Abstract 081: Obesity-related Reductions in Cardiac Baroreflex Sensitivity and Higher 24-hour Blood Pressure Variability Are Not Related to Carotid Artery and Aortic Stiffness in Young And Middle-aged Adults

Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Seth Holwerda ◽  
Jess Fiedorowicz ◽  
Lyndsey DuBose ◽  
Amy Stroud ◽  
Tiwa Ajibewa ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Carotid Artery ◽  
Blood Pressure Variability ◽  
Aortic Stiffness ◽  
Baroreflex Sensitivity ◽  
Normal Weight ◽  
Middle Aged ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Artery Stiffness

Alterations in cardiac baroreflex sensitivity (BRS) and 24-hr blood pressure variability (24-hr BPV) are independent predictors of increased cardiovascular disease (CVD) risk, and occur in individuals with obesity. Obese humans are also likely to have a higher large elastic artery stiffness compared with normal-weight individuals. While an increase in stiffness of carotid and aortic arteries, the anatomical sites where baroreceptors reside, may likely be responsible in part for the decline in cardiac BRS with advancing age in adults, it remains unclear whether 1) elevated carotid and aortic stiffness are also directly associated with obesity-associated reductions in cardiac BRS in young/middle-aged individuals, and 2) if reduced BRS with obesity is associated with elevated 24hr BPV. We tested the hypothesis that lower BRS would be associated with higher carotid and aortic stiffness and 24hr BPV in young and middle-aged individuals with obesity. In a cross-sectional design, 22 normal-weight (body mass index, BMI 24.5 ± 0.6 kg/m 2 ; age 35±2 yrs; 8M/14F) and 22 obese (BMI 34.2 ± 1.1 kg/m 2 ; age 39 ± 2 yrs; 8M/14F) individuals underwent measures of spontaneous cardiac BRS (sequence technique), carotid artery β-stiffness (carotid tonometry and B-mode ultrasound of common carotid artery), aortic stiffness (carotid-femoral pulse wave velocity, CFPWV), and 24-hr-systolic BPV (24 hr ambulatory BP monitoring). A significant relation between cardiac BRS and 24-hr systolic BPV (r=-0.42, P<0.01) was corroborated by lower cardiac BRS (11.7±1.2 vs. 16.8±1.7 ms/mmHg, P<0.05) and higher 24-hr BPV (12.4±0.6 vs. 10.1±0.4 mmHg SD, P<0.05) among obese compared with normal-weight subjects. In contrast, carotid β-stiffness (7.8±0.6 vs. 6.9±0.4 U, P>0.05) and CFPWV (745±71 vs. 611±19 cm/s, P=0.07) were not significantly different between groups despite greater average 24-hr systolic BP in the obese vs. normal weight subjects (127±2 vs. 118±1 mmHg, P<0.05). These preliminary data suggest that an increase in carotid artery and aortic stiffness may not precede the decline in cardiac BRS and increase in 24hr BPV in young and middle-aged obese individuals, suggesting non-arterial stiffness related mechanisms for obesity-related reductions in cardiac BRS.

Abstract P199: Higher Circulating Triglycerides are Independently Associated With Greater Short-term Blood Pressure Variability in Middle-aged/older Adults With Obesity

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Rachel E Luehrs ◽  
Graziela Z Kalil ◽  
Seth W Holwerda ◽  
Nealy A Wooldridge ◽  
Jess G Fiedorowicz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Blood Pressure Variability ◽  
Plasma Lipids ◽  
Target Organ Damage ◽  
Density Lipoprotein ◽  
Multiple Linear Regression Model ◽  
Middle Aged ◽  
Short Term ◽  
Cvd Risk

