Opposite changes in carotid versus aortic stiffness during healthy human pregnancy

2005 ◽  
Vol 109 (1) ◽  
pp. 103-107 ◽  
Author(s):  
Beatrix MERSICH ◽  
János RIGÓ ◽  
Csilla BESENYEI ◽  
Zsuzsanna LÉNÁRD ◽  
Péter STUDINGER ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Pregnant Women ◽  
Augmentation Index ◽  
Arterial Compliance ◽  
Aortic Distensibility ◽  
Applanation Tonometry ◽  
Stiffness Index ◽  
Elastic Behaviour ◽  
Elastic Parameters ◽  
Healthy Human

Systemic arterial compliance has been known to increase during healthy pregnancy, whereas, recently, the carotid artery has been reported to stiffen. To clarify this controversy, we simultaneously measured aortic PWV (pulse wave velocity) and carotid artery elastic parameters in a cohort of pregnant women. Twelve normotensive pregnant women were studied longitudinally during the three trimesters of pregnancy (T1, T2 and T3 respectively) and 12 weeks PP (postpartum). Carotid artery diastolic diameter and pulsatile distension was measured by an echo-wall tracking method and carotid pulse pressure by applanation tonometry. Carotid strain, compliance, distensibility coefficient, stiffness index β, Einc (incremental elastic modulus) and augmentation index were calculated. Aortic PWV was determined to estimate aortic distensibility. All carotid artery elastic parameters indicated significant stiffening from T1 to T3 (1.8±0.2 versus 2.9±0.3 mmHg for Einc), which was reversed after delivery (2.3±0.2 mmHg). Aortic PWV decreased during pregnancy (6.2±0.2 versus 5.4±0.2 m/s) and increased in the PP period (6.7±0.2 m/s). No correlation was found between changes in carotid artery elastic parameters and changes in aortic PWV either from T1 to T3 or from T3 to PP. The carotid artery exhibits regionally specific stiffening during pregnancy, which appears to represent a qualitatively different change in arterial elastic behaviour.

Abstract 2994: Gender-Related Differences in the Central Arterial Pressure Waveform Begin in Childhood and are Independent of Height

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Julian G Ayer ◽  
Albert Avolio ◽  
Guy Marks ◽  
Jason A Harmer ◽  
David S Celermajer
Keyword(s):  
Arterial Pressure ◽  
Wave Reflection ◽  
Augmentation Index ◽  
Systolic Pressure ◽  
Pressure Rise ◽  
Radial Pressure ◽  
Applanation Tonometry ◽  
Stiffness Index ◽  
Reflected Wave ◽  
Age Related

Introduction Women develop age-related LV hypertrophy and symptomatic heart failure to a greater extent than men. Contributing to this may be a higher pulsatile afterload in women, with a higher central arterial systolic augmentation pressure (AP, peak pressure minus pressure at systolic shoulder) and augmentation index (AIx, ratio of AP to pulse pressure). It is unclear if these differences are due to gender per se or shorter female stature. We studied 8-year old children to determine if gender-related differences in carotid pressure augmentation are present in early life and if so, whether they are independent of height (Ht). Methods 406 children (age 8.0 ± 0.1, 49% girls) had anthropometry, brachial systolic and diastolic BP (SBP, DBP), heart rate (HR) and carotid and radial pressure waveforms (by applanation tonometry, calibrated to mean BP and DBP) assessed. Carotid ultrasound evaluated arterial elasticity [Carotid Artery Compliance (CAC), Stiffness Index (SI) and Young’s Elastic Modulus (YEM)]. Results Boys and girls had a similar Ht (129 ± 6 v 128 ± 6 cm), BMI (17.6 ± 3.1 v 17.5 ± 3.0), SBP (100 ± 7 v 101 ± 5 mmHg), DBP (59 ± 6 v 60 ± 5 mmHg) and HR (80 ± 10 v 82 ± 10 bpm). The carotid AP and AIx were significantly higher in girls (−4 ± 3 v −6 ± 4 mmHg and −12 ± 8 v −16 ± 9 respectively, p < 0.001), indicating greater systolic pressure augmentation. Time to onset of the reflected wave ( Tr ) and time to peak of the reflected wave were shorter in girls (154 ± 19 v 163 ± 18 msec, p < 0.001 and 206 ± 23 v 212 ± 22 msec, p = 0.03 respectively), indicating earlier wave reflection. Girls had a higher velocity index (Vr) estimated from Ht ( Vr = Ht /Tr , 8.4 ± 1.0 v 8.0 ± 0.9 m/sec, p = 0.001). Ejection duration, maximum rate of pressure rise and time to systolic peak (indicating effect of ventricular ejection on the carotid waveform) were not significantly different between genders. Boys, however, had stiffer carotid arteries than girls [lower CAC (5.8 ± 1.5 v 6.2 ± 1.8 %/10 mmHg, p = 0.016), higher SI (2.7 ± 0.7 v 2.5 ± 0.7, p = 0.012) and YEM (735 ± 217 v 681 ± 237, p = 0.021)]. Conclusion Even in the first decade of life, girls demonstrate greater central arterial pressure augmentation than boys, with earlier wave reflection. This is independent of height and may contribute to cardiovascular morbidity in females, later in life.

