Abstract P218: The Association Of Mid-life Cumulative Exposure To Systolic Blood Pressure, Myocardial Oxygen Demand, And Hypertension With Later-life Central Arterial Stiffness And Its 5-year Change: The Atherosclerosis Risk In Communities Study - Neurocognitive Study (ARIC-NCS)

Background: Greater central artery stiffness predicts cardiovascular disease and all-cause mortality, thus understanding arterial stiffness determinants has prevention implications. Reports of the temporal association of blood pressure with arterial stiffness are conflicting and the association with myocardial oxygen demand has not been evaluated. Objective: Characterize the association of mid- to later-life cumulative exposure to systolic blood pressure (SBP), myocardial oxygen demand, and hypertension (HTN) with arterial stiffness and its 5-year change in older adults. Methods: We included 1,975 adults (1151 women; 359 Black; visit 5 mean age 74 years) examined in visits 5 (2011-13) and 6 or 7 (2016-19) of the population-based ARIC-NCS with measures of arterial stiffness (carotid-femoral pulse wave velocity (cfPWV)). Higher cfPWV indicates greater arterial stiffness. We calculated cumulative exposures as the sum of averages from four consecutive visits from 1987-89 to 1996-98 divided by total time. Myocardial oxygen demand was calculated as the rate pressure product (RPP): (SBP x heart rate)/1,000. We derived HTN duration as the time since first HTN detection. Associations of cumulative exposures with visit 5 cfPWV and the 5-year cfPWV change were evaluated by multivariable linear regression adjusted for demographics and cardiometabolic factors. Results: Over the mean 5.7 years between visits 5 and 6 or 7, cfPWV increased by 144.9 cm/s (SD: 276.0; range -680.0, 961.5 cm/s). HTN at any visit, duration, and the time-weighted cumulative measures were associated with higher visit 5 cfPWV (Table). Prevalent HTN was inversely associated with cfPWV change. No statistically significant associations were observed for the other exposures and cfPWV change. Conclusion: Cumulative exposure to SBP, RPP, and HTN are modifiable traits associated with higher cfPWV at later-life, but not with rate of cfPWV change in older adulthood. HTN at visit 5 was associated with lower cfPWV change, albeit the change is of small magnitude.

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Atenolol and Amiodarone: A Comparative Study of Their Anti-Ischaemic Effect

Journal of International Medical Research ◽

10.1177/030006058801600206 ◽

1988 ◽

Vol 16 (2) ◽

pp. 114-124 ◽

Cited By ~ 1

Author(s):

S. Ferraro ◽

V. Liguori ◽

S. Fazio ◽

C. Iacono ◽

S. Di Somma ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Systolic Blood Pressure ◽

Oxygen Demand ◽

Work Capacity ◽

Myocardial Oxygen Demand ◽

Once Daily ◽

Multi Stage ◽

St Segment ◽

Significant Difference

A total of 10 patients with mixed angina were entered into a study to compare the anti-ischaemic efficacy of atenolol and amiodarone. The study was divided into three parts: (a) placebo for 2 weeks; (b) 100 mg atenolol given for 8 weeks; and (c) amiodarone given for 8 weeks, divided into week 1, 200 mg three times daily; week 2, 200 mg twice daily; weeks 3 and 4, 200 mg once daily; weeks 5–8, 200 mg once daily for 5 days a week. Clinical examination, basal and multi-stage effort electrocardiograms were performed at the end of each treatment. The number of anginal attacks and the amount of trinitrin taken by the patients were significantly reduced by both drugs with no significant difference between them. Compared with placebo, both drugs induced a significant increase in work capacity and in the time to decrease the ST-segment by 1 mm. At rest, atenolol reduced systolic blood pressure, heart rate and the systolic blood pressure–heart rate product compared with placebo. Systolic blood pressure was also reduced significantly compared with patients given amiodarone. Amiodarone did not influence these parameters. At maximum effort, amiodarone reduced heart rate and the systolic blood pressure–heart rate product compared with placebo. This reduction was greater for atenolol. The ST-segment depression was comparable between patients given either test drug. Amiodarone, therefore, exerts an anti-ischaemic effect similar to that shown by atenolol with different haemodynamics: atenolol reducing myocardial oxygen demand, amiodarone having an additive increase of coronary flow. Such an effect was obtained with a lower dose of amiodarone than is commonly used.

