The aortic-femoral arterial stiffness gradient is blood pressure independent in older adults

Background High‐resistance inspiratory muscle strength training (IMST) is a novel, time‐efficient physical training modality. Methods and Results We performed a double‐blind, randomized, sham‐controlled trial to investigate whether 6 weeks of IMST (30 breaths/day, 6 days/week) improves blood pressure, endothelial function, and arterial stiffness in midlife/older adults (aged 50–79 years) with systolic blood pressure ≥120 mm Hg, while also investigating potential mechanisms and long‐lasting effects. Thirty‐six participants completed high‐resistance IMST (75% maximal inspiratory pressure, n=18) or low‐resistance sham training (15% maximal inspiratory pressure, n=18). IMST was safe, well tolerated, and had excellent adherence (≈95% of training sessions completed). Casual systolic blood pressure decreased from 135±2 mm Hg to 126±3 mm Hg ( P <0.01) with IMST, which was ≈75% sustained 6 weeks after IMST ( P <0.01), whereas IMST modestly decreased casual diastolic blood pressure (79±2 mm Hg to 77±2 mm Hg, P =0.03); blood pressure was unaffected by sham training (all P >0.05). Twenty‐four hour systolic blood pressure was lower after IMST versus sham training ( P =0.01). Brachial artery flow‐mediated dilation improved ≈45% with IMST ( P <0.01) but was unchanged with sham training ( P =0.73). Human umbilical vein endothelial cells cultured with subject serum sampled after versus before IMST exhibited increased NO bioavailability, greater endothelial NO synthase activation, and lower reactive oxygen species bioactivity ( P <0.05). IMST decreased C‐reactive protein ( P =0.05) and altered select circulating metabolites (targeted plasma metabolomics) associated with cardiovascular function. Neither IMST nor sham training influenced arterial stiffness ( P >0.05). Conclusions High‐resistance IMST is a safe, highly adherable lifestyle intervention for improving blood pressure and endothelial function in midlife/older adults with above‐normal initial systolic blood pressure. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03266510.

Download Full-text

Faculty Opinions recommendation of Arterial stiffness, cardiovagal baroreflex sensitivity and postural blood pressure changes in older adults: the Rotterdam Study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1089168.542365 ◽

2007 ◽

Author(s):

Michael Frenneaux

Keyword(s):

Blood Pressure ◽

Older Adults ◽

Arterial Stiffness ◽

Baroreflex Sensitivity ◽

Rotterdam Study ◽

Pressure Changes

Download Full-text

Abstract 13: Mineralocorticoid Receptor Blockade does not Result in Arterial Destiffening in Healthy Older Adults

Hypertension ◽

10.1161/hyp.60.suppl_1.a13 ◽

2012 ◽

Vol 60 (suppl_1) ◽

Author(s):

Demetra D Christou ◽

Jeung-Ki Yoo ◽

Moon-Hyon Hwang ◽

Meredith Luttrell ◽

Han-Kyul Kim ◽

...

Keyword(s):

Blood Pressure ◽

Older Adults ◽

Carotid Artery ◽

Arterial Stiffness ◽

Mineralocorticoid Receptor ◽

Augmentation Index ◽

Stiffness Index ◽

Double Blind ◽

Healthy Older Adults ◽

Carotid Artery Compliance

Arterial stiffness, an independent predictor of cardiovascular disease, is increased in aging, but the underlying mechanisms are not completely understood. We hypothesized that mineralocorticoid receptor (MR) activation is partly responsible for increased arterial stiffness and that MR blockade would lead to arterial destiffening in healthy older adults. To test this hypothesis, we administered in a randomized, double blind, crossover study, 100 mg of Eplerenone (MR blocker) or placebo once per day for one month with one month washout, in 23 healthy older adults (age, 64±1 years; mean±SE) and assessed arterial stiffness (aortic, arm and leg pulse wave velocity (PWV; doppler flowmeter) and carotid artery compliance, distensibility, beta-stiffness index, augmentation index (high resolution ultrasonography and applanation tonometry). Despite reductions in blood pressure in response to Eplerenone (systolic blood pressure: 127±3 vs. 120±2 mmHg, P=0.01; diastolic blood pressure: 74±1 vs.72±1 mmHg, P=0.02; placebo vs. Eplerenone), arterial stiffness did not change (aortic PWV, 9.2±1.2 vs. 8.9±1.2m/sec, P=0.5; arm PWV, 11.4±0.6 vs. 11.7±0.7 m/sec, P=0.7; leg PWV, 13.4±0.4 vs.12.8±0.5 m/sec, P=0.3; carotid artery compliance, 0.17±0.02 vs. 0.16±0.02 mm 2 /mmHg, P=0.6; distensibility, 12.7±1.6 vs.13.6±1.5 10 -3 kPa -1 , P=0.6; beta stiffness index, 3.2±0.3 vs. 3.4±0.3, P=0.5; augmentation index, 24.3±2.9 vs. 22.0±2.9 %, P=0.3, placebo vs. Eplerenone). In conclusion, MR blockade does not result in arterial destiffening in healthy older adults despite reductions in blood pressure.