scholarly journals Acute effects of resistance exercise on arterial compliance

2005 ◽  
Vol 98 (6) ◽  
pp. 2287-2291 ◽  
Author(s):  
Allison E. DeVan ◽  
Maria M. Anton ◽  
Jill N. Cook ◽  
Daria B. Neidre ◽  
Miriam Y. Cortez-Cooper ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Resistance Training ◽  
Resistance Exercise ◽  
Systolic Blood Pressure ◽  
Arterial Compliance ◽  
Applanation Tonometry ◽  
Stiffness Index ◽  
Sham Control ◽  
Experimental Conditions ◽  
Brachial Systolic Blood Pressure

Decreased central arterial compliance is an emerging risk factor for cardiovascular disease. Resistance training is associated with reductions in the elastic properties of central arteries. Currently, it is not known whether this reduction is from one bout of resistance exercise or from an adaptation to multiple bouts of resistance training. Sixteen healthy sedentary or recreationally active adults (11 men and 5 women, age 27 ± 1 yr) were studied under parallel experimental conditions on 2 separate days. The order of experiments was randomized between resistance exercise (9 resistance exercises at 75% of 1 repetition maximum) and sham control (seated rest in the exercise room). Baseline hemodynamic values were not different between the two experimental conditions. Carotid arterial compliance (via simultaneous B-mode ultrasound and applanation tonometry) decreased and β-stiffness index increased ( P < 0.01) immediately and 30 min after resistance exercise. Immediately after resistance exercise, carotid systolic blood pressure increased ( P < 0.01), although no changes were observed in brachial systolic blood pressure at any time points. These measures returned to baseline values within 60 min after the completion of resistance exercise. No significant changes in these variables were observed during the sham control condition. These results indicate that one bout of resistance exercise acutely decreases central arterial compliance, but this effect is sustained for <60 min after the completion of resistance exercise.

The Influence of Dialytic Modality on Arterial Stiffness, Pulse Wave Reflections, and Vasomotor Function

2004 ◽  
Vol 24 (4) ◽  
pp. 365-372 ◽  
Author(s):  
Adrian Covic ◽  
David J.A. Goldsmith ◽  
Laura Florea ◽  
Paul Gusbeth–Tatomir ◽  
Maria Covic
Keyword(s):  
Arterial Stiffness ◽  
Vascular Reactivity ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Arterial Compliance ◽  
Applanation Tonometry ◽  
Normal Serum ◽  
Contour Analysis ◽  
Cross Sectional ◽  
Vasomotor Function