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Association between Objectively Measured Physical Activity and Arterial Stiffness in Children with Congenital Heart Disease

Journal of Clinical Medicine ◽

10.3390/jcm10153266 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3266

Author(s):

Laura Willinger ◽

Leon Brudy ◽

Renate Oberhoffer-Fritz ◽

Peter Ewert ◽

Jan Müller

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Heart Rate ◽

Congenital Heart Disease ◽

Heart Disease ◽

Arterial Stiffness ◽

Systolic Blood Pressure ◽

Congenital Heart ◽

Z Score ◽

Objectively Measured

Background: The association between physical activity (PA) and arterial stiffness is particularly important in children with congenital heart disease (CHD) who are at risk for arterial stiffening. The aim of this study was to examine the association between objectively measured PA and arterial stiffness in children and adolescents with CHD. Methods: In 387 children and adolescents with various CHD (12.2 ± 3.3 years; 162 girls) moderate-to-vigorous PA (MVPA) was assessed with the “Garmin vivofit jr.” for 7 consecutive days. Arterial stiffness parameters including pulse wave velocity (PWV) and central systolic blood pressure (cSBP) were non-invasively assessed by oscillometric measurement via Mobil-O-Graph®. Results: MVPA was not associated with PWV (ß = −0.025, p = 0.446) and cSBP (ß = −0.020, p = 0.552) in children with CHD after adjusting for age, sex, BMI z-score, peripheral systolic blood pressure, heart rate and hypertensive agents. Children with CHD were remarkably active with 80% of the study population reaching the WHO recommendation of average 60 min of MVPA per day. Arterial stiffness did not differ between low-active and high-active CHD group after adjusting for age, sex, BMI z-score, peripheral systolic blood pressure, heart rate and hypertensive agents (PWV: F = 0.530, p = 0.467; cSBP: F = 0.843, p = 0.359). Conclusion: In this active cohort, no association between PA and arterial stiffness was found. Longer exposure to the respective risk factors of physical inactivity might be necessary to determine an impact of PA on the vascular system.

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P5.06INCREASED ARTERIAL STIFFNESS AND SYSTOLIC BLOOD PRESSURE FOLLOWING SUBCLAVIAN FLAP REPAIR FOR AORTIC COARCTATION IN INFANCY

Artery Research ◽

10.1016/j.artres.2009.10.061 ◽

2009 ◽

Vol 3 (4) ◽

pp. 175

Author(s):

D. Kenny ◽

J. Polson ◽

J.R. Cockcroft ◽

R. Martin ◽

J. Paton ◽

...

Keyword(s):

Blood Pressure ◽

Arterial Stiffness ◽

Systolic Blood Pressure ◽

Aortic Coarctation ◽

Flap Repair

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Maternal Carbenoxolone Treatment Lowers Birthweight and Induces Hypertension in the Offspring of Rats Fed a Protein-Replete Diet

Clinical Science ◽

10.1042/cs0930423 ◽

1997 ◽

Vol 93 (5) ◽

pp. 423-429 ◽

Cited By ~ 68

Author(s):

Simon C. Langley-Evans

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Fetal Growth ◽

Low Birthweight ◽

Control Diet ◽

Later Life ◽

Hydroxysteroid Dehydrogenase ◽

Fetal Exposure ◽

Low Protein ◽

Protein Diets

1. In the rat low birthweight and raised systolic blood pressure are the consequence of fetal exposure to maternal low protein diets. Nutritional down-regulation of the placental isoform of 11β-hydroxysteroid dehydrogenase, which may increase exposure of the fetus to maternal glucocorticoids, has been suggested to underlie effects of low protein diets on fetal growth and blood pressure. 2. Pregnant rats were fed control (18% casein) or low protein (9% casein) diets throughout gestation. Animals fed the control diet were injected with carbenoxolone, an inhibitor of 11β-hydroxysteroid dehydrogenase. Injections were administered either throughout pregnancy (days 0–22), or targeted to specific periods in early (days 0–7), mid- (days 8–14) or late (days 15–22) gestation. 3. Exposure to a low protein diet reduced birthweight and at 4 weeks of age systolic blood pressure was significantly elevated in the rats exposed to low protein. These hypertensive animals had small kidneys in proportion to body weight. 4. Fetal exposure to carbenoxolone at any period in gestation resulted in lower weight at birth. In rats exposed to the inhibitor over days 8–14, 15–22 or 0–22 systolic blood pressure at 4 weeks was significantly higher than in control animals. The greatest elevation of pressure was associated with carbenoxolone treatment in late (days 15–22) gestation. Animals with carbenoxolone-induced hypertension did not exhibit evidence of retarded renal growth. 5. Increased fetal exposure to maternal glucocorticoids impairs fetal growth and programmes elevated blood pressure in later life.

