Calibration of noninvasive central blood pressure devices and negative aortic-to-brachial systolic pressure amplification

Introduction: Lifestyle changes (LC) influence peripheral blood pressure (BP) in pre-hypertensive (PH) individuals; the behavior of central systolic BP (CBP) in respect to LC is not fully known. However, pre-hypertension cardiovascular risk is similar to mild hypertension and can be associated with changes in the endothelial function thereby altering the CBP. Objective: Thus, to demonstrate the influence of LC on the peripheral and the central blood pressure in PH individuals.Methods: Fifty-six PH patients were studied before and after three months of LC (Dash diet and aerobic exercises). The CBP was measured by tonometry of the radial artery before and after LC.Results: The mean age of the study population was 48 ± 10.8 years. There were significant reductions in peripheral systolic pressure (127±8.1 vs. 122 ± 9.2, P=0.003), in the body mass index (29.0±4.6 vs. 28.5±4.6, P=0.001) and the waist-hip ratio(0.91 ± 0.07 vs. 0.89 ± 0.06, P=0.0007) and also in the central systolic pressure (113±10.7 vs. 107±10.9, P=0.0001) after three months of LC.Conclusion: Lifestyle changes promote improvement in peripheral and central BP in PH individuals.Aconselhamento sobre mudanças no estilo de vida reduz a pressão arterial central em indivíduos pré-hipertensos: um estudo de intervençãoIntrodução: Aconcselhamento para Modificação no estilo de vida (MEV) influencia diretamente a pressão arterial periférica em indivíduos pré-hipertensos. O comportamento da pressão sistólica central (PSC) em relação à MEV não está plenamente conhecido. Além disso, a pré-hipertensão (PH) oferece risco cardiovascular semelhante ao de um hipertenso leve e pode estar associado com alterações da função endotelial alterando a PSC.Objetivo: Demonstrar a influência da MEV com exercício físico e dieta alimentar em parâmetros antropométricos e hemodinâmicos, incluindo a PSC, em indivíduos pré-hipertensos.Métodos: Foram estudados 56 pacientes com PH antes e após 3 meses de MEV. A PSC foi avaliada utilizando-se um sistema de tonometria da artéria radial antes e após a MEV.Resultados: A média de idade da população estudada foi 48±10,8 anos. Houve redução significativa na PAS (127±8,1 para 122±9,2; p=0,003), PAD (75±7,4 para 72±7,7; p=0,003), PAM (92±7,0 para 89±7,6; p=0,002), IMC (29,0±4,6 para 28,5±4,6; p=0,001) e na relação C/Q (0,91±0,07 para 0,89±0,06; p=0,0007) após 03 meses de MEV. Também se observou redução da PSC (113±10,7 para 107±10,9; p=0,0001) após três meses de MEV.Conclusão: A MEV promoveu melhora pressão arterial periférica e central de indivíduos pré-hipertensos.

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Abstract 12973: Atrial Fibrillation is Associated With Increased Central Blood Pressure and Arterial Stiffness

Circulation ◽

10.1161/circ.142.suppl_3.12973 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Priit Pauklin ◽

Jaan Eha ◽

Kaspar Tootsi ◽

Rein Kolk ◽

Rain Paju ◽

...

Keyword(s):

Atrial Fibrillation ◽

Blood Pressure ◽

Arterial Stiffness ◽

Pulse Pressure ◽

Augmentation Index ◽

Systolic Pressure ◽

Applanation Tonometry ◽

Central Blood Pressure ◽

Control Group ◽

Lack Of Information

Background: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in clinical practice, yet there is a lack of information about the hemodynamic profile and arterial stiffness of these patients. Purpose: The purpose of this study is to describe the differences in arterial stiffness and central blood pressures in patients with paroxysmal/persistent AF compared to a healthy control group. Methods: We included 76 patients with paroxysmal and persistent AF who underwent electrical cardioversion or pulmonary vein isolation (PVI) for AF. Carotid-femoral pulse wave velocity (cfPWV), augmentation index (AIx) and central blood pressure (cBP) were measured by applanation tonometry. All measurements were done in sinus rhythm (SR). We compared the results with 75 healthy age matched individuals. Results: Patients with a history of AF had higher cfPWV compared to the control group (8,0 m/s vs 7,2 m/s, p<0,001). AF patients also had higher central systolic blood pressure (cSBP) (118 mmHg vs 114 mmHg, p=0,03) and central pulse pressure (cPP) (39 mmHg vs 37 mmHg, p=0,03), without differences in peripheral systolic pressure (pSBP) (127 mmHg vs 123 mmHg, p=0,13), peripheral diastolic blood pressure (pDPB) (78 mmHg vs 76 mmHg, p=0,14) and peripheral pulse pressure (pPP) (48 mmHg vs 47 mmHg, p=0,37). There was no difference in heart rate (HR) (58 vs 61 bpm, p=0,08) (Table 1). In a multiple regression analysis (adjusted R 2 = 0,37) where cfPWV was set as the dependent variable and adjusting for age, sex, HR, weight, mean central arterial pressure (cMAP), estimated glomerular filtration rate (eGFR), the AF group remained to be an independent predictor for cfPWV (p=0,016). Conclusions: Patients with atrial fibrillation have a higher cSBP, cPP and cfPWV compared to healthy subjects without differences in peripheral blood pressure and HR. These findings support the hypothesis that arterial stiffness may play an important role in the development of atrial fibrillation.