Background Measurements of aortic stiffness [aortic pulse wave velocity (PWV) and augmentation index (AIx)] have been established as powerful predictors of survival on hemodialysis (HD). Abnormal endothelial-dependent and endothelial-independent vascular reactivity and increased arterial stiffness are commonly described in HD patients. There is, however, a lack of information on the comparative impact of different renal replacement therapies (RRTs) on PWV and AIx, and how these different methods might influence endothelial-dependent abnormal vasodilatation. Objective To describe in a cross-sectional design arterial compliance and distensibility in continuous ambulatory peritoneal dialysis (CAPD) versus HD versus renal transplant (RTx) patients, compared with age- and blood pressure-matched essential hypertensive controls. The PWV and aortic AIx were determined from contour analysis of arterial waveforms recorded by applanation tonometry in 40 CAPD, 41 HD, 20 RTx patients (with normal serum creatinine), and 20 controls with essential hypertension (all normotensive under treatment). Endothelial-dependent and endothelial-independent vascular reactivities were assessed by changes in AIx following challenges with inhaled salbutamol and sublingual nitroglycerin respectively. Results CAPD patients had significantly stiffer arteries than all other categories. The PWV was 8.29 ± 1.09 m/second in CAPD patients, significantly higher ( p < 0.05) compared to HD subjects (7.19 ± 1.87 m/s). Both dialysis subgroups had significantly higher PWV values compared to RTx patients (6.59 ± 1.62 m/s) and essential hypertensive controls (6.34 ± 1.32 m/s), p < 0.05. The AIx had a profile similar to PWV in different RRTs. All groups with the exception of CAPD subjects had a significant decrease in AIx following salbutamol. Moreover, the vasodilatation induced by either nitroglycerin or salbutamol was significantly blunted compared to HD. Overall, both dialysis categories had more abnormal responses compared to RTx patients and essential hypertensive controls. Conclusion CAPD is associated with stiffer arteries and more profoundly abnormal endothelial-dependent vasomotor function, compared to matched HD subjects. These differences in arterial physical properties might explain differences seen in cardiac structure and function between the RRTs.

Abstract 13: Mineralocorticoid Receptor Blockade does not Result in Arterial Destiffening in Healthy Older Adults

Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Demetra D Christou ◽  
Jeung-Ki Yoo ◽  
Moon-Hyon Hwang ◽  
Meredith Luttrell ◽  
Han-Kyul Kim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Carotid Artery ◽  
Arterial Stiffness ◽  
Mineralocorticoid Receptor ◽  
Augmentation Index ◽  
Stiffness Index ◽  
Double Blind ◽  
Healthy Older Adults ◽  
Carotid Artery Compliance

Arterial stiffness, an independent predictor of cardiovascular disease, is increased in aging, but the underlying mechanisms are not completely understood. We hypothesized that mineralocorticoid receptor (MR) activation is partly responsible for increased arterial stiffness and that MR blockade would lead to arterial destiffening in healthy older adults. To test this hypothesis, we administered in a randomized, double blind, crossover study, 100 mg of Eplerenone (MR blocker) or placebo once per day for one month with one month washout, in 23 healthy older adults (age, 64±1 years; mean±SE) and assessed arterial stiffness (aortic, arm and leg pulse wave velocity (PWV; doppler flowmeter) and carotid artery compliance, distensibility, beta-stiffness index, augmentation index (high resolution ultrasonography and applanation tonometry). Despite reductions in blood pressure in response to Eplerenone (systolic blood pressure: 127±3 vs. 120±2 mmHg, P=0.01; diastolic blood pressure: 74±1 vs.72±1 mmHg, P=0.02; placebo vs. Eplerenone), arterial stiffness did not change (aortic PWV, 9.2±1.2 vs. 8.9±1.2m/sec, P=0.5; arm PWV, 11.4±0.6 vs. 11.7±0.7 m/sec, P=0.7; leg PWV, 13.4±0.4 vs.12.8±0.5 m/sec, P=0.3; carotid artery compliance, 0.17±0.02 vs. 0.16±0.02 mm 2 /mmHg, P=0.6; distensibility, 12.7±1.6 vs.13.6±1.5 10 -3 kPa -1 , P=0.6; beta stiffness index, 3.2±0.3 vs. 3.4±0.3, P=0.5; augmentation index, 24.3±2.9 vs. 22.0±2.9 %, P=0.3, placebo vs. Eplerenone). In conclusion, MR blockade does not result in arterial destiffening in healthy older adults despite reductions in blood pressure.

