Arterial stiffness: clinical relevance, measurement and treatment

2007 ◽  
Vol 113 (4) ◽  
pp. 157-170 ◽  
Author(s):  
Paul K. Hamilton ◽  
Christopher J. Lockhart ◽  
Cathy E. Quinn ◽  
Gary E. Mcveigh
Keyword(s):  
Cardiovascular Risk ◽  
Arterial Stiffness ◽  
Arterial Wall ◽  
Pressure Pulse ◽  
Pulse Wave ◽  
Waveform Analysis ◽  
Evidence Based ◽  
Velocity Pulse ◽  
Pulse Waveform Analysis ◽  
Vessel Mechanics

Most traditional cardiovascular risk factors alter the structure and/or function of arteries. An assessment of arterial wall integrity could therefore allow accurate prediction of cardiovascular risk in individuals. The term ‘arterial stiffness’ denotes alterations in the mechanical properties of arteries, and much effort has focused on how best to measure this. Pulse pressure, pulse wave velocity, pulse waveform analysis, localized assessment of blood vessel mechanics and other methods have all been used. We review the methodology underlying each of these measures, and present an evidence-based critique of their relative merits and limitations. An overview is also given of the drug therapies that may prove useful in the treatment of patients with altered arterial mechanics.

scholarly journals Elevated levels of urine isocitrate, hydroxymethylglutarate, and formiminoglutamate are associated with arterial stiffness in Korean adults

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ji-Hee Haam ◽  
Young-Sang Kim ◽  
Doo-Yeoun Cho ◽  
Hyejin Chun ◽  
Sang-Woon Choi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Cardiovascular Risk Factors ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Urinary Metabolites ◽  
Metabolic Disturbances ◽  
Liquid Chromatograph

AbstractRecent evidence suggests that cellular perturbations play an important role in the pathogenesis of cardiovascular diseases. Therefore, we analyzed the association between the levels of urinary metabolites and arterial stiffness. Our cross-sectional study included 330 Korean men and women. The brachial-ankle pulse wave velocity was measured as a marker of arterial stiffness. Urinary metabolites were evaluated using a high-performance liquid chromatograph-mass spectrometer. The brachial-ankle pulse wave velocity was found to be positively correlated with l-lactate, citrate, isocitrate, succinate, malate, hydroxymethylglutarate, α-ketoisovalerate, α-keto-β-methylvalerate, methylmalonate, and formiminoglutamate among men. Whereas, among women, the brachial-ankle pulse wave velocity was positively correlated with cis-aconitate, isocitrate, hydroxymethylglutarate, and formiminoglutamate. In the multivariable regression models adjusted for conventional cardiovascular risk factors, three metabolite concentrations (urine isocitrate, hydroxymethylglutarate, and formiminoglutamate) were independently and positively associated with brachial-ankle pulse wave velocity. Increased urine isocitrate, hydroxymethylglutarate, and formiminoglutamate concentrations were associated with brachial-ankle pulse wave velocity and independent of conventional cardiovascular risk factors. Our findings suggest that metabolic disturbances in cells may be related to arterial stiffness.

scholarly journals The Emergence of Ambulatory Measurement of Arterial Stiffness and Central Blood Pressure. A Promising Novelty of Clinical Importance or Just Another Marker?

2013 ◽  
Vol 5 (1) ◽  
pp. 82-86
Author(s):  
A. Lazaridis ◽  
E. Gkaliagkousi ◽  
M. Doumas ◽  
A. Reklou ◽  
A. Karagiannis
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Arterial Stiffness ◽  
Integrated Assessment ◽  
Pulse Wave ◽  
Clinical Importance ◽  
Organ Damage ◽  
Brachial Blood Pressure ◽  
Ambulatory Measurement ◽  
The Everyday

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.