Download Full-text

Arterial stiffness, cardiovagal baroreflex sensitivity and postural blood pressure changes in older adults: The Rotterdam Study

Journal of Hypertension ◽

10.1097/hjh.0b013e32811d6a07 ◽

2007 ◽

Vol 25 (7) ◽

pp. 1421-1426 ◽

Cited By ~ 122

Author(s):

Francesco US Mattace-Raso ◽

Anton H van den Meiracker ◽

Willem Jan Bos ◽

Tischa JM van der Cammen ◽

Berend E Westerhof ◽

...

Keyword(s):

Blood Pressure ◽

Older Adults ◽

Arterial Stiffness ◽

Baroreflex Sensitivity ◽

Rotterdam Study ◽

Pressure Changes

Download Full-text

P9 Repeatability and Predictors of a Potentially Blood Pressure-Independent Parameter of Arterial Stiffness

Artery Research ◽

10.2991/artres.k.191224.044 ◽

2020 ◽

Vol 25 (Supplement 1) ◽

pp. S51

Author(s):

Mark Butlin ◽

James Cox ◽

Bart Spronck ◽

Isabella Tan ◽

Alberto Avolio

Keyword(s):

Blood Pressure ◽

Arterial Stiffness ◽

Independent Parameter ◽

Pressure Independent

Download Full-text

Biological aortic age derived from the arterial pressure waveform

Journal of Applied Physiology ◽

10.1152/japplphysiol.01261.2010 ◽

2011 ◽

Vol 110 (4) ◽

pp. 981-987 ◽

Cited By ~ 21

Author(s):

Shigeki Shibata ◽

Benjamin D. Levine

Keyword(s):

Blood Pressure ◽

Arterial Stiffness ◽

Lower Body Negative Pressure ◽

Arterial Compliance ◽

Stiffness Index ◽

Masters Athletes ◽

Age Appropriate ◽

Pressure Independent ◽

Aortic Stiffening ◽

Systemic Arterial Stiffness

Indexes for arterial stiffness are, by their nature, influenced by the ambient blood pressure due to the curvilinear nature of arterial compliance. We developed a new concept of the “Modelflow aortic age,” which is, theoretically, not influenced by the ambient blood pressure and provides an easily understood context (biological vs. chronological age) for measures of arterial stiffness. The purpose of the present study was to validate this pressure-independent index for aortic stiffness in humans. Twelve sedentary elderly (65–77 yr), 11 Masters athletes (65–73 yr), and 12 sedentary young individuals (20–42 yr) were studied. Modelflow aortic ages were comparable with chronological ages in both sedentary groups, indicating that healthy sedentary individuals have age-appropriate aortas. In contrast, Masters athletes showed younger Modelflow aortic ages than their chronological ages. The coefficient of variation of sedentary subjects was three times smaller with the Modelflow aortic age (21%) than with other indexes, such as static systemic arterial stiffness (61%), central pulse wave velocity (61%), or carotid β-stiffness index (58%). The typical error was very small and two times smaller in the Modelflow aortic age (<7%) than in static systemic arterial stiffness (>13%) during cardiac unloading by lower body negative pressure. The Modelflow aortic age can more precisely and reliably estimate aortic stiffening with aging and modifiers, such as life-long exercise training compared with the pressure-dependent index of static systemic arterial stiffness, and provides a physiologically relevant and clinically compelling context for such measurements.

Download Full-text