The influence of central arterial compliance on cerebrovascular hemodynamics: insights from endurance training intervention

2015 ◽  
Vol 119 (5) ◽  
pp. 445-451 ◽  
Author(s):  
Tsubasa Tomoto ◽  
Jun Sugawara ◽  
Yoshie Nogami ◽  
Kazutaka Aonuma ◽  
Seiji Maeda
Keyword(s):  
Carotid Artery ◽  
Endurance Training ◽  
Systolic Function ◽  
Arterial Compliance ◽  
Pressure Fluctuations ◽  
Cerebral Hemodynamics ◽  
Applanation Tonometry ◽  
Training Intervention ◽  
Central Artery ◽  
Carotid Arterial

Normally, central elastic arteries (e.g., aorta and common carotid artery) effectively buffer cardiac pulsation-induced flow/pressure fluctuations. With advancing age, arterial stiffening deteriorates this function and produces the greater cerebral hemodynamic pulsatility that impacts vulnerable brain tissue. It is well known that the buffering function of the central artery is improved by regular aerobic exercise, but the influence of endurance training on the pulsatile component of cerebral hemodynamics remains poorly understood. To characterize the functional role of the central artery at the heart-brain hemodynamic connection comprehensively, we assessed relations among the endurance training-induced changes in the left ventricle (LV), carotid arterial compliance, and cerebral hemodynamics. Thirteen collegiate tennis players (20 ± 1 yr) underwent a 16-wk endurance training intervention designed for improving cardiovascular function. Expectedly, maximal oxygen uptake (V̇o2peak), LV ejection velocity (via Doppler ultrasound), and the maximal rate of pressure increase of estimated aortic pressure waveform (via general transfer function) improved after the training intervention, whereas middle cerebral arterial (MCA) hemodynamics (via transcranial Doppler), such as mean and pulsatile flow velocities, remained unchanged. Carotid arterial compliance (via ultrasound and applanation tonometry) increased after the training intervention, and a larger increase in carotid arterial compliance was significantly associated with the greater attenuations of pulsatile MCA velocity ( r = −0.621) normalized by mean MCA velocity. These results suggest that the training-induced improvement of carotid artery Windkessel function might offset the expected increase in the pulsatile component of cerebral perfusion induced by the enhanced LV systolic function.

Association of Circulating Extracellular Matrix Components with Central Hemodynamics and Arterial Distensibility of Peripheral Arteries

2021 ◽  
pp. 1-9
Author(s):  
Vladimir N. Melnikov ◽  
Lena B. Kim ◽  
Anna N. Putyatina ◽  
Sergey G. Krivoschekov
Keyword(s):  
Matrix Metalloproteinase ◽  
Augmentation Index ◽  
Arterial Compliance ◽  
Applanation Tonometry ◽  
Collagen Type Iv ◽  
Peripheral Arteries ◽  
Arterial Distensibility ◽  
Type Iv ◽  
Matrix Metalloproteinase 1 ◽  
Extracellular Matrix Components

<b><i>Background:</i></b> In addition to neuronal and endothelial regulators of vascular tone, the passive mechanical properties of arteries, determined by the molecular structure of extracellular matrices, are the principle modulators of vascular distensibility. Specifically, the association between collagen type IV (Col IV), a constituent of basement membrane, and arterial compliance remains unclear. <b><i>Methods:</i></b> In 31 healthy adult men, radial applanation tonometry and pulse wave analysis were used to assess aortic augmentation index (AIx), aortic-to-radial pulse pressure amplification (PPAmpl), and time to reflection wave. <b><i>Results:</i></b> Plasma Col IV and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) concentrations were correlated with AIx (<i>r</i> = 0.51, <i>p</i> = 0.021 and <i>r</i> = −0.45, <i>p</i> = 0.042, respectively) after adjustment for age and heart rate (HR). Greater matrix metalloproteinase-9 (MMP-9) and TIMP-1 levels were associated with high PPAmpl (<i>r</i> = 0.45 and <i>r</i> = 0.64, respectively) and hence with compliant arteries. Multiple regression analyses revealed that 99% of the variation in PPAmpl was attributable to age, HR, Col IV, TIMP-1, and Col × TIMP-1 interaction (<i>p</i> &#x3c; 0.001). No relations between tonometric variables and levels of MMP-1, -2, and -3; TIMP-2 and -4; fibronectin; glycosaminoglycans; and hydroxyproline were found. <b><i>Conclusion:</i></b> High circulating Col IV level indexes were associated with stiffer peripheral arteries whereas increased MMP-9 and TIMP-1 concentrations were associated with more compliant ones.