Elevated short-term (24 hour) blood pressure variability (BPV) is associated with subclinical target organ damage and cardiovascular disease (CVD) among middle-aged/older (MA/O) adults with hypertension and obesity. Circulating total cholesterol (TC), low-density cholesterol (LDL-C) and triglycerides (TGs) increase with human obesity and are independent risk factors for CVD. In addition, BPV is increased in mouse models of hyperlipidemia and is normalized with statins. However, whether higher circulating lipoproteins independently contribute to greater short-term BPV among adults with obesity remains unclear. We hypothesized that higher LDL-C, TGs and lower high-density lipoprotein (HDL-C) would be associated with greater short-term BPV among individuals with obesity. Fasting plasma lipids and 24 hour ambulatory BP monitoring were assessed in fifty-six MA/O adults with obesity defined as body mass index (BMI) ≥ 30 kg/m 2 (56% F; age 54±7 yrs; BMI, 38.2±5.6 kg/m 2 ) and at least one other CVD risk factor. There was a significant relation between 24 hour systolic BPV and TC (r=0.30, P=0.03), TGs (r=0.34, P=0.01) and LDL-C (r=0.25, P=0.059), but not HDL-C (r=-0.07, P=0.61). Interestingly, these findings remained significant after adjusting for age, sex, BMI and 24 hour systolic BP (TC: r=0.34, P=0.01; TGs: r=0.39, P<0.01; LDL-C: r=0.31, P=0.03) but HDL-C remained non-significant (r=-0.16, P=0.27). In contrast, other cardiometabolic risk factors such as fasting glucose, insulin, c-reactive protein concentrations, carotid-femoral pulse wave velocity and HOMA-IR were not associated with 24 hour systolic BPV. In a multiple linear regression model that included age, sex, BMI, 24 hour systolic BP, TGs and LDL-C, only fasting TGs (β=0.02 ± 0.01, P=0.02) were a significant correlate of 24 hour systolic BPV (Model R 2 =0.24, P=0.03). Results were the same if TC was substituted for LDL-C in the model. In conclusion, higher plasma TC, LDL-C and TGs are associated with greater 24 hour BPV among MA/O adults with obesity with only TGs being independently associated with BPV. These data suggest that greater variability in BP among MA/O adults with obesity is mediated in part through circulating TGs suggesting that TGs may be a therapeutic target to modify short-term BPV.

scholarly journals Role of Blood Pressure in Mediating Carotid Artery Dilation in Response to Sympathetic Stimulation in Healthy, Middle-Aged Individuals

2019 ◽  
Author(s):  
Arron Peace ◽  
Virginia Pinna ◽  
Friso Timmen ◽  
Guillherme Speretta ◽  
Helen Jones ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Carotid Artery ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Sympathetic Stimulation ◽  
Middle Aged ◽  
Cvd Risk ◽  
Significant Difference ◽  
History Of ◽  
Relative Change

Abstract Objectives Carotid artery diameter responses to sympathetic stimulation, i.e., carotid artery reactivity (CAR), represent a novel test of vascular health and relates to cardiovascular disease (CVD)/risk. This study aims to understand the relationship between the increase in blood pressure and carotid artery diameter response during the CAR-test in healthy, middle-aged men. Methods Sample consisted of 40 normotensive men (aged 31–59 years) with no history of CVD of currently taking medication. Noninvasive ultrasound was used to measure carotid artery diameter during the cold pressor test (CPT), with CAR% being calculated as the relative change from baseline (%). Mean arterial pressure (MAP) was measured with beat-to-beat blood pressure recording. Results CAR% was 4.4 ± 5.4%, peaking at 92 ± 43 seconds. MAP increased from 88 ± 9 mmHg to 110 ± 15 mmHg, peaked at 112 ± 38 seconds, which was significantly later than the diameter peak (P = 0.04). The correlation between resting MAP and CAR% was weak (r = 0.209 P = 0.197). Tertiles based on resting MAP or MAP-increase revealed no significant differences between groups in subject characteristics including age, body mass index, or CAR% (all P > 0.05). Subgroup analysis of individuals with carotid constriction (n = 6) vs. dilation (n = 34), revealed no significant difference in resting MAP or increase in MAP (P = 0.209 and 0.272, respectively). Conclusion Our data suggest that the characteristic increase in MAP during the CPT does not mediate carotid artery vasomotion.

scholarly journals Carotid β-stiffness index is associated with slower processing speed but not working memory or white matter integrity in healthy middle-aged/older adults

2017 ◽  
Vol 122 (4) ◽  
pp. 868-876 ◽  
Author(s):  
Lyndsey E. DuBose ◽  
Michelle W. Voss ◽  
Timothy B. Weng ◽  
James D. Kent ◽  
Kaitlyn M. Dubishar ◽  
...  
Keyword(s):  
Working Memory ◽  
Carotid Artery ◽  
Processing Speed ◽  
Aortic Stiffness ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Stiffness Index ◽  
Middle Aged ◽  
Artery Stiffness ◽  
Memory Cost

