performed. Additionally, tests were conducted to assess blood lipids and determine glucose levels. Immunophenotyping of Tregs and their subtypes (resting (rTregs) and effector/memory (mTregs)) was performed by 8-chanel flow cytometry. Participants were categorized according to atherosclerotic plaque status. Linear and logistic regression models were used to analyze associations between parameters. ResultsSAP was detected in a total of 29 participants. The participants with plaque were older (64.8 ± 3.6 years vs. 62.9 ± 3.5 years) and had higher peripheral systolic blood pressure (133.8 ± 14.7 mmHg vs. 125.8 ± 10.9 mmHg). The participants with SAP were characterized by a lower percentage of rTregs (28.8% ± 10.7% vs. 34.6% ± 10.7%) and a higher percentage of mTregs (40.3% ± 14.7% vs. 30.0% ± 11.9%). Multiple logistic regression identified age (odds ratio (OR) = 1.20 (95% confidence interval (95%CI): 1.01–1.42)) and mTregs (OR = 1.05 (95%CI: 1.02–1.10)) as independent risk factors for SAP. Stepwise linear regression could reveal an association of peak oxygen uptake (β = 0.441), low-density lipoprotein (LDL) (β = –0.096), and SAP (β = 6.733) with mTregs and LDL (β = 0.104) with rTregs. ConclusionWhile at an early stage of SAP, the total proportion of Tregs gives no indication of vascular changes, this is indicated by a shift in the Treg subgroups. Factors such as serum LDL or cardiopulmonary fitness may be associated with this shift and may also be additional diagnostic indicators. This could be used to initiate lifestyle-based preventive measures at an early stage, which may have a protective effect against disease progression.

Central Blood Pressure predicts the future cardiovascular risk better than peripheral Blood Pressure: the northern shanghai study

Abstract Background Controversy exists in the comparison between central and peripheral blood pressure (BP) in predicting the future cardiovascular risk. Aim To examine whether central BP predicts cardiovascular events and mortality better than brachial BP in a large cohort of elderly Chinese. Method A total of 3048 participants enrolled in the Northern Shanghai Study, a prospective cohort study focusing on the cardiovascular risk of community-dwelling elderly Chinese living in the north of Shanghai, China between 2014 and 2019, were included. Central BP was estimated tonometrically from the redial pulse waveform. The vital status and cardiovascular events of all participants were confirmed by reviewing the regional morality record system in October 2022. Cox proportional hazards models were conducted to evaluated the predictive value of central and peripheral systolic BP (SBP) and pulse pressure (PP). Results During the median follow-up of 5.6 years, the primary composite cardiovascular endpoint was occurred in 315 participants (10.3%). When central and peripheral SBP were analyzed separately, both central and peripheral SBP significantly associated with the primary composite endpoint (Peripheral: HR 1.047, 95% CI 1.016 to 1.079; Central: HR 1.051, 95%CI 1.020 to 1.091; Per 5 mm Hg), after adjusting age, sex, BMI, current smoking, lipid, cerebrocardiovascular disease, diabetes, antihypertensive treatment, statin treatment, hypoglycemic treatment and estimated glomerular filtration rate. When central and peripheral SBP were included in the same stepwise Cox regression, only central SBP stayed in the final model (HR 1.054, 95%CI 1.024 to 1.085, per 5 mm Hg), after adjustment for covariates. Similar trends were observed on the comparison between central and peripheral PP. Conclusions Central BP predicts the future cardiovascular risk better than peripheral BP in the elderly Chinese.

Evaluation of Arterial Stiffness and Subfoveal Choroidal Thickness in Patients with Coronary Slow Flow.

Coronary slow flow may not only affect the coronary arteries, but it may also be a vascular problem affecting the rest of the arterial system. The aim of this study was to determine peripheral arterial stiffness and the thickness of the choroid layer in patients with slow coronary flow. Fifty consecutive patients (age, 54.3 ± 11.4 years, 38 male) with coronary slow flow and 25 consecutive patients (age, 50.5 ± 9.9 years, 16 male) with normal coronary arteries both documented by coronary angiography were included. Arterial stiffness parameters were measured noninvasively using a Mobil-O-Graph arteriography system. The choroidal thickness was assessed using the enhanced depth imaging optical coherence tomography method. The patients with coronary slow flow had significantly higher peripheral systolic blood pressure, peripheral pulse pressure, central pulse pressure, and pulse wave velocity (PWV) and significantly thinner choroidal thickness compared to the controls. Thrombolysis in myocardial infarction frame count was positively correlated with PWV (r: 0.237, p = 0.041) and negatively correlated with choroidal thickness (r: -0.249, p = 0.031). There was also a negative correlation between PWV and mean choroidal thickness (r: -0.565, p < 0.001). Linear regression analysis showed that coronary slow flow was an independent predictor of both PWV and choroidal thickness when adjusted by age and sex. The acceleration of average peripheral arterial PWV with a thinning of choroidal thickness in patients with coronary slow flow may support the idea that this phenomenon may be a coronary presentation of a systemic microvascular disorder.