scholarly journals Relationship between carotid arterial properties and cerebral white matter hyperintensities

Neurology ◽  
2017 ◽  
Vol 88 (21) ◽  
pp. 2036-2042 ◽  
Author(s):  
Tatjana Rundek ◽  
David Della-Morte ◽  
Hannah Gardener ◽  
Chuanhui Dong ◽  
Matthew S. Markert ◽  
...  
Keyword(s):  
White Matter ◽  
Carotid Artery ◽  
Arterial Compliance ◽  
Cross Sectional Study ◽  
Stiffness Index ◽  
White Matter Hyperintensity ◽  
Cerebral White Matter ◽  
Large Artery ◽  
Cross Sectional ◽  
The Difference

Objective:Since arterial stiffness is a functional measure of arterial compliance and may be an important marker of cerebrovascular disease, we examined the association of carotid artery stiffness with white matter hyperintensity volume (WMHV) in a cross-sectional study of 1,166 stroke-free participants.Methods:Carotid beta stiffness index (STIFF) was assessed by M-mode ultrasound of the common carotid artery and calculated as the ratio of natural log of the difference between systolic and diastolic blood pressure over STRAIN, a ratio of the difference between carotid systolic and diastolic diameter (DD) divided by DD. WMHV was measured by fluid-attenuated inversion recovery MRI. The associations of STIFF, DD, and STRAIN with WMHV were examined using linear regression after adjusting for sociodemographic, lifestyle, and vascular risk factors.Results:In a fully adjusted model, larger carotid DD was significantly associated with greater log-WMHV (β = 0.09, p = 0.001). STIFF and STRAIN were not significantly associated with WMHV. In adjusted analyses stratified by race–ethnicity, STRAIN (β = −1.78, p = 0.002) and DD (β = 0.11, p = 0.001) were both associated with greater log-WMHV among Hispanic participants, but not among black or white participants.Conclusions:Large carotid artery diameters are associated with greater burden of white matter hyperintensity (WMH) in this multiethnic population. The association between increased diameters, decreased STRAIN, and greater WMH burden is more pronounced among Hispanics. These associations suggest a potential important pathophysiologic role of extracranial large artery remodeling in the burden of WMH.

Age-associated changes in cardiovagal baroreflex sensitivity are related to central arterial compliance

2001 ◽  
Vol 281 (1) ◽  
pp. H284-H289 ◽  
Author(s):  
Kevin D. Monahan ◽  
Frank A. Dinenno ◽  
Douglas R. Seals ◽  
Christopher M. Clevenger ◽  
Christopher A. Desouza ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Baroreflex Sensitivity ◽  
Exercise Intervention ◽  
Valsalva Maneuver ◽  
Arterial Compliance ◽  
Underlying Mechanism ◽  
Applanation Tonometry ◽  
Stepwise Multiple Regression ◽  
Simultaneous Application ◽  
Carotid Artery Compliance

Cardiovagal baroreflex sensitivity (BRS) declines with advancing age in humans, but the underlying mechanism has not been established. Using two different approaches, we determined the relation between age-associated decline in cardiovagal BRS and the compliance of an artery in which arterial baroreceptors are located. First, we measured carotid artery compliance (via the simultaneous application of ultrasonography and arterial applanation tonometry) and cardiovagal BRS (phase IV of the Valsalva maneuver) in 47 healthy sedentary men that varied widely in age (19–76 yr). Cardiovagal BRS declined progressively with age ( r = −0.69; P ≤ 0.001) and was positively related to carotid artery compliance ( r = 0.71; P ≤ 0.001). Stepwise multiple-regression analysis revealed that carotid artery compliance was the strongest independent physiological correlate of cardiovagal BRS and that it explained 51% of the total variance. Second, we studied 13 middle-aged and older previously sedentary men (age 56 ± 2 yr) before and after 13 wk of aerobic exercise intervention. Regular exercise increased both cardiovagal BRS and carotid artery compliance ( P < 0.05) and the two events were strongly and positively related ( r = 0.72; P < 0.01). We conclude that reduced carotid artery compliance may play an important mechanistic role in age-associated decrease in cardiovagal BRS in healthy sedentary humans.

