Abstract P142: Association of the Metabolic Syndrome With Pulse Wave Velocity: The Atherosclerosis Risk in Communities Study (ARIC)

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Anna K Poon ◽  
Michelle L Snyder ◽  
Elizabeth Selvin ◽  
James S Pankow ◽  
David Couper ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Abdominal Obesity ◽  
Pulse Wave ◽  
Fasting Glucose ◽  
Metabolic Abnormalities ◽  
The Metabolic Syndrome

Introduction: Arterial stiffness is an indicator of subclinical cardiovascular disease (CVD) and is associated with increased CVD risk. The determinants of arterial stiffness may be explained in part by a clustering of metabolic abnormalities (as defined by the metabolic syndrome). Our goal was to examine the association of central and peripheral arterial stiffness (as measured by carotid-femoral, brachial-ankle, and femoral-ankle pulse wave velocity) with the metabolic syndrome in older adults. We predicted higher arterial stiffness (i.e. higher pulse wave velocity measurements) in persons with compared to persons without the metabolic syndrome. Methods: We analyzed 3542 persons without diabetes at the ARIC Visit 5 examination in 2011-13 (61% female; 18% African American; median age 75 yrs). The metabolic syndrome was defined as ≥3 of the following: (1) abdominal obesity (waist circumference ≥102 cm in males and ≥88 cm in females); (2) hypertriglyceridemia (≥150 mg/dL), (3) low HDL-cholesterol (<40 mg/dL in males and <50 mg/dL in females), (4) high blood pressure (BP) (systolic BP ≥130 mmHg and/or diastolic BP≥85 mmHg and/or BP-lowering medications), and (5) high fasting glucose (≥100 mg/dL). Pulse wave velocity (PWV) included carotid-femoral PWV (cfPWV), brachial-ankle PWV (baPWV), and femoral-ankle PWV (faPWV); values were measured using the Colin VP-1000 Plus system (Omron Co., Ltd., Kyoto, Japan). Multivariable regression, with adjustment for age, sex, and race-center, was used to evaluate the association of cfPWV, baPWV, and faPWV with the metabolic syndrome, with each component metabolic abnormality, and with the number of metabolic abnormalities. Results: The prevalence of metabolic syndrome was 49% (SE 2); the three metabolic abnormalities with the highest prevalence were abdominal obesity (63% (SE 1)), elevated fasting glucose (60% (SE 1)), and high blood pressure (76% (SE 1)). A majority of participants had two (29% (SE 3)) or three (28% (SE 3)) metabolic abnormalities. Persons with the metabolic syndrome had a higher mean cfPWV (54 cm/s; 95% CI: 35, 73 cm/s), higher mean baPWV (22; 95% CI: 2, 42 cm/s, respectively), and lower mean faPWV (-18 cm/s; 95% CI: -31, -6 cm/s) compared to persons without the metabolic syndrome. Each additional metabolic abnormality was associated with a 28 cm/s (95% CI: 20, 36 cm/s) higher cfPWV, 19 cm/s (95% CI: 11, 27 cm/s) higher baPWV, and 6 cm/s (95% CI: -11, -1 cm/s) lower faPWV. Conclusion: Metabolic syndrome and each additional metabolic abnormality was positively associated with cfPWV and baPWV, and inversely associated with faPWV in older adults. Abdominal obesity, elevated fasting glucose, and high blood pressure were the most common metabolic abnormalities in this cohort of older men and women. Having the metabolic syndrome and its abnormalities may contribute to arterial stiffness that is predictive of CVD events and mortality.

scholarly journals 24-hour arterial stiffness monitoring in comorbid patients with cardiovascular pathology

2016 ◽  
Vol 97 (1) ◽  
pp. 5-12
Author(s):  
L A Panchenkova ◽  
Kh A Khamidova ◽  
M O Shelkovnikova ◽  
T E Yurkova ◽  
N V Rassudova ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Vascular Stiffness ◽  
Stiffness Index ◽  
The Metabolic Syndrome ◽  
Pulse Wave Transit Time ◽  
Arterial Stiffness Index

Aim. To evaluate 24-hour dynamics of the arterial stiffness main indicators in patients with arterial hypertension associated with metabolic syndrome, coronary heart disease and type 2 diabetes mellitus.Methods. The study included 54 patients with hypertension, who formed main groups: the first group - 17 patients with hypertension amid the metabolic syndrome, the second - 21 patients with metabolic syndrome and coronary heart disease, the third group - 16 patients with hypertension and type 2 diabetes mellitus. All patients underwent the vascular stiffness parameters study using a multifunctional complex for the 24-hour monitoring and office measurements of blood pressure and vessels condition. At the same time blood pressure, cardiac function and vascular stiffness indicators were examined: PWVao - pulse wave velocity in the aorta (m/s); PWTT - the pulse wave transit time (m/s); Aix - augmentation index (%); Asi - the arterial stiffness index. (mmHg).Results. When comparing the 24-hour arterial stiffness dynamics indicators, changes were found in all main patients groups compared to the healthy group. Thus, a statistically significant increase in the pulse wave velocity in the aorta (PWVao) in all groups of patients compared with the control group, a decrease in the index of the pulse wave transit time (PWTT) in all main groups of patients and a significant increase in arterial stiffness index (Asi) were found. When assessing the results of arterial stiffness monitoring at night time significantly larger values of the pulse wave velocity in the aorta were observed in patients with the metabolic syndrome and combination of metabolic syndrome and coronary heart disease. The obtained data are indicative of improvement in vascular stiffness indicators at night time in healthy individuals group, as well as maintaining a high degree of the vascular wall stiffness both in the night and in the daytime in a group of examined patients, especially in groups with the metabolic syndrome, and a combination of metabolic syndrome and coronary heart disease.Conclusion. 24-hour monitoring of vascular stiffness indicators in comorbid patients have revealed variability of the main indicators during the day; such arterial stiffness indicators as the pulse wave transit time, pulse wave velocity in the aorta, the arterial stiffness index, augmentation index can be used to assess early signs of the major arteries remodeling.

