Stiffness In Hypertension Research Articles

ARTERIAL STIFFNESS ASSOCIATES WITH MALNUTRITION IN HYPERTENSIVE PATIENTS WITH CONCOMITANT CHRONIC PANCREATITIS

Objective: The association between pancreatitis and cardiovascular diseases remains incompletely understood. Malnutrition in chronic pancreatitis may be associated with an increase in arterial stiffness in hypertension. Objective: to evaluate interaction between malnutrition markers and arterial stiffness in patients with hypertension and chronic pancreatitis. Design and method: Methods: 70 non-diabetic patients with 1st degree hypertension with concomitant chronic pancreatitis (median age – 52,4 [43,8;63,7] years) were included in the study. We divided all included patients into two groups: 1st group – 41 patients with malnutrition, 2nd group – 29 patients without malnutrition. Standard laboratory blood tests, haematological parameters, lipid profile, glucose, renal and liver function tests, pancreatic fecal elastase-1, total protein, serum albumin, serum iron, vitamin 25(OH)D, serum zinc and magnesium detection were performed for all patients. The groups were comparable in terms of age, gender structure, functional state of the kidneys. Non-parametric methods were used for statistical data analysis. To determine the prognostic significance, the ROC analysis was performed. Significant differences were considered when the p-value was p<0.001 Results: In patients with a combined course of hypertension and chronic pancreatitis with established malnutrition, an increase in arterial stiffness was significantly more often compared to patients with normal nutritional status - 83% and 62%, respectively (p<0.001). A significantly lower level of brachial artery augmentation index was established by 43% (p<0.001) in the first group. It was established that patients with malnutrition had a significantly higher caritid-femoral pulse wave velocity by 17.5% (p<0.001). Correlations were established between brachial artery augmentation index and serum levels of zinc (R=0.63, p<0.001), magnesium (R=0.66, p<0.001), albumin (R=0.58, p<0.001), vitamin 25(OH)D (R=0.68, p<0.001) in patients with the combined course of hypertension and chronic pancreatitis. ROC analysis revealed that serum zinc level had an excellent diagnostic power for arterial stiffness in hypertensive patients with chronic pancreatitis (AUC = 0.910). Serum albumin had very good diagnostic power for arterial stiffness in hypertensive patients with chronic pancreatitis (AUC = 0.859). Conclusions: Arterial stiffness may be associated with malnutrition in hypertensive patients with concomitant chronic pancreatitis.

Identification and Characterization of Potential Anti-Hypertensive Therapeutic Candidates in Rho-related BTB Domain Containing 1 (RhoBTB1)-Cullin 3 (CUL3) Axis

Blood pressure (BP) is regulated by a variety of cellular mechanisms. We previously reported the regulation of endothelial nitric oxide (NO)-dependent vessel tone and BP through RhoBTB1-CUL3 mediated proteasomal turnover of Phosphodiesterase 5 (PDE5). We determined that the C-terminal half of RhoBTB1 consisting of two BTB-domains (B1 & B2) and the C-terminal (C) domain of RhoBTB1 can deliver PDE5 to proteasomal pathway. The cellular expression of RhoBTB1 and CUL3 is ubiquitous whereas expression of PDE5 is cell specific. Moreover, vessel tone is regulated through NO-independent mechanisms. Therefore, we hypothesized that RhoBTB1 may have other interacting partners, potentially functioning as regulators of vessel tone and BP in vascular smooth muscle (VSM) cells, through a similar mode of binding as PDE5. Therefore, we utilized ascorbate peroxidase (APEX2) proximity labelling system comprising APEX2 tagged B1B2C domain (B1B2C-APEX2) to identify unknown potential regulators of vasomotor tone in RhoBTB1-CUL3 axis in A7R5 VSM cells. The background of the proteomic screen was minimized by utilizing APEX2-B1B2 which lacks the final C-terminal region of the protein and cannot bind PDE5. We validated the interaction of several identified proteins with RhoBTB1 and the B1B2C domains using co-immunoprecipitation (Co-IP). Our Co-IP data corroborated the proteomic screen as several proteins demonstrated differential interaction with B1B2C and B1B2. Among them, we examined RbFox2, a regulator of mRNA splicing for further investigation. Further data established that RbFox2 is upregulated under the following conditions: 1) pharmacological inhibition of the proteasomal pathway, 2) in CRISPR edited CUL3KO HEK293 cells, 3) in aorta of VSM cell-specific CUL3 deleted mice, 4) by siRNA mediated knock-down of RhoBTB1 in SMCs, and 5) in Ang-II treated SMCs and aorta of Ang-II treated animals. We hypothesized that RbFox2 could modulate actin and actinin-dependent cytoskeletal dynamics, an important regulator of arterial stiffness. First, Co-IP data suggest an interaction between RbFox2 and SMC-specific alpha actinin. Next, siRNA-mediated knock down of RbFox2 altered the actin and actinin-dependent cytoskeletal dynamics in SMCs. Collectively, this establishes the potential regulation of RbFox2 through the RhoBTB1-CUL3 proteasomal pathway and that RbFox2 may play a mechanistic role in arterial stiffness in hypertension. Funding: NIH R35 HL144807 (to Dr. Curt D. Sigmund). 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.

