PARALLEL CHANGE IN PERIPHERAL AND NONAUGMENTED CENTRAL PULSE PRESSURE WITH AGE

Abstract Background Central pulse pressure is responsible for the hemodynamics of vital organs, and monitoring this parameter is important for cardiovascular disease prevention. Excess sodium intake and (micro)albuminuria (a manifestation of renal microvascular damage) are known to be strong predictors of cardiovascular disease. We sought to investigate the cross-sectional relationships among dietary sodium intake, albuminuria, and central pulse pressure in a general population cohort. Methods The subjects were 933 apparently healthy adults (mean age, 56 ± 10 years). Radial pressure waveforms were recorded with applanation tonometry to estimate mean arterial pressure, central pulse pressure, forward and backward pressure amplitudes, and augmentation index. The urinary sodium/creatinine and albumin/creatinine ratios were measured in spot urine samples. Results Both the urinary sodium/creatinine and albumin/creatinine ratios were positively correlated with central pulse pressure, even after adjusting for mean arterial pressure (P < 0.001). Moreover, both ratios had a synergistic influence on increasing the central pulse pressure independent of age, sex, estimated glomerular filtration rate, hyperlipidemia, and diabetes (interaction P = 0.04). A similar synergistic influence was found on the forward pressure amplitude, but not on the backward pressure amplitude or augmentation index. The overall results were not altered when the urinary albumin/creatinine ratio was replaced with the existence of chronic kidney disease. Conclusion (Micro)albuminuria strengthens the positive association between urinary sodium excretion and central pulse pressure and systolic forward pressure. Excess sodium intake may magnify the cardiovascular risk by widening the aortic pulsatile pressure, particularly in the presence of concomitant chronic kidney disease.

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Central pulse load and coronary flow benefit in relation to endogenous testosterone and the Mediterranean regime in hypertensive males with erectile dysfunction

European Heart Journal ◽

10.1093/ehjci/ehaa946.2768 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

A Angelis ◽

K Aggeli ◽

N Ioakeimidis ◽

C Georgakopoulos ◽

K Zisimos ◽

...

Keyword(s):

Erectile Dysfunction ◽

Pulse Pressure ◽

Coronary Flow ◽

Linear Regression Analysis ◽

Significant Coronary Artery Disease ◽

Diet Adherence ◽

Flow Reserve ◽

Arterial Blood ◽

The Mediterranean ◽

Central Pulse Pressure

Abstract Background Central pulse pressure (cPP) is an important parameter of target organ damage (TOD) in essential hypertension. Coronary flow reserve (CFR) displays the ability of both macro and microcirculation to augment flow to the myocardium while endogenous total testosterone (TT) exhibits vasodilator effects. The Mediterranean diet (Med-diet) benefits cardiovascular health and erectile dysfunction (ED) often coexists with the decline of endogenous testosterone in the aging male population. Purpose To investigate the possible benefits of the Med-diet in central PP, CFR and erectile ability in relation to endogenous TT in the primary hypertensive population with ED. Methods 247 male hypertensive patients (mean age 57 yo) with ED enrolled the study. Significant coronary artery disease was formerly excluded by a dobutamine stess echo test. We measured the CFR of the left anterior descending artery by performing an adenosine protocol (maximum dose 140 μg/kg/min over 6 minutes). Measurements by the PW Doppler were achieved at the middle/distal LAD segment under the guidance of color Doppler flow mapping. CFR was validated as ratio between peak diastolic flow velocity following drug infusion and rest. Ratios ≥2 are considered as non-ischemic response and higher values indicate microvascular coronary integrity. TT was measured in all patients on blood samples taken before 09:00 am. ED severity and adherence to the Med-diet were assessed by the SHIM-5 (range: 0–25) and the Med-diet (range: 0–55) scores. Higher values indicate a better erectile ability and Med-diet compliance respectively. Finally, cPP and augmentation index (AIx) were estimated as parameters of central hemodynamic load and wave reflection amplification respectively (sphygmocor device). Results In bivariate analysis Med-diet was favorably related to CFR (p=0.24, r=0.48), TT (p=0.01, r=0.57) and the SHIM-5 score (p=0.01, r=0.45). On the contrary, it was negatively related to cPP (p=0.15, r=−0.60) and AIx (p=0.31, r=−0.45). CFR was strongly related to TT (p=0.001, r=0.8) and the SHIM-5 score (p=0.01, r=0.41). By multiple linear regression analysis the relation of CFR, SHIM-5 and Med-diet score remained significant after adjustment for age, BMI, systolic arterial blood pressure and smoking habits. We further subdivide our population according to the mean Med-diet value (26) into high and low Med-diet adherence groups. Only in the group with the greater Med-diet adherence (n=153, 62%) there were still positive relation with the CFR, TT and SHIM-5 score as well as negative correlation to cPP and AIx (p=0.04). Conclusion In essential hypertensive males with erectile dysfunction the Med-diet regime lessens central pulse pressure while enhancing coronary flow, testosterone levels and so peripheral vascular physiology. We strongly recommend this dietary pattern as a life-style option and strategic component of holistic therapeutic approach. Funding Acknowledgement Type of funding source: None

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The Influence of Resting Heart Rate on Central Pulse Pressure is Age-Dependent

High Blood Pressure & Cardiovascular Prevention ◽

10.1007/s40292-020-00432-8 ◽

2021 ◽

Vol 28 (1) ◽

pp. 27-34

Author(s):

