Pulse Wave Velocity In Adults Research Articles

Abstract 61: Differential Associations of Cardiovascular Health Factors With Vascular Health in Adults Free of Cardiovascular Disease

Background: There is limited understanding of the association of the AHA's Life's Essential 8 (LE8), reflecting cardiovascular health (CVH) behaviors and factors, with vascular stiffness and hemodynamics in adults without cardiovascular diseases (CVD). Methods: In 2330 Framingham Heart Study Offspring participants (Exam 7, 1998-2002) with applanation tonometry and LE8 data (diet, physical activity, smoking, sleep health, BMI, lipids, glucose, blood pressure), we calculated CVH scores per AHA guidelines. In multivariable linear regression analyses adjusting for CV risk factors, we analyzed LE8 as a predictor of vascular health, assessed by carotid femoral pulse wave velocity (PWV) and central pulse pressure (CPP). We examined for effect modification by age (dichotomized at median) and sex in the associations between LE8 and arterial stiffness. We set p=0.05 and p=0.10 as thresholds for significance in primary and secondary analyses, respectively. Mediation analysis was utilized to discern the indirect effects of PWV and CPP on the relationship between LE8 and both all-cause and CVD mortality. Results: In our sample (60±9 years; 57% women; LE8 = 69±12), higher LE8 indicating better CVH, was associated with lower PWV and CPP (Table). Age and sex interactions were noted for PWV (p=0.01 and 0.07, respectively). Higher LE8 was associated with lower PWV in adults ≥59 years and women but not in <59 years or men (Table). With low CVH category as referent, intermediate CVH category had no significant association with PWV and high CVH category had lower PWV. CPP was lower in the intermediate and high CVH categories compared to low CVH category (Table). PWV mediated 19% and CPP 10% of the association between LE8 and CVD mortality and 17% and 15%, respectively, for all-cause mortality. Conclusion: In our community cohort, we observed age and sex differences in the relationship between CVH and vascular health. Mediation analyses revealed indirect effects on mortality, warranting further study. Table

Sex differences in sympathetic activity and pulse wave velocity in adults with chronic kidney disease.

Chronic kidney disease (CKD) is characterized by sympathetic nervous system (SNS) overactivity that contributes to increased vascular stiffness and cardiovascular risk. Although it is well established that SNS activity and vascular stiffness are substantially elevated in CKD, whether sex differences in autonomic and vascular function exist in CKD remains unknown. We tested the hypothesis that compared with females, males with CKD have higher baseline sympathetic activity that is related to increased arterial stiffness. One hundred twenty-nine participants (96 males and 33 females) with CKD stages III and IV were recruited and enrolled. During two separate study visits, vascular stiffness was assessed by measuring carotid-to-femoral pulse wave velocity (cfPWV), and resting muscle sympathetic nerve activity (MSNA) was measured by microneurography. Males with CKD had higher resting MSNA compared with females with CKD (68 ± 16 vs. 55 ± 14 bursts/100 heart beats, P = 0.005), whereas there was no difference in cfPWV between the groups (P = 0.248). Resting MSNA was not associated with cfPWV in both males and females. In conclusion, males with CKD have higher resting sympathetic activity compared with females with CKD. However, there was no difference in vascular stiffness between the sexes. There was no correlation between resting MSNA and cfPWV, suggesting that non-neural mechanisms may play a greater role in the progression of vascular stiffness in CKD, particularly in females.NEW & NOTEWORTHY Males with chronic kidney disease (CKD) have higher resting muscle sympathetic nerve activity (MSNA) compared with females. There was no correlation between MSNA and carotid-to-femoral pulse wave velocity (cfPWV), suggesting that non-neural mechanisms may play a greater role in the progression of vascular stiffness in CKD. Sex differences in SNS activity may play a mechanistic role in observations from epidemiological studies suggesting greater cardiovascular risk in males compared with females with CKD.

Effect of aerobic exercise training on pulse wave velocity in adults with and without long-term conditions: a systematic review and meta-analysis

RationaleThere is conflicting evidence whether aerobic exercise training (AET) reduces pulse wave velocity (PWV) in adults with and without long-term conditions (LTCs).ObjectiveTo explore whether PWV improves with AET in adults...

Cardioprotective medication lowers central blood pressure and pulse wave velocity in adults with congenital heart disease

Cardioprotective medication lowers central blood pressure and pulse wave velocity in adults with congenital heart disease

A Systematic Review of Reviews on The Impact of Exercise Training on Pulse Wave Velocity in Adults.