Effect of Fixed-dose Combination Amlodipine/Valsartan in Comparison to Two Drug Combination Nebivolol/Valsartan on 24-Hour Ambulatory Blood Pressure.

Nebivolol has a dual mechanism of action, exerting a moderate b- blockade effect and reducing peripheral arterial resistance, as a result, the antihypertensive effect of nebivolol may be higher than that of a potent vasodilator CCB such as amlodipine. The study evaluated the effect of two nebivolol/valsartan on 24 hour ambulatory blood pressure versus amlodipine/valsartan in grade II or III hypertension patients or having uncontrolled BP despite treatment. Ambulatory blood pressure monitoring is a powerful method to monitor the changes in blood pressure over the 24 hour. A total of 74 from 90 patients continued the study. Fourty patients received amlodipine 10 mg/valsartan 160 mg (group I), and thirty-four patients received nebivolol 5 mg/ valsartan 160 mg (group II). Peripheral blood pressure readings were measured at randomization at 6 and 12 weeks. Ambulatory blood pressure was measured at randomization and 12 weeks. Both drug combinations showed high efficacy in reducing peripheral and 24 hour ambulatory BP. There was no statistically significant difference between the groups in lowering peripheral systolic and diastolic blood pressure at 6 and 12 weeks. Furthermore, both groups failed to show any significant difference in reducing 24 hour SBP and DBP. Regarding day SBP, the blood pressure dropped by -5.63 ± 14.87 in group I and -6.25 ± 11.59 in group II (p = 0.844). Also, group I reduced the day DBP average by -2.53 ± 9.83 and group II by -3.61 ± 9.78 (p = 0.640). In addition, both drug combinations had no statistically significant difference in lowering night SBP and DBP average. Both treatment groups reached the target ambulatory blood pressure, and there was no statistically significant difference between both groups as a regard reduction in all ambulatory blood pressure readings.

Assessment of Cardiovascular Risk and Arterial Stiffness in Patients With Human Immunodeficiency Virus.

Several studies suggest that patients infected with the human immunodeficiency virus (HIV) under highly active antiretroviral therapy (HAART) have a higher cardiovascular risk than the general population. Arterial stiffness is an independent predictor of cardiovascular events and can be measured through carotid-femoral pulse wave velocity (PWV). The objectives of this study were to characterize a sample of HIV-infected patients under HAART regarding cardiovascular risk, compare PWV values of this group with those of uninfected controls,and investigate predictors of PWV in the HIV-infected group. PWV was measured, and data was collected from a sample of 125 HIV-infected patients under HAART. PWV measurements in the study group were compared with those in a control group of 250 subjects similar in sex, age, prevalence of hypertension, and type 2 diabetes mellitus (DM). A linear regression model was constructed to identify predictors of PWV in the HIV-infected group. In the HIV-infected group, composed mostly of men, the mean age and respective standard deviation were 48.6 ± 11.6 years. In this group, 112 individuals (89.6%) presented moderate to very high cardiovascular risk. Significant differences were found in median PWV between HIV-infected and control groups (8.56 vs. 8.00 m/s,p= .002). Age, peripheral systolic blood pressure, presence of DM, amount of alcohol consumed, and current CD4+T cell count were independent predictors of PWV in the HIV-infected group. Conclusions: The HIV-infected group showed higher cardiovascular risk and arterial stiffness measurements than the general population. PWV may be an important predictor of subclinical cardiovascular disease in HIV-infected patients.

Clinical significance of early troponin I levels on the prognosis of patients with severe heat stroke

