Systolic blood pressure, pulse pressure and arterial stiffness as cardiovascular risk factors

2001 ◽  
Vol 10 (2) ◽  
pp. 257-261 ◽  
Author(s):  
Michel E Safar
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Arterial Stiffness ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Pulse Pressure ◽  
Pressure Pulse

Abstract 1316: Preclinical Atherosclerosis in Primary Antiphospholipid Syndrome: The Impact of Oxidative Properties of High Density Lipopoprotein

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Marietta Charakida ◽  
Julian Halcox ◽  
Joanna Batuca ◽  
Ann Donald ◽  
Shirish Sangle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Arterial Stiffness ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Antiphospholipid Syndrome ◽  
High Density ◽  
Primary Antiphospholipid Syndrome ◽  
The Impact

Background: Antiphospholipid syndrome (APS) is characterised by increased thrombogenicity and/or pregnancy morbidity in the presence of raised levels of antiphospholipid antibodies (aPL). Increased oxidative properties of high density lipoprotein (HDL)(decreased activity of paraoxonase (PON)) is associated with increased risk for atherosclerosis and has been described in APS. The impact of PON on atherosclerotic disease progression in APS is unclear. We therefore examined the effect of PON on intima media thickness (IMT), and pulse wave velocity (PWV) in patients with positive aPL. Methods: We studied 77 women with positive aPL (aPL) aged 46.6±1.2 yrs (mean±SE) and a control group of 77 women aged 47.5±1.2 yrs matched for traditional cardiovascular risk factors. High resolution ultrasound was used to determine carotid IMT. Arterial stiffness was assessed non-invasively by carotid-radial PWV. PON activity was assessed by measuring p-nitrophenol formation and activity expressed as nmoles p-nitrophenol/ml serum/minute. Results: APL patients had significantly increased IMT and PWV compared to controls (0.75±0.02mm vs 0.65±0.01mm, p<0.001 and 9.14±0.18 m/s vs 8.56±0.21m/s, p<0.05 respectively). PON activity was significantly reduced in aPL compared to controls (91.5[64.3, 05.1]mmol/ml/min, median[IQR] vs 103.1[80.4, 111.5] mmol/ml/min, p<0.006). Although PON activity was not associated with vascular measures in controls, an inverse association was noted in aPL patients (r=−0.26 [cIMT] and r=−0.23 [PWV], both p<0.05). In multivariate analysis, accounting for cardiovascular risk factors, PON activity (β=−0.42, p<0.001), age (β=0.33, p<0.001) and systolic blood pressure (β=0.24, p<0.05) were independent determinants of cIMT while PON activity (β=−0.32, p<0.01) and systolic blood pressure (β=0.28, p<0.05) remained the only independent predictors of PWV in aPL positive patients. Conclusions: APS is associated with increased arterial stiffness and carotid intimal thickening. Paraoxonase activity is inversely associated with IMT and PWV in ApL positve patients. These findings indicate that oxidative stress may play an important role in the development of atherosclerosis in patients with primary antiphospholipid syndrome.

Long-term effects (>24 months) of multiple lifestyle intervention on major cardiovascular risk factors among high risk subjects: a meta-analysis

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
H Bergum ◽  
I Sandven ◽  
TO Klemsdal
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Total Cholesterol ◽  
Cardiovascular Risk Factors ◽  
Lifestyle Intervention ◽  
Small Study ◽  
Long Term Effects

