P154 DOES THE METHOD OF THE MEASUREMENT OF BLOOD PRESSURE CORRELATES DIFFERENTLY WITH PULSE WAVE VELOCITY IN RESISTANT HYPERTENSION?

2018 ◽  
Vol 24 (C) ◽  
pp. 124
Author(s):  
Jose Mesquita Bastos ◽  
Susana Lopes ◽  
Catarina Garcia ◽  
Verónica Ribau ◽  
Susana Bertoquini ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Resistant Hypertension ◽  
Pulse Wave

scholarly journals Spironolactone Reduces Aortic Stiffness in Patients With Resistant Hypertension Independent of Blood Pressure Change

2021 ◽  
Author(s):  
Sudeep R. Aryal ◽  
Mohammed Siddiqui ◽  
Oleg F. Sharifov ◽  
Megan D. Coffin ◽  
Bin Zhang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Resistant Hypertension ◽  
Aortic Stiffness ◽  
Pulse Wave ◽  
Antihypertensive Medications ◽  
Mineralocorticoid Receptor Antagonist ◽  
Stiffness Reduction ◽  
Arterial Blood

Background Aortic stiffness is an independent predictor of cardiovascular events in patients with arterial hypertension. Resistant hypertension is often linked to hyperaldosteronism and associated with adverse outcomes. Spironolactone, a mineralocorticoid receptor antagonist, has been shown to reduce both the arterial blood pressure (BP) and aortic stiffness in resistant hypertension. However, the mechanism of aortic stiffness reduction by spironolactone is not well understood. We hypothesized that spironolactone reduces aortic stiffness in resistant hypertension independently of BP change. Methods and Results Patients with uncontrolled BP (≥140/90 mm Hg) despite use of ≥3 antihypertensive medications (including diuretics) were prospectively recruited. Participants were started on spironolactone at 25 mg/d, and increased to 50 mg/d at 4 weeks while other antihypertensive medications were withdrawn to maintain constant mean BP. Phase‐contrast cardiac magnetic resonance imaging of the ascending aorta was performed in 30 participants at baseline and after 6 months of spironolactone treatment to measure aortic pulsatility, distensibility, and pulse wave velocity. Pulse wave velocity decreased (6.3±2.3 m/s to 4.5±1.8 m/s, P <0.001) and pulsatility and distensibility increased (15.9%±5.3% to 22.1%±7.9%, P <0.001; and 0.28%±0.10%/mm Hg to 0.40%±0.14%/mm Hg, P <0.001, respectively) following 6 months of spironolactone. Conclusions Our results suggest that spironolactone improves aortic properties in resistant hypertension independently of BP, which may support the hypothesis of an effect of aldosterone on the arterial wall. A larger prospective study is needed to confirm our findings.

scholarly journals Long-Term Effects of Renal Artery Denervation

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 662
Author(s):  
Vytautas Juknevičius ◽  
Andrius Berūkštis ◽  
Renata Juknevičienė ◽  
Eugenijus Jasiūnas ◽  
Pranas Šerpytis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Renal Artery ◽  
Wave Velocity ◽  
Resistant Hypertension ◽  
Pulse Wave ◽  
Aortic Pulse Wave Velocity ◽  
Pill Group ◽  
Renal Artery Denervation

Background and Objectives: Renal artery denervation (RDN) procedure is a broadly discussed method in the treatment of resistant hypertension. Many studies report short-term (3–12 months) results for blood pressure and arterial stiffness. The primary endpoints were changes in 24 h mean systolic blood pressure (BP) and office systolic BP 48 months after RDN. The secondary endpoints were changes in aortic pulse wave velocity and impact of polypharmacy on these variables. Materials and Methods: Renal artery denervation was performed in 73 patients treated for resistant hypertension; 49 patients remained in final analysis. Patient examination was carried out before the procedure, and subsequently at 3, 6, 12, 24, and 48 months later. Patients’ antihypertensive and overall medication regimens were carefully analysed. Results: Mean 24 h arterial blood pressure lowered and was sustained at lower levels for up to 48 months; median (interequartile range—IQR) from 158(23.5)/100(14.2) to 140(26.5)/86(16.2) mmHg. Mean reduction in 24 h ambulatory systolic BP was −11 ± 25 mmHg (95% CI, −20 to −2; p < 0.001), while office systolic BP reduced by −7 ± 23 mmHg (95%CI, −24 to −1; p < 0.02). A significant reduction in median aortic pulse wave velocity 12 months after the procedure (drop from baseline 11.2 [3.15] m/s (95%CI 6.1 to 16.2) to 9.8 [2.1] m/s (95%CI 6.1 to 13.7; p = 0.002)). After 48 months, there was no worsening compared to the baseline level of 10.3 [4.0] m/s (95% CI 6.9 to 17.8) (p > 0.05). The total mean number of antihypertensive drugs remained unchanged: 5.97(±1.1) vs. 5.24 (±1.45). A higher number of pills after 48 months was associated with higher aortic pulse wave velocity (1–5 pill group: 8.1 ± 1.6 m/s; 6–10 pill group: 10.9 ± 1.8 m/s; >11 pill group: 15.1 ± 2.6 m/s) (p = 0.003). Conclusions: Antihypertensive effect after renal denervation lasts up to 48 months with no worsening of arterial stiffness compared to baseline. In our study, polypharmacy was associated with increased arterial stiffness 48 months after the procedure.

