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

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.

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Aerobic exercise training increases plasma Klotho levels and reduces arterial stiffness in postmenopausal women

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00429.2013 ◽

2014 ◽

Vol 306 (3) ◽

pp. H348-H355 ◽

Cited By ~ 47

Author(s):

Tomoko Matsubara ◽

Asako Miyaki ◽

Nobuhiko Akazawa ◽

Youngju Choi ◽

Song-Gyu Ra ◽

...

Keyword(s):

Carotid Artery ◽

Exercise Training ◽

Arterial Stiffness ◽

Aerobic Exercise ◽

Postmenopausal Women ◽

Aerobic Exercise Training ◽

Stiffness Index ◽

Cross Sectional ◽

Habitual Exercise ◽

Carotid Artery Compliance

The Klotho gene is a suppressor of the aging phenomena, and the secretion as well as the circulation of Klotho proteins decrease with aging. Although habitual exercise has antiaging effects (e.g., a decrease in arterial stiffness), the relationship between Klotho and habitual exercise remains unclear. In the present study, we investigated the effect of habitual exercise on Klotho, with a particular focus on arterial stiffness. First, we examined the correlation between plasma Klotho concentration and arterial stiffness (carotid artery compliance and β-stiffness index) or aerobic exercise capacity [oxygen uptake at ventilatory threshold (VT)] in 69 healthy, postmenopausal women (50–76 years old) by conducting a cross-sectional study. Second, we tested the effects of aerobic exercise training on plasma Klotho concentrations and arterial stiffness. A total of 19 healthy, postmenopausal women (50–76 years old) were divided into two groups: control group and exercise group. The exercise group completed 12 wk of moderate aerobic exercise training. In the cross-sectional study, plasma Klotho concentrations positively correlated with carotid artery compliance and VT and negatively correlated with the β-stiffness index. In the interventional study, aerobic exercise training increased plasma Klotho concentrations and carotid artery compliance and decreased the β-stiffness index. Moreover, the changes in plasma Klotho concentration and arterial stiffness were found to be correlated. These results suggest a possible role for secreted Klotho in the exercise-induced modulation of arterial stiffness.

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Abstract 18689: Lower Carotid Artery Compliance and Greater Carotid β-stiffness Index are Associated With Slower Processing Speed and Reduced Working Memory Performance in Older Healthy Adults

Circulation ◽

10.1161/circ.132.suppl_3.18689 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Lyndsey E DuBose ◽

Michelle W Voss ◽

Timothy B Weng ◽

Kaitlyn M Dubishar ◽

Abbi Lane-Cordova ◽

...

Keyword(s):

Older Adults ◽

Working Memory ◽

Carotid Artery ◽

Processing Speed ◽

Aortic Stiffness ◽

Memory Performance ◽

Stiffness Index ◽

Brain White Matter ◽

Artery Stiffness ◽

Carotid Artery Compliance

Introduction: Higher central elastic artery stiffness is associated with greater brain white matter hyperintensity volume and lower cognitive performance in older adults. However, it is unknown if higher central artery stiffness is related to regional decreases in brain white matter integrity (WMI) and reductions in working memory or processing speed. We hypothesized that greater large elastic artery stiffness would be associated with lower working memory and slower processing speed as well as lower regional WMI in older adults. Methods: In young (n=19; 23.8 ± 0.7 yrs) and older (n=22; 64.4 ± 4.2 yrs; range 60-71 yrs) healthy adults, aortic stiffness (carotid-femoral pulse wave velocity, cfPWV, via tonometry) and carotid artery compliance and β-stiffness index (carotid artery ultrasound and tonometry) were determined non-invasively. WMI was assessed by fractional anisotrophy (FA) (3T MRI) from diffusion tensor images. An N-Back task and letter and pattern comparison tests were performed as measures of working memory and processing speed, respectively. d’Prime, a measure of signal detection, was calculated on the N-Back task as a ratio of positive ‘hits’ to ‘false alarm’ responses. Results: cfPWV (8.4 ± 0.5 vs. 5.2 ± 0.2 m/sec, P<0.01) and carotid β-stiffness (11.3 ± 0.9 vs. 6.1 ± 0.7 U, P<0.01) were greater and carotid compliance (0.16 ± 0.02 vs. 0.07 ± 0.01 mm/mmHg, P<0.01) was lower in older vs. young adults. Carotid β, but not aortic, stiffness was associated with slower processing speed on letter (10.7 ± 0.5 vs. 13.5 ± 0.6 units/ 30 sec, p<0.01) and pattern (16.6 ± 0.6 vs. 22.0 ± 0.7 units/30 sec, p<0.01) comparison tasks and reduced working memory (1.8 ± 0.2 vs. 3.1± 0.2, P<0.01) in older vs. young adults. Lower carotid compliance was associated with slower performance on the letter (r=0.55, P<0.01) and pattern (r=0.54, P<0.01) tests and lower d’Prime (r=0.48, P<0.05). Greater β-stiffness was related to pattern comparison scores only (r=-0.54, P<0.01). Aortic stiffness, carotid compliance and β-stiffness were not related to WMI in any brain region. Conclusions: Our results suggest that lower carotid artery compliance and greater β-stiffness are associated with reduced working memory performance and slower processing speed but not regional WMI in older adults.