Associations of brachial-ankle pulse wave velocity with left atrial stiffness and left atrial phasic function in inpatients with hypertension.

Hypertension induces left atrial (LA) and left ventricular (LV) dysfunction, and an increase in arterial stiffness. This study aimed to investigate the associations of brachial-ankle pulse wave velocity (baPWV) with LA stiffness and LA phasic function in hypertension. A total of 305 hypertensive inpatients enrolled and were divided into two groups based on baPWV [Group I, baPWV ≤ 1515 (cm/s), n = 153; Group II, baPWV > 1515 (cm/s), n = 152]. Two-dimensional speckle tracking echocardiography (2D-STE) based LA phasic strains (LAS-S, LAS-E, LAS-A) and LV global longitudinal strain (LVGLS) were evaluated. LA stiffness index (LASI) was defined as the ratio of E/e' to LAS-S. Multivariate linear regression modeling was used to analyze the associations of baPWV with LASI and LA phasic function in all patients as well as age-specific and sex-specific subgroups. LASI was significantly higher in Group II [0.35(0.26, 0.52)] compared with Group I [0.26(0.20, 0.36)] (P < 0.001). After adjusting cardiovascular risk factors, medication, and LV structural and functional parameters (LVEF, LVMI, E/A ratio, and LVGLS), baPWV remained significantly correlated with LASI (P < 0.05). We also evaluated the predictive value of baPWV for LASI, the area under the curve (AUC) was 0.663 (95% CI: 0.607-0.716, P < 0.001). In conclusion, BaPWV was independently associated with LA stiffness in hypertensive inpatients. BaPWV also exhibited a certain predictive value for LA stiffness in these inpatients. Measuring arterial stiffness can provide clinicians clues for early cardiac target organ damage (TOD) in addition to vascular TOD.

Volumetric Ultrasound Analysis of the Abdominal Aorta Enhances Strain Assessment in Hypertensive Mice

Aortic stiffness (AS) is a well-described and underutilized predictor of cardiovascular morbidity and mortality, particularly in hypertension (HTN). Employing noninvasive ultrasound technology to quantify AS metrics could have therapeutic application, but regional variation has compromised integration. We hypothesize that integrating 4-dimensional (4D) ultrasound with volumetric analysis will enhance the AS analysis in hypertensive mice as a foundation for clinical translation. Systolic blood pressure (SBP) was captured by Coda tail-cuff in normotensive C57Bl/6 mice (n = 3) on day 0. Under inhaled anesthetic, the Vevo3100 high-resolution micro-ultrasound was utilized to capture images of the infrarenal aorta which included (1) axial plane at three segments (proximal, middle, and distal); (2) longitudinal plane; and (3) 4D images of volumetric changes across the cardiac cycle. VevoVasc software enabled quantification of distensibility, pulse propagation velocity, global radial strain, and volumetric strain (VS). HTN was then induced by osmotic pump angiotensin-II infusion (1.46 mg/kg/day). SBP and ultrasound measurements were reassessed at 21 days. The t test was utilized to compare strain metrics at day 0 vs 21 with significance at P < .05. With AngII infusion, SBP increased 32 ± 2% (P < .05). Values for distensibility significantly decreased from proximal to distal aortic regions at day 0, and demonstrated a 50 ± 5% reduction with HTN at day 21 (P < .05). As another indicator of aortic stiffness in HTN, pulse propagation velocity increased >2.8-fold. Global radial strain, on the other hand, provided discordant results along the axial aortic regions at day 0 as well as day 21, and no change could be detected in the longitudinal plane. With 4D ultrasound to capture volume and normalize by pulse pressure to create the VS analysis, however, we detected a significant reduction in VS (0.74 ± 0.3 μL/mm Hg to 0.36 ± 0.1 μL/mm Hg; P < .05) to effectively quantify infrarenal aortic strain as an indicator of increased AS. Methodology to ensure sensitive, specific, and reproducible quantification of AS is vital to establishing clinical utilization. Ultrasound-derived VS analysis decreased regional variability and further investigation is warranted to define this technique in the medical management of HTN and other regional aortic pathology.