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EFFECT OF SEQUENTIAL NEPHRON BLOCKING IN COMPARISON WITH THE DOUBLE BLOCKADE OF THE RENIN- ANGIOTENSIN SYSTEM + BISOPROLOL ON CENTRAL SYSTOLIC BLOOD PRESSURE AND ARTERIAL STIFFNESS

Journal of Hypertension ◽

10.1097/01.hjh.0000748620.90653.e8 ◽

2021 ◽

Vol 39 (Supplement 1) ◽

pp. e354

Author(s):

Elizabeth do Espirito Santo Cestari ◽

Priscilla Galisteu de Mello ◽

Tatiane de Azevedo Rubio ◽

Maira Regina de Souza ◽

Eliangela Gianini Gonzales ◽

...

Keyword(s):

Blood Pressure ◽

Arterial Stiffness ◽

Systolic Blood Pressure ◽

Renin Angiotensin System ◽

Angiotensin System ◽

Renin Angiotensin ◽

Central Systolic Blood Pressure

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Time‐Efficient Inspiratory Muscle Strength Training Lowers Blood Pressure and Improves Endothelial Function, NO Bioavailability, and Oxidative Stress in Midlife/Older Adults With Above‐Normal Blood Pressure

Journal of the American Heart Association ◽

10.1161/jaha.121.020980 ◽

2021 ◽

Author(s):

Daniel H. Craighead ◽

Thomas C. Heinbockel ◽

Kaitlin A. Freeberg ◽

Matthew J. Rossman ◽

Rachel A. Jackman ◽

...

Keyword(s):

Blood Pressure ◽

Older Adults ◽

Muscle Strength ◽

Arterial Stiffness ◽

Endothelial Function ◽

Systolic Blood Pressure ◽

High Resistance ◽

Maximal Inspiratory Pressure ◽

No Bioavailability ◽

Inspiratory Muscle Strength

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.

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Effect of Exercise Speed on Heart Rate, Systolic Blood Pressure, and Rate-Pressure Product During Upper Extremity Ergometry

Physical Therapy ◽

10.1093/ptj/67.7.1085 ◽

1987 ◽

Vol 67 (7) ◽

pp. 1085-1088 ◽

Cited By ~ 7

Author(s):

Wayne A. MacMasters ◽

Debbie J. Harned ◽

Pamela W. Duncan

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Systolic Blood Pressure ◽

Upper Extremity ◽

Rate Pressure Product

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β-Adrenergic blockade enhances coronary vasoconstrictor response to forehead cooling

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00787.2013 ◽

2014 ◽

Vol 306 (6) ◽

pp. H910-H917 ◽

Cited By ~ 9

Author(s):

Matthew D. Muller ◽

Zhaohui Gao ◽

Hardikkumar M. Patel ◽

Matthew J. Heffernan ◽

Urs A. Leuenberger ◽

...

Keyword(s):

Pressor Response ◽

Oxygen Demand ◽

Significant Rise ◽

Rate Pressure Product ◽

Myocardial Oxygen Demand ◽

Adrenergic Blockade ◽

Vasoconstrictor Response ◽

Β Receptor ◽

Age Range ◽

Coronary Vasoconstrictor

Forehead cooling activates the sympathetic nervous system and can trigger angina pectoris in susceptible individuals. However, the effect of forehead cooling on coronary blood flow velocity (CBV) is not well understood. In this human experiment, we tested the hypotheses that forehead cooling reduces CBV (i.e., coronary vasoconstriction) and that this vasoconstrictor effect would be enhanced under systemic β-adrenergic blockade. A total of 30 healthy subjects (age range, 23–79 years) underwent Doppler echocardiography evaluation of CBV in response to 60 s of forehead cooling (1°C ice bag on forehead). A subset of subjects (n = 10) also underwent the procedures after an intravenous infusion of propranolol. Rate pressure product (RPP) was used as an index of myocardial oxygen demand. Consistent with our first hypothesis, forehead cooling reduced CBV from 19.5 ± 0.7 to 17.5 ± 0.8 cm/s ( P < 0.001), whereas mean arterial pressure increased by 11 ± 2 mmHg (P < 0.001). Consistent with our second hypothesis, forehead cooling reduced CBV under propranolol despite a significant rise in RPP. The current studies indicate that forehead cooling elicits a sympathetically mediated pressor response and a reduction in CBV, and this effect is augmented under β-blockade. The results are consistent with sympathetic activation of β-receptor coronary vasodilation in humans, as has been demonstrated in animals.

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