scholarly journals Measuring methods of blood pressure and arterial stiffness. A new approach

Author(s):  
Christina Antza ◽  
Vasilios Kotsis

Carotid-femoral pulse wave velocity (c-f PWV) is considered to be one of the main factors affecting CV risk in the hypertensive population and has been included to the detailed screening of the hypertensive patients according to the ESH guidelines. Despite the large number of studies proving the correlation of blood pressure (BP) and c-f PWV as well as arterial stiffness, there are only few studies to show which BP measurement method can better predict arterial stiffness. Generally, these studies express the superiority of ABPM in the prediction of c-f PWV and early vascular aging (EVA). Furthermore, while guidelines recommend measuring c-f PWV in the hypertensive population, on the other hand it is difficult, time consuming and expensive to measure arterial stiffness in the everyday clinical practice, limiting its use only for experts. These limitations lead to the creation of a new score, the Early Vascular Aging Ambulatory score (EVAAs), which uses parameters from the ABPM and other cardiovascular risk factors in order to identify the possibility of each patient to have EVA. The score should be further studied for its accuracy in a larger population, as well for predicting hard end points in prospective studies.

2013 ◽  
Vol 5 (1) ◽  
pp. 82-86
Author(s):  
A. Lazaridis ◽  
E. Gkaliagkousi ◽  
M. Doumas ◽  
A. Reklou ◽  
A. Karagiannis

Whereas brachial blood pressure (BP) is still considered the gold standard for the estimation of cardiovascular risk in all clinical trials and guidelines, scientific interest is shifting towards central hemodynamics and the scientific community is experiencing a whole new revolution with the emergence of novel cardiovascular markers such as the ambulatory measurement of central BP and arterial stiffness. Central BP has already started to demonstrate its superiority over peripheral BP as a better and more reliable predictor of end-organ damage in cardiovascular diseases. Furthermore, ambulatory measurement of central BP and pulse wave velocity are expected to add much more useful information towards a more integrated assessment of cardiovascular risk and profile. However, more research is required before these novel markers could be incorporated in the everyday practice of BP measurement.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 873-874
Author(s):  
Kevin Heffernan ◽  
Janet Wilmoth ◽  
Andrew London

Abstract Vascular aging, which is associated with cardiovascular disease risk and mortality, is characterized by increasing arterial stiffness. The gold standard method for the assessment of arterial stiffness is carotid-femoral Pulse Wave Velocity (cfPWV). An emerging body of research suggests that cfPWV can be reasonably estimated from two commonly measured clinical variables—age and blood pressure. Thus, estimated Pulse Wave Velocity (ePWV) holds promise as a novel and easily obtained measure of arterial stiffness that can be used to study vascular aging, particularly with nationally representative datasets that collect biomarker data on sufficiently large sample sizes to examine race/ethnic differences. This analysis uses data from the 2006-2016 Health and Retirement Study to examine race/ethnic variation in the relationship between ePWV and mortality risk. We estimate logistic regression models predicting mortality over an eight-year period for four racial/ethnic groups: White, Black, Other, and Hispanic. Controls are included for sociodemographic characteristics, health status and behaviors, and blood biomarkers such as C-reactive protein, cystatin-C, hemoglobin A1c, total cholesterol and high-density lipoprotein (HDL) cholesterol. The results indicate ePWV increases the risk of mortality in the total sample and among each race/ethnic group, net the effect of age, systolic blood pressure, and diastolic blood pressure. Mechanisms that mediate this relationship are explored. The findings provide insight into vascular aging processes that influence mortality risk among race/ethnic groups.


Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Fanny Huyard ◽  
Laurence Vaujois ◽  
Mariane Bertagnolli ◽  
Anik Cloutier ◽  
Jean-Luc Bigras ◽  
...  