Carotid arterial stiffness is increased and related to left ventricular function in patients with hypertrophic cardiomyopathy

2019 ◽  
Vol 21 (8) ◽  
pp. 923-931
Author(s):  
Monica Roşca ◽  
Leonard Mandeş ◽  
Daniela Ciupercă ◽  
Andreea Călin ◽  
Carmen C Beladan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Elastic Modulus ◽  
Hypertrophic Cardiomyopathy ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Left Ventricular Function ◽  
Pulse Wave ◽  
Left Ventricular ◽  
Carotid Arterial

Abstract Aims To assess the carotid mechanical properties in patients with hypertrophic cardiomyopathy and the relation between arterial stiffness and left ventricular function in this setting. Methods and results We have prospectively enrolled 71 patients (52 ± 16 years, 34 men) with hypertrophic cardiomyopathy, divided into two groups depending on the presence (46 patients) or absence (25 patients) of cardiovascular risk factors associated with increased arterial stiffness. Twenty-five normal subjects similar by age and gender with hypertrophic cardiomyopathy patients without risk factors formed the control group. A comprehensive echocardiography was performed in all subjects. Carotid arterial stiffness index (β index), pressure–strain elastic modulus, arterial compliance, and pulse wave velocity were also obtained using an echo-tracking system. β index, pulse wave velocity, and pressure–strain elastic modulus were significantly higher in hypertrophic cardiomyopathy patients without risk factors compared to controls. After linear regression analysis, the increase in carotid β index was independently correlated with the presence of hypertrophic cardiomyopathy [beta = 0.49, 95% confidence interval (CI) = 1.04–3.02; P < 0.001]. In the entire hypertrophic cardiomyopathy population arterial stiffness parameters correlated with age, gender, hypertension degree, presence of hypercholesterolaemia, and the E/e′ ratio. In multivariable analysis, β index (beta = 0.36, 95% CI = 0.32–1.25; P = 0.001), global left ventricular longitudinal strain, and the presence of left ventricular outflow tract obstruction were independently correlated with the E/e′ ratio. Conclusion In patients with hypertrophic cardiomyopathy arterial stiffness is increased independently of age or presence of cardiovascular risk factors. Carotid artery stiffness is independently related to left ventricular filling pressure, increased arterial stiffness representing a possible marker of a more severe phenotype.

Association of High Serum Uric Acid and Increased Arterial Stiffness is Dependent on Cardiovascular Risk Factors in Female Population

2019 ◽  
Vol 51 (06) ◽  
pp. 367-374 ◽  
Author(s):  
Yin Yuan ◽  
Feng Huang ◽  
Fan Lin ◽  
Min Lin ◽  
Pengli Zhu
Keyword(s):  
Risk Factors ◽  
Uric Acid ◽  
Cardiovascular Risk ◽  
Arterial Stiffness ◽  
Cardiovascular Risk Factors ◽  
Serum Uric Acid ◽  
Pulse Wave ◽  
Elevated Serum ◽  
High Serum ◽  
Female Population

AbstractAn elevated serum uric acid (SUA) level is closely associated with increased arterial stiffness. However, whether this association is independent of conventional cardiovascular risk factors is controversial. This study aimed to investigate whether SUA is independently associated with arterial stiffness as assessed by Brachial-ankle pulse wave velocity (baPWV), and to what extent this association is dependent on cardiovascular risk factors. Increased arterial stiffness was defined as baPWV>1 400 cm/s. Cardiovascular risk factors were defined as hypertension, diabetes, dyslipidaemia, and a BMI≥24.0 kg/m2. A total of 3 342 subjects (1 334 men and 2008 women, mean age 53.79±13.18 years) were included. SUA levels exhibited a graded elevation with an increasing number of cardiovascular risk factors. In female subjects with more than two cardiovascular risk factors, compared with the first quartile of SUA, higher SUA quartiles were associated with a higher probability of increased baPWV (OR=1.500, 1.478, 1.774 for SUA Q2–Q4). In further stratified association analysis, compared with Q1, SUA quartiles showed a graded association with increased baPWV in subjects with TC≥5.2 mmol/l (OR=1.758, 1.942, 2.354 for Q2, Q3, and Q4 respectively), LDL-C≥3.3 mmol/l (OR=1.510, 2.255 for Q3 and Q4) and FBG≥7.0 mmol/l (OR=1.516, 1.748 for Q3 and Q4). In the Chinese coastal female population, the association of high SUA and increased arterial stiffness is dependent on the coexistence of at least one cardiovascular risk factor, especially hypercholesterolemia.

scholarly journals Arterial Stiffness and Renal Replacement Therapy: A Controversial Topic

