Abstract P150: Sex Differences In Augmentation Index And Aortic Pulse Pressure Among Patients Diagnosed With Acute Primary Intracerebral Hemorrhage

Introduction: Intracerebral hemorrhage (ICH) is the second most common subtype of stroke. Hypertension is a major cause of primary spontaneous ICH. However, sex difference in blood pressure (BP) and arterial stiffness among ICH patients is not well characterized. Methods: A prospective pilot study to investigate the feasibility of measuring arterial stiffness in acute primary ICH patients was approved by the institutional research board at Wake Forest Baptist Health. Eligible subjects with primary ICH were enrolled in the study within 7 days of onset. Non-invasive measurements of brachial BP, aortic BP, augmentation index at heart rate of 75 beats per minute (AIx75), and carotid-femoral pulse wave velocity (cf-PWV) were measured at the patient’s bedside, using the SphygmoCor XCEL System v1 (AtCor Medical Pty Ltd., Sydney, Australia). Results: A total of 20 patients have been enrolled in the study over 5 months. Over half the patients enrolled were female (55%, n = 11), including 82% (n = 9) White, 9% (n = 1) Asian and 9% (n = 1) Hispanic. There was increased diversity in the male patients (45%, n = 9) including 44% (n = 4) Black, 22% (n = 2) White, 22% (n = 2) Hispanic, and 11% (n = 1) Asian. Men were significantly younger than women (57 ± 5 years vs 74 ± 3 years, respectively, P = 0.009). There were no significant differences in BMI or ICH score. At the time of measurement, there were no significant sex differences in brachial or aortic blood pressures (systolic and diastolic), however, females had significantly higher AIx75 (35 ± 4 vs 20 ± 6, P = 0.036) and aortic PP (53 ± 2 mm Hg vs 42 ± 4 mm Hg, P = 0.020) than males. Sex difference in cf-PWV was not statistically significant (p = 0.054). Conclusion: In the current feasibility pilot study, preliminary data show that females had higher arterial stiffness measured as AIx75 and aortic PP than males in the acute setting of ICH. Further study will be required to ascertain whether this is related to higher age at presentation in females. Whether sex differences in arterial stiffness predict differences in the outcome among ICH patients is not well characterized; thus, assessment of 30-day functional and neurological outcomes will be performed with NIHSS and modified Rankin Scores.

Download Full-text

PO265 Arterial Stiffness,Central Blood Pressures and Microalbuminuia Reduction With Barnidipine and Enalapril In Obese, Hypertensive and Diabetic Patients. A Pilot Study

Global Heart ◽

10.1016/j.gheart.2018.09.219 ◽

2018 ◽

Vol 13 (4) ◽

pp. 438

Author(s):

R.M. Cabrera-Solé ◽

L. Urrego Rivera ◽

J. Cañas Gonzalez ◽

S. Garcia Ruiz ◽

C. Turpin Lucas

Keyword(s):

Pilot Study ◽

Arterial Stiffness ◽

Diabetic Patients ◽

Blood Pressures

Download Full-text

MON-LB52 Evaluation of Arterial Stiffness in Acromegaly Patients

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.2110 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

sevil alagüney ◽

Goknur Yorulmaz ◽

Toygar Ahmet Kalkan ◽

Kadir Ugur Mert ◽

Muhammet Dural ◽

...

Keyword(s):

