PS 05-57 24-HOUR AORTIC BLOOD PRESSURE VARIABILITY IS BETTER ASSOCIATED WITH CAROTID INTIMAL-MEDIAL THICKNESS AND CROSS-SECTIONAL AREA THAN BRACHIAL BLOOD PRESSURE VARIABILITY

Background. Central aortic blood pressure (CABP) indices, central hemodynamics, and arterial stiffness are better predictors of cardiovascular events as compared with brachial cuff pressure measurements alone. The present study is aimed at assessing the effects of different antihypertensive drug combination regimens involving renin-angiotensin-aldosterone system (RAAS) inhibitors on CABP indices in Indian patients with hypertension. Methods. This was a cross-sectional, single-center study conducted in patients treated for hypertension for >6 weeks using different treatment regimens involving the combination of RAAS inhibitors with drugs from other classes. CABP indices, vascular age, arterial stiffness, and central hemodynamics were measured in patients using the noninvasive Agedio B900 device (IEM, Stolberg, Germany) and compared between different treatment regimens. Results. A total of 199 patients with a mean age of 54.22±10.15 years were enrolled, where 68.8% had hypertension for over three years and 50.25% had their systolic blood pressure SBP<140 mmHg. Combination treatment with angiotensin II receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) was given to 77.9% and to 20.1% patients, respectively. The mean vascular age was higher than the actual age (58.13±12.43 vs. 54.22±10.15, p=0.001). The SBP and diastolic blood pressure (DBP) levels in patients treated with ACEI-based combinations were lower than those in patients treated with ARB-based combinations (p<0.05). The mean central pulse pressure amplification, augmentation pressure, and augmentation index were lower in patients treated with ACEI-based combinations than those treated with other treatments (p=0.001). In a subgroup analysis, patients given perindopril and calcium channel blockers (CCBs) or diuretics had significantly lower CABP and pulse wave velocity than those given other treatments (p<0.05). A total of 6.5% patients experienced any side effects. Conclusion. The majority of central hemodynamic parameters, including vascular age, were found to improve more effectively in patients treated with ACEIs than with ARBs. Our results indicate a gap between routine clinical practice and evidence-based guidelines in Indian settings and identify a need to reevaluate the current antihypertensive prescription strategy.

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Interarm Differences in Brachial Blood Pressure and their Effect on the Derivation on Central Aortic Blood Pressure

Artery Research ◽

10.2991/artres.k.200201.002 ◽

2020 ◽

Author(s):

Karen C. Peebles ◽

Isabella Tan ◽

Mitchell T.D. Cook ◽

Davis A. Theobald ◽

Alberto P. Avolio ◽

...

Keyword(s):

Blood Pressure ◽

Brachial Blood Pressure ◽

Aortic Blood ◽

Aortic Blood Pressure ◽

Central Aortic Blood Pressure

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In spontaneously hypertensive rats alterations in aortic wall properties precede development of hypertension

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.2000.278.4.h1241 ◽

2000 ◽

Vol 278 (4) ◽

pp. H1241-H1247 ◽

Cited By ~ 47

Author(s):

Ad W. van Gorp ◽

Dorette S. Van Ingen Schenau ◽

Arnold P. G. Hoeks ◽

Harry A. J. Struijker Boudier ◽

Jo G. R. de Mey ◽

...

Keyword(s):