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Norwegian health department Background The evidence of the long-term effects of multiple lifestyle intervention on cardiovascular risk is uncertain. We aimed to summarize the evidence from randomized clinical trials examining the efficacy of lifestyle intervention on major cardiovascular risk factors in subjects at high cardiovascular risk. Methods  Eligible trials investigated the impact of lifestyle intervention versus usual care with minimum 24 months follow-up, reporting more than one major cardiovascular risk factor. A literature search updated April 15, 2020 identified 12 eligible studies. The results from individual trials were combined using fixed and random effect models, using the standardized mean difference (SMD) to estimate effect sizes. Small-study effect was evaluated, and heterogeneity between studies examined by subgroup and meta-regression analyses considering patient- and study-level variables. Results  Small-study effect was not identified. Lifestyle intervention reduced systolic blood pressure modestly with an estimated SMD of -0.13, 95% confidence interval (CI): -0.21 to -0.04, with moderate heterogeneity (I² = 59%), corresponding to a mean difference of approximately 2 mmHg (MD = -1.86, 95% CI: -3.14 to -0.57, p = 0.0046). This effect disappeared in the subgroup of trials judged at low risk of bias (SMD = 0.02, 95% CI: -0.08 to 0.11). For the outcome total cholesterol SMD was -0.06, 95% CI: -0.13 to 0.00, with no heterogeneity (I² = 0%), indicating no effect of the intervention. Conclusion  Lifestyle intervention resulted in only a modest effect on systolic blood pressure and no effect on total cholesterol after 24 months. Further lifestyle trials should consider the challenge of maintaining larger long-term benefits to ensure impact on cardiovascular outcomes.

scholarly journals Association of arterial wall stiffness with cardiovascular risk factors

2009 ◽  
Vol 15 (3) ◽  
pp. 290-295 ◽  
Author(s):  
V. V. Ivanenko ◽  
O. P. Rotar ◽  
A. Konradi
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Arterial Stiffness ◽  
Cardiovascular Risk Factors ◽  
Cholesterol Level ◽  
Augmentation Index ◽  
Central Blood Pressure ◽  
Blood Pressure Elevation ◽  
Wall Stiffness

Objective. To assess relation between central blood pressure and arterial stiffness with cardiovascular risk factors. Design and methods. 116 subjects considering themselves healthy were examined. 63 showed blood pressure elevation. Anthropometry was performed and fasting blood specimens were obtained from all patients. Plasma glucose and lipids levels were measured. Pulse wave velocity (PWV) and augmentation index (AI) were measured by Sphygmocor Px device (Australia). Results. Parameters of arterial stiffness were strongly associated with hypertension, increased waist circumference, age, cholesterol level, and metaboloc syndrome. Females had higher AI as compared to males. Conclusion. Central blood pressure and arterial stiffness are determined not only by age and peripheral blood pressure but by cholesterol level and anthropometric parameters as well.

Abstract P011: Cardiovascular Risk Factors and Longevity

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Michelle C Odden ◽  
Andreea Rawlings ◽  
Alice Arnold ◽  
Mary Cushman ◽  
Mary Lou Biggs ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Old Age ◽  
Repeated Measures ◽  
Ldl Cholesterol ◽  
Low Cardiovascular Risk

Introduction: Cardiovascular disease is the leading cause of mortality in old age, yet there is limited research on the patterns of cardiovascular risk factors that predict survival to 90 years. Hypothesis: The patterns of cardiovascular risk factors that portend longevity will differ from those that confer low cardiovascular risk. Methods: We examined repeated measures of blood pressure, LDL-cholesterol, and BMI from age 67 and survival to 90 years in the Cardiovascular Health Study (CHS). CHS is a prospective study of 5,888 black and white adults in two waves (1989-90 and 1992-93) from Medicare eligibility lists in four counties in the U.S. We restricted to participants aged 67 to 75 years at baseline to control for birth cohort effects and examined repeated measures of cardiovascular risk factors throughout the late-life course. We fit logistic regression models to predict survival to age 90 using generalized estimating equations, and modeled the risk factors as linear, a linear spline, and clinically relevant categories. Models were adjusted for demographics and medication use, and we also examined whether the association of each risk factor with longevity varied by the age of risk factor measurement. Best fit models are presented. Results: Among 3,645 participants in the birth cohort, 1,160 (31.8%) survived to 90 by June 16 th , 2015. Higher systolic blood pressure in early old age was associated with reduced odds for longevity, but there was an interaction with age such that the association crossed the null at 80 years. (Table) Among those with LDL-cholesterol <130 mg/dL, higher LDL-cholesterol was associated with greater longevity; at levels above 130 mg/dL there was no association between LDL-cholesterol and longevity. BMI had a u-shaped association with longevity. Conclusions: In summary, the patterns of risk factors that predict longevity differ from that considered to predict low cardiovascular risk. The risk of high systolic blood pressure appears to depend on the age of blood pressure measurement.