To investigate the clinical significance of early troponin I (TnI) level in the prognosis of severe heat stroke. Clinical data of 131 patients with severe heat stroke in the intensive care unit (ICU) of the Affiliated Changzhou NO.2 People's Hospital of Nanjing Medical University (study dataset) and ICU 67 patients with severe heat stroke in Jintan First People's Hospital of Changzhou (validation dataset) were retrospectively analyzed from June 2013 to September 2022. The patients were divided into survival group and death group according to 30-day outcomes. TnI was collected within 24 hours after admission to the emergency department. Cox regression analysis was performed to analyze the risk factors of severe heat stroke death. Spearman correlation test was used to analyze the correlation between TnI and heart rate, and peripheral systolic blood pressure. The receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive value of TnI for death in patients with severe heat stroke. Decision curve analysis (DCA) was conducted to assess the clinical net benefit rate of TnI prediction. Grouping by TnI cut-off value, Kaplan-Meier survival curve was used to analyze 30-day cumulative survival. Sensitivity analysis included modified Possion regression, E-value, and subgroup forest map was used to evaluate the mortality risk of TnI in different populations. External dataset was used to verify the predictive value of TnI. The death group had significantly higher TnI compared to the survival group [μg/L: 0.623 (0.196, 1.510) vs. 0.084 (0.019, 0.285), P < 0.01]. Multivariate Cox regression analysis after adjusting for confounding factors showed that TnI was an independent risk factor for death [hazard ratio (HR) = 1.885, 95% confidence interval (95%CI) was 1.528-2.325,P < 0.001]. Spearman correlation test showed that TnI was positively correlated with heart rate (r = 0.537, P < 0.001) and negatively correlated with peripheral systolic blood pressure (r = -0.611, P < 0.001). ROC curve showed that the area under the curve (AUC) of the TnI (0.817) was better than that of the acute physiology and chronic health evaluation II (APACHE II, 0.756). The DCA curve showed that the range of clinical net benefit rate of TnI (6.21%-20.00%) was higher than that of APACHE II score (5.14%-20.00%). Kaplan-Meier survival curve showed that patients in the low-risk group (TnI ≤ 0.106) had a significantly higher 30-day survival rate than that in the high-risk group (TnI > 0.106) group (Log-Rank test: χ2 = 17.350, P < 0.001). Modified Possion regression with adjustment for confounding factors showed that TnI was still an independent risk factor for death in patients with severe heat stroke [relative risk (RR) = 1.425, 95%CI was 1.284-1.583, P < 0.001]. The E-value was 2.215. The subgroup forest plot showed that the risk factors of TnI were obvious in male patients and patients ≤ 60 years old (male: HR = 1.731, 95%CI was 1.402-2.138, P < 0.001; ≤ 60 years old: HR = 1.651, 95%CI was 1.362-2.012, P < 0.001). In the validation dataset, ROC curve analysis showed that the AUC (0.836) of TnI predicting the prognosis of severe heat stroke was still higher than the APACHE II score (0.763). Early elevation of TnI is a high-risk factor for death in patients with severe heat stroke, and it has a good predictive value for death.

#3813 EFFECT OF ORAL FLAVONOIDS ON ARTERIAL STIFFNESS IN CKD: A PILOT PROSPECTIVE STUDY

Abstract Background and Aims Flavonoids, the main category of polyphenols possess antioxidative and antihypertensive properties mediated through endothelial protection, renin-angiotensin-aldosterone and sympathetic system suppression. The aim of the study was to evaluate the effect of oral flavonoids administration in arterial stiffness indices and of oxidative stress markers in patients with Chronic Kidney Disease (CKD). Method The enrolled patients received chocolate bars rich in polyphenols (200 mg) daily for a period of 3 months The patients underwent clinical examination and laboratory test arterial stiffness measurements with Sphygmocor. Markers of oxidative stress (total phenols, total plasma antioxidant capacity, protein carbonyls) were also measured Results Sixteen patients were enrolled in the study, [median age 62.5 years (± 8,2), 14 patients (87,5%) were male]. Clinical characteristics, blood pressure measurements, arterial stiffness indices and markers of oxidative stress are summarized in table 1,2 and 3. Peripheral systolic Blood Pressure (PSBP) was decreased by 13,56 mmHg (± 2,57), (p&amp;lt; 0,001). Pulse wave velocity (PWV) and central pulse pressure (CPP) were significantly decreased (8,2 m/sec (5,1-9,22), vs 8,85 m/sec (6,7-11,75), (p&amp;lt;0,001) and 47,63 (36,5-60) versus [59,13 mmHg (43,5-69 respectively) at the end of the study], (p=0,003). Markers of oxidative stress were also improved. A decreased in plasma proteinic carbonyls 52,54 nmol/ml ± 25,04 versus (73,50 nmol/ml ± 18,65, (p&amp;lt;0,001) was observed while antioxidative capacity was increased 3,55% (1,15-6,38) versus 12,51% (6,26-17,66) (p= 0,013). Importantly no side effects were observed during the study period. Conclusion In this pilot study, oral flavonoid supplementation in the dose of 200 mg may improve arterial stiffness indices and systolic blood pressure measurements and contribute to the improvement of antioxidative capacity in CKD patients.

