Abstract P514: Age-related Differences in the Annual Changes of the Ankle-brachial Pressure Index: Underlying Mechanisms

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Shogen Fujii ◽  
Kazuki Shiina ◽  
Taishiro Chikamori ◽  
Akira yamashina ◽  
Chisa Matsumoto ◽  
...  

Objectives: The present prospective observational study was conducted to examine the age-related annual changes of the ankle-brachial pressure index (ABI) and their association with the longitudinal changes of the brachial-ankle pulse wave velocity (baPWV), a marker of arterial stiffness, and the radial augmentation index (rAI), a marker of the pressure wave reflection in middle-aged Japanese men. Methods and Results: In 4264 men (42 ± 9 years old) of a Japanese construction company, the ABI, baPWV and rAI were measured annually over a 9-year observation period. During the study period, ABI (from 1.10 ± 0.07 to 1.13 ± 0.07), baPWV (from 1295 ± 194 to 1344 ± 217 cm/sec) and rAI (from 69 ± 13 to 72 ± 13 %) were increased significantly (p<0.01). Mixed model linear regression analysis of the repeated-measures data revealed that the annual increase of the ABI was lower in men aged over 50 years of age (n = 1237: 0.28 ± 0.06) than in those aged under 50 years of age (n = 3027: 0.50 ± 0.04) (p < 0.01). Furthermore, while increased baPWV (estimate = 0.017, p < 0.05) and increased rAI (estimate 0.254, p < 0.05) were significantly related to the annual increase of the ABI in men aged <50 years (p < 0.01), no such association was observed in men aged > 50 years. Conclusion: In middle-aged Japanese men, the ABI increases with age until the age of 50 years, and increased arterial stiffness and increased pressure wave reflection may contribute to this annual increase. In men aged > 50 years, the annual increase of the ABI was attenuated, which could be related, at least in part, to the attenuation of the increase of the pressure wave reflection and also attenuation of the effect of increased arterial stiffness on the hydrostatic pressure in the arteries with age. These findings may suggest the usefulness of ABI measurement as a screening tool for peripheral arterial disease in men over 50 years old.

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Takahashi ◽  
H Tomiyama ◽  
V Abyoyans ◽  
C Matsumoto ◽  
H Nakano ◽  
...  

Abstract   In addition to both pulse wave velocity (PWV; a marker of arterial stiffness) and augmentation index (AI; a marker of central hemodynamics), not only the decrease of ankle-brachial pressure index (ABI) but also its increase predict the future cardiovascular events. While arterial stiffness and central hemodynamics have been proposed to affect the increase in ABI logically, their effects on increase in ABI have not been fully clarified. The present cross-sectional and longitudinal studies were conducted to examine the associations of arterial stiffness and central hemodynamics with increase in ABI and also examine the age-related difference of those associations. In 4016 men (42±9 years old), ABI, brachial-ankle PWV (baPWV) and radial AI (rAI) were measured annually for 9 years' observation period. In the cross-sectional analyses adjusted with age, heart rate and mean blood pressure, both baPWV and rAI were associated with ABI in men aged &lt;50, but not in men aged &gt;50. As shown in Figure, ABI was annually increased in subjects aged &lt;50 (n=2870), but not in those aged &gt;50 (n=1146) during the follow-up period. The mixed model linear regression analysis (MMA) conducted in 9 years' annual repeated measurement data demonstrated that increased baPWV (estimate = 0.017, p&lt;0.05) and increased rAI (estimate 0.254, p&lt;0.05) were significant determinant of annual increase of ABI (p&lt;0.01) in men aged &lt;50, but not in men aged &gt;50. In conclusion, the arterial stiffness and central hemodynamics may individually affect the increase in ABI in men aged &lt;50, but not in men &gt;50. Thus, further studies are needed to clarify whether ABI, arterial stiffness, and central hemodynamics individually predicts future cardiovascular events, and their age-related difference of their predictabilities. figure1 Funding Acknowledgement Type of funding source: Private hospital(s). Main funding source(s): Tokyo Medical University


Author(s):  
Tsubasa Tomoto ◽  
Justin Repshas ◽  
Rong Zhang ◽  
Takashi Tarumi

Midlife aerobic exercise may significantly impact age-related changes in the cerebro- and cardiovascular regulations. This study investigated the associations of midlife aerobic exercise with dynamic cerebral autoregulation (dCA), cardiovagal baroreflex sensitivity (BRS), and central arterial stiffness. Twenty middle-aged athletes (MA) who had aerobic training for >10 years were compared with 20 young (YS) and 20 middle-aged sedentary (MS) adults. Beat-to-beat cerebral blood flow velocity, blood pressure (BP), and heart rate were measured at rest and during forced BP oscillations induced by repeated sit-stand maneuvers at 0.05 Hz. Transfer function analysis was used to calculate dCA and BRS parameters. Carotid distensibility was measured by ultrasonography. MA had the highest peak oxygen uptake (VO2peak) among all groups. During forced BP oscillations, MS showed lower BRS gain than YS, but this age-related reduction was absent in MA. Conversely, dCA was similar among all groups. At rest, BRS and dCA gains at low frequency (~0.1 Hz) were higher in the MA compared with MS and YS groups. Carotid distensibility was similar between MA and YS groups, but it was lower in the MS. Across all subjects, VO2peak was positively associated with BRS gains at rest and during forced BP oscillations (r=0.257~0.382, p=0.003~0.050) and carotid distensibility (r=0.428~0.490, p=0.001). Furthermore, dCA gain at rest and carotid distensibility were positively correlated with BRS gain at rest in YS and MA groups (all p<0.05). These findings suggest that midlife aerobic exercise improves central arterial elasticity and BRS which may contribute to CBF regulation through dCA.


Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Hirofumi Tomiyama ◽  
Kazuki N Shiina ◽  
Taishiro Chikamori ◽  
Akira Yamashina

Importance: While increased arterial stiffness and augmented pressure wave reflection are thought to be key factors in the development of systolic/diastolic hypertension (SDHT) or isolated systolic hypertension (ISHT) via the elevation of systolic blood pressure, their associations with the development of isolated diastolic hypertension (IDHT) have not been clarified. Objective: To examine the significance of augmented pressure wave reflection in the absence of accompanying increase of the arterial stiffness in the development of IDHT. Design and Setting: The prospective observational study conducted in the employees of a Japanese construction company at its health care center from year 2007 through year 2015 with a mean follow-up of 6.4 years, respectively. Participants: A total of 3022 Japanese male employees without hypertension at the start of this study. Main Outcomes and Measures: The annual assessment of prevalence of any phenotypes of hypertension. The blood pressure, brachial-ankle pulse wave velocity (baPWV), and radial augmentation index (rAI) were measured annually during the study period. Results: At the end of the study period, 129 subjects were diagnosed as having SDHT, 112 as having ISHT, and 74 as having IDHT. Both the baPWV and rAI showed significant individual odds ratios for new onset of SDHT and new onset of ISHT. However, only rAI, but not the brachial-ankle PWV, showed a significant odds ratio (1.44, P<0.01) for new onset of IDHT. This association was significant in subjects without elevated baPWV values at the start of the study (i.e., baPWV < 1224 cm/sec), but not in those with elevated brachial-ankle PWV at the start of the study. Generalized estimating equation analyses demonstrated a significant longitudinal association of the rAI, but not baPWV, with the prevalence of IDHT (estimate = 0.02, P=0.02). Conclusions: While increased arterial stiffness and augmented pressure wave reflection present concomitantly may be associated with the development of SDHT and ISHT, augmented pressure wave reflection alone, which may be related to isolated peripheral vascular damage, in the absence of accompanying increase of the arterial stiffness, may be a significant factor in the development of IDHT.


2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
T Ochiai ◽  
H Tomiyama ◽  
H Ikebe ◽  
S Fujii ◽  
K Kimura ◽  
...  

2007 ◽  
Vol 232 (9) ◽  
pp. 1228-1235 ◽  
Author(s):  
Darren P. Casey ◽  
Darren T. Beck ◽  
Randy W. Braith

Endurance exercise is efficacious in reducing arterial stiffness. However, the effect of resistance training (RT) on arterial stiffening is controversial. High-intensity, high-volume RT has been shown to increase arterial stiffness in young adults. We tested the hypothesis that an RT protocol consisting of progressively higher intensity without concurrent increases in training volume would not elicit increases in either central or peripheral arterial stiffness or alter aortic pressure wave reflection in young men and women. The RT group ( n = 24; 21 ± 1 years) performed two sets of 8–12 repetitions to volitional fatigue on seven exercise machines on 3 days/week for 12 weeks, whereas the control group ( n = 18; 22 ± 1 years) did not perform RT. Central and peripheral arterial pulse wave velocity (PWV), aortic pressure wave reflection (augmentation index; AIx), brachial flow–mediated dilation (FMD), and plasma levels of nitrate/nitrite (NOx) and norepinephrine (NE) were measured before and after RT. RT increased the one-repetition maximum for the chest press and the leg extension ( P < 0.001). RT also increased lean body mass ( P < 0.01) and reduced body fat (%; P < 0.01). However, RT did not affect carotid-radial, carotid-femoral, and femoral-distal PWV (8.4 ± 0.2 vs. 8.0 ± 0.2 m/sec; 6.5 ± 0.1 vs. 6.3 ± 0.2 m/sec; 9.5 ± 0.3 vs. 9.5 ± 0.3 m/sec, respectively) or AIx (2.5% ± 2.3% vs. 4.8% ± 1.8 %, respectively). Additionally, no changes were observed in brachial FMD, NOx, NE, or blood pressures. These results suggest that an RT protocol consisting of progressively higher intensity without concurrent increases in training volume does not increase central or peripheral arterial stiffness or alter aortic pressure wave characteristics in young subjects.


2017 ◽  
Vol 20 (C) ◽  
pp. 56
Author(s):  
Hirofumi Tomiyama ◽  
Akira Yamashina ◽  
Shunsuke Komatsu ◽  
Kazuki Shiina ◽  
Chisa Matsumoto ◽  
...  

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