Aging is associated with increased carotid artery stiffness, a predictor of incident stroke, and reduced cognitive performance and brain white matter integrity (WMI) in humans. Therefore, we hypothesized that higher carotid stiffness/lower compliance would be independently associated with slower processing speed, higher working memory cost, and lower WMI in healthy middle-aged/older (MA/O) adults. Carotid β-stiffness ( P < 0.001) was greater and compliance ( P < 0.001) was lower in MA/O ( n = 32; 64.4 ± 4.3 yr) vs. young ( n = 19; 23.8 ± 2.9 yr) adults. MA/O adults demonstrated slower processing speed (27.4 ± 4.6 vs. 35.4 ± 5.0 U/60 s, P < 0.001) and higher working memory cost (−15.4 ± 0.14 vs. −2.2 ± 0.05%, P < 0.001) vs. young adults. Global WMI was lower in MA/O adults ( P < 0.001) and regionally in the frontal lobe ( P = 0.020) and genu ( P = 0.009). In the entire cohort, multiple regression analysis that included education, sex, and body mass index, carotid β-stiffness index (B = −0.53 ± 0.15 U, P = 0.001) and age group (B = −4.61 ± 1.7, P = 0.012, adjusted R2 = 0.4) predicted processing speed but not working memory cost or WMI. Among MA/O adults, higher β-stiffness (B = −0.60 ± 0.18, P = 0.002) and lower compliance (B = 0.93 ± 0.26, P = 0.002) were associated with slower processing speed but not working memory cost or WMI. These data suggest that greater carotid artery stiffness is independently and selectively associated with slower processing speed but not working memory among MA/O adults. Carotid artery stiffening may modulate reductions in processing speed earlier than working memory with healthy aging in humans. NEW & NOTEWORTHY Previously, studies investigating the relation between large elastic artery stiffness, cognition, and brain structure have focused mainly on aortic stiffness in aged individuals with cardiovascular disease risk factors and other comorbidities. This study adds to the field by demonstrating that the age-related increases in carotid artery stiffness, but not aortic stiffness, is independently and selectively associated with slower processing speed but not working memory among middle-aged/older adults with low cardiovascular disease risk factor burden.

scholarly journals Associations between normal weight central obesity and cardiovascular disease risk factors in Japanese middle-aged adults: a cross-sectional study

2019 ◽  
Vol 38 (1) ◽  
Author(s):  
Takako Shirasawa ◽  
Hirotaka Ochiai ◽  
Takahiko Yoshimoto ◽  
Satsue Nagahama ◽  
Mariko Kobayashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Central Obesity ◽  
Normal Weight ◽  
Cvd Risk Factors ◽  
Middle Aged ◽  
Cvd Risk ◽  
Japanese Adults ◽  
Middle Aged Adults

Abstract Background Several studies have shown that normal weight central obesity (NWCO) is associated with cardiovascular disease (CVD) risk factors. However, studies conducted in the Japanese population have been very limited. Thus, the relationships between normal weight central obesity, classified using body mass index (BMI), the waist-to-height ratio (WHtR), and CVD risk factors in middle-aged Japanese adults were investigated. Methods The participants were Japanese adults aged 40–64 years who had undergone periodic health examinations in Japan during the period from April 2013 to March 2014. The participants were categorized into the following four groups: normal weight (BMI 18.5–24.9 kg/m2) and no central obesity (WHtR < 0.5) (NW); normal weight and central obesity (WHtR ≥ 0.5) (NWCO); obesity (BMI ≥ 25 kg/m2) and no central obesity (OB); and obesity and central obesity (OBCO). Hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or taking medication for hypertension. Dyslipidemia was defined as LDL-C ≥ 140 mg/dl, HDL-C < 40 mg/dl, triglyceride ≥ 150 mg/dl, or taking medication for dyslipidemia. Diabetes was defined as fasting plasma glucose ≥ 126 mg/dl, random plasma glucose ≥ 200 mg/dl, HbA1c ≥ 6.5%, or receiving medical treatment for diabetes mellitus. A logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for hypertension, dyslipidemia, and diabetes. Results A total of 117,163 participants (82,487 men and 34,676 women) were analyzed. The prevalence of NWCO was 15.6% in men and 30.2% in women. With reference to NW, the ORs for hypertension (adjusted OR 1.22, 95% CI 1.17–1.27 in men, 1.23, 1.16–1.31 in women), dyslipidemia (1.81, 1.74–1.89 in men, 1.60, 1.52–1.69 in women), and diabetes (1.35, 1.25–1.46 in men, 1.60, 1.35–1.90 in women) were significantly higher in NWCO. Conclusions Normal weight with central obesity was associated with CVD risk factors, such as hypertension, dyslipidemia, and diabetes, compared with normal weight without central obesity, regardless of sex. It is important to focus on normal weight with central obesity for the prevention of CVD in Japanese middle-aged adults.