José Alfie ◽

Lucas S. Aparicio ◽

Paula E. Cuffaro

Keyword(s):

Heart Rate ◽

Pulse Pressure ◽

Resting Heart Rate ◽

Age Dependent ◽

Central Pulse Pressure

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24-hour central aortic systolic pressure and 24-hour central pulse pressure are related to diabetic complications in type 1 diabetes – a cross-sectional study

Cardiovascular Diabetology ◽

10.1186/1475-2840-12-122 ◽

2013 ◽

Vol 12 (1) ◽

pp. 122 ◽

Cited By ~ 16

Author(s):

Simone Theilade ◽

Maria Lajer ◽

Tine Hansen ◽

Christel Joergensen ◽

Frederik Persson ◽

...

Keyword(s):

Type 1 Diabetes ◽

Diabetic Complications ◽

Pulse Pressure ◽

Systolic Pressure ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Central Pulse Pressure

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Cardiovascular Effects of Aerobic Exercise With Self-Selected or Predetermined Intensity in Adolescents With Obesity

Pediatric Exercise Science ◽

10.1123/pes.2020-0104 ◽

2021 ◽

pp. 1-7

Author(s):

Tércio A.R. Barros ◽

Wagner L. do Prado ◽

Thiago R.S. Tenório ◽

Raphael M. Ritti-Dias ◽

Antônio H. Germano-Soares ◽

...

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Heart Rate ◽

Pulse Pressure ◽

Exercise Intensity ◽

Pulse Wave ◽

Augmentation Index ◽

Cardiovascular Effects ◽

Heart Rate Reserve ◽

Central Pulse Pressure

This study compared the effects of self-selected exercise intensity (SEI) versus predetermined exercise intensity (PEI) on blood pressure (BP) and arterial stiffness in adolescents with obesity. A total of 37 adolescents, 14.7 (1.6) years old, body mass index ≥95th percentile were randomly allocated into SEI (n = 18; 12 boys) or PEI (n = 19; 13 boys). Both groups exercised for 35 minutes on a treadmill, 3 times per week, for 12 weeks. The SEI could set the speed at the beginning of the sessions and make changes every 5 minutes. The PEI adolescents were trained at an intensity set at 60% to 70% of heart rate reserve. Brachial and central BP, pulse pressure, augmentation index, and carotid–femoral pulse wave were determined at baseline and after 12 weeks. Both groups reduced brachial systolic BP (SEI, Δ = −9 mm Hg; PEI, Δ = −4 mm Hg; P < .01), central systolic BP (SEI, Δ = −4 mm Hg; PEI, Δ = −4 mm Hg; P = .01), and central pulse pressure (SEI, Δ = −4 mm Hg; PEI, Δ = −3 mm Hg; P = .02) without differences between groups. No changes in the augmentation index and carotid–femoral pulse wave were observed in either group. The SEI induced similar changes in various cardiovascular outcomes compared with PEI in adolescents with obesity.

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Aortic Root Diameter and Arterial Stiffness: Conjoint Relations to the Incidence of Cardiovascular Disease in the Framingham Heart Study

Hypertension ◽

10.1161/hypertensionaha.121.17702 ◽

2021 ◽

Author(s):

Ramachandran S. Vasan ◽

Rebecca J. Song ◽

Vanessa Xanthakis ◽

Gary F. Mitchell

Keyword(s):

Cardiovascular Disease ◽

Pulse Pressure ◽

Aortic Root ◽

Cox Regression ◽

Prognostic Significance ◽

Root Diameter ◽

Cvd Risk ◽

Heart Study ◽

Increased Risk ◽

Central Pulse Pressure

Higher central pulse pressure is associated with higher carotid-femoral pulse wave velocity (CFPWV) and an increased risk of cardiovascular disease (CVD). A smaller aortic root diameter (AoR) is associated with higher central pulse pressure. We hypothesized that the combination of a smaller AoR and higher CFPWV is associated with increased CVD risk (relative to a larger AoR and lower CFPWV). We tested this hypothesis in the community-based Framingham Study (N=1970, mean age 60 years, 57% women). We created sex-specific longitudinal echocardiographic AoR trajectories over 2 decades, categorizing participants into smaller versus larger AoR groups. We cross-classified participants based on their AoR trajectory and CFPWV (dichotomized at the sex-specific median). We used Cox regression to relate the cross-classified groups to CVD incidence on follow-up (median 17 years): lower CFPWV, larger AoR (referent group; 6.4/1000 person-years); lower CFPWV, smaller AoR (6.9/1000 person-years); higher CFPWV, larger AoR (23.1/1000 person-years); and higher CFPWV, smaller AoR (21.9/1000 person-years). In sex-pooled analyses, groups with higher CFPWV were associated with a multivariable-adjusted 1.8-fold risk of CVD ( P <0.01) regardless of AoR size. We observed effect modification by sex ( P for sex×AoR-CFPWV group interaction 0.04). In men, the group with smaller AoR and higher CFPWV was associated with a 2.5- to 2.8-fold risk of CVD ( P <0.001). In women, the group with larger AoR and higher CFPWV experienced a statistically nonsignificant 70% to 80% higher CVD risk. Our observations indicate that the prognostic significance of a smaller versus larger AoR varies in men versus women. Additional studies are warranted to confirm our findings.

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