#6157 PREDICTORS OF 24 PULSE WAVE VELIOCITY IN HYPERTENSIVE CHRONIC KIDNEY DISEASE PATIENTS: A CASE CONTROL STUDY

Abstract Background and Aims Pulse wave velocity (PWV) is a significant predictor of chronic kidney disease (CKD) progression and death in people with impaired kidney function. It is known that patients with type 2 diabetes mellitus have higher values of PWV. Our study assessed the difference in arterial stiffness parameters (value of peripheral and central blood pressure parameters and PWV) according diabetic status and to evaluate predictors of PWV in hypertensive CKD patients. Method This case control, cross-sectional study included 252 hypertensive CKD patients 143 (56.7%) men and 109 (43.3%) women, aged 67 years (IQR = 15). For each participant data about sex, age, height, presence of CKD, AH and other comorbidities were collected. Laboratory parameters (urea, creatinine, estimated glomerular filtration rate (eGFR), glycated hemoglobin (HbA1c)) were obtained from peripheral blood and 24-hour urine samples were collected to analyze albuminuria. Each participant underwent 24-hour ambulatory blood pressure measurement using the IEM Mobil-O-Graph based on the oscillometry. Tanita MC780 Multi Frequency segmental body composition analyzer was used to measure body weight and level of visceral fat. Body mass index (BMI) was calculated. Results Out of 252 participants with AH and CKD, 107 (42.5%) also had DM. Participants with DM were older (p&amp;lt;0001), had higher pulse pressure (p&amp;lt;0.001) and PWV (p&amp;lt;0.001) while the levels of peripheral and central diastolic pressure (p&amp;lt;0.001) were lower. Regarding body composition parameters, DM participants had higher BMI (p = 0.001) and visceral fat level (p&amp;lt;0.001). Positive predictors of PWV adjusted for age, sex, presence of DM and eGFR were HbA1c (β = 0.216, p = 0.007), albuminuria (β = 0.000, p = 0.002), central and peripheral systolic and diastolic blood pressure (β = 0.035, p&amp;lt;0.001; β = 0.035, p&amp;lt;0.001; β = 0.033, p&amp;lt;0.001; β = 0.035, p&amp;lt;0.001), pulse pressure (β = 0.047, p&amp;lt;0.001) and mean arterial pressure (β = 0.042, p&amp;lt;0.001). Body composition parameters were not found to be significant predictors of PWV. Conclusion We found significant differences in 24-hour blood pressure parameters and body composition in relation to the presence of DM. One possible explanation for the lower peripheral and central diastolic blood pressure in diabetic participants is the older age of these participants. Accordingly, PWV as a parameter of arterial stiffness, which is higher in DM participants, could also be due to the age difference. As for the predictors of PWV, the expected predictors were parameters of blood pressure. HbA1c and albuminuria were also associated with PWV as parameter of arterial stiffness in CKD participants with AH.

CARDIOVASCULAR AND ALL-CAUSE MORTALITY ARE NOT CLOSER ASSOCIATED WITH CENTRAL THAN PERIPHERAL BLOOD PRESSURE IN AN ELDERLY CHINESE POPULATION: THE NORTHERN SHANGHAI STUDY

Objective: Controversy exists in the comparison between central and peripheral blood pressure (BP) in prediction of cardiovascular and all-cause mortality. To examine whether central BP predicts cardiovascular and all-cause mortality better than brachial BP in a large cohort of elderly Chinese. Design and method: A total of 3050 participants enrolled in the Northern Shanghai Study, a prospective cohort study focusing on the cardiovascular risk of community-dwelling elderly Chinese living in the north of Shanghai, China between 2014 and 2019, were included. Central BP was estimated tonometrically from the redial pulse waveform. Vital status of all participants was confirmed by reviewing the regional morality record system in October 2020. Cox proportional hazards models were conducted to evaluated the predictive value of central and peripheral systolic BP (SBP) and pulse pressure (PP). Results: During the median follow-up of 5.6 years, 203 deaths, 77 of which were cardiovascular, occurred. When central and peripheral SBP were analyzed separately, both central and peripheral SBP predicted all-causes mortality (Peripheral: HR 1.040, 95% CI 1.002 to 1.080; Central: HR 1.038, 95%CI 1.000 to 1.078; Per 5 mm Hg), but not cardiovascular mortality, after adjusting age, sex, BMI, current smoking, lipid, cerebrocardiovascular disease, diabetes, antihypertensive treatment, statin treatment, hypoglycemic treatment and estimated glomerular filtration rate. When central and peripheral SBP were included in the same stepwise regression of all-cause mortality, only peripheral SBP were stayed in the final model (HR 1.037, 95%CI 1.000 to 1.074, per 5 mm Hg), after adjustment for covariates. Neither central nor peripheral PP predicted mortality after adjusted covariates. Conclusions: Central BP was not superior than peripheral BP in predicting cardiovascular and all-cause mortality in the elderly Chinese.

