scholarly journals Late aortic systolic pressure augmentation and increased pulse pressure in treated hypertensive patients

2003 ◽  
Vol 41 (6) ◽  
pp. 245
Author(s):  
Marcus C. Sims ◽  
Rahul Aggarwal ◽  
Juan Estrada ◽  
Wilmer W. Nichols
Keyword(s):  
Pulse Pressure ◽  
Systolic Pressure ◽  
Hypertensive Patients

Factors determining cardiac hypertrophy in hypertensive patients with or without peripheral vascular disease

1998 ◽  
Vol 95 (3) ◽  
pp. 261-267 ◽  
Author(s):  
M. BRAHIMI ◽  
B. I. LEVY ◽  
M. E. SAFAR ◽  
H. DABIRÉ
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Cardiac Hypertrophy ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Pulse Pressure ◽  
Systolic Pressure ◽  
Cardiac Mass ◽  
Peripheral Vascular ◽  
Hypertensive Patients

1.Coronary ischaemic disease and congestive heart failure are the principal causes of mortality in patients with peripheral vascular disease. Whether cardiac hypertrophy is present and even more pronounced in peripheral vascular disease than in other populations has never been explored. 2.Twenty-five hypertensive patients were investigated, 11 without and 14 with peripheral vascular disease, matched for age, sex, mean arterial pressure and antihypertensive drug treatment. Cardiac mass was determined using echocardiography together with measurement of systemic blood pressure, ratio between ankle systolic pressure (ASP) and brachial systolic pressure (BSP), and standard biochemical parameters including natriuresis per 24 ;h. 3.At the same mean arterial pressure, patients with peripheral vascular disease had a significantly higher cardiac mass (157±12 versus 116±6 ;g/m2; P< 0.01), pulse pressure (81±5 versus 55±4 ;mmHg; P< 0.01) and natriuresis (180±17 versus 144±6 ;mmol/24 h; P< 0.01) than controls. Using univariate correlations, cardiac mass was positively associated with pulse pressure, mean arterial pressure and natriuresis, and negatively with the ASP/BSP ratio. On the basis of multivariate regression analysis, only natriuresis was positively correlated to cardiac mass. 4.Patients with peripheral vascular disease develop a higher degree of cardiac hypertrophy in comparison with hypertensive subjects with the same level of mean arterial pressure. Sodium intake rather than mechanical factors seems to be the major modulating factor which influences the degree of cardiac hypertrophy.

scholarly journals Central aortic pressure and long-term outcome in hypertensive patients undergoing percutaneous coronary intervention

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Han-Ping Wu ◽  
Mao-Jen Lin
Keyword(s):  
Pulse Pressure ◽  
Negative Impact ◽  
Systolic Pressure ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Hypertensive Patients ◽  
All Cause Mortality ◽  
The Impact ◽  
Central Pulse Pressure

Abstract Elevated central pulse pressure (CPP) had a negative influence on long-term outcome in patients with hypertension (HT). However, little is known about the impact of central pulse pressure on long-term outcomes in hypertensive patients undergoing PCI. A total number of 1184 hypertensive patients who received PCI procedure were prospectively collected. They were divided into two groups according to the median of central pulse pressure. Baseline characteristics, risk factors, hemodynamic data including central systolic pressure (CSP), central diastolic pressure (CDP) and CPP were measured. Invasive strategies were also analyzed to compare the long term outcome between patients with reference CPP and patients with high CPP. We further analyzed the predictors for myocardial infarction (MI), mortality, repeated PCI procedure in hypertensive patients undergoing PCI. We found patients in the reference CPP group had a lower CSP and higher CDP compared with high CPP group (Both P < 0.001) and male preponderance (P < 0.001). Patients with diabetes and chronic kidney disease (CKD) tend to have a high CPP (both P < 0.001). Drugs including Angiotensin Converting Enzyme inhibitors (ACEI) and statin were used more frequently in patients with reference CPP group (P = 0.035 and P = 0.001, respectively). Freedom from all-cause mortality and cardiovascular(CV) mortality was lower in the patients with high CPP group (P = 0.001, P = 0.01, respectively).Logistic regression revealed that CPP is a major predictor for all-cause mortality and repeated PCI procedure [hazard ratio (HR): 2.46 and 1.41, respectively]. In hypertensive patients receiving PCI, elevated CPP had a negative impact on long-term mortality; CPP also strongly predicts all-cause mortality and repeated PCI procedures in hypertensive patients undergoing PCI.

Diastolic pressure, systolic pressure, or pulse pressure?