Blood Pressure ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

Pulse Wave ◽

Augmentation Index ◽

Morbidity And Mortality ◽

Increased Risk ◽

Study Results ◽

Blood Pressures

Abstract Acromegaly is associated with increased morbidity and mortality primarily attributed to cardiovascular and cerebrovascular diseases, thus demonstrating the negative arterial impact of chronic GH and IGF-1 excess. There are limited and conflicting data regarding coronary artery disease (CAD) in acromegaly that consists mainly of heterogeneous cohorts and pathological reviews of old case series. Increased arterial stiffness is associated with an increased risk of cardiovascular events such as myocardial infarction. Arterial stiffness may measured from pulse wave velocity(PWV). In this study we aimed to evaluate the association between pulse wave velocity and aortic augmentation index in acromegalic patients. Methods: Our study population consists of a consecutive subset of 32 acromegalic patients and 19 control. Acromegalic patients IGF 1 levels were noted. All patients BMI, age, blood pressure, gender also were noted. Also pulse pressure, central blood pressures were measured by non-invasive central blood pressure measurement device (SphygmoCor). Pulse wave velocity and aortic augmentation index were measured by the same device. Results: A total of 32 acromegalic patients and 19 control were enrolled in the study. Body mass index and gender were not significantly different between the groups. Aortic augmentation index (5 vs. 6, p =0,685) variables weren’t significantly different in the study. Systolic and diastolic blood pressures were significantly high in the acromegalic group. (130/82 vs. 120/70) PWV was significantly high in the acromegalic group. (13 vs 11,5 p=0,002)Conclusions: Our study results suggest that acromegaly patients have worse arterial stiffness due to increased pulse wave velocity. Acromegaly is associated with increased morbidity and mortality primarily attributed to cardiovascular problems. We thought that it may be a guiding method in disease management since it can be an early marker of cardiovascular risk.Keywords: acromegaly, pulse wave velocity, aortic augmentation index

Download Full-text

The effects of thyrotoxicosis and its treatment on central arterial stiffness

Acta Endocrinologica ◽

10.1530/eje.0.1470035 ◽

2002 ◽

pp. 35-40 ◽

Cited By ~ 11

Author(s):

K Obuobie ◽

J Smith ◽

R John ◽

JS Davies ◽

JH Lazarus

Keyword(s):

Heart Rate ◽

Arterial Stiffness ◽

Arterial Pressure ◽

Pulse Wave ◽

Augmentation Index ◽

Significant Rise ◽

Blood Pressures ◽

Analysis Design ◽

Additional Therapy ◽

Control Study

OBJECTIVE: To assess central arterial stiffness in thyrotoxicosis using the technique of pulse wave analysis. DESIGN: Case control study designed to determine the effect of thyrotoxicosis on central arterial stiffness and at 6 months after radioiodine treatment. PATIENTS: Twenty (18 women and 2 men) thyrotoxic patients and 20 age- and sex-matched controls were studied at baseline. Thyrotoxic patients were re-studied at 6 months following treatment of thyrotoxicosis with 555 MBq (131)I with no additional therapy for the six-month period. MEASUREMENTS: Using the sphygmocor apparatus, peripheral pressure waveforms were recorded non-invasively from the radial artery and central pressure waveforms were generated from these. Indices of arterial stiffness, central augmentation index (AI), augmentation of central arterial pressure (AG) and central blood pressures were derived. AI corrected for heart rate (AIc) was calculated. RESULTS: Thyrotoxic patients recorded a significantly lower AI (means+/-s.e.m.) compared with controls (15.0+/-2.1 vs 28.0+/-2.1%; P<0.0005) even when corrected for differences in heart rate AIc (20.0+/-2.1 vs 28.0+/-2.1%; P<0.005) as well as AG (6.0+/-0.8 vs 10.0+/-1.1 mmHg; P<0.002) but higher pulse pressure (58.0+/-3.5 vs 47.0+/-2.0 mmHg; P<0.02). At 6 months following treatment, a significant rise in AIc (27.0+/-1.8 vs 20.0+/-2.1%; P<0.005) and AG (11.0+/-1.0 vs 6.0+/-0.8 mmHg; P<0.005) was noted. Lipid profiles were comparable between the groups. CONCLUSIONS: These data suggested that subjects with untreated thyrotoxicosis have a decreased augmentation of central arterial pressure or lowered central arterial stiffness that would not appear to contribute to any excess cardiovascular risk in that condition.

Download Full-text

Postprandial effects of macronutrient composition meals on the metabolic responses and arterial stiffness indices of lean and obese male adults: a protocol of a pilot study

Pilot and Feasibility Studies ◽

10.1186/s40814-021-00787-2 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Safieh Firouzi ◽

Reza Rezvani ◽

Naseh Pahlavani ◽

Lida Jarahi ◽

Jamshid Gholizadeh Navashenaq ◽

...