EFFECT OF ORAL FLAVONOIDS ON ARTERIAL STIFFNESS IN CKD – A PILOT PROSPECTIVE STUDY

Objective: Flavonoids, the main category of polyphenols possess antioxidative and antihypertensive properties mediated through endothelial protection, renin-angiotensin-aldosterone and sympathetic system suppression. The aim of the study was to evaluate the effect of oral flavonoids administration in arterial stiffness indices and of oxidative stress markers in patients with Chronic Kidney Disease (CKD). Design and method: The enrolled patients received chocolate bars rich in polyphenols (200 mg) daily for a period of 3 months The patients underwent clinical examination and laboratory test arterial stiffness measurements with Sphygmocor. Markers of oxidative stress (total phenolic contents, total plasma antioxidant capacity, protein carbonyls) were also measured. Results: Sixteen patients were enrolled in the study, [median age 62.5 years (± 8,2), 14 patients (87,5%) were male]. Clinical characteristics, blood pressure measurements, arterial stiffness indices and markers of oxidative stress are summarized in table 1,2 and 3. Peripheral systolic Blood Pressure (PSBP) was decreased by 13,56 mmHg (± 2,57), (p&lt;0,001). Pulse wave velocity (PWV) and central pulse pressure (CPP) were significantly decreased (8,2 m/sec (5,1-9,22), vs 8,85 m/sec (6,7-11,75), (p&lt;0,001) and 47,63 (36,5-60) versus [59,13 mmHg (43,5-69 respectively) at the end of the study], (p = 0,003). Markers of oxidative stress were also improved. A decreased in plasma proteinic carbonyls 52,54 nmol/ml ± 25,04 versus (73,50 nmol/ml ± 18,65, (p&lt;0,001) was observed while antioxidative capacity was increased 3,55% (1,15-6,38) versus 12,51% (6,26-17,66) (p = 0,013). Importantly no side effects were observed during the study period. Conclusions: In this pilot study, oral flavonoid supplementation in the dose of 200 mg may improve arterial stiffness indices and systolic blood pressure measurements and contribute to the improvement of antioxidative capacity in CKD patients.

SUBCLINICAL TARGET ORGAN DAMAGE IN PATIENTS WITH TYPE 1 DIABETES MELLITUS. A PROSPECTIVE PRELIMINARY STUDY

Objective: Early atherosclerosis is the main cause of cardiovascular damage and death in patients with type 1 Diabetes Mellitus (T1DM). Some vascular indexes can help to identify and stratify patients before clinical events. This study aims to evaluate the trend over time of some markers of subclinical vascular damage to identify possible associations with anthropometric parameters, blood pressure (BP) and metabolic variables. Design and method: Fifty-six patients with T1DM (mean age: 17.5±2.5 years; mean duration of diabetes: 8.9±4.0 years) were assessed in two occasions (mean follow-up time: 2.7±0.9 years). Peripheral systolic and diastolic BP (pSBP, pDBP), central systolic and diastolic BP (cSBP, cDBP) and Pulse Wave Velocity (PWV) were measured by the SphygmoCorXCEL. Carotid Intima-Media Thickness (cIMT) and the carotid Distensibility Coefficient (cCD) were assessed by ultrasound connected with an image acquisition and analysis system (CardiovascularSuite). Biochemical and anthropometric data were also recorded. Results: At follow-up, PWV and BP values increased significantly while cDC further decreased with the 80.4% of patients that presented a pathological cDC (lower than 40x10 -3 KPa or the 5th percentile). BP values at baseline correlated with all vascular indexes at follow-up: in particular, cSBP was associated with cDC (r = -0.46, p&lt; 0.001), cIMT (r = 0.39, p = 0.004) and PWV (r = 0.32, p = 0.01). These associations remained significant even after adjustment for metabolic (including glycated hemoglobin) and anthropometric parameters. Moreover, baseline arterial stiffness significantly correlated with BP values at follow-up: particularly cDC and PWV were associated with cDBP (r = -0.354, p = 0.009 and r = 0.40, p = 0.002; respectively) even after multiple adjustments. Regarding metabolic parameters, non-HDL-to-HDL-cholesterol ratio correlated with both cDC (r = -0.36, p = 0.007) and PWV (r = 0.30, p = 0.03). Conclusions: The most important finding of this study is the strict and independent association between BP parameters, especially cSBP at baseline, and indexes of vascular damage at follow-up, even after multiple adjustments. Indeed, cDC at baseline is also associated with increased cDBP at follow-up. Our data support the hypothesis of a vicious cycle between BP and arterial stiffness, which may worsen both parameters over time.