2000 ◽  
Vol 2 (3) ◽  
pp. 271-279 ◽  
Author(s):  
Charalambos Vlachopoulos ◽  
Michael O’Rourke
Keyword(s):  
Pulse Pressure ◽  
Diastolic Pressure ◽  
Systolic Pressure

Non-invasive determination of the systolic peak-to-peak gradient in children with aortic stenosis: validation of a mathematical model

2000 ◽  
Vol 10 (2) ◽  
pp. 115-119 ◽  
Author(s):  
Valter C. Lima ◽  
Evan Zahn ◽  
Christine Houde ◽  
Jeffrey Smallhorn ◽  
Robert M. Freedom ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Pulse Pressure ◽  
Linear Regression Analysis ◽  
Systolic Pressure ◽  
Pressure Gradients ◽  
Non Invasive ◽  
The Mean ◽  
Congenital Aortic Valvar Stenosis ◽  
Peak Gradient

AbstractDoppler derived systolic pressure gradients have become widely applied as noninvasively obtained estimates of the severity of aortic valvar stenosis. There is little correlation, however, between the Doppler derived peak instantaneous gradient and the peak-to-peak gradient obtained at catheterisation, the latter being the most applied variable to determine severity in children. The purpose of this study was to validate a mathematical model based on data from catheterisation which estimates the peak-to-peak gradient from variables which can be obtained by noninvasive means (Doppler derived mean gradient and pulse pressure), according to the formula: peak-to-peak systolic gradient=6.02+1.49*(mean gradient)−0.44*(pulse pressure). Simultaneous cardiac catheterization and Doppler studies were performed on 10 patients with congenital aortic valvar stenosis. Correlations between the gradients measured at catheter measured, and those derived by Doppler, were performed using linear regression analysis. The mean gradients correlated well (y=0.67 × + 11.11, r=0.87, SEE=6 mm Hg, p=0.001). The gradients predicted by the formula also correlated well with the peak-to-peak gradients measured at catheter (y=0.66 × + 14.44, r=0.84, SEE=9 mm Hg, p=O.002). The data support the application of the model, allowing noninvasive prediction of the peak-to-peak gradient across the aortic valvar stenosis.

Platelet Cytosolic Free Calcium in Essential Hypertension: Responses to Vasopressin

1989 ◽  
Vol 77 (2) ◽  
pp. 183-188 ◽  
Author(s):  
A. F. Dominiczak ◽  
J. J. Morton ◽  
G. Murray ◽  
P. F. Semple
Keyword(s):  
Essential Hypertension ◽  
Arginine Vasopressin ◽  
Calcium Concentration ◽  
Systolic Pressure ◽  
Extracellular Calcium ◽  
Free Calcium ◽  
Cytosolic Free Calcium ◽  
Hypertensive Patients ◽  
Free Calcium Concentration ◽  
The Difference

1. Resting and stimulated free calcium concentrations have been measured in platelets loaded with the fluorescent probe quin2 from 30 patients with essential hypertension and from 30 age-matched controls. 2. Cytosolic free calcium concentrations were 94.6 ± 2.7 (mean ± sem) in the hypertensive group and 91.7 ± 2.8 nmol/l in the normotensive group, the difference was not significant. 3. Arginine vasopressin caused a transient increase in platelet free calcium concentration in all subjects. In the presence of extracellular calcium the increase was significantly higher in the control subjects than in the hypertensive patients (P = 0.005). In the absence of extracellular calcium, arginine vasopressin caused much smaller increases, and there was then no difference between the responses of the two groups. 4. Platelet free calcium concentrations were measured again in 13 patients after 8 weeks treatment with either verapamil (n = 6) or atenolol (n = 7). The reductions in systolic pressure after drug treatment were correlated with the changes in cytosolic free calcium concentrations (r = 0.75, P < 0.01).

scholarly journals Residential Proximity to Greenness Mitigates the Hemodynamic Effects of Ambient Air Pollution

2021 ◽  
Author(s):  
Daniel W. Riggs ◽  
Ray Yeager ◽  
Daniel J. Conklin ◽  
Natasha DeJarnett ◽  
Rachel J Keith ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Pulse Pressure ◽  
Vegetation Index ◽  
Augmentation Index ◽  
Systolic Pressure ◽  
Ambient Air ◽  
Ambient Air Pollution ◽  
Linear Regression Models ◽  
Residential Proximity ◽  
Augmentation Pressure