Background: Epidemiological studies reported that preterm infants have increased arterial systemic blood pressure in adulthood. We have recently shown in an animal model that premature vascular aging could be involved in this process. Aim: To assess biophysical properties (arterial stiffness) of the aorta as early signs of a vascular aging process in young adult women born extremely preterm. Methods: We studied 4 women (aged 24±1 years) born extremely preterm (26.1±0.5 weeks, 803±58 grams) in the absence of any significant medical or psychiatric co-morbidity. Subjects were compared to 6 control women born at term (40.6±0.8 weeks, 32518±139 grams) matched for age. The aortic diameters, the pulse wave transit time around the aortic arch and the ascending aortic peak flow were measured with echo-Doppler and the blood pressure recorded. Pulse wave velocity, aortic input impedance (Zi), characteristic impedance (Zc), arterial pressure-strain elastic modulus (Ep), and arterial wall stiffness index (βSI) were calculated. Results: Preterm women had slightly but not significantly increased arterial systolic blood pressure compared to young women born term (111±6 vs. 104±2 mmHg, p=0.23). Diastolic and mean arterial blood pressure were similar (62±4 vs. 61±3, p=0.84 and 77±4 vs. 75±3 mmHg, p=0.73 respectively). Pulse wave velocity did not differ between groups (3.6±0.6 vs. 3.2±0.2 m/sec, p=0.53). βSI and Ep, direct indices of central arterial rigidity, were not significantly different between preterm women compared to controls (4.9±2.1 vs. 3.7±0.4, p=0.46 and 58±24 vs. 42±4 kPa, p=0.38 respectively). Zc and Zi, indices of the resistance to ejection to blood flow, were increased compared to controls (134±21 vs. 105±9, p=0.18 and 185±8 vs. 152±10, p<0.05 dynes. sec. cm -5 , respectively). Conclusions: This first series of results suggest that women who were born very preterm present indices of arterial rigidity compared to term controls. This alteration of the vascular tree could be a patho-physiological mechanism linking prematurity to adult cardiovascular diseases.


2012 ◽  
Vol 8 (4) ◽  
pp. 244-249
Author(s):  
Antonio Bellasi ◽  
Paolo Salvi ◽  
Sergio Papagni ◽  
Emiliana Ferramosca ◽  
Carlo Ratti ◽  
...  

2018 ◽  
Vol 41 (7) ◽  
pp. 378-384 ◽  
Author(s):  
Alper Erdan ◽  
Abdullah Ozkok ◽  
Nadir Alpay ◽  
Vakur Akkaya ◽  
Alaattin Yildiz

Background: Arterial stiffness is a strong predictor of mortality in hemodialysis patients. In this study, we aimed to investigate possible relations of arterial stiffness with volume status determined by bioimpedance analysis and aortic blood pressure parameters. Also, effects of a single hemodialysis session on these parameters were studied. Methods: A total of 75 hemodialysis patients (M/F: 43/32; mean age: 53 ± 17) were enrolled. Carotid-femoral pulse wave velocity, augmentation index, and aortic pulse pressure were measured by applanation tonometry before and after hemodialysis. Extracellular fluid and total body fluid volumes were determined by bioimpedance analysis. Results: Carotid-femoral pulse wave velocity (9.30 ± 3.30 vs 7.59 ± 2.66 m/s, p < 0.001), augmentation index (24.52 ± 9.42 vs 20.28 ± 10.19, p < 0.001), and aortic pulse pressure (38 ± 14 vs 29 ± 8 mmHg, p < 0.001) significantly decreased after hemodialysis. Pre-dialysis carotid-femoral pulse wave velocity was associated with age (r2 = 0.15, p = 0.01), total cholesterol (r2 = 0.06, p = 0.02), peripheral mean blood pressure (r2 = 0.10, p = 0.005), aortic-mean blood pressure (r2 = 0.06, p = 0.02), aortic pulse pressure (r2 = 0.14, p = 0.001), and extracellular fluid/total body fluid (r2 = 0.30, p < 0.0001). Pre-dialysis augmentation index was associated with total cholesterol (r2 = 0.06, p = 0,02), aortic-mean blood pressure (r2 = 0.16, p < 0.001), and aortic pulse pressure (r2 = 0.22, p < 0.001). Δcarotid-femoral pulse wave velocity was associated with Δaortic-mean blood pressure (r2 = 0.06, p = 0.02) and inversely correlated with baseline carotid-femoral pulse wave velocity (r2 = 0.29, p < 0.001). Pre-dialysis Δaugmentation index was significantly associated with Δaortic-mean blood pressure (r2 = 0.09, p = 0.009) and Δaortic pulse pressure (r2 = 0.06, p = 0.03) and inversely associated with baseline augmentation index (r2 = 0.14, p = 0.001). In multiple linear regression analysis (adjusted R2 = 0.46, p < 0.001) to determine the factors predicting Log carotid-femoral pulse wave velocity, extracellular fluid/total body fluid and peripheral mean blood pressure significantly predicted Log carotid-femoral pulse wave velocity (p = 0.001 and p = 0.006, respectively). Conclusion: Carotid-femoral pulse wave velocity, augmentation index, and aortic pulse pressure significantly decreased after hemodialysis. Arterial stiffness was associated with both peripheral and aortic blood pressure. Furthermore, reduction in arterial stiffness parameters was related to reduction in aortic blood pressure. Pre-dialysis carotid-femoral pulse wave velocity was associated with volume status determined by bioimpedance analysis. Volume control may improve not only the aortic blood pressure measurements but also arterial stiffness in hemodialysis patients.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Brianna K Bruggeman ◽  
Katharine E Storo ◽  
Haley M Fair ◽  
Andrew J Wommack ◽  
James M Smoliga ◽  
...  