SEX DIFFERENCES IN PULSE WAVE AND SUBENDOCARDIAL VIABILITY RATIO IN HYPERTENSIVE PATIENTS

Objective: Myocardial ischemia represents the main cause of morbidity and mortality in hypertensive patients in both women and men, although some difference in pathophysiology and in the exposure to risk factors may explain the lower global cardiovascular risk of women. Sex differences in the structure and function of the cardiovascular system may affect the aortic pressure wave and the functional balance in myocardial perfusion determined by central aortic pressure, which may lead to myocardial ischemia and type 2 myocardial infarction. Design and method: In a population of 318 treated hypertensive patients (162 females, 156 males) referring to a single Hypertension centre (University of Trieste, Italy), we measured peripheral blood pressure and performed arterial applanation tonometry (PulsePen, DiaTecne, Italy) to determine central blood pressure waveform, aortic pulse wave velocity (PWV), augmentation index (AIx), pulse wave separation analysis with timing and amplitude of forward (fT, fP) and backward reflected (bT, bP) waves, and the subendocardial viability ratio (SEVR), i.e. the ratio between diastolic and systolic pressure-time index, as a risk marker of myocardial ischemia. Results: Despite similar peripheral systolic and diastolic blood pressure values, heart rate and PWV between sexes, females showed a longer forward pressure wave duration (119.8±38.6 vs 105.0±30.4 ms, p&lt;0.0001) and lower amplitude (52.7±19,4 vs 57.1±19.3 mmHg, p = 0.039) compared to males. Backward pressure waved were similar in timing and amplitude between males and females. The difference in forward wave caused a marked higher AIx (19.5±12.4 vs 11.9±14.9, p&lt;0.0001) and a lower SEVR (101.6±24.4 vs 108.5±27.7, p = 0.018) in women compared to men. Conclusions: Hypertensive women and men showed significant differences in forward pressure wave, causing a significant increase in AIx and a decreased SEVR in women compared to men. This may have important implications in sex-specific risk and myocardial ischemia.

Assessment of Hydration, Nutritional Status and Arterial Stiffness in Hypertensive Chronic Kidney Disease Patients

The aim of this cross-sectional study was to determine the body fluid volume in patients diagnosed with both chronic kidney disease (CKD) and arterial hypertension (AH), and to investigate the relationship between fluid overload (FO), nutritional status and arterial stiffness in this specific patient population. A total of 169 participants with CKD and AH were enrolled in the study, and data on general parameters, comorbidities, medication use, and laboratory parameters were collected. Body composition was assessed with a Tanita MC 780 device, and data on the central and peripheral systolic and diastolic blood pressure, as well as pulse wave velocity (PWV) and the augmentation index (AIx) were collected with an IEM Mobil-O-Graph 24 h ambulatory blood pressure monitor, which was based on oscillometry. The Mediterranean Diet Serving Score (MDSS) questionnaire was used to determine the adherence to the Mediterranean diet (MeDi). Our results showed that the significant positive predictors of hydration status were the use of diuretics and oral hypoglycemic agents, whereas the negative predictors were female sex, higher body mass index level and use of two or more antihypertensives in the form of a single-pill combination. We also found differences in blood pressure and arterial stiffness parameters in relation to volume status, along with differences based on the presence of diabetes mellitus (DM). In conclusion, these results call for a higher awareness of volume status in the care of CKD patients with AH, especially in those with diabetes mellitus.

Effects of High-Intensity Interval Training on Central Blood Pressure: A Systematic Review and Meta-Analysis.

Central blood pressure (cBP) is considered an independent predictor of organ damage, cardiovascular events and all-cause mortality. Evidence has shown that high intensity interval training (HIIT) is superior to moderate-intensity continuous training (MICT) for improving cardiorespiratory fitness and vascular function. However, the effects of these aerobic training modalities on cBP have not yet been properly reviewed.This meta-analysis aims to investigate to effects of HIIT versus MICT on cBP.We conducted a meta-analysis of randomized controlled trials that compared HIIT versus MICT on cBP. Primary outcomes were measures of central systolic blood pressure (cSBP) and central diastolic blood pressure (cDBP). Peripheral systolic blood pressure (pSBP) and diastolic blood pressure (pDBP), pulse wave velocity (PWV) and maximal oxygen uptake (VO2max) were analyzed as second outcomes. Meta-analysis of mean differences (MD) was conducted using the random effects model.Our study included 163 patients enrolled in six trials. We found that HIIT was superior to MICT in reducing the cSBP (MD = -3.12 mmHg, 95% CI: -4.75 to -1.50, p = 0.0002) and SBP (MD = -2.67 mmHg, 95% CI: -5.18 to -0.16, p = 0.04), and increasing VO2max(MD = 2.49 mL/kg/min, 95% CI: 1.25 to 3.73, p = 0.001). However, no significant differences were reported for cDBP, DBP and PWV.HIIT was superior to MICT in reducing the cSBP, which suggests its potential role as a non-pharmacological therapy for high blood pressure.