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Edmundo Cabrera Fischer ◽  
Yanina Zócalo ◽  
Cintia Galli ◽  
Sandra Wray ◽  
Daniel Bia
Keyword(s):  
Renal Replacement Therapy ◽  
Arterial Stiffness ◽  
Replacement Therapy ◽  
Arterial Wall ◽  
Pulse Wave ◽  
Wall Stiffness ◽  
Reliable Parameter ◽  
Controversial Topic ◽  
Stage Renal Disease ◽  
End Stage

The increase of arterial stiffness has been to have a significant impact on predicting mortality in end-stage renal disease patients. Pulse wave velocity (PWV) is a noninvasive, reliable parameter of regional arterial stiffness that integrates the vascular geometry and arterial wall intrinsic elasticity and is capable of predicting cardiovascular mortality in this patient population. Nevertheless, reports on PWV in dialyzed patients are contradictory and sometimes inconsistent: some reports claim the arterial wall stiffness increases (i.e., PWV increase), others claim that it is reduced, and some even state that it augments in the aorta while it simultaneously decreases in the brachial artery pathway. The purpose of this study was to analyze the literature in which longitudinal or transversal studies were performed in hemodialysis and/or peritoneal dialysis patients, in order to characterize arterial stiffness and the responsiveness to renal replacement therapy.

scholarly journals Relationship of arterial wall parameters to cardiovascular risk factors and cardiovascular risk assessed by SCORE system

Medicina ◽  
2007 ◽  
Vol 43 (7) ◽  
pp. 529 ◽  
Author(s):  
Milda Kovaitė ◽  
Žaneta Petrulionienė ◽  
Ligita Ryliškytė ◽  
Jolita Badarienė ◽  
Alma Čypienė ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Arterial Wall ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness ◽  
Flow Mediated Dilatation

Objective. To investigate the relationship of arterial wall parameters (flow-mediated dilatation of the brachial artery, augmentation index, pulse wave velocity, stiffness index, carotid intima-media thickness) to conventional cardiovascular risk factors and cardiovascular risk assessed by SCORE system. Material and methods. A total of 209 subjects aged 40–65 years without clinically overt cardiovascular disease were examined. Parameters of arterial stiffness were obtained by two methods: augmentation index and carotid-radial pulse wave velocity by applanation tonometry and stiffness index by the means of finger photoplethysmography. Flow-mediated dilatation of the brachial artery, reflecting endothelial function, and carotid intima-media thickness was determined using a high-resolution B-mode ultrasonography. Results. Age and the presence of diabetes strongly influenced all parameters of the arterial wall (diabetes was not independent predictor when evaluating augmentation index). Mean arterial pressure and gender were independent predictors for arterial stiffness parameters – carotid-radial pulse wave velocity and augmentation index. Flow-mediated dilatation was strongly dependent on the diameter of the brachial artery, age, and body mass index. Using logistic regression, it was found that pulse wave velocity (P=0.014), intima-media thickness (P=0.004), and flow-mediated dilatation (P=0.020) were important parameters dividing subjects to the groups of increased (³5%) and low (<5%) cardiovascular risk assessed by SCORE system. The cutoff values for intima-media thickness and pulse wave velocity were 0.078 cm and 8.95 m/s, respectively. Conclusions. Arterial wall parameters are closely associated with conventional risk factors; they are influenced by age and the presence of diabetes. Arterial stiffness parameters are also influenced by mean arterial pressure; high-density lipoprotein cholesterol has influence on carotid intima-media thickness. Cutoff values for carotid intima-media thickness and carotid-radial pulse wave velocity could help to discriminate patients with increased cardiovascular risk.

scholarly journals The increasing of arterial vascular resistance is a primary factor of development isolated systolic hypertensions

2007 ◽  
Vol 13 (1) ◽  
pp. 7-13
Author(s):  
A. A. Sokolov ◽  
M. V. Soldatenko
Keyword(s):  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Arterial Hypertension ◽  
Vascular Resistance ◽  
Vascular Tone ◽  
Arterial Wall ◽  
Pulse Wave ◽  
Vascular Wall ◽  
Non Invasive ◽  
Modern Methods

In the submitted review value of increase of vascular resistance and a vascular tone in development of an isolated arterial hypertension has been shown. Parameters of elasticity of the arteries, used for the characteristic of properties of a vascular wall are discussed. In the review modern methods non invasive study of the properties of the arterial wall was described. The special attention has been given study of the pulse wave velocity, value of parameters of resistance and arterial stiffness for an estimation of the forecast was shown.

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