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Gender is a determinant of carotid artery stiffness independent of age and blood pressure

British Journal of Radiology ◽

10.1259/bjr.20200796 ◽

2021 ◽

Vol 94 (1119) ◽

pp. 20200796

Author(s):

Zhenzhen Wang ◽

Wei Li ◽

Wei Liu ◽

Jiawei Tian

Keyword(s):

Blood Pressure ◽

Regression Analysis ◽

Carotid Artery ◽

Linear Regression ◽

Arterial Stiffness ◽

Multiple Linear Regression ◽

Linear Regression Analysis ◽

Multiple Linear Regression Analysis ◽

Stiffness Index ◽

Males And Females

Objective: To identify the gender-specific differences in carotid artery structural and stiffening parameters by radiofrequency ultrasound (RFU) with an automatic arterial stiffness analyzing system. Methods: Seventy-two consecutive individuals (32 males and 40 females, age range from 36 to 62 years) with no history of significant cardiovascular diseases or carotid artery plaques were enrolled between September and December 2017. Quality intima-media thickness (QIMT) and quality arterial stiffness (QAS) parameters were automatically computed, including pulse wave velocity (PWV), vascular distension, compliance coefficient (CC), distensibility coefficient (DC), stiffness index α and β, augmentation pressure (AP), and augmentation index (AIx). Those parameters were compared between males and females. Multiple linear regression analysis was performed to assess the independent association between gender and RFU parameters. Results: The mean age had no difference between males and females (47.8 ± 3.3 vs 50.0 ± 8.5 years, p = 0.19). Females had higher systolic blood pressure (134.53 ± 9.65 vs 127.78 ± 6.12 mm Hg) and diastolic blood pressure (85.83 ± 3.94 vs 78.03 ± 5.22 mm Hg), greater carotid QIMT (598.73 ± 72.16 vs 550.84 ± 29.37 µm), advanced PWV (8.08 ± 1.60 vs 6.24 ± 0.70 m/s), higher stiffness index α (6.21 ± 1.94 vs 3.95 ± 0.78) and β (9.43 ± 3.17 vs 6.38 ± 0.78), higher AP (6.68 ± 2.24 vs 3.64 ± 1.22 mm Hg) and AIx (7.42 ± 2.08 vs 4.69 ± 1.26%), all p < 0.001. Multiple linear regression analysis demonstrated gender was independently associated with carotid structural and elastic parameters. Conclusion: Gender independently impacts carotid structure and function, with females more vulnerable to the progression of arterial aging. Awareness of the gender differences on the risk stratification of carotid artery disease will benefit reliable assessments and specific management recommendations in clinical practice. Advances in knowledge: (1) RFU provides an μm-unit quality IMT measurement and multiple quality arterial stiffness parameters. (2) Gender is an independent determinant in both the arterial structural and elastic aspects, with females of stiffer arteries in low CVD risk individuals.