A correlation study of arterial stiffness, cardiac autonomic neuropathy and lipid profile in type 2 diabetes mellitus patients

Objectives: Micro and macrovasculopathy are common complications of undertreated or undiagnosed type 2 diabetes mellitus (T2DM) patients. One of the underlying factors of macrovasculopathy is arterial stiffness, which may lead to cardiovascular and cerebrovascular diseases. Understandably, diabetic micro and macrovasculopathy affect vital functions, which may affect the well-being of the individual. However, few studies have attempted to determine arterial stiffness, cardiac autonomic neuropathy (CAN) and lipid profile separately in South Asian population and examined its associations with T2DM. Moreover, there is a need to understand the mechanistic links among cardiovascular risk factors. This forms the basis of the present study. Materials and Methods: T2DM patients of 53–62 years and age- and gender-matched healthy control subjects were recruited in the cross-sectional and observational study (n = 30 each, eight women). Anthropometric measurements, physiological parameters such as resting heart rate, peripheral blood pressure (PBP), central blood pressure (CBP), augmentation index% (AIx%), brachial-ankle pulse wave velocity and lead II ECG for analysis of heart rate variability parameters were recorded after obtaining the consent of the study participants. The lipid profile and fasting blood glucose were also analysed. Results: Peripheral systolic blood pressure was significantly higher (P = 0.05) in T2DM patients. Dyslipidaemia was evident in T2DM patients. Atherogenic index of plasma (AIP) was also significantly higher in T2DM patients. Correlation analysis revealed a positive association between AIx% with PBP and CBP as well as between AIP index and central systolic blood pressure, serum triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and very low-density lipoprotein cholesterol (VLDL-C) levels. AIP index was found to be negatively associated with HF (nu). Serum TG, high-density lipoprotein cholesterol (HDL-C) levels and AIP index have emerged as significant independent predictors of T2DM vasculopathy by multiple regression analysis. Conclusion: In the present study, atherogenic dyslipidaemia was observed in T2DM patients in combination with increased serum levels of TG, VLDL-C and decreased serum levels of HDL-C. Moreover, AIP index, a predictor cardiovascular risk, was found to be significantly higher in T2DM patients. Dyslipidaemia was found to be associated with dysregulation of autonomic nervous system in those patients. A positive association between noninvasive, surrogate markers of arterial stiffness with PBP and CBP indicates that enhanced arterial stiffness may elevate systemic arterial pressure. Therefore, early screening of T2DM patients for the estimation of serum lipid profile, arterial stiffness and cardiac autonomic neuropathy may be performed to unravel diabetic vasculopathy.

Prospective analysis of the major risk factors and vascular status in students during the period of education at a medical university

Aim. To study the changes of the major risk factors (RFs) and vascular status in students over six years of their education at a medical university.Material and methods. A total of 667 students aged 17,8±1,2 years were examined in the 1st year and 6th year (162 men, 505 women). Students who entered in the same year were combined into one cohort, while in total 5 cohorts were recruited. The screening examination was carried out as part of the annual intra-university events "Freshman Week", "Graduate Week" by staff of the University Health Center and included the collection of complaints and history, height, body weight, the measurement of peripheral and central blood pressure, as well as the assessment vascular stiffness and metabolic status. Statistical analysis of the material was carried out using SPSS Statistics 23.0.Results. Analysis of RFs in medical students over 6 years showed a significant increase of the prevalence of hypertension/prehypertension, resting tachycardia, obesity/overweight, malnutrition and physical inactivity. An assessment of cen­tral and peripheral hemodynamics, as well as vascular stiffness of students, revealed an increase in the level of aortic systolic pressure, combined with an increase in peripheral systolic blood pressure and pulse. At the same time, there was no significant increase in some parameters of vascular stiffness, against the background of a 2-fold increase in the prevalence of overweight. Analysis of the metabolic status reveals a significant change in total cholesterol and triglycerides but no alterations in capillary blood glucose.Conclusion. The data obtained indicate an increase in the prevalence of not only behavioral, but also biological RFs among medical students, as well as the development of preclinical vascular remodeling in them during a six-year education, which can later lead to early cardiovascular diseases. Therefore, widespread screening system of risk factors among students should be developed.