Keyword(s):

Pilot Study ◽

Energy Expenditure ◽

Arterial Stiffness ◽

Augmentation Index ◽

Controlled Trial ◽

Resting Energy Expenditure ◽

Primary Objective ◽

Metabolic Responses ◽

Obese Adults ◽

Meal Composition

Abstract Background Prior studies have shown that meal composition may affect the metabolic responses and arterial stiffness indices, and these responses may be different in lean and obese adults. The primary objective of this study is to determine the feasibility of conducting a trial to compare the effect of three test meals in lean and obese men. Due to the lack of a comprehensive study that concurrently compares metabolic responses and vascular stiffness indices after receiving three different meals in lean and obese men, this pilot study will be conducted with a three-phase parallel design, aiming to investigate the effects of meal composition on the metabolic parameters and arterial stiffness indices of lean and obese adults. Methods This pilot, a parallel clinical trial will be performed on 24 male adults aged 18–35 years since January 2021 and will continue until March 2021 who are disease-free and selected based on the inclusion and exclusion criteria at Mashhad University of Medical Sciences, Iran. The subjects will complete three interventions at a 1-week interval, including high carbohydrate (70% carbohydrates, 10% protein, 20% fat), high protein (30% protein, 50% carbohydrates, 20% fat), and high-fat meal (50% fat, 40% carbohydrates, 10% protein). Postprandial effects will be assessed within 360 min after each meal, including the energy expenditure component (resting energy expenditure, thermic effects of feeding, respiratory quotient, and substrate oxidation) and arterial stiffness indices (augmentation index and pulse wave velocity). In addition, blood sampling will be performed to measure glucose, insulin, free fatty acids, and lipid profile. Discussion The differences in the postprandial responses can affect the metabolic and vascular parameters due to different meal compositions, thereby providing beneficial data for the establishment of new strategies in terms of nutritional education and metabolic/vascular improvement. Also, the results from this pilot study will inform intervention refinement and efficacy testing of the intervention in a larger randomized controlled trial. Trial registration Iranian Registry of Clinical Trials; code: IRCT20190818044552N1; registered on August 26, 2019

Download Full-text

Arterial Stiffness Assessment Using the Arteriograph in Patients with Moderate–Severe OSA and Metabolic Syndrome—A Pilot Study

Journal of Clinical Medicine ◽

10.3390/jcm10184238 ◽

2021 ◽

Vol 10 (18) ◽

pp. 4238

Author(s):

Ioana Mădălina Zota ◽

Cristian Stătescu ◽

Radu Andy Sascău ◽

Mihai Roca ◽

Larisa Anghel ◽

...

Keyword(s):

Metabolic Syndrome ◽

Pilot Study ◽

Arterial Stiffness ◽

Augmentation Index ◽

Organ Damage ◽

Aortic Pulse Wave Velocity ◽

Cpap Therapy ◽

Obstructive Sleep ◽

Before And After ◽

A Prospective Study

Background: Both obstructive sleep apnea (OSA) and metabolic syndrome (MS) promote arterial stiffening. As a basis for this study, we presumed that arterial stiffness could be assessed using the Arteriograph (TensioMed, Budapest, Hungary) to detect early modifications induced by continuous positive airway therapy (CPAP) in reversing this detrimental vascular remodeling. Arterial stiffness is increasingly acknowledged as a major cardiovascular risk factor and a marker of subclinical hypertension-mediated organ damage. The aim of this pilot study was to evaluate the arterial stiffness changes in patients with moderate–severe OSA and MS after short-term CPAP use. Methodsː We performed a prospective study that included patients with moderate–severe OSA and MS who had not undergone previous CPAP therapy. All subjects underwent clinical examination and arterial stiffness assessment using the oscillometric technique with Arteriograph (TensioMed, Budapest, Hungary) detection before and after 8-week CPAP therapy. Resultsː 39 patients with moderate–severe OSA were included. Eight weeks of CPAP therapy significantly improved central systolic blood pressure (Δ = −11.4 mmHg, p = 0.009), aortic pulse wave velocity (aoPWV: Δ = −0.66 m/s, p = 0.03), and aortic augmentation index (aoAix: Δ = −8.25%, p = 0.01) only in patients who used the device for a minimum of 4 h/night (n = 20). Conclusionsː Arterial stiffness was improved only among CPAP adherent patients and could be detected using the Arteriograph (TensioMed, Budapest, Hungary), which involves a noninvasive procedure that is easy to implement for the clinical evaluation of arterial stiffness.