scholarly journals Trends in cardiovascular disease risk factors by body mass index category among adults in England 2003-18: analysis of repeated cross-sectional national health surveys

2020 ◽  
Author(s):  
Shaun Scholes ◽  
Linda Ng Fat ◽  
Jennifer S Mindell
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Factor ◽  
Total Cholesterol ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Risk Factor Prevalence

Objective. Favourable trends in cardiovascular disease (CVD) risk factors at the population level potentially mask differences within high- and low-risk groups. Data from annual, repeated cross-sectional surveys (Health Survey for England 2003-18) was used to examine trends in the prevalence of key CVD risk factors by body mass index (BMI) category among adults aged 16 years or older (n=115,860). Methods. Six risk factors were investigated: (i) current cigarette smoking; (ii) physical inactivity (<30 minutes of moderate-to-vigorous physical activity per week); (iii) drinking above recommended daily alcohol limits; (iv) hypertension (measured blood pressure ≥140/90mmHg or use of medicine prescribed for high blood pressure); (v) total diabetes (reported diagnosed or elevated glycated haemoglobin); and (vi) raised total cholesterol (≥5mmol/L). Age-standardised risk factor prevalence was computed in each four-year time period (2003-06; 2007-10; 2011-14; 2015-18) in all adults and by BMI category (normal-weight; overweight; obesity). Change in risk factor prevalence on the absolute scale was computed as the difference between the first and last time-periods, expressed in percentage points (PP). Results. Risk factor change varied by BMI category in a number of cases. Current smoking prevalence fell more sharply for normal-weight men (-8.1 PP; 95% CI: -10.3, -5.8) versus men with obesity (-3.8 PP; 95% CI: -6.2, -1.4). Hypertension remained at a stable level among normal-weight men but decreased among men with obesity (-4.1 PP; 95% CI: -7.1, -1.0). Total diabetes remained at a stable level among normal-weight adults, but increased among adults with obesity (men: 3.5 PP; 95% CI: 1.2, 5.7; women: 3.6 PP; 95% CI: 1.8, 5.4). Raised total cholesterol decreased in all BMI groups, but fell more sharply among women with obesity (-21 PP; 95% CI: -25, -17) versus their normal-weight counterparts (-16 PP; 95% CI: -18, -14). Conclusions. Relative to adults with normal weight, greater reductions in hypertension and raised total cholesterol among adults with overweight and obesity reflect at least in part improvements in screening, treatment and control among those at highest cardiovascular risk. Higher levels of risk factor prevalence among adults with overweight and obesity, in parallel with rising diabetes, highlight the importance of national prevention efforts to combat the public health impact of excess adiposity.

scholarly journals Beat-to-Beat Blood Pressure Variability in the First Trimester Is Associated With the Development of Preeclampsia in a Prospective Cohort

Hypertension ◽  
2020 ◽  
Vol 76 (6) ◽  
pp. 1800-1807 ◽  
Author(s):  
Virginia R. Nuckols ◽  
Seth W. Holwerda ◽  
Rachel E. Luehrs ◽  
Lyndsey E. DuBose ◽  
Amy K. Stroud ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Blood Pressure Variability ◽  
Aortic Stiffness ◽  
Baroreflex Sensitivity ◽  
Pulse Wave ◽  
First Trimester ◽  
Study Cohort ◽  
Hypertensive Disorder