scholarly journals Hypothetical interventions and risk of myocardial infarction in a general population: application of the parametric g-formula in a longitudinal cohort study—the Tromsø Study

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e035584
Author(s):  
Tom Wilsgaard ◽  
Anne Merete Vangen-Lønne ◽  
Ellisiv Mathiesen ◽  
Maja-Lisa Løchen ◽  
Inger Njølstad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Blood Pressure ◽  
Cohort Study ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Risk Reduction ◽  
Absolute Risk

ObjectivesThe aim of this study was to use the parametric g-formula to estimate the 19-year risk of myocardial infarction (MI) under hypothetical interventions on six cardiovascular risk factors.Design and settingA populations-based cohort study with repeated measurements, the Tromsø Study.Primary outcome measureMyocardial infarction.ParticipantsWe estimated the relative and absolute risk reduction under feasible and intensive risk reduction strategies for smoking, physical activity, alcohol drinking, body mass index, total serum cholesterol and systolic blood pressure in 14 965 men and women with 19 years of follow-up (1994–2013).ResultsThe estimated 19-year risk of MI under no intervention was 7.5% in individuals with baseline mean age 49.3 years (range 25–69). This risk was reduced by 30% (95% CI 19% to 39%) under joint feasible interventions on all risk factors, and 70% (60%, 78%) under a set of more intensive interventions. The most effective interventions were lowering of total cholesterol to 5.18 mmol/L and lowering of systolic blood pressure to 120 mm Hg (33% and 37% lower MI risk, respectively). The absolute risk reductions were significantly larger in men, in older participants, in smokers and in those with low education.ConclusionModification of population levels of cardiovascular risk factors could have prevented close to one-third of the cases of MI in the municipality of Tromsø during 19 years of follow-up.

scholarly journals Independent cardiovascular risk factors: hyperhomocysteinemia and vascular stiffness in patients with hypertension

HYPERTENSION ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 5-16
Author(s):  
O.L. Rekovets ◽  
Yu.M. Sirenko ◽  
O.O. Torbas ◽  
S.M. Kushnir ◽  
H.F. Prymak ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Body Mass Index ◽  
Glomerular Filtration Rate ◽  
Cardiovascular Risk ◽  
Arterial Stiffness ◽  
Cardiovascular Risk Factors ◽  
Glomerular Filtration ◽  
Body Mass ◽  
Filtration Rate

Background. Identification of risk factors and preliminary assessment of overall cardiovascular risk in patients with hypertension is the most important task in clinical practice. Most patients, in addition to high blood pressure (BP), have other cardiovascular risk factors that aggravate each other, leading to an increase in overall cardiovascular risk. One of the cardiovascular risk factors is an increased arterial stiffness. Arterial stiffness is evaluated using pulse wave velocity (PWV). The other independent risk factor for cardiovascular diseases is elevated level of total homocysteine in the blood. The purpose was to evaluate the relationship between hyperhomocysteinemia (HHc) and vascular stiffness in patients with hypertension. Materials and methods. Our research was carried out as a part of the ХІПСТЕР trial in Ukraine. The study included 40 patients with hypertension stage 1 and 2 (average office systolic (SBP)/diasto-lic blood pressure (DBP) was 155.88/92.60 ± 1.63/1.43 mmHg, heart rate — 71.40 ± 1.29 bpm). The average age of the patients was 55.85 ± 2.09 (26–74) years. Individuals with homocysteine levels ≥ 10 μmol/l were referred to as those with HHc (H-type hypertension). Arterial stiffness was determined by PWV. Results. We found that at the beginning of the study, 75 % of patients (30 individuals with mild and moderate hypertension) had H-type hypertension with an increased level of homocysteine. Patients with H-type hypertension (HHc) and hypertension without HHc did not differ in terms of age, duration of hypertension. At the same time, patients with H-type hypertension had higher body weight and body mass index. Office SBP in patients with H-type hypertension at baseline and after 6 months of treatment was higher compared to patients without HHc (156.45 ± 1.04 mmHg and 152.55 ±1.41 mmHg (p < 0.05) at baseline vs 130.65 ± 0.96 mmHg and 126.97 ± 1.08 mmHg (p < 0.05) in 6 months). At the beginning of the study, body mass index was 30.72 ± 0.39 kg/m2 in patients with H-type hypertension vs 28.34 ± 0.69 kg/m2 in those without HHc (p < 0.05). Patients with H-type hypertension less often achieved target blood pressure levels during treatment and initially had higher blood pressure values. Individuals with H-type hypertension compared to patients without HHc had a more severe insulin resistance (according to the homeostatic model assessment), lower glomerular filtration rate, both at baseline and by the end of treatment. According to ambulatory blood pressure monitoring data, before the start of treatment, patients with H-type hypertension compared to those with hypertension without HHc had a significantly higher SBP level. After regression analysis, homocysteine level was associated with PWVel, regardless of the degree of BP reduction (PWVel (6 months), m/s, b = 0.307, P = 0.001). Conclusions. Male gender, body mass index, glomerular filtration rate, blood glucose, office and central blood pressure were associated with elevated serum homocysteine levels.