Download Full-text

Abstract P457: Hypertensive, Type II Diabetic and Obese Patients, Are Better Controlled and Reduce the Number of Drugs When Empagliflozin is Added to Standard Treatment Improving Also Arterial Stiffness and Central Blood Pressures

Hypertension ◽

10.1161/hyp.70.suppl_1.p457 ◽

2017 ◽

Vol 70 (suppl_1) ◽

Author(s):

Ricardo Cabrera-Sole ◽

Caridad Turpin Lucas ◽

Liliana Urrera Rivera ◽

Santiago Garcia Ruiz ◽

Manuel Aguilera

Keyword(s):

Blood Pressure ◽

Arterial Stiffness ◽

Standard Treatment ◽

Pulse Wave ◽

Antihypertensive Drugs ◽

Augmentation Index ◽

P Value ◽

Channel Blockers ◽

Blood Pressures ◽

Central Systolic Blood Pressure

Introduction: It is known the difficulty of adequate control of blood pressure (BP) with a single drug, being necessary in most use 2 or more antihypertensive drugs. If they are also obese and diabetic, require even more drugs so we present our experience of adding empagliflozin to the treatment of patients with these characteristics. Objectives: To assess the benefits of metabolic ,BP and arterial stiffness parameters introducing empagliflozin in obese ,hypertensive and diabetics patients (PHTAD). Material and Methods: we studied 32 PHTAD receiving at least 3 drugs (ACE inhibitors, calcium channel blockers, hydrochlorothiazide) and two or more anti diabetic drugs (metformin, glimepirina, sitagliptin, insulin and Statins) for controlling their pathologies). We checked number of drug, BP, glicosylated hemoglobin (A1cHb), BMI and arterial stiffness measured by augmentation index (AI) and pulse wave velocity (PWV) and central systolic blood pressure (SBPc). Patients were followed for 32 weeks, adding to the beginning of the study empagliflozina .Every two months we checked them . The beginning and the end results were compared and are set out in the following table. *means p value less than 0.05 Conclusions: According to our data, the introduction of empagliflozin to the treatment of PHTAD significantly improves metabolic parameters and helps to reduce the number of antihypertensive and antidiabetic drugs they are taking, improving the arterial stiffness indexes and the central pressure values, obtaining a clear improvement in the control of their cardiovascular risk . So it should be thought about this group of drugs when it comes to medicating PHTAD.

Download Full-text

Postprandial Effects of Macronutrient Composition Meals on the Metabolic Responses and Arterial Stiffness Indices of Lean and Obese Male Adults: A Protocol of pilot Study

10.21203/rs.3.rs-56681/v2 ◽

2021 ◽

Author(s):

Safieh Firouzi ◽

Reza Rezvani ◽

Naseh Pahlavani ◽

Lida Jarahi ◽

Jamshid Gholizadeh Navashenaq ◽

...

Keyword(s):

Pilot Study ◽

Energy Expenditure ◽

Arterial Stiffness ◽

Augmentation Index ◽

Resting Energy Expenditure ◽

Metabolic Responses ◽

Medical Sciences ◽

Objective Prior ◽

Three Phase ◽

Meal Composition

Abstract Background & Objective: Prior studies have shown that meal composition may affect the metabolic responses and arterial stiffness indices. Due to the lack of a comprehensive study that concurrently compares metabolic responses and vascular stiffness indices after receiving three different meals in lean and obese men, this pilot study has been conducted with a three-phase parallel design, aiming to investigate the effects of meal composition on the metabolic parameters and arterial stiffness indices of lean and obese adults. Materials and Methods: This pilot, parallel clinical trial has been performed on 20 male adults aged 18-35 years who are disease-free and selected based on the inclusion and exclusion criteria at Mashhad University of Medical Sciences, Iran. The subjects have completed three interventions at a one-week interval, including high carbohydrate (70% carbohydrates, 10% protein, 20% fat), high protein (30% protein, 50% carbohydrates, 20% fat), and high fat meal (50% fat, 40% carbohydrates, 10% protein). Postprandial effects have been assessed within 360 minutes after each meal, including the energy expenditure component (resting energy expenditure, thermic effects of feeding, respiratory quotient, and substrate oxidation) and arterial stiffness indices (augmentation index and pulse wave velocity). In addition, blood sampling has been performed to measure glucose, insulin, free fatty acids, and lipid profile. Results: The study has started since September 2020 and will continue until January 2021. The assessment of the intervention outcomes will be carried out six hours after the end of the intervention. Conclusion: The differences in the postprandial responses c affect the metabolic and vascular parameters due to different meal compositions, thereby providing beneficial data for the establishment of new strategies in terms of nutritional education and metabolic/vascular improvement.