S-03-2: ASSOCIATIONS OF BRACHIAL-ANKLE PULSE WAVE VELOCITY WITH LEFT ATRIAL STIFFNESS AND LEFT ATRIAL PHASIC FUNCTION IN HYPERTENSION

Aims: Hypertension induces left atrial (LA) and left ventricular (LV) dysfunction, and arterial stiffness increased. This study aimed to investigate the associations of brachial-ankle pulse wave velocity (baPWV) with LA stiffness and LA phasic function in hypertension. Methods: A total of 309 hypertensive patients enrolled and were divided into two groups based on baPWV [Group I, baPWV&lt; 1517 (cm/s), n = 151; Group II, baPWV&gt; 1517 (cm/s), n = 158]. Two dimensional speckle tracking echocardiography (2D-STE) based LA phasic strains (LAS-S, LAS-E, LAS-A) and LV global longitudinal strain (LVGLS) were evaluated. LA stiffness index (LASI) was defined as the ratio of E/e’ to LAS-S. Multivariate linear regression modeling was used to analyze the associations of baPWV with LASI and LA phasic function in all patients as well as age-specific and sex-specific subgroups. Age, sex, and BMI were adjusted (Model 1), systolic blood pressure, Diabetes, HbA1c, LDL-C and eGFR were added (Model 2), then ACEIs/ARBs/ARNI treatment was added (Model 3), and last LVMI, LVEF, E/A ratio and LVGLS were added (Model 4). Results: LAS-S and LAS-E were significantly lower in Group II compared with Group I (P &lt; 0.05 for both). LASI was significantly higher in Group II [0.36(0.25, 0.53)] compared with Group I [0.26(0.20, 0.36)] (P &lt; 0.001). In multiple linear regression analysis, baPWV was associated with LASI, LAS-S, and LAS-E in Mode l, Model 2 and Model 3. However, after adjusting cardiovascular risk factors, medication, and LV structural and functional parameters (LVEF, LVMI, E/A ratio and LVGLS), baPWV only remained significantly correlated with LASI in Model 4 (P = 0.002) for all patients and in both subgroups (Table). We also evaluated the predictive value of baPWV for LASI, the area under the curve (AUC) was 0.666 (95% CI: 0.605–0.726, P &lt; 0.001). Furthermore, baPWV also had predictive values for LASI in age-specific and sex-specific subgroups, however, there were no significant differences between both sexes, or between younger (&lt;50 years old) and older patients (&gt;50 years old) (DeLong test: P &gt; 0.05 for both). Conclusion: BaPWV was independently associated with LA stiffness, for all patients as well as in age-specific and sex-specific subgroups. BaPWV also had the predictive value for LA stiffness in hypertension. BaPWV maybe a convenient and useful screening tool for early detection of cardiac functional remodeling and interactions between cardiovascular abnormalities in hypertension.

Carotid Artery Stiffness Mechanisms in Hypertension and Their Association with Echolucency and Texture Features: The Multi-ethnic Study of Atherosclerosis (MESA).