Elevated pulse wave velocity (PWV) determined arterial stiffness is a prominent marker of cardiovascular disease (CVD) risk. Exercise training delays the progression of CVD, but existing reviews on the impact of training on PWV are conflicting. We synthesized the evidence on the effects of exercise training interventions on PWV. We searched Scopus, EMBASE, PubMed, CINAHL, and Academic Search Premier databases for systematic reviews including PWV, and examined the effects of exercise training on PWV. 842 citations were screened which resulted in 44 systematic reviews, including 22 meta-analyses [unique participants n=6719 (3390 females)]. Studies were conducted in general adults with/without disease(s) (n=19, 8 meta-analyses), kidney disease (n=9, 6 meta-analyses), increased CVD risk or CVD (n=7, 5 meta-analyses), type 2 diabetes mellitus (n=3, 2 meta-analyses), and other conditions (n=6, 2 meta-analyses). In general adults, PWV was reduced by aerobic exercise (β:-0.75 to -0.52 m/s) and low-to-moderate intensity resistance exercise training (β:-0.34 m/s). Exercise training was beneficial for patients with kidney disease (β:-1.13 to -0.56 m/s). Aerobic exercise improved PWV in adults with CVD or high CVD risk (β:-0.70 to -0.42 m/s). Combined aerobic and resistance exercise training decreased carotid-femoral PWV in patients with CVD (β:-1.15 m/s) and decreased brachial-ankle PWV in post-menopausal females (β:-1.18 m/s). Neither aerobic nor combined training improved PWV in individuals with type 2 diabetes. The potential physiological mechanisms involved are discussed. Overall, the included systematic reviews and meta-analyses documented that exercise training was an effective strategy to improve PWV, but the optimal type of training varied between populations.

Association of Vitamin K Status with Arterial Calcification and Stiffness in Chronic Kidney Disease: The Chronic Renal Insufficiency Cohort

BackgroundArterial calcification and stiffness are common in people with chronic kidney disease (CKD). Higher vitamin K status has been associated with less arterial calcification and stiffness in CKD in cross-sectional studies. ObjectivesTo determine the association of vitamin K status with coronary artery calcium (CAC) and arterial stiffness [pulse wave velocity (PWV)] at baseline and over 2–4 follow-up years in adults with mild-to-moderate CKD. MethodsParticipants (n = 2722) were drawn from the well-characterized Chronic Renal Insufficiency Cohort. Two vitamin K status biomarkers, plasma phylloquinone and plasma dephospho-uncarboxylated matrix gla protein [(dp)ucMGP], were measured at baseline. CAC and PWV were measured at baseline and over 2–4 y of follow-up. Differences across vitamin K status categories in CAC prevalence, incidence, and progression (defined as ≥100 Agatston units/y increase) and PWV at baseline and over follow-up were evaluated using multivariable-adjusted generalized linear models. ResultsCAC prevalence, incidence, and progression did not differ across plasma phylloquinone categories. Moreover, CAC prevalence and incidence did not differ according to plasma (dp)ucMGP concentration. Compared with participants with the highest (dp)ucMGP (≥450 pmol/L), those in the middle category (300–449 pmol/L) had a 49% lower rate of CAC progression (incidence rate ratio: 0.51; 95% CI: 0.33, 0.78). However, CAC progression did not differ between those with the lowest (<300 pmol/L) and those with the highest plasma (dp)ucMGP concentration (incidence rate ratio: 0.82; 95% CI: 0.56, 1.19). Neither vitamin K status biomarker was associated with PWV at baseline or longitudinally. ConclusionsVitamin K status was not consistently associated with CAC or PWV in adults with mild-to-moderate CKD.

Differential Roles of Life-Course Cumulative Burden of Cardiovascular Risk Factors in Arterial Stiffness and Thickness.