Background: Residential proximity to greenness is associated with a lower risk of cardiovascular disease (CVD) and all-cause mortality. However, it is unclear whether the beneficial effects of greenness are linked to a reduction in the effects of ambient air pollutants. Methods and Results: We measured arterial stiffness in 73 participants with moderate to high CVD risk. Average levels of ambient PM2.5 and ozone were calculated from local monitoring stations. Residential greenness was estimated using satellite-derived normalized difference vegetation index (NDVI) for a 200m and 1km radius around each participant's home. Participants were 51% female; average age of 52 years; and, 79% had diagnosed hypertension. In multiple linear regression models, residential NDVI was negatively associated with augmentation index (-3.8% per 0.1 NDVI). Ambient levels of PM2.5 (per interquartile range (IQR) of 6.9 μg/m3) were positively associated with augmentation pressure (3.1 mmHg), pulse pressure (5.9 mmHg), and aortic systolic pressure (8.1 mmHg). Ozone (per IQR of 0.03 ppm) was positively associated with augmentation index (5.5%), augmentation pressure (3.1 mmHg), and aortic systolic pressure (10 mmHg). In areas of low greenness, both PM2.5 and ozone were positively associated with pulse pressure. Additionally, ozone was positively associated with augmentation pressure and systolic blood pressure. However, in areas of high greenness, there was no significant association between indices of arterial stiffness with either PM2.5 or ozone.Conclusions: Residential proximity to greenness is associated with lower values of arterial stiffness. Residential greenness may mitigate the adverse effects of PM2.5 and ozone on arterial stiffness.

scholarly journals Parameters of arterial stiffness in hypertensive patients with and without subclinical carotid atherosclerosis

2021 ◽  
Vol 27 (4) ◽  
pp. 427-435
Author(s):  
V. E. Gumerova ◽  
S. A. Sayganov ◽  
V. V. Gomonova
Keyword(s):  
Arterial Stiffness ◽  
Pulse Pressure ◽  
Augmentation Index ◽  
Subclinical Atherosclerosis ◽  
Stiffness Index ◽  
Control Group ◽  
Hypertensive Patients ◽  
Significant Difference ◽  
Arterial Stiffness Index ◽  
Plaque Detection

Objective. To assess the relationship between arterial stiffness parameters in hypertensive patients with and without atherosclerotic lesions.Design and methods. We included 127 subjects who were divided into 3 groups: patients with hypertension (HTN) without atherosclerosis (n = 42); patients with HTN and subclinical atherosclerosis (SА) (n = 52) and control group which consisted of individuals without HTN, SA, or coronary artery disease (n = 33). All groups matched by age and gender. All subjects underwent following examinations: ultrasonography of extracranial segments of carotid arteries, 24-hour blood pressure monitoring with the assessment of arterial stiffness parameters.Results. In subjects with HTN compared to controls, pulse wave velocity in aorta (PWVao) was significantly higher (11,3 ± 1,5; 12,3 ± 1,8 vs 10,4 ± 1,3 m/s; p < 0,05), as well as pulse pressure (PP) (46,4 ± 9,8; 45,6 ± 10,6 vs 39,9 ± 6,5 mmHg; p < 0,05), central pulse pressure (PPао) (35,5 ± 8,5; 34,9 ± 8,5 vs 30,9 ± 5,4 mmHg; p < 0,05), and arterial stiffness index (ASI) (141 (127, 159); 139 (128,5, 160,5) vs 126 (118, 138) mmHg; p < 0,05). In subjects with HTN and SA, PWVao was significantly higher compared to other groups (p < 0,05). No significant difference in augmentation index was found (–32,5 (–45, –12); –22 (–36, –12); –37 (–50, –17); p = 0,25). Аmbulatory arterial stiffness index was higher in controls (0,5 ± 0,2) compared to HTN group (0,4 ± 0,2; p = 0,05), while HTN and SA group did not differ significantly (0,5 ± 0,2; p = 0,3). PWVao above 11,15 m/s is associated with 4,3 (2,3–8,2) times higher rate of atherosclerosis plaque detection.Conclusions. In HTN patients, arterial stiffness is changed compared to healthy individuals. PWVao above 11,15 m/s is associated with 4,3 (2,3–8,2) times higher rate of atherosclerosis plaque detection. In patients with HTN and SA arterial stiffness is higher, which might have additional predictive value in risk stratification.

Augmentor action of the sympathetic cardiac nerves in man

1960 ◽  
Vol 15 (4) ◽  
pp. 629-631 ◽  
Author(s):  
Walter C. Randall ◽  
Howard McNally
Keyword(s):  
Electrical Stimulation ◽  
Surgical Procedures ◽  
Pulse Pressure ◽  
Diastolic Pressure ◽  
Animal Experiments ◽  
Systolic Pressure ◽  
Myocardial Contraction ◽  
Inotropic Action ◽  
Upper Thoracic ◽  
Cardiac Nerves

During surgical procedures involving the upper thoracic sympathetic trunk in man, systolic and diastolic pressures were recorded during electrical stimulation. Significant and frequently profound elevation in systolic pressure, with little change in diastolic pressure, resulted in a marked increase in pulse pressure which has been designated as an augmentor response. Cardiac acceleration was an accompanying but less impressive response. The upper four or five thoracic segments mediate both the chronotropic and the inotropic action of the sympathetics but the T1 to T3 levels are the most significant. Corollary observations in animal experiments indicate the response is related to increased force of myocardial contraction with consequent increased systolic ejection. Submitted on February 1, 1960

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