Arterial stiffness, echolucency and texture features are altered with hypertension and associated with increased cardiovascular disease risk. The relationship between these markers and structural and load-dependent artery wall changes in hypertension are poorly understood. The Multi-ethnic Study of Atherosclerosis (MESA) is a longitudinal study of 6814 adults from six communities across the United States designed to study subclinical cardiovascular disease. From B-mode imaging of the right common carotid artery at the baseline MESA examination, we calculated carotid artery Young's elastic modulus (YEM, n=5894) and carotid artery gray-scale texture features (n=1403). The standard YEM calculation represented total arterial stiffness. Structural stiffness was calculated by adjusting YEM to a standard blood pressure of 120/80 mm Hg with participant-specific models. Load-dependent stiffness was the difference between total and structural stiffness. We found that load-dependent YEM was elevated in hypertensive individuals compared with normotensive individuals (35.7 ± 105.5 vs. -62.0 ± 112.4 kPa, p < 0.001) but that structural YEM was similar (425.3 ± 274.8 vs. 428.4 ± 293.0 kPa, p=0.60). Gray-scale measures of heterogeneity in carotid artery wall texture (gray-level difference statistic contrast) had small but statistically signification correlations with carotid artery stiffness mechanisms. This association was positive for structural YEM (0.107, p < 0.001), while for load-dependent YEM, the association was negative (-0.064, p=0.02). In conclusion, increased arterial stiffness in hypertension was owing solely to the non-linear mechanics of having higher blood pressure, not structural changes in the artery wall, and high load-dependent stiffness was associated with a more homogenous carotid artery wall texture. This is potentially related to arterial remodeling associated with subclinical atherosclerosis and future cardiovascular disease development. These results also indicate that gray-scale texture features from ultrasound imaging had a small but statistically significant association with load-dependent arterial stiffness and that gray-scale texture features may be partially load dependent.

THE IMPACT AND INTERACTION OF METABOLIC ELEMENTS ON LEFT ATRIAL STIFFNESS IN HYPERTENSION

Objective: To evaluate left atrial (LA) stiffness using two-dimensional speckle-tracking echocardiography (2DSTE) and investigate the impact and interaction of metabolic elements on LA stiffness index (LASI). Design and method: 340 subjects were enrolled and divided into three groups: Group I (n = 38), healthy controls; Group II (n = 138), hypertension without metabolic syndrome (MS); Group III (n = 164), hypertension with MS. All subjects were performed LA phasic strains using 2DSTE, and the following parameters were measured: LA reservoir strain and strain rate (LAS-S, LASR-S), LA conduit strain and strain rate (LAS-E and LASR-E), LA booster strain and strain rate (LAS-A and LASR-A). The LASI was defined as the ratio of early diastolic transmitral flow velocity/lateral mitral annulus myocardial velocity (E/e’) to LAS-S. Binary logistic regression models were performed, and the odds ratios (OR) at 95% confidence interval (CIs) were used to approximate the associated risk of the elements of MS (obesity, diabetes and dyslipidaemia) for LA stiffness, with the lowest binary serving as the reference category. Results: LASI was significantly higher in Group II (0.34 ± 0.21) than Group I (0.19 ± 0.04) (p &lt; 0.001), and further increased in Group III (0.39 ± 0.22) (p &lt; 0.001). LA reservoir and conduit functions gradually and significantly decreased from Group I to Group III (p &lt; 0.001). However, there were no significant differences in LA booster pump function among three groups (p&gt; 0.05). Regarding the elements of MS, body mass index (BMI), hemoglobin A1c (HbA1c) and triglyceride (TG) were positively associated with LASI. Furthermore, we performed the interaction analyses between two of the three elements of MS (BMI, HbA1c and TG). We simultaneously stratified both elements into equal-sized binaries of their individual distribution and then showed that compared with the lowest risk reference group, risk for LA stiffness significantly increased in other groups (Figure). Conclusions: LA phasic function was impaired and LA stiffness was increased in hypertensive patients with MS. Elements of MS (BMI, HbA1c and TG levels) had independent and interaction effect on LA stiffness in hypertension.