Volume status and arterial blood pressures are associated with arterial stiffness in hemodialysis patients

2018 ◽  
Vol 41 (7) ◽  
pp. 378-384 ◽  
Author(s):  
Alper Erdan ◽  
Abdullah Ozkok ◽  
Nadir Alpay ◽  
Vakur Akkaya ◽  
Alaattin Yildiz
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Pressure ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Mean Blood Pressure ◽  
Aortic Blood ◽  
Aortic Blood Pressure

Background: Arterial stiffness is a strong predictor of mortality in hemodialysis patients. In this study, we aimed to investigate possible relations of arterial stiffness with volume status determined by bioimpedance analysis and aortic blood pressure parameters. Also, effects of a single hemodialysis session on these parameters were studied. Methods: A total of 75 hemodialysis patients (M/F: 43/32; mean age: 53 ± 17) were enrolled. Carotid-femoral pulse wave velocity, augmentation index, and aortic pulse pressure were measured by applanation tonometry before and after hemodialysis. Extracellular fluid and total body fluid volumes were determined by bioimpedance analysis. Results: Carotid-femoral pulse wave velocity (9.30 ± 3.30 vs 7.59 ± 2.66 m/s, p < 0.001), augmentation index (24.52 ± 9.42 vs 20.28 ± 10.19, p < 0.001), and aortic pulse pressure (38 ± 14 vs 29 ± 8 mmHg, p < 0.001) significantly decreased after hemodialysis. Pre-dialysis carotid-femoral pulse wave velocity was associated with age (r2 = 0.15, p = 0.01), total cholesterol (r2 = 0.06, p = 0.02), peripheral mean blood pressure (r2 = 0.10, p = 0.005), aortic-mean blood pressure (r2 = 0.06, p = 0.02), aortic pulse pressure (r2 = 0.14, p = 0.001), and extracellular fluid/total body fluid (r2 = 0.30, p < 0.0001). Pre-dialysis augmentation index was associated with total cholesterol (r2 = 0.06, p = 0,02), aortic-mean blood pressure (r2 = 0.16, p < 0.001), and aortic pulse pressure (r2 = 0.22, p < 0.001). Δcarotid-femoral pulse wave velocity was associated with Δaortic-mean blood pressure (r2 = 0.06, p = 0.02) and inversely correlated with baseline carotid-femoral pulse wave velocity (r2 = 0.29, p < 0.001). Pre-dialysis Δaugmentation index was significantly associated with Δaortic-mean blood pressure (r2 = 0.09, p = 0.009) and Δaortic pulse pressure (r2 = 0.06, p = 0.03) and inversely associated with baseline augmentation index (r2 = 0.14, p = 0.001). In multiple linear regression analysis (adjusted R2 = 0.46, p < 0.001) to determine the factors predicting Log carotid-femoral pulse wave velocity, extracellular fluid/total body fluid and peripheral mean blood pressure significantly predicted Log carotid-femoral pulse wave velocity (p = 0.001 and p = 0.006, respectively). Conclusion: Carotid-femoral pulse wave velocity, augmentation index, and aortic pulse pressure significantly decreased after hemodialysis. Arterial stiffness was associated with both peripheral and aortic blood pressure. Furthermore, reduction in arterial stiffness parameters was related to reduction in aortic blood pressure. Pre-dialysis carotid-femoral pulse wave velocity was associated with volume status determined by bioimpedance analysis. Volume control may improve not only the aortic blood pressure measurements but also arterial stiffness in hemodialysis patients.

scholarly journals Race/Ethnicity, Vascular Aging, and Mortality Risk: Evidence from the Health and Retirement Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 873-874
Author(s):  
Kevin Heffernan ◽  
Janet Wilmoth ◽  
Andrew London
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Ethnic Groups ◽  
Wave Velocity ◽  
Mortality Risk ◽  
Pulse Wave ◽  
Health And Retirement Study ◽  
Vascular Aging ◽  
Retirement Study

Abstract Vascular aging, which is associated with cardiovascular disease risk and mortality, is characterized by increasing arterial stiffness. The gold standard method for the assessment of arterial stiffness is carotid-femoral Pulse Wave Velocity (cfPWV). An emerging body of research suggests that cfPWV can be reasonably estimated from two commonly measured clinical variables—age and blood pressure. Thus, estimated Pulse Wave Velocity (ePWV) holds promise as a novel and easily obtained measure of arterial stiffness that can be used to study vascular aging, particularly with nationally representative datasets that collect biomarker data on sufficiently large sample sizes to examine race/ethnic differences. This analysis uses data from the 2006-2016 Health and Retirement Study to examine race/ethnic variation in the relationship between ePWV and mortality risk. We estimate logistic regression models predicting mortality over an eight-year period for four racial/ethnic groups: White, Black, Other, and Hispanic. Controls are included for sociodemographic characteristics, health status and behaviors, and blood biomarkers such as C-reactive protein, cystatin-C, hemoglobin A1c, total cholesterol and high-density lipoprotein (HDL) cholesterol. The results indicate ePWV increases the risk of mortality in the total sample and among each race/ethnic group, net the effect of age, systolic blood pressure, and diastolic blood pressure. Mechanisms that mediate this relationship are explored. The findings provide insight into vascular aging processes that influence mortality risk among race/ethnic groups.

Sign in / Sign up

Export Citation Format

Share Document