THE ELASTICITY OF THE LARGE ARTERIES IN HYPERTENSION

1952 ◽  
Vol 30 (2) ◽  
pp. 125-129
Author(s):  
J. P. Adamson ◽  
J. Doupe
Keyword(s):  
Blood Pressure ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Diastolic Pressure ◽  
Arterial Elasticity ◽  
Large Arteries ◽  
Wave Velocities

Intra-arterial pressures and pulse wave velocities were measured in 18 subjects whose auscultatory diastolic pressures ranged from 45 to 120 mm. Hg. Various methods were used to lower the blood pressure in the hypertensive and to raise it in nonhypertensive subjects so that pulse wave velocities might be compared in all subjects at a common diastolic pressure. The pulse wave velocities were calculated for a diastolic pressure of 80 mm. Hg. No significant differences were found between hypertensive and nonhypertensive subjects. It was concluded that a defect of arterial elasticity as gauged by pulse wave velocity is not a factor in the pathogenesis of hypertension.

scholarly journals Normal and reference values for cardiovascular magnetic resonance-based pulse wave velocity in the middle-aged general population

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Max J. van Hout ◽  
Ilona A. Dekkers ◽  
Jos J. Westenberg ◽  
Martin J. Schalij ◽  
Ralph L. Widya ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
General Population ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Reference Values ◽  
Pulse Wave ◽  
Disease Risk ◽  
Cardiovascular Disease Risk

Abstract Background Aortic stiffness, assessed through pulse wave velocity (PWV), is an independent predictor for cardiovascular disease risk. However, the scarce availability of normal and reference values for cardiovascular magnetic resonance imaging (CMR) based PWV is limiting clinical implementation. The aim of this study was to determine normal and reference values for CMR assessed PWV in the general population. Methods From the 2,484 participants of the Netherlands Epidemiology of Obesity (NEO) study that have available CMR-PWV data, 1,394 participants free from cardiovasculard disease, smokers or treatment for diabetes, hypertension or dyslipidaemia were selected (45–65 years, 51% female). Participants were divided into sex, age and blood pressure (BP) subgroups. Normal values were specified for participants with a BP < 130/80 mmHg and reference values for elevated BP subgroups (≥ 130/80 and < 140/90 mmHg; and ≥ 140/90 mmHg). Differences between groups were tested with independent samples t-test or ANOVA. Due to an oversampling of obese individuals in this study, PWV values are based on a weighted analysis making them representative of the general population. Results Normal mean PWV was 6.0 m/s [95% CI 5.8–6.1]. PWV increased with advancing age and BP categories (both p < 0.001). There was no difference between sex in normal PWV, however in the BP > 140/90 mmHg women had a higher PWV (p = 0.005). The interpercentile ranges were smaller for participants < 55 years old compared to participants ≥ 55 years, indicating an increasing variability of PWV with age. PWV upper limits were particularly elevated in participants ≥ 55 years old in the high blood pressure subgroups. Conclusion This study provides normal and reference values for CMR-assessed PWV per sex, age and blood pressure category in the general population.

scholarly journals Effects of an Innovative Head-Up Tilt Protocol on Blood Pressure and Arterial Stiffness Changes

2021 ◽  
Vol 10 (6) ◽  
pp. 1198
Author(s):  
Victor N. Dorogovtsev ◽  
Dmitry S. Yankevich ◽  
Nandu Goswami
Keyword(s):  
Blood Pressure ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Healthy Subjects ◽  
Pulse Wave ◽  
Task Force ◽  
Column Height ◽  
Tilt Test ◽  
Test Protocol ◽  
Head Up Tilt

The objective of our study was to identify blood pressure (BP) and pulse wave velocity (PWV) changes during orthostatic loading, using a new the head-up tilt test (HUTT), which incorporates the usage of a standardized hydrostatic column height. Methods: 40 healthy subjects 20–32 years performed HUTT, which was standardized to a height of the hydrostatic column at 133 cm. Exposure time was 10 min in each of 3 positions: horizontal supine 1, HUTT, and horizontal supine 2. The individual tilt up angle made it possible to set the standard value of the hydrostatic column. Hemodynamic parameters were recorded beat to beat using “Task Force Monitor 3040 i”, pulse-wave velocity (PWV) was measured with a sphygmograph–sphygmomanometer VaSera VS1500N. Results: Orthostatic loading caused a significant increase in heart rate (HR) and a decrease in stroke volume (SV) (p < 0.05) but no significant reductions in cardiac output, changes in total vascular resistance (TVR), or BP. An analysis of personalized data on systolic blood pressure (SBP) changes in tilt up position as compared to horizontal position (ΔSBP) revealed non-significant changes in this index in 48% of subjects (orthostatic normotension group), in 32% there was a significant decrease in it (orthostatic hypotension group) and in 20% there was a significant increase in it (orthostatic hypertension group). These orthostatic changes were not accompanied by any clinical symptoms and/or syncope. During HUTT, all subjects had in the PWV a significant increase of approximately 27% (p < 0.001). Conclusion: The new test protocol involving HUTT standardized to a height of hydrostatic column at 133 cm causes typical hemodynamics responses during orthostatic loading. Individual analysis of the subjects revealed subclinical orthostatic disorders (OSD) in up to 52% of the test persons. During HUTT, all test subjects showed a significant increase in PWV. The new innovative HUTT protocol can be applied in multi-center studies in healthy subjects to detect preclinical forms of orthostatic disorders under standard gravity load conditions.

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