Opisthenar microvessel area as a sensitive predictive index of arterial stiffness in hypertensive patients

We aimed to analyze whether opisthenar microvessel area (OMA, measured with Optical Coherence Tomography (OCT) angiography) was associated with blood pressure (BP), arterial stiffness and whether OMA can predict arterial stiffness in hypertensive (HTN) patients. Results from 90 participants showed that BP, brachial-ankle pulse wave velocity (baPWV) and ankle brachial index (ABI) were significantly higher but OMA (in control, with cold- and warm-stimulation, NT, CST, HST and the differences, CSD, HSD) were significantly reduced in HTN group (n = 36) compared to non-HTN (n = 54). NT, CST, HST and HSD showed negative correlations with baPWV and ABI in all participants, female (n = 47) and male group (n = 43), but the correlation was absent when the participants were divided into HTN and non-HTN. Logistic Regression analysis showed that only baPWV was a significant risk factor for HSD (OR 19.7, 95%CI 4.959–78.733, p < 0.0001) but not the age, BMI, smoking, drinking or exercise status (p > 0.05). Receiver Operating Characteristics analysis for HSD was 0.781, 0.804, 0.770, respectively. HSD < 9439.5 μm2 predicted high BP and arterial stiffness (95% CI in all participants: baPWV, 0.681–0.881, SBP, 0.709–0.900, DBP, 0.672–0.867, p < 0.001). These results suggest that OMA is a sensitive index to predict arterial stiffness in HTN population.

Pulse pressure and cognitive impairment

Elevated pulse pressure (PP) is the one of simplest and most accessible markers of vascular damage and increased arterial stiffness in hypertension (HTN). To date, an extensive body of evidence has been accumulated in terms of the PP effect on central nervous system (CNS), leading to neuronal damage and death, which contribute to the development and progression of cognitive impairment (CI). Elevated PP violate the blood-brain barrier, can intensify the production of reactive oxygen species in the CNS, lead to endothelial dysfunction, microbleeds and directly stimulate the amyloid beta creation, which is a substrate of Alzheimer’s disease. Due to the important role of increased PP in CI, an important aspect of antihypertensives’ effects is their impact on PP and the ability to reduce it. Among antihypertensives, a single-pill combination of amlodipine/indapamide sustained release deserves special attention, since it has a body of evidence for reducing PP and thereby improving cognitive functioning in patients with HTN, which in turn will improve their quality of life.

High serum uric acid is associated with increased arterial stiffness in hypertension.

Serum uric acid level has been found to be associated with cerebrovascular diseases. However, whether serum uric acid level is a risk factor for arterial stiffness in the hypertension population is unclear. This study was designed to determine the relationship between serum uric acid level and arterial stiffness in the hypertension population. A total of 10450 participants were evaluated for the risk of arterial stiffness. Brachial-ankle pulse wave velocity (baPWV) was assessed, and high baPWV was determined as the highest quartile of baPWV values in a sex-specific manner. We evaluated the association between serum uric acid level and baPWV through multivariate-adjusted linear and logistic regression analyses. There was a significant difference on high baPWV between patients with quartiles of serum uric acid level in females and males (p<0.01), respectively. The odds ratios (95% CI) of the highest baPWV quartile across the sex-specific serum uric acid level were 1.0, 1.71 (1.35, 2.17), 1.75 (1.38, 2.23), and 1.95 (1.51, 2.51) in female, and 1.0, 1.33 (1.09, 1.64), 1.36 (1.11, 1.67), and 1.67 (1.36, 2.04) in male after adjusting for potential confounders. In conclusion, serum uric acid level could be considered as an important risk factor for arterial stiffness in Chinese hypertension population.

Arterial Stiffness in Hypertension and Function of Large Arteries.

Arterial stiffness-typically assessed from non-invasive measurement of pulse wave velocity along a straight portion of the vascular tree between the right common carotid and femoral arteries-is a reliable predictor of cardiovascular risk in patients with essential hypertension. We reviewed how carotid-femoral pulse wave velocity increases with age and is significantly higher in hypertension (than in age- and gender-matched individuals without hypertension), particularly when hypertension is associated with diabetes mellitus. From the elastic aorta to the muscular peripheral arteries of young healthy individuals, there is a gradual but significant increase in stiffness, with a specific gradient. This moderates the transmission of pulsatile pressure towards the periphery, thus protecting the microcirculatory network. The heterogeneity of stiffness between the elastic and muscular arteries causes the gradient to disappear or be inversed with aging, particularly in long-standing hypertension. In hypertension therefore, pulsatile pressure transmission to the microcirculation is augmented, increasing the potential risk of damage to the brain, the heart, and the kidney. Furthermore, elevated pulse pressure exacerbates end-stage renal disease, particularly in older hypertensive individuals. With increasing age, the elastin content of vessel walls declines throughout the arterial network, and arterial stiffening increases further due to the presence of rigid wall material such as collagen, but also fibronectin, proteoglycans, and vascular calcification. Certain genes, mainly related to angiotensin and/or aldosterone, affect this aging process and contribute to the extent of arterial stiffness, which can independently affect both forward and reflected pressure waves.