Carotid artery stiffening does not explain baroreflex impairment in pre-eclampsia

2004 ◽  
Vol 107 (4) ◽  
pp. 407-413 ◽  
Author(s):  
Beatrix MERSICH ◽  
János RIGÓ ◽  
Zsuzsanna LÉNÁRD ◽  
Péter STUDINGER ◽  
Zsuzsanna VISONTAI ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Pregnant Women ◽  
Vessel Wall ◽  
Maternal Age ◽  
Baroreflex Sensitivity ◽  
Applanation Tonometry ◽  
Third Trimester ◽  
The Third ◽  
Arterial Blood ◽  
Carotid Distensibility

Stiffening of the barosensory vessel wall in hypertension has been suggested to play a role in the associated baroreflex impairment. The carotid distensibility–BRS (baroreflex sensitivity) relationship, however, has not been studied in pre-eclampsia, a condition where hypertension is spontaneously reversible. Twelve normotensive pregnant women and 12 patients with pre-eclampsia matched for maternal age and week of gestation were studied in the third trimester and 3 months postpartum. Carotid artery diastolic diameter and pulsatile distension was measured by echo-wall tracking and carotid pulse pressure by applanation tonometry, and the carotid distensibility coefficient was calculated. Spontaneous BRS was determined by the sequence and spectral methods from 10 min continuous recording of ECG and finger arterial blood pressure. In the third trimester, carotid distensibility was lower in patients with pre-eclampsia than in normotensive pregnant women (2.47±0.17 compared with 4.08±0.16×10−3/mmHg); postpartum, it increased moderately in patients, but remained below normotensive values (3.25±0.12 compared with 4.25±0.19×10−3/mmHg). In the third trimester, both patients and healthy pregnant women had equally low BRS values; postpartum, the various BRS indices increased markedly (by 60–190%) and to the same level in both groups. No correlation was found between changes in carotid artery distensibility and those in BRS from the third trimester to postpartum period in patients and healthy pregnant women. The lack of association between changes in carotid distensibility and BRS suggest that stiffening of the carotid artery in pre-eclampsia is not responsible for baroreflex dysfunction.

Arterial compliance of rowers: implications for combined aerobic and strength training on arterial elasticity

2006 ◽  
Vol 290 (4) ◽  
pp. H1596-H1600 ◽  
Author(s):  
Jill N. Cook ◽  
Allison E. DeVan ◽  
Jessica L. Schleifer ◽  
Maria M. Anton ◽  
Miriam Y. Cortez-Cooper ◽  
...  
Keyword(s):  
Resistance Training ◽  
Strength Training ◽  
Valsalva Maneuver ◽  
Arterial Compliance ◽  
Cross Sectional Study ◽  
Applanation Tonometry ◽  
Stiffness Index ◽  
Favorable Effect ◽  
Group Differences ◽  
Cross Sectional

Regular endurance exercise increases central arterial compliance, whereas resistance training decreases it. It is not known how the vasculature adapts to a combination of endurance and resistance training. Rowing is unique, because its training encompasses endurance- and strength-training components. We used a cross-sectional study design to determine arterial compliance of 15 healthy, habitual rowers [50 ± 9 (SD) yr, 11 men and 4 women] and 15 sedentary controls (52 ± 8 yr, 10 men and 5 women). Rowers had been training 5.4 ± 1.2 days/wk for 5.7 ± 4.0 yr. The two groups were matched for age, body composition, blood pressure, and metabolic risk factors. Central arterial compliance (simultaneous ultrasound and applanation tonometry on the common carotid artery) was higher ( P < 0.001) and carotid β-stiffness index was lower ( P < 0.001) in rowers than in sedentary controls. There were no group differences for measures of peripheral (femoral) arterial stiffness. The higher central arterial compliance in rowers was associated with a greater cardiovagal baroreflex sensitivity, as estimated during a Valsalva maneuver ( r = 0.54, P < 0.005). In conclusion, regular rowing exercise in middle-aged and older adults is associated with a favorable effect on the elastic properties of the central arteries. Our results suggest that simultaneously performed endurance training may negate the stiffening effects of strength training.

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