Comparison of an exergame and a moderate-intensity endurance training intervention on physiological parameters

Background&#x0D; Exergames are interactive video games that stimulate an active, whole-body gaming experience (Best, 2013). By combining electronic entertainment with physical exercise, exergames offer novel opportunities to expand physical activity in different age groups and settings. Even though studies have found a significant increase in energy expenditure when playing exergames compared to normal video games, most games only induce low to moderate-intensity activity which is too low to result in relevant physical adjustments (Biddiss &amp; Irwin, 2010). This study assessed the effects of an 8-week exergame-training (EXT) in an innovative exergame called the ExerCube and compared it with a typical moderate-intensity endurance training (ET) intervention.&#x0D; Methods&#x0D; In total, 19 individuals (10 female; age 26.9 ±8.7 years; body mass index (BMI) 23.6 ±3.1 kg/m2) participated and were block randomized into an EXT group (n = 9) and an ET group (n = 10). Throughout the 8-week intervention period, the EXT group attended 20-30-minutes of EXT three times a week while the ET group completed 15-45-minutes of ET (jogging/cycling at 65-75% of maximal heart rate) three times a week. Before and after the intervention BMI, systolic and diastolic blood pressure, and VO2max (spiroergometry; start: 50 or 75 W; increment: 25 W/min) were assessed and compared (paired-samples t-test, ANOVA).&#x0D; Results&#x0D; Significant time × group interaction effects were found for VO2max (F(1,17) = 11.345; p = .004, ηp2 = .400). The EXT group revealed significant within-group effects in VO2max from pre (43.2 ±10.6 ml/kg*min) to post (46.9 ±10.9 ml/kg*min; p = .004, d = 1.308) while the ET group revealed no significant changes (pre: 39.4 ±5.4 ml/kg*min; post: 39.7 ±4.9 ml/kg*min; p = .466, d = .241). No significant time × group interaction effects were detected in systolic blood pressure (F(1,17) = .050; p = .825, ηp2 = .003) or diastolic blood pressure (F(1,17) = .005; p = .943, ηp2 = .000). However, there was a significant decrease in the peripheral systolic blood pressure from pre (122 ±10 mmHg) to post (117 ±12 mmHg; p = .034, d = .792) in the ET group but not in the EXT group (pre: 118 ±8; post: 114 ±7; p = .156, d = .523). Concerning BMI, no significant interaction effects (F(1,17) = 2.818; p = .111, ηp2 = .142) were detected.&#x0D; Conclusions&#x0D; The EXT seems to be more effective as conventional ET exercise approach to improve endurance performance. This is promising as exergame may develop intrinsic motivation/enjoyment for physical activity. Further studies confirming these findings and extending to psychological variables are needed.&#x0D; References&#x0D; Best, J. R. (2013). Exergaming in youth: Effects on physical and cognitive health. Zeitschrift für Psychologie, 221(2), 72-78. https://doi.org/10.1027/2151-2604/a000137&#x0D; Biddiss, E., &amp; Irwin, J. (2010). Active video games to promote physical activity in children and youth: A systematic review. Archives of Pediatrics &amp; Adolescent Medicine, 164(7), 664-672. https://doi.org/10.1001/archpediatrics.2010.104

Функциональное состояние педагогов северного университета при переходе к дистанционному формату работы

The purpose of this paper was to perform a comprehensive study of the functional state of male and female teachers of a northern university during the quarantine due to the coronavirus pandemic, when they had to switch from on-campus to distance teaching. Materials and Methods. The study involved 56 teachers (36 men and 20 women) from Surgut State Pedagogical University, who were examined before and after the switch to distance teaching. The functional state of the central nervous system (CNS) was evaluated according to the data of simple visual-motor reaction. The state of autonomic regulation was characterized based on the dynamics of heart rate variability at rest and during active orthostatic test. Peripheral systolic and diastolic blood pressure and central systolic aortic pressure were measured. The psychophysiological state was analysed using the Maslach Burnout Inventory and Eysenck’s “Self-assessment of anxiety, frustration, aggressiveness and rigidity”. The quality of life was evaluated using the Short Form (36) Health Survey. Results. During on-campus teaching, female university teachers showed more pronounced impairments of autonomic regulation and functional state of the CNS compared to their male colleagues. In addition, women experienced professional burnout more often, while an increase in central and peripheral blood pressure was less common among them. After the transition from on-campus to distance teaching during the COVID-19 quarantine, functional disorders of autonomic hear rate regulation and haemodynamics were more pronounced in men than in women. Women under the same conditions had greater impairments of the functional state of the CNS, while demonstrating improvements in the psychophysiological state. Thus, the research found that changes in the form of teaching produce different effects on the functional state of male and female university teachers.