Emerging Roles of Lysyl Oxidases in the Cardiovascular System: New Concepts and Therapeutic Challenges.

Lysyl oxidases (LOX and LOX-likes (LOXLs) isoenzymes) belong to a family of copper-dependent enzymes classically involved in the covalent cross-linking of collagen and elastin, a pivotal process that ensures extracellular matrix (ECM) stability and provides the tensile and elastic characteristics of connective tissues. Besides this structural role, in the last years, novel biological properties have been attributed to these enzymes, which can critically influence cardiovascular function. LOX and LOXLs control cell proliferation, migration, adhesion, differentiation, oxidative stress, and transcriptional regulation and, thereby, their dysregulation has been linked to a myriad of cardiovascular pathologies. Lysyl oxidase could modulate virtually all stages of the atherosclerotic process, from endothelial dysfunction and plaque progression to calcification and rupture of advanced and complicated plaques, and contributes to vascular stiffness in hypertension. The alteration of LOX/LOXLs expression underlies the development of other vascular pathologies characterized by a destructive remodeling of the ECM, such as aneurysm and artery dissections, and contributes to the adverse myocardial remodeling and dysfunction in hypertension, myocardial infarction, and obesity. This review examines the most recent advances in the study of LOX and LOXLs biology and their pathophysiological role in cardiovascular diseases with special emphasis on their potential as therapeutic targets.

Relationship between blood lipid and arterial stiffness in hypertension

To explore the relationship between blood lipids and pulse wave velocity (PWV). We retrospectively selected subjects who had undergone treatment in an outpatient or inpatient clinic. The subjects were sub-grouped into four groups: Group A (no history of hypertension and dyslipidemia), Group B (a history of dyslipidemia but not hypertension), Group C (a history of hypertension but not dyslipidemia) and Group D (a history of both hypertension and dyslipidemia). We determined brachial-ankle pulse wave velocity (baPWV), atherogenic index of plasma (AIP), non-high-density lipoprotein (non-HDL-C), total cholesterol/high density lipoprotein (TC/HDL-C) and atherogenic indices (AI) for hypertension and non-hypertension and dyslipidemia and non-dyslipidemia patients. A total of 380 subjects were included. Uric acid, systolic pressure, diastolic pressure, pulse pressure and mean arterial pressure were significantly different among the groups. The prevalence of coronary arterial disease and diabetes mellitus, age, body mass index, heart rate, blood glucose, creatinine, urea, smoking history and alcohol consumption did not differ among groups. The baPWV was significantly different between both hypertension/nonhypertension and dyslipidemia/non-dyslipidemia patients. In hypertension patients (in Group C and D), partial correlation analysis showed that ΔbaPWV correlated with TC, HDL-C, AI, AIP and TC/HDL-C but not LDL-C, triglyceride (TG) or non-HDL-C. Hypertension and/or dyslipidemia may be risk factors for arterial stiffness. In hypertension patients, TC, HDL-C, AIP, AI and TC/HDL-C might correlate to arterial stiffness and pathological increases in these levels may indicate risk factors for arterial stiffness.

Xanthine Oxidase Inhibition as a Potential Treatment for Aortic Stiffness in Hypertension.

Xanthine Oxidase Inhibition as a Potential Treatment for Aortic Stiffness in Hypertension.