Abstract P333: Carotid Intima Media Echolucency is Related to Age, Female Sex, Systolic Blood Pressure, BMI and Smoking in Patients with Familial Hypercholesterolemia

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Karlijn A Groenewegen ◽  
Sanne A Peters ◽  
Hester M den Ruijter ◽  
Michiel L Bots
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Familial Hypercholesterolemia ◽  
Controlled Trial ◽  
Multivariable Model ◽  
Female Sex ◽  
The Common

Background: Atherosclerotic vascular disease can be assessed non-invasively with B-mode ultrasound. Echolucency is an ultrasound characteristic which is measured as the Gray Scale Median (GSM). Echolucent structures appear dark on ultrasound images; echogenic structures appear light. Echolucency of the carotid intima-media is thought to be a marker of the content of the vascular wall, where low values of GSM might reflect inflammation and/or high lipid content and high values of GSM reflect increased collagen and/or calcifications. In previous studies in asymptomatic individuals, echolucency of the carotid intima-media was associated with cardiovascular risk factors. Studies in high-risk populations are lacking. Aim: To assess the relation between cardiovascular risk factors and carotid intima media echolucency in patients with familial hypercholesterolemia. Methods: Baseline data were used from the RADIANCE 1 trial, a randomized controlled trial on the effects of atorvastatin and torcetrapib (a CETP-inhibitor) compared to atorvastatin alone in familial hypercholesterolemia. Echolucency of the common carotid artery intima media was measured as the mean GSM of the first baseline visit. Linear mixed effects models were used to assess the relation between each cardiovascular risk factor and mean GSM (adjusted for age, sex and carotid intima media thickness (CIMT), and in a multivariable model containing all risk factors). We studied systolic blood pressure (SBP), body mass index (BMI), high and low density lipoprotein (HDL and LDL), triglycerides (TGs), smoking, diabetes mellitus and C - reactive protein (CRP). Results: 875 patients were included in the current analysis. Mean age was 46 years (sd 13) and 50% was female. Mean GSM was 67 (sd 18). In age, sex and CIMT adjusted analyses, higher age (ß/sd: -5.71 (95% CI-6.82;-4.61)), female sex (β:-3.53 (95% CI -5.32;-1.73)), higher SBP (β/sd:-1.86 (95% CI -2.81;-0.91)), higher BMI (β/sd:-2.37 (95% CI -2.26;-1.29)) and higher levels of TGs (β/sd:-1.34 (95% CI -2.21;-0.47 were related to a lower GSM (i.e, more echolucency) and smoking (ß 2.91 (95% CI 0.52-5.29)) was related to a higher GSM. In the multivariable model, age (β/sd: -4.92 (95% CI -6.18;-3.65)), female sex (β: -4.35 (-6.41;-2.29), systolic blood pressure (β/sd: -1.32 (-2.38;-0.25) and BMI (β/sd: -1.82 (-2.90;-0.73)) were related to a lower GSM and smoking (β: 2.78 (0.39;5.18)) was related to a higher GSM. Conclusion: Several established risk factors were related to the echolucency of the common carotid intima media in patients with familial hypercholesterolemia.

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