Download Full-text

Arterial stiffness is a potential mechanism and promising indicator of orthostatic hypotension in the general population

VASA ◽

10.1024/0301-1526/a000389 ◽

2014 ◽

Vol 43 (6) ◽

pp. 423-432 ◽

Cited By ~ 11

Author(s):

Qingtao Meng ◽

Si Wang ◽

Yong Wang ◽

Shixi Wan ◽

Kai Liu ◽

...

Keyword(s):

General Population ◽

Arterial Stiffness ◽

Orthostatic Hypotension ◽

Operating Characteristic ◽

Pulse Wave ◽

Augmentation Index ◽

Multiple Logistic Regression Analysis ◽

The Elderly ◽

Baroreceptor Sensitivity ◽

Roc Curve Analysis

Background: Orthostatic hypotension (OH) is a disease prevalent among middle-aged men and the elderly. The association between arterial stiffness and OH is unclear. This study evaluates whether arterial stiffness is correlated with OH and tests the usefulness of brachial-ankle pulse wave velocity (baPWV), an arterial stiffness marker, with regard to identifying OH. Patients and methods: A sample of 1,010 participants was recruited from the general population (64.8 ± 7.7 years; 426 men) who attended health check-ups. BaPWV and the radial augmentation index (rAI) were both assessed as the arterial stiffness markers, and OH was determined using blood pressure (BP) measured in the supine position, as well as 30 seconds and 2 minutes after standing. Results: The prevalence of OH in this population was 4.9 %. Compared with the non-OH group, both baPWV (20.5 ± 4.5 vs 17.3 ± 3.7, p < 0.001) and rAI (88.1 ± 10.8 vs 84.2 ± 10.7, p < 0.05) were significantly higher in the OH group. In the multiple logistic regression analysis, baPWV (OR, 1.3; 95 % CI, 1.106–1.528; p < 0.05) remained associated with OH. Moreover, the degree of orthostatic BP reduction was related to arterial stiffness. In addition, increases in arterial stiffness predicted decreases in the degree of heart rate (HR) elevation. Finally, a receiver operating characteristic (ROC) curve analysis showed that baPWV was useful in discriminating OH (AUC, 0.721; p < 0.001), with the cut-off value of 18.58 m/s (sensitivity, 0.714; specificity, 0.686). Conclusions: Arterial stiffness determined via baPWV, rather than rAI, was significantly correlated with the attenuation of the orthostatic hemodynamic response and the resultant OH. The impaired baroreceptor sensitivity might be the mechanism. In addition, baPWV appears to be a relatively sensitive and reliable indicator of OH in routine clinical practice.

Download Full-text

Markers of arterial stiffness in peripheral arterial disease

VASA ◽

10.1024/0301-1526/a000452 ◽

2015 ◽

Vol 44 (5) ◽

pp. 341-348 ◽

Cited By ~ 25

Author(s):

Marc Husmann ◽

Vincenzo Jacomella ◽

Christoph Thalhammer ◽

Beatrice R. Amann-Vesti

Keyword(s):

Arterial Stiffness ◽

Peripheral Arterial Disease ◽

Pulse Wave ◽

Augmentation Index ◽

Arterial Disease ◽

Care Physician ◽

Additional Information ◽

Non Invasive ◽

Assessment Techniques ◽

Peripheral Arterial

Abstract. Increased arterial stiffness results from reduced elasticity of the arterial wall and is an independent predictor for cardiovascular risk. The gold standard for assessment of arterial stiffness is the carotid-femoral pulse wave velocity. Other parameters such as central aortic pulse pressure and aortic augmentation index are indirect, surrogate markers of arterial stiffness, but provide additional information on the characteristics of wave reflection. Peripheral arterial disease (PAD) is characterised by its association with systolic hypertension, increased arterial stiffness, disturbed wave reflexion and prognosis depending on ankle-brachial pressure index. This review summarises the physiology of pulse wave propagation and reflection and its changes due to aging and atherosclerosis. We discuss different non-invasive assessment techniques and highlight the importance of the understanding of arterial pulse wave analysis for each vascular specialist and primary care physician alike in the context of PAD.

Download Full-text

The Relationship of Compliance with Coping Strategies and Self-Esteem

European Journal of Psychological Assessment ◽

10.1027//1015-5759.19.2.117 ◽

2003 ◽

Vol 19 (2) ◽

pp. 117-123 ◽

Cited By ~ 40

Author(s):

Gisli H. Gudjonsson ◽

Jon