Data are limited regarding differential and common effects of cardiovascular risk factors on subclinical changes in vascular structure and function. We aimed to examine the relationships of life-course cumulative burdens of cardiovascular risk factors with adult arterial pulse wave velocity (PWV) and carotid intima-media thickness (CIMT) in a longitudinal cohort of the Bogalusa Heart Study. The cohort consisted of 900 subjects who had aortic-femoral PWV and CIMT measurements. These participants were examined 5-16 times for body mass index (BMI), blood pressure, atherogenic index of plasma (AIP), and low-density lipoprotein cholesterol (LDLC) from childhood to adulthood. The area under the curve (AUC) was calculated as a measure of long-term burden of the risk factors. Adjusting for covariates, adult PWV was associated with AUCs of BMI, systolic blood pressure (SBP) and AIP (standardized regression coefficient [β]= 0.191, 0.321, 0.153, respectively; P < 0.001 for all). Adult CIMT was associated with AUCs of BMI, SBP, AIP and LDLC (β= 0.115, 0.202, 0.141, 0.152, respectively; P < 0.001 for all). Moreover, childhood BMI was associated with adult PWV and CIMT (β= 0.088 and 0.075, respectively; false discovery rate q values < 0.05 for both), and childhood LDLC with adult CIMT (β= 0.079; false discovery rate q value < 0.05). These associations did not differ significantly among race and sex groups. The life-course cumulative burden of BMI, SBP, and AIP has common effects on arterial wall stiffening and thickening, whereas LDLC is specifically associated with arterial wall thickness, and this effect starts in early life.

What type of physical exercise should be recommended for improving arterial stiffness on adult population? A network meta-analysis.

Physical exercise has been associated with a reduction in arterial stiffness, a subclinical process underlying cardiovascular disease. However, the effect of different types of exercise (aerobic, resistance, combined, interval training, stretching, or mind-body modalities) on arterial stiffness is unclear. This network meta-analysis aimed to examine the effectiveness of different types of exercise on arterial stiffness as measured by pulse wave velocity in adults. We searched Cochrane Central Register of Controlled Trials, CINAHL, MEDLINE (via Pubmed), Embase, and Web of Science databases, for randomized clinical trials including at least a comparison group, from their inception to 30 June 2020. A frequentist network meta-analysis was performed to compare the effect of different types of physical exercise on arterial stiffness as measured by pulse wave velocity. Finally, 35 studies, with a total of 1125 participants for exercise intervention and 633 participants for the control group, were included. In the pairwise meta-analyses, the exercises that improved arterial stiffness were: interval training [effect size (ES) 0.37; 95% confidence interval (CI) 0.01-0.73], aerobic exercise (ES 0.30; 95% CI 0.13-0.48) and combined exercise (ES 0.22; 95% CI 0.04-0.40). Furthermore, the network meta-analysis showed that mind-body interventions were the most effective type of exercise to reduce the pulse wave velocity (ES 0.86; 95% CI 0.04-1.69). In addition, combined exercise (ES 0.35; 95% CI 0.08-0.62), aerobic exercise (ES 0.33; 95% CI 0.09-0.57), and interval training (ES 0.33; 95% CI 0.02-0.64) showed significant improvements. Our findings showed that aerobic exercise, combined exercise, interval training, and mind-body exercises were the most effective exercise modalities for reducing arterial stiffness, assuming an important role in the prevention of cardiovascular diseases.

The Effects of a Simulated Workday of Prolonged Sitting on Seated versus Supine Blood Pressure and Pulse Wave Velocity in Adults with Overweight/Obesity and Elevated Blood Pressure

We evaluated the effects of a simulated workday of prolonged sitting on blood pressure (BP) and pulse wave velocity (PWV) and examined whether posture (seated vs. supine) affected responses. Participants (n = 25) were adults, with overweight/obesity and elevated BP, and performed seated desk work for 7.5 h. BP and PWV were measured in seated and supine postures at baseline (7:15 a.m.), midday (12:05 p.m.), and afternoon (4:45 p.m.). Generalized linear mixed models evaluated the effects of prolonged sitting on BP and PWV within each posture and interactions by posture and sex. In the recommended postures, seated BP and supine carotid-femoral pulse wave velocity (cfPWV) and carotid-ankle pulse wave velocity (caPWV), but not carotid-radial pulse wave velocity (crPWV), significantly increased over the simulated seated workday (all p < 0.05; effect sizes [d] ranged from 0.25 to 0.44). Whilst no posture-by-time interactions were observed (p > 0.05), BP, caPWV, and crPWV were higher when seated versus supine (main effects of posture p < 0.05; d ranged from 0.30 to 1.04). Exploratory analysis revealed that females had greater seated BP responses (p for interaction <0.05); seated PWV and supine BP and PWV responses were similar by sex (p for interaction >0.05). A simulated workday of prolonged sitting increased seated BP and supine cfPWV and caPWV, and posture minimally influenced these responses. These results add to the evidence suggesting a deleterious effect of prolonged sitting on cardiovascular health.

Exercise training reduces arterial stiffness in adults with hypertension: a systematic review and meta-analysis.

Arterial stiffness, namely pulse wave velocity (PWV), is an emerging biomarker in the assessment of vascular health. This meta-analysis aims to determine the effects of exercise training on PWV in patients with hypertension, and to identify the possible moderator variables (e.g. type of exercise) of the effect of exercise on PWV. MEDLINE, EMBASE, Cochrane and Web of Science were searched up until July 2019 for randomized controlled trials assessing the effect of exercise interventions lasting 4 or more weeks on PWV in adults with hypertension. Random-effects modelling was used to compare changes from pre to postintervention in PWV between exercise and control groups. Data were reported as weighted mean difference (WMD) and 95% confidence interval (95% CI). Protocol registration: PROSPERO registration number CRD42019138658. We included 14 trials (15 interventions), involving five aerobic, two dynamic resistance, six combined and two isometric resistance groups, totalling 642 participants with hypertension. PWV was significantly reduced by exercise training [(WMD (95% CI) = -0.76 m/s (-1.05 to -0.47)]. Analysis of moderator variables showed that aerobic exercise [WMD (95% CI) = -0.70 m/s (-1.20 to -0.19)], combined exercise [WMD (95% CI) = -0.74 m/s (-1.41 to -0.08)] and isometric resistance exercise [WMD (95% CI) = -0.98 m/s (-1.24 to -0.73)] reduced PWV. There was no significant reduction in PWV in participants undertaking dynamic resistance training [WMD (95% CI) = -0.58 (-1.58 to 0.42)]. This meta-analysis supports that exercise interventions based on aerobic, combined or isometric exercise are suitable to improve PWV in adults with hypertension.

Correlation between age and pulse wave velocity in adults, salvador, bahia, brazil in a populationbased study: Design, methods and preliminary results

Cardiovascular diseases are the leading cause of death in Brazil. The pulse wave velocity (PWV) is an independent cardiovascular risk factor detecting arterial stiffness, correlated to age, among other variables

Steps per Day and Arterial Stiffness.

Arterial stiffness has emerged as an independent predictor of cardiovascular morbidity and mortality. Furthermore, objectively monitored steps per day is widely perceived to be beneficial for controlling health risk factors, and for preventing morbidity and mortality. The aim of this review was to determine the relationship between steps per day and arterial stiffness, as measured by its reference standard, pulse wave velocity (PWv). We systematically searched for cross-sectional data from studies addressing the association between steps per day and PWv. The DerSimonian and Laird method was used to compute pooled estimates of correlation and their respective 95% CI. Additionally, we used a regression model to estimate the pooled mean PWv by categories of physical activity behavior: sedentary <5000; low active 5000 to 7499; active 7500 to 9999; and highly active 10 000+. Twenty published studies were included in the systematic review, but only 10 studies in adults and older adults could be incorporated in the meta-analysis. Steps per day was inversely correlated with arterial stiffness measured by PWv in adults and older adults (r=-0.18; 95% CI: -0.27 to -0.10; P<0.001), with substantial heterogeneity ( I2=77.9%; P<0.001). The regression model showed that the pooled PWv was lower with a corresponding higher level of steps per day, influenced primarily by low PWv values for the highly active lifestyle category ( Ptrend=0.005). This systematic review and meta-analysis demonstrates a clinically meaningful association between objectively monitored steps per day and PWv, an accepted indicator of arterial stiffness and an early subclinical risk factor for cardiovascular disease. Systematic Review Registration- PROSPERO CRD42018088228.

Childhood pulse pressure predicts subclinical vascular damage in adulthood: the Beijing Blood Pressure Cohort Study.

We aimed to investigate associations of childhood pulse pressure (PP) and change in PP status with adult subclinical vascular damage. Data were obtained from a population-based cohort of children aged 6-18 years started in 1987. The study constituted 1254 participants who were followed up in 2010-2011 (aged 28-42 years). Carotid arteriosclerosis and aortic stiffness were assessed by carotid intima-media thickness (IMT) and brachial-ankle pulse wave velocity (PWV), respectively. Both childhood PP and mean arterial pressure (MAP) were independently associated with adult carotid IMT and PWV adjusted for sex, childhood age, follow-up duration, and other traditional cardiovascular risk factors. After further adjustment for adult values of PP and MAP, childhood PP was still associated with adult carotid IMT but not with PWV, whereas childhood MAP was associated with adult PWV but not with carotid IMT. In addition, compared with participants who had normal PP in both childhood and adulthood, participants who had high PP in adulthood, irrespective of their childhood PP status, had higher levels of carotid IMT and PWV (all P < 0.05). Participants who had high PP in childhood and normal PP in adulthood also had higher levels of adult carotid IMT but similar levels of PWV compared with participants who had consistently normal PP. Large PP in childhood plays an important role in the development of subclinical vascular damage in adulthood. These findings underscore the importance of early prevention of large PP to reduce future risk of cardiovascular disease.

Relationship between step counts and carotid femoral pulse wave velocity in adults treated for hypertension and diabetes

Relationship between step counts and carotid femoral pulse wave velocity in adults treated for hypertension and diabetes

The long-term effect between co-administration of simvastatin and ezetimibe and atorvastatin on central pulse wave velocity in adults with hypercholesterolemia

The long-term effect between co-administration of simvastatin and ezetimibe and atorvastatin on central pulse wave velocity in adults with hypercholesterolemia

Maternal Alcohol Intake and Offspring Pulse Wave Velocity

Background: Intrauterine exposure to alcohol may affect cardiovascular development, increasing risk of cardiovascular malformations. Intrauterine exposure to light maternal alcohol intake has been reported to affect human umbilical arterial contractility, and adult sheep exposed in utero have had altered cerebrovascular reactivity. In human adults, alcohol intake affects arterial stiffness. Objectives: We investigated whether intrauterine exposure to alcohol was associated with childhood pulse wave velocity (PWV), a measure of arterial stiffness. Methods: On postnatal day 4, mothers of 147 twin pairs born in Tasmania from 1991 to 1993 reported alcohol intake during each trimester of pregnancy. At 9 years, child PWV was assessed over carotid-femoral and femoral-dorsalis pedis arterial segments by applanation tonometry. Results: Carotid-femoral PWV was 0.2 m/s (95% CI 0.06, 0.4) higher (indicating stiffer vessels) in children whose mothers drank alcohol in the 2nd trimester rather than abstained, after adjusting for potential confounding factors. A similar effect was not seen for femoral-dorsalis pedis PWV. Findings were independent of child blood pressure which correlated strongly with PWV. Alcohol intake varied little between trimesters, so it was not possible to assess the effect of timing of exposure. Conclusions: Carotid-femoral PWV in adults is predictive of cardiovascular morbidity and mortality. The degree of continuity between childhood and adulthood PWV is unknown, but as we found an association between prenatal alcohol exposure and carotid-femoral PWV at 9 years, a permanent change in vessel wall structure or function is possible. These findings need to be confirmed in other and larger cohorts, and mechanistic animal studies are needed.

Adolescent blood pressure does not predict aortic stiffness in healthy young adults. The Atherosclerosis Risk in Young Adults (ARYA) study.

Increased arterial stiffness has been shown to be a good predictor of cardiovascular morbidity and mortality and to be associated with an adverse cardiovascular risk profile. To evaluate the relationship between adolescent blood pressure and aortic stiffness in 524 healthy young adults aged 27-30 years, as a means of investigating early determinants of arterial stiffness. General community. We studied 524 healthy young adults, aged 27-30 years, who attended secondary school in Utrecht, The Netherlands. Data on adolescent weight, height, blood pressure and stage of puberty were available from the original school health records of the Municipal Health Service. At young adulthood, a questionnaire on cardiovascular risk factors was completed and a fasting blood sample was drawn. Arterial stiffness, assessed by carotid-femoral pulse wave velocity (PWV). Adolescent blood pressure did not predict aortic PWV at young adulthood (linear regression coefficient 0.03 m/s per 10 mmHg increase in systolic blood pressure; 95% confidence interval 0.09 to 0.14). Repeated analysis in a subgroup (n = 199) for whom two adolescent blood pressure measurements were averaged showed stronger (2-19x) associations with adult PWV, although these were not significant. Adolescent blood pressure did not predict arterial stiffness in healthy young adults. Measurement error in the baseline blood readings (regression to the mean phenomenon) may partly explain the lack of association in our study. Further studies should confirm our results in order to enable better understanding of the role of adolescent blood pressure in the aetiology of vascular damage.