Intro: Glutathione is endogenous within human plasma, erythrocyte lysate and is also bound to the protein within plasma. Glutathione mediates redox chemistry and prevents oxidative damage within and around cellular components via reduction of reactive species (e.g. reactive oxygen, nitrogen, or sulfur species). Polyphenols and antioxidants have been shown to improve NO bioavailability which may reduce long term incidence of endothelial dysfunction. Less is known about whether changes in antioxidant capacity augments the risk of developing hypertension. Hypothesis: We hypothesized that acute glutathione supplementation would decrease arterial stiffness and reduce both brachial (bBP) and central blood pressure (cBP) in healthy male and female volunteers. Methods: Six males and six females (25 ± 3 and 22 ± 1 years, respectively) participated in a randomized, double blind, placebo controlled, crossover protocol. On two visits separated by 1 week, following a 12-hour fast, participants consumed either a placebo or glutathione (negligible and 200 mg, respectively) supplement via 90 second sublingual absorption which was then swallowed. Concentrations of oxidized (GSSG) and reduced glutathione (GSH) were spectrophotometrically measured in plasma (protein-bound) and erythrocyte lysate using a kinetic, enzymatic assay. Arterial stiffness was measured via pulse wave velocity (PWV) using applanation tonometry, and cBP was determined non-invasively using pulse wave analysis. All data were recorded before supplementation (baseline) and at 10, 30, 60 and 120 minutes post-consumption. Results: Linear mixed effect models revealed a significant (p<0.01) increase in total glutathione (GSH+GSSG) in the supplement group compared to placebo across all post-supplementation time points with the greatest increase occurring at 120 minutes (mean 99.0; 95%CI: 7.9,190.1). At 120 minutes post-consumption, no difference was present between glutathione and placebo groups for PWV (5.86 ± 1.19 and 6.08 ± 1.25 m/s, respectively; p=0.43), resting heart rate (52.95 ± 3.55 and 55.83 ± 6.36, respectively; p=0.16), systolic bBP (123.05 ± 12.75 and 123.13 ± 14.52 mmHg; p=0.22), diastolic bBP (71.81 ± 7.87 and 74.21 ± 6.53; p=0.48), systolic cBP (108.05 ± 10.45 and 108.68 ± 11.14 mmHg, respectively; p=0.11) and diastolic cBP (72.03 ± 7.82 and 74.94 ± 6.42 mmHg, respectively; p=0.46). Conclusion: Young healthy males and females experienced an increase in circulating humoral antioxidants in response to glutathione supplementation. However, supplementation had minimal effects on resting hemodynamics. Future research should examine glutathione supplementation’s effect in participants with decreased antioxidant capacity and increased oxidative stress including patients with known disease such as hypertension or peripheral artery disease.


2021 ◽  
Vol 64 ◽  
pp. 102242
Author(s):  
Djamaleddine Djeldjli ◽  
Frédéric Bousefsaf ◽  
Choubeila Maaoui ◽  
Fethi Bereksi-Reguig ◽  
Alain Pruski

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