Changes in Aortic Stiffness and Augmentation Index After Acute Converting Enzyme or Vasopeptidase Inhibition

Background: Increased vascular stiffness and excessive blood pressure (BP) pulsatility are important risk factors for age-related morbidity. Vascular stiffness and BP pulsatility are related, with a prevailing view that hypertension antedates and contributes to premature vascular aging and a secondary increase in vascular stiffness. However, temporal relations between comprehensive vascular measures and BP elevation have not been fully delineated in a large community-based sample. Methods: We examined longitudinal relations of BP and 3 measures of vascular stiffness and pressure pulsatility derived from arterial tonometry (carotid-femoral pulse wave velocity [CFPWV], forward wave amplitude and augmentation index) over a 7-year period in 1,898 Framingham Offspring participants (mean age 60 yrs, 1,057 women). We also examined relations between measures of microvascular and endothelial function derived from brachial artery Doppler and future progression of BP or vascular stiffness. Results: In multivariable-adjusted regression models, baseline tonometry measures were separately and jointly associated with higher systolic and pulse pressure and incident hypertension ( Table ). Conversely, higher baseline BP was associated with higher forward wave amplitude and augmentation index (all p<0.05) but not CFPWV at follow-up. Higher baseline resting brachial artery flow and lower flow-mediated dilation were associated with incident hypertension in models that included BP and tonometry measures ( Table ). Conclusion: Higher aortic stiffness (CFPWV), pressure pulsatility (forward wave amplitude), and wave reflection (augmentation index) and lower flow-mediated dilation are associated with blood pressure progression and incident hypertension. Our findings support the notion of aortic stiffness as a precursor of hypertension and further suggest a vicious cycle of increasing pressure pulsatility with advancing age. Table. Correlates of incident hypertension. Predictor Variables (baseline) OR 95% CI P Systolic BP 3.24 (2.17; 4.84) <0.0001 Diastolic BP 1.47 (1.13; 1.92) 0.0042 CFPWV 1.30 (1.02; 1.67) 0.037 Forward wave amplitude 1.66 (1.32; 2.09) <0.0001 Augmentation index 1.78 (1.45; 2.17) <0.0001 Brachial artery baseline flow 1.23 (1.05; 1.45) 0.013 Flow-mediated dilation 0.83 (0.70; 0.98) 0.029 Results of a single multivariable model that further adjusted for age,sex, BMI, height and triglycerides in 1,019 participants free of hypertension at baseline who experienced 337 cases of incident hypertension during follow-up. OR expressed per 1 SD of the independent variable.

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Effects of Angiotensin-Converting Enzyme Inhibition Versus β-Adrenergic Blockade on Aortic Stiffness in Essential Hypertension

Journal of Cardiovascular Pharmacology ◽

10.1097/00005344-199601000-00016 ◽

1996 ◽

Vol 27 (1) ◽

pp. 99-104 ◽

Cited By ~ 27

Author(s):

Aslak Savolainen ◽

Pekka Keto ◽

Veli-Pekka Poutanen ◽

Pauli Hekali ◽

Carl-Gustaf Standertskjöld-Nordenstam ◽

...

Keyword(s):

Essential Hypertension ◽

Angiotensin Converting Enzyme ◽

Enzyme Inhibition ◽

Aortic Stiffness ◽

Angiotensin Converting Enzyme Inhibition ◽

Adrenergic Blockade ◽

Converting Enzyme ◽

Converting Enzyme Inhibition

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Vascular and renal effects of vasopeptidase inhibition and angiotensin-converting enzyme blockade in spontaneously diabetic Goto-Kakizaki rats

Journal of Hypertension ◽

10.1097/01.hjh.0000179765.48324.b4 ◽

2005 ◽

Vol 23 (9) ◽

pp. 1757-1770 ◽

Cited By ~ 18

Author(s):

Zhong Jian Cheng ◽

Tina Grönholm ◽

Marjut Louhelainen ◽

Piet Finckenberg ◽

Saara Merasto ◽

...

Keyword(s):

Angiotensin Converting Enzyme ◽

Converting Enzyme ◽

Renal Effects ◽

Vasopeptidase Inhibition

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Influence of Angiotensin-Converting Enzyme and Angiotensin II Type 1 Receptor Gene Polymorphisms on Aortic Stiffness in Normotensive and Hypertensive Patients

Circulation ◽

10.1161/01.cir.94.4.698 ◽

1996 ◽

Vol 94 (4) ◽

pp. 698-703 ◽

Cited By ~ 165

Author(s):

Athanase Benetos ◽

Sylvie Gautier ◽

Sylvain Ricard ◽

Jirar Topouchian ◽

Roland Asmar ◽

...

Keyword(s):

Angiotensin Ii ◽

Angiotensin Converting Enzyme ◽

Gene Polymorphisms ◽

Aortic Stiffness ◽

Receptor Gene ◽

Converting Enzyme ◽

Hypertensive Patients ◽

Receptor Gene Polymorphisms

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Renal accumulation and clearance of advanced glycation end-products in type 2 diabetic nephropathy: effect of angiotensin-converting enzyme and vasopeptidase inhibition

Diabetologia ◽

10.1007/s00125-005-1837-9 ◽

2005 ◽

Vol 48 (8) ◽

pp. 1645-1653 ◽

Cited By ~ 32

Author(s):

C. Wihler ◽

S. Schäfer ◽

K. Schmid ◽

E. K. Deemer ◽

G. Münch ◽

...