Women with preeclampsia, a hypertensive disorder of pregnancy, exhibit greater beat-to-beat blood pressure variability (BPV) in the third trimester after clinical onset of the disorder. However, it remains unknown whether elevated BPV precedes the development of preeclampsia. A prospective study cohort of 139 women (age 30.2±4.0 years) were enrolled in early pregnancy (<14 weeks gestation). BPV was quantified by time domain analyses of 10-minute continuous beat-to-beat blood pressure recordings via finger photoplethysmography in the first, second, and third trimesters. Aortic stiffness (carotid-femoral pulse wave velocity) and spontaneous cardiovagal baroreflex sensitivity were also measured each trimester. Eighteen women (13%) developed preeclampsia. Systolic BPV was higher in all trimesters among women who developed versus did not develop preeclampsia (first: 4.8±1.3 versus 3.7±1.2, P =0.001; second: 5.1±1.8 versus 3.8±1.1, P =0.02; third: 5.2±0.8 versus 4.0±1.1 mm Hg, P =0.002). Elevated first trimester systolic BPV was associated with preeclampsia (odds ratio, 1.94 [95% CI, 1.27–2.99]), even after adjusting for risk factors (age, body mass index, systolic blood pressure, history of preeclampsia, and diabetes mellitus) and was a significant predictor of preeclampsia (area under the receiver operator characteristic curve=0.75±0.07; P =0.002). Carotid-femoral pulse wave velocity was elevated in the first trimester among women who developed preeclampsia (5.9±0.8 versus 5.2±0.8 m/s; P =0.002) and was associated with BPV after adjustment for mean blood pressure ( r =0.26; P =0.005). First trimester baroreflex sensitivity did not differ between groups ( P =0.23) and was not related to BPV ( P =0.36). Elevated systolic BPV is independently associated with the development of preeclampsia as early as the first trimester, possibly mediated in part by higher aortic stiffness.

scholarly journals Serum alanine aminotransferase activity and risk factors for cardiovascular disease in a Caucasian population: the Tromsø study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Svein Ivar Bekkelund
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Alanine Aminotransferase ◽  
Maximum Level ◽  
Glycated Haemoglobin ◽  
Caucasian Population ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Serum Alanine Aminotransferase

Abstract Background High and low levels of serum alanine aminotransferase (ALT) are both associated with cardiovascular diseases (CVD) risks especially in elderly, but the mechanisms are less known. This study investigated associations between ALT and CVD risk factors including effects of sex and age in a Caucasian population. Methods Cross-sectional data were analysed sex-stratified in 2555 men (mean age 60.4 years) and 2858 women (mean age 60.0 years) from the population study Tromsø 6. Associations were assessed by variance analysis and multivariable logistic regression of odds to have abnormal ALT. Risk factors included body mass index (BMI), waist-to-hip-ratio, blood pressure, lipids, glucose, glycated haemoglobin and high-sensitive C-reactive protein (CRP). Results Abnormal elevated ALT was detected in 113 men (4.4%) and 188 women (6.6%). Most CVD risk factors associated positively with ALT in both sexes except systolic blood pressure and CRP (women only), while ALT was positively associated with age in men when adjusted for CVD risk factors, P < 0.001. BMI predicted ALT in men (OR 0.94; 95% CI 0.88–1.00, P = 0.047) and women (OR 0.90; 95% CI 0.86–0.95, P < 0.001). A linear inversed association between age and ALT in men and a non-linear inversed U-trend in women with maximum level between 60 and 64 years were found. Conclusion This study confirms a positive relationship between ALT and CVD risk factors, particularly BMI. Age is not a major confounder in the ALT-CVD relationship, but separate sex-analyses is recommended in such studies.

Heart rate and blood pressure variability and baroreflex sensitivity in patients with acute brain injury

2005 ◽  
Vol 20 (4) ◽  
pp. 394 ◽  
Author(s):  
V. Papaioannou ◽  
M. Giannakou ◽  
N. Maglaveras ◽  
E. Sofianos ◽  
M. Giala
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Brain Injury ◽  
Blood Pressure Variability ◽  
Baroreflex Sensitivity ◽  
Acute Brain Injury
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