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The Acute Effects of High‐Intensity Cycling Exercise on Arterial Stiffness in Adolescent Wrestlers

Journal of Human Kinetics ◽

10.2478/hukin-2018-0100 ◽

2019 ◽

Vol 69 (1) ◽

pp. 99-107

Author(s):

Okkes Alpaslan Gencay ◽

Murat Baykara ◽

Adnan Demirel ◽

Ejder Berk ◽

Selcuk Gencay

Keyword(s):

Carotid Artery ◽

Arterial Stiffness ◽

High Intensity ◽

Body Height ◽

Stiffness Index ◽

Acute Effects ◽

Power Performance ◽

Cycling Exercise ◽

Study Results ◽

Carotid Artery Compliance

Abstract The aim of this study was to determine the acute effects of high‐intensity cycling exercise on the variables of carotid artery compliance, distensibility and beta stiffness index in elite adolescent wrestlers. The subjects were elite athletes competing in national, European and World Championships, who attended a training camp in the province of Kahramanmaras organized by the Turkish Centre for Olympic Preparation. The study sample comprised 31 male elite wrestlers with a mean age of 15.90 ± 0.87 years, body height of 165.97 ± 9.7 cm and body mass of 66.3 ± 18.45 kg. The arterial stiffness variables of the wrestlers were measured with high‐resolution Doppler ultrasonography before and 5 min after 30 s of high‐intensity cycling exercise (the Wingate Anaerobic Cycling test). The results showed a statistically significant correlation between mean power performance and carotid artery compliance at the 5th min after a single cycling sprint exercise (p < 0.05). No correlation was determined between peak power and the arterial stiffness variables (p > 0.05). The study results indicate that acute changes in arterial stiffness variables are associated with the performance level of high‐intensity cycling exercise in a group of elite adolescent wrestlers.

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Higher habitual dietary flavonoid intake associates with lower central blood pressure and arterial stiffness in healthy older adults

British Journal Of Nutrition ◽

10.1017/s000711452100324x ◽

2021 ◽

pp. 1-28

Author(s):

Benjamin H Parmenter ◽

Kevin D Croft ◽

Lachlan Cribb ◽

Matthew B Cooke ◽

Catherine P Bondonno ◽

...

Keyword(s):

Blood Pressure ◽

Older Adults ◽

Arterial Stiffness ◽

Vascular Function ◽

Dietary Quality ◽

Central Blood Pressure ◽

Central Hemodynamics ◽

Healthy Older Adults ◽

Flavonoid Intake ◽

The Impact

Abstract Flavonoids have shown anti-hypertensive and anti-atherosclerotic properties: the impact of habitual flavonoid intake on vascular function, central hemodynamics and arterial stiffness may be important. We investigated the relationship between habitual flavonoid consumption and measures of central blood pressure and arterial stiffness. We performed cross-sectional analysis of 381 non-smoking healthy older adults (mean ± SD age, 66.0 ± 4.1 years; BMI, 26.4 ± 4.41 kg/m2; 41% male) recruited as part of the Australian Research Council Longevity Intervention (ARCLI) study. Flavonoid intake [i.e., flavonols, flavones, flavanones, anthocyanins, isoflavones, flavan-3-ol monomers, proanthocyanidins, theaflavins/thearubigins and total consumption] was estimated from food-frequency questionnaires using the US Department of Agriculture food composition databases. Measures of central hemodynamics and arterial stiffness included systolic blood pressure (cSBP), diastolic blood pressure (cDBP), mean arterial pressure (cMAP), and augmentation index (cAIx). After adjusting for demographic and lifestyle confounders, each standard deviation (SD)/day higher intake of anthocyanins (SD=44.3 mg/day) was associated with significantly lower cDBP (−1.56 mmHg, 95% CI: −2.65, −0.48) and cMAP (−1.62 mmHg, 95% CI: −2.82, −0.41). Similarly, each SD/day higher intake of flavanones (SD=19.5 mg/day) was associated with ˜1% lower cAIx (−0.93%, 95% CI: −1.77, −0.09). These associations remained signiﬁcant after additional adjustment for 1) a dietary quality score and 2) other major nutrients that may affect blood pressure or arterial stiffness (i.e., sodium, potassium, calcium, magnesium, omega-3, total protein and fibre). This study suggests a possible benefit of dietary anthocyanin and flavanone intake on central hemodynamics and arterial stiffness; these findings require corroboration in further research.

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The Effects of Beetroot Juice on Blood Pressure, Microvascular Function and Large-Vessel Endothelial Function: A Randomized, Double-Blind, Placebo-Controlled Pilot Study in Healthy Older Adults

Nutrients ◽

10.3390/nu11081792 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1792 ◽

Cited By ~ 4

Author(s):

Jones ◽

Dunn ◽

Macdonald ◽

Kubis ◽

McMahon ◽

...