Blood Pressure ◽

Elastic Modulus ◽

Spontaneously Hypertensive Rats ◽

Aortic Wall ◽

Cross Sectional Area ◽

Sectional Area ◽

Hypertensive Rats ◽

Cross Sectional ◽

Spontaneously Hypertensive ◽

Wall Properties

In hypertension arterial wall properties do not necessarily depend on increased blood pressure alone. The present study investigates the relationship between the development of hypertension and thoracic aortic wall properties in 1.5-, 3-, and 6-mo-old spontaneously hypertensive rats (SHR); Wistar-Kyoto rats (WKY) served as controls. During ketamine-xylazine anesthesia, compliance and distensibility were assessed by means of a noninvasive ultrasound technique combined with invasive blood pressure measurements. Morphometric measurements provided in vivo media cross-sectional area and thickness, allowing the calculation of the incremental elastic modulus. Extracellular matrix protein contents were determined as well. Blood pressure was not significantly different in 1.5-mo-old SHR and WKY, but compliance and distensibility were significantly lower in SHR. Incremental elastic modulus was not significantly different between SHR and WKY at this age. Media thickness and media cross-sectional area were significantly larger in SHR than in WKY, but there was no consistent difference in collagen density and content between the strains. Blood pressure was significantly higher in 3- and 6-mo-old SHR than in WKY, and compliance was significantly lower in SHR. The findings in this study show that in SHR, in which hypertension develops over weeks, alterations in functional aortic wall properties precede the development of hypertension. The decrease in compliance and distensibility at a young age most likely results from media hypertrophy rather than a change in intrinsic elastic properties.

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Does central aortic blood pressure better correlate with left ventricular mass compared to brachial blood pressure measurements in pre-hypertensives?

Journal of Cardiovascular Magnetic Resonance ◽

10.1186/1532-429x-12-s1-p177 ◽

2010 ◽

Vol 12 (S1) ◽

Author(s):

Tarek M Mousa ◽

Mark Balek ◽

Gorgi Kozeski ◽

Sofya Kostanyan ◽

Susan Ingenito ◽

...

Keyword(s):

Blood Pressure ◽

Left Ventricular Mass ◽

Left Ventricular ◽

Pressure Measurements ◽

Brachial Blood Pressure ◽

Aortic Blood ◽

Ventricular Mass ◽

Aortic Blood Pressure ◽

Central Aortic Blood Pressure

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Angiotensin-(1–7) attenuates angiotensin II-induced cardiac remodeling associated with upregulation of dual-specificity phosphatase 1

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00908.2011 ◽

2012 ◽

Vol 302 (3) ◽

pp. H801-H810 ◽

Cited By ~ 57

Author(s):

LaTronya T. McCollum ◽

Patricia E. Gallagher ◽

E. Ann Tallant

Keyword(s):

Blood Pressure ◽

Natriuretic Peptide ◽

Cardiac Remodeling ◽

Cross Sectional Area ◽

Ang Ii ◽

Sectional Area ◽

Cross Sectional ◽

Dual Specificity Phosphatase ◽

Dual Specificity ◽

Mapk Phosphatase

Chronic hypertension induces cardiac remodeling, including left ventricular hypertrophy and fibrosis, through a combination of both hemodynamic and humoral factors. In previous studies, we showed that the heptapeptide ANG-(1–7) prevented mitogen-stimulated growth of cardiac myocytes in vitro, through a reduction in the activity of the MAPKs ERK1 and ERK2. In this study, saline- or ANG II-infused rats were treated with ANG-(1–7) to determine whether the heptapeptide reduces myocyte hypertrophy in vivo and to identify the signaling pathways involved in the process. ANG II infusion into normotensive rats elevated systolic blood pressure >50 mmHg, in association with increased myocyte cross-sectional area, ventricular atrial natriuretic peptide mRNA, and ventricular brain natriuretric peptide mRNA. Although infusion with ANG-(1–7) had no effect on the ANG II-stimulated elevation in blood pressure, the heptapeptide hormone significantly reduced the ANG II-mediated increase in myocyte cross-sectional area, interstitial fibrosis, and natriuretic peptide mRNAs. ANG II increased phospho-ERK1 and phospho-ERK2, whereas cotreatment with ANG-(1–7) reduced the phosphorylation of both MAPKs. Neither ANG II nor ANG-(1–7) altered the ERK1/2 MAPK kinase MEK1/2. However, ANG-(1–7) infusion, with or without ANG II, increased the MAPK phosphatase dual-specificity phosphatase (DUSP)-1; in contrast, treatment with ANG II had no effect on DUSP-1, suggesting that ANG-(1–7) upregulates DUSP-1 to reduce ANG II-stimulated ERK activation. These results indicate that ANG-(1–7) attenuates cardiac remodeling associated with a chronic elevation in blood pressure and upregulation of a MAPK phosphatase and may be cardioprotective in patients with hypertension.

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