Impact of Concomitant Use of Beta blocker, Statin, Aspirin, and Metformin on Central Hemodynamics and Arterial Stiffness in Hypertension

Objective: To assess the impact of concomitant use of aspirin, BB (metoprolol), statin (atorvastatin), and metformin on central haemodynamics and arterial stiffness parameters in treated hypertensive patients. Materials and Methods: We did a cross-sectional study on 476 treated hypertensives. Oscillometric PWA was accomplished by Mobil-o-Graph (IEM, Germany) and groups were stratified using low-dose aspirin, statin, BB, or metformin. Parameters studied were brachial hemodynamics (BP, heart rate, and rate pressure product), arterial stiffness (augmentation pressure, augmentation index, pulse wave velocity, total arterial stiffness, and pulse pressure amplification), and central hemodynamics (central BP, cardiac output, and stroke work). Results: All pairs were matched by or comparable for major confounding factors except concomitant use of drugs. The use of BB, aspirin, and statin had favorable effect on brachial and central hemodynamics. Metformin use had effect more on central than brachial hemodynamics. BB and metformin had negative, statin had indifferent, and aspirin had positive effect on arterial stiffness. Only few of these differences had statistical significance. Frequency of central pulse pressure ≥40 was insignificantly affected by drugs studied. Conclusions: Concomitant aspirin, BB, and metformin in hypertensives have favorable effects on hemodynamics, brachial more than central. Arterial stiffness has positive impact of metformin and negative impact of BB use. These effects must be considered in studies focusing hypertensive therapies. It remains inconclusive whether these results are due to drugs or their indication.

Association between handgrip strength and vascular function in patients with hypertension

ABSTRACTBackground: Increased handgrip strength has been associated with lower cardiovascular and non-cardiovascular mortality in different populations. In patients with hypertension, arterial stiffness relates to cardiovascular mortality. However, whether muscle strength is associated with arterial stiffness in hypertensives is unknown. Thus, the objective of this study was to analyze the association between handgrip strength and arterial stiffness parameters in hypertensive patients.Methods: Seventy-two hypertensive patients completed all evaluations and were included in the analysis. The ambulatory arterial stiffness index (AASI) was obtained based on 24-h ambulatory blood pressure monitoring. Carotid-femoral pulse wave velocity (cfPWV), and reflected wave indicator (AIx and AIx@75) were estimated using applanation tonometry technique, whereas handgrip strength test was performed using a digital dynamometer. Crude and adjusted linear regression models were performed.Results: The crude analysis revealed a negative association between handgrip strength and AASI (b = −0.41, p = 0.002) and AIx (b = −0.49, p < 0.001), and AIx@75 (b = −0.54, p < 0.001) which remained significant after adjustments for age, sex, and body mass index, mean blood pressure, and heart rate only for AASI (b = −0.46, p = 0.028) and AIx@75 (b = −0.24, p- = 0.040). Handgrip strength was not associated with cfPWV (p > 0.05).Conclusion: Handgrip strength is negatively associated with AASI and AIx@75, but not with AIx and cfPWV in hypertensive patients.

A12457 The Characteristic of central blood pressure and arterial stiffness in hypertensive female with different menopause period

Objectives: The aim of this study is to make sure the characteristic of central blood pressure and arterial stiffness in female hypertension with different menopause period. Methods: One hundred and eighteen subjects of essential hypertension were selected from Lanzhou University Second Hospital during November 2014 to November 2015. All female patients divided into two groups by the duration of menopause,one was short-term group (duration of menopause ≤5 Years).And at same time,the male patients whose age similar to female were selected as the short duration controls group.Another female hypertensive patients was long-term menopausegroup (duration of menopause 5 > years),equally,the male patients of similar age were also selected as the long-term control subjects.Sex hormone of female,SBP,DBP,PP were measured. cSBP,cDBP,CPP,AP,AIx,AIx75HR,carotid-femoral pulse wave velocity (cf-PWV) were detected. Results: In short-term control group,SBP,DBP,HR,cSBP,cf-PWV were higher than short-term menopause group,but the parameters of PP,AP,CPP,AIx and AIx75HR were higher in short-term group.The difference of SBP,DBP,cDBP,AIx75HR between tow groups a were significant (P < 0.05)).However,in long-term menopause group,the parameter of SBP,DBP,PP,HR,cSBP,CPP,AP,AIx,AIx75HR and cf-PWV were higher than those of in long-term control group,and the differences of SBP,PP,cDBP, CPP,AP,AIx75HR were significant (P < 0.05).For the short-tern groups,the estrogen of estradial (eE2) and progesterone (PGRE) were higher than long-term groups,and the difference of eE2 is significant (P < 0.05). Conclusion: For the short-term menopause females the protective effect of estrogen were existed,this effect is not only protect the peripheral brachial blood pressure but also the central blood pressure.But the effect of estrogen on arterial stiffness were not clearly.