Keyword(s):

Blood Pressure ◽

Older Adults ◽

Pilot Study ◽

Endothelial Function ◽

Microvascular Function ◽

Large Vessel ◽

Doppler Imaging ◽

Beetroot Juice ◽

Double Blind ◽

Healthy Older Adults

: Dietary nitrate (NO3−) has been reported to improve endothelial function (EF) and blood pressure (BP). However, most studies only assess large-vessel EF with little research on the microvasculature. Thus, the aim of the present pilot study is to examine NO3− supplementation on microvascular and large-vessel EF and BP. Twenty older adults (63 ± 6 years) were randomized to a beetroot juice (BRJ) or placebo (PLA) group for 28 (±7) days and attended three laboratory visitations. Across visitations, blood pressure, microvascular function and large-vessel EF were assessed by laser Doppler imaging (LDI) with iontophoresis of vasoactive substances and flow-mediated dilatation (FMD), respectively. Plasma NO3−concentrations, BP and the presence of NO3− reducing bacteria were also assessed. Plasma NO3− increased following two weeks of BRJ supplementation (p = 0.04) along with a concomitant decrease in systolic and diastolic BP of approximately −6 mmHg and −4 mmHg, respectively (p = 0.04; p = 0.01, respectively). BP remained unchanged in the PLA group. There were no significant differences in endothelium-dependent or endothelium-independent microvascular responses between groups. FMD increased by 1.5% following two weeks of BRJ (p = 0.04), with only a minimal (0.1%) change for the PLA group. In conclusion, this pilot study demonstrated that medium-term BRJ ingestion potentially improves SBP, DBP and large-vessel EF in healthy older adults. The improvements observed in the present study are likely to be greater in populations presenting with endothelial dysfunction. Thus, further prospective studies are warranted in individuals at greater risk for cardiovascular disease.

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The Effects of a Low Sodium Meal Plan on Blood Pressure in Older Adults: The SOTRUE Randomized Feasibility Trial

Nutrients ◽

10.3390/nu13030964 ◽

2021 ◽

Vol 13 (3) ◽

pp. 964

Author(s):

Stephen P. Juraschek ◽

Courtney L. Millar ◽

Abby Foley ◽

Misha Shtivelman ◽

Alegria Cohen ◽

...

Keyword(s):

Blood Pressure ◽

Older Adults ◽

Feasibility Trial ◽

Creatinine Ratio ◽

Urine Sodium ◽

Double Blind ◽

Sodium Diet ◽

Low Sodium ◽

Federal Department ◽

Meal Plan

Reduced sodium meal plans are recommended by the Centers of Disease Control to lower blood pressure in older adults; however, this strategy has not been tested in a clinical trial. The Satter House Trial of Reduced Sodium Meals (SOTRUE) was an individual-level, double-blind, randomized controlled pilot study of adults living in a congregate living facility subsidized by the Federal Department of Housing and Urban Development (HUD). Adults over age 60 years ate 3 isocaloric meals with two snacks daily for 14 days. The meal plans differed in sodium density (<0.95 vs. >2 mg/kcal), but were equivalent in potassium and macronutrients. Seated systolic BP (SBP) was the primary outcome, while urine sodium-creatinine ratio was used to measure compliance. Twenty participants were randomized (95% women; 95% white; mean age 78 ± 8 years), beginning in 7 October 2019. Retention was 100% with the last participant ending 4 November 2019. Mean baseline SBP changed from 121 to 116 mmHg with the typical sodium diet (−5 mmHg; 95% CI: −18, 8) and from 123 to 112 mmHg with the low sodium diet (−11 mmHg; 95% CI: −15.2, −7.7). Compared to the typical sodium meal plan, the low sodium meal plan lowered SBP by 4.8 mmHg (95% CI: −14.4, 4.9; p = 0.31) and urine sodium-creatinine ratio by 36% (−36.0; 95% CI: −60.3, 3.4; p = 0.07), both non-significant. SOTRUE demonstrates the feasibility of sodium reduction in federally mandated meal plans. A longer and larger study is needed to establish the efficacy and safety of low sodium meals in older adults.

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