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Central blood pressure in adults screened for a genetic polymorphism in folate metabolism

Proceedings of The Nutrition Society ◽

10.1017/s002966512000018x ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

M. Rooney ◽

C. F. Hughes ◽

J. J. Strain ◽

M. Clements ◽

R. Blair ◽

...

Keyword(s):

Blood Pressure ◽

Pulse Pressure ◽

Augmentation Index ◽

Healthy Adults ◽

Central Blood Pressure ◽

Vascular Health ◽

C677t Polymorphism ◽

Gene Encoding ◽

Pressure Amplification ◽

Mean Pressure

AbstractAs the primary risk factor for cardiovascular disease (CVD), hypertension is the leading cause of preventable, premature mortality globally. Hypertension, or elevated blood pressure (BP), has a number of well-established risk factors, including genetics. A common C677T polymorphism in the gene encoding the folate metabolising enzyme methylenetetrahydrofolate reductase (MTHFR) affects 10–12% of UK and Irish populations and has been linked with 24–87% increased risk of hypertension globally. Evidence from randomised controlled trials (RCTs) conducted at this Centre has shown BP to be highly responsive (by 5–13 mmHg) to supplementation with riboflavin (MTHFR co-factor), an effect confined to homozygous individuals (TT genotype). To date, our trials have focused on peripheral BP; however, additional measures of vascular health such as central pressure are reported to be more closely correlated with CVD risk. Investigation of central BP, augmentation index (AIx) and pulse pressure amplification (PPA) may thus offer further insight into the role of this gene-nutrient interaction in blood pressure. The present study aims to investigate BP, and measures of vascular health in healthy adults stratified by MTHFR 677 genotype. Apparently healthy adults aged 18–60 years were recruited from workplaces across Northern Ireland and screened for MTHFR genotype via buccal swab. Clinic BP, anthropometry and blood sample were measured in TT individuals (n 209) and age and sex-matched CC (n 98) and CT (n 102) controls. AIx and central BP were assessed using SphygmoCor® (AtCor Medical, Australia). Preliminary results demonstrate higher BP in individuals with the MTHFR 677TT genotype compared to non-TT controls (systolic BP 134.7 ± 13.8 mmHg vs 129.7 ± 12.4 mmHg, P < 0.001; diastolic BP 81.6 ± 9.5 mmHg vs 79.7 mmHg ± 8.9 mmHg, P = 0.023, respectively). The MTHFR 677TT genotype group had significantly higher central systolic BP (119.4 ± 11.8 vs 116.7 ± 10.9 mmHg, P = 0.018), central pulse pressure (P = 0.006) and central mean pressure (P = 0.011) compared to the non-TT group. No significant differences for central diastolic BP, pulse pressure amplification, pulse pressure ratio and augmentation index were observed. This study confirms the phenotype of elevated BP in individuals with the C677T polymorphism in the gene encoding MTHFR. For the first time, this study reports that individuals with the MTHFR 677TT genotype have higher central systolic BP, central mean pressure and pulse pressure. Further investigations through RCTs investigating the effect of the MTHFR cofactor, riboflavin, on central blood pressure in these genetically at-risk adults are warranted.

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P86 Can Central Blood Pressure be Accurately Estimated in Individuals with and Without Systolic Blood Pressure Amplification?

Artery Research ◽

10.2991/artres.k.191224.116 ◽

2020 ◽

Vol 25 (Supplement 1) ◽

pp. S129

Author(s):

Goupil Remi ◽

Cédric Kowalski ◽

Florence Lamarche

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Central Blood Pressure ◽

Pressure Amplification

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Central Blood Pressure and Heart Output in Surfaced and Submerged Frogs

Journal of Experimental Biology ◽

10.1242/jeb.42.2.339 ◽

1965 ◽

Vol 42 (2) ◽

pp. 339-357

Author(s):

G. SHELTON ◽

D. R. JONES

Keyword(s):

Blood Pressure ◽

Rana Pipiens ◽

Pulse Wave ◽

Diastolic Pressure ◽

Peripheral Resistance ◽

Systolic Pressure ◽

Systemic Blood Pressure ◽

Minute Volume ◽

Central Blood Pressure ◽

Systemic Blood

1. The systemic blood pressure of Rana pipiens and R. temporaria is slightly higher than the pulmocutaneous pressure at systole and much higher at diastole. The pulses differ in shape and a conus component can be seen in the systemic wave. 2. Submersion of the animal causes a fall in systolic pressure in both arches, the diastolic pressure remaining relatively constant. The shape of the pulse wave changes, the conus component being accentuated and visible in recordings from both arches. 3. Heart rate and stroke volume fall during submersion so that after 30 min. under water the minute volume may be 20-50% of the value at the surface. The heart becomes increasingly full of blood. 4. The differences in systemic and pulmocutaneous pressures are explained in terms of resistance, compliance and flow in lung and body circuits. The same general relationships persist during submersion but selective increases in peripheral resistance must occur to maintain the central blood pressure in face of falling heart output.

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