Keyword(s):

Diabetic Nephropathy ◽

Angiotensin Converting Enzyme ◽

Advanced Glycation End Products ◽

Converting Enzyme ◽

Advanced Glycation ◽

Vasopeptidase Inhibition ◽

Glycation End Products ◽

End Products ◽

Type 2 Diabetic

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Hemodynamic and arterial stiffness differences between African-Americans and Caucasians after maximal exercise

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00710.2013 ◽

2014 ◽

Vol 306 (1) ◽

pp. H60-H68 ◽

Cited By ~ 27

Author(s):

Huimin Yan ◽

Sushant M. Ranadive ◽

Kevin S. Heffernan ◽

Abbi D. Lane ◽

Rebecca M. Kappus ◽

...

Keyword(s):

Arterial Stiffness ◽

Aerobic Exercise ◽

Aortic Stiffness ◽

Maximal Exercise ◽

Augmentation Index ◽

Premenopausal Women ◽

Applanation Tonometry ◽

Future Research ◽

Healthy Individuals ◽

Acute Bout

African-American (AA) men have higher arterial stiffness and augmentation index (AIx) than Caucasian-American (CA) men. Women have greater age-associated increases in arterial stiffness and AIx than men. This study examined racial and sex differences in arterial stiffness and central hemodynamics at rest and after an acute bout of maximal exercise in young healthy individuals. One hundred young, healthy individuals (28 AA men, 24 AA women, 25 CA men, and 23 CA women) underwent measurements of aortic blood pressure (BP) and arterial stiffness at rest and 15 and 30 min after an acute bout of graded maximal aerobic exercise. Aortic BP and AIx were derived from radial artery applanation tonometry. Aortic stiffness (carotid-femoral) was measured via pulse wave velocity. Aortic stiffness was increased in AA subjects but not in CA subjects ( P < 0.05) after an acute bout of maximal cycling exercise, after controlling for body mass index. Aortic BP decreased after exercise in CA subjects but not in AA subjects ( P < 0.05). Women exhibited greater reductions in AIx after maximal aerobic exercise compared with men ( P < 0.05). In conclusion, race and sex impact vascular and central hemodynamic responses to exercise. Young AA and CA subjects exhibited differential responses in central stiffness and central BP after acute maximal exercise. Premenopausal women had greater augmented pressure at rest and after maximal aerobic exercise than men. Future research is needed to examine the potential mechanisms.

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Chronic vasopeptidase inhibition restores endothelin‐converting enzyme activity and normalizes endothelin levels in salt‐induced hypertension

Nephrology Dialysis Transplantation ◽

10.1093/ndt/16.6.1176 ◽

2001 ◽

Vol 16 (6) ◽

pp. 1176-1182 ◽

Cited By ~ 9

Author(s):

Thomas Quaschning ◽

Livius V. d'Uscio ◽

Sidney Shaw ◽

Hema Viswambharan ◽

Frank T. Ruschitzka ◽

...

Keyword(s):

Enzyme Activity ◽

Converting Enzyme ◽

Vasopeptidase Inhibition ◽

Endothelin Converting Enzyme ◽

Induced Hypertension

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Correlations between aortic stiffness and parasympathetic autonomic function in healthy volunteers

Canadian Journal of Physiology and Pharmacology ◽

10.1139/y10-095 ◽

2010 ◽

Vol 88 (12) ◽

pp. 1166-1171 ◽

Cited By ~ 11

Author(s):

Attila Nemes ◽

Róbert Takács ◽

Henriette Gavallér ◽

Tamás T. Várkonyi ◽

Tibor Wittmann ◽

...

Keyword(s):

Healthy Volunteers ◽

Aortic Stiffness ◽

Autonomic Function ◽

Augmentation Index ◽

Stiffness Index ◽

Sympathetic Function ◽

Cardiovascular Reflex ◽

Cardiovascular Reflex Tests ◽

Parasympathetic Function ◽

Aortic Strain

Cardiovascular autonomic dysfunction and alterations in vascular elasticity are known complications of several disorders, including diabetes mellitus, hypertension, hypercholesterolemia, aging, and chronic kidney disease. The current study was designed to test whether a relationship existed between pulse wave velocity (PWV), augmentation index (AIx), aortic elastic properties, and cardiovascular autonomic function in healthy volunteers. The study comprised 25 healthy volunteers, whose aortic strain, distensibility, and stiffness index were measured by echocardiography, whereas PWV and AIx were evaluated by Arteriograph (TensioMed, Budapest, Hungary) in all cases. Autonomic function was assessed by means of 5 standard cardiovascular reflex tests. We found that heart rate response to deep breathing, as the most reproducible cardiovascular reflex test to characterize parasympathetic function, showed low to moderate correlations with PWV (r = –0.431, p = 0.032), aortic strain (r = 0.594, p = 0.002), distensibility (r = 0.407, p = 0.043), and stiffness index (r = –0.453, p = 0.023). Valsalva ratio and autonomic neuropathy score (ANS) correlated with PWV (r = –0.557, p = 0.004 and r = –0.421, p = 0.036, respectively) and AIx (r = –0.461, p = 0.020 and r = –0.385, p = 0.057, respectively), while ANS correlated with even aortic stiffness index (r = –0.457, p = 0.022). Cardiovascular reflex tests mainly characterizing sympathetic function had no correlation with aortic stiffness parameters (p = NS for all correlations). Correlations exist between parameters characterizing aortic elasticity and parasympathetic autonomic function, as shown by standard cardiovascular reflex tests in healthy volunteers.

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