A16299 Interaction between Neutrophil to Lymphocyte Ratio and Arterial Stiffness in Hypertensive Patients

Objectives: Increased arterial stiffness in patients with hypertension is associated with adverse cardiovascular outcomes. Inflammation plays a role in the development of arterial stiffness. Neutrophil to lymphocyte ratio (NLR) may exhibit inflammation. We thus investigated the association of arterial stiffness with NLR and hs-CRP in hypertensive patients. Methods: We retrospectively analyzed the results of a cohort of individuals from Kailuan Company in Hebei province undergoing health examinations. A total of 6,023 hypertensive patients were recruited. We analyzed the association between NLR, hs-CRP and brachial-ankle pulse wave velocity (baPWV) using linear regression. Results: We found that the level of NLR, hs-CRP and baPWV were significantly increased among hypertensive patients. Adjusted NLR, PLR and hs-CRP are gradually increased across the quartiles of NLR. A significantly increased baPWV was found in the highest quartile of NLR (P < 0.001). The multivariate linear regression analysis demonstrated NLR and hs-CRP were significant related with increased baPWV in hypertension. In male hypertensive patients, NLR and hs-CRP were statistically significant related with baPWV (P < 0.01, respectively). In older hypertensive patients, NLR had showed a significant association with baPWV (P < 0.01). NLR and hs-CRP were showed strong association with baPWV in untreated hypertensive patients (P < 0.01). Conclusion: Increased NLR and hs-CRP are associated with an increased baPWV in hypertensive patients. As an easy and inexpensive laboratory measure, NLR may provide important information regarding arterial stiffness in hypertension.

A0128 The relationship between abnormal metabolic conditions and arterial stiffness in hypertensives

Objectives: We investigated the relationship between abnormal metabolic conditions and arterial stiffness in hypertensives. Methods: A total of 680 subjects (age 58.44 ± 11.67 years, male 63.53%, hypertension 65.00%) enrolled in the studies was divided into five groups based on the number of known components of metabolic syndrome according to the criteria of 2010 Chinses Guidelines for Prevention and Management of Hypertension (0MS: n = 86; 1MS: n = 153;. 2MS: n = 201;.3MS: n = 148;. 4/5MS: n = 92.). Body weight, height, waist circumference, hip circumference, blood pressure and biochemical markers were measured. Carotid-femoral pulse wave velocity (cfPWV) was measured using a non-invasive automatic device. Results: The level of cfPWV was significantly increased with the increase of the number of abnormal metabolic components even after adjustments for age, gender (8.20 ± 1.54 vs 8.72 ± 1.48 vs 9.34 ± 1.77 vs 9.64 ± 1.86 vs 9.91 ± 2.19 m/s, P < 0.05). Subjects with hypertension (n = 442) had higher cfPWV than in subjects without hypertension (n = 238) after adjustments for age, gender and blood pressure.(9.59 ± 1.90 vs 8.49 ± 1.50 m/s, P < 0.05). Stepwise multiple regression analysis revealed that age, gender, blood pressure, heart rate as well as the serum uric acid level of the subjects were influent factors for cfPWV (P < 0.05). In the subgroups based on age, the prevalence of hypertension could make the influence of systolic blood pressure on arterial stiffness happen in advance (nonhypertensive in 60 years old, hypertensive in 50 years old). Conclusion: The arterial stiffness increased with the increasing of the abnormal metabolic component numbers, which is independent of age, gender and blood pressure. And the prevalence of hypertension could make the influence of systolic blood pressure on arterial stiffness happen in advance.

A12464 The Relationship between Blood Lipid and Arterial Stiffness in Hypertension

A12464 The Relationship between Blood Lipid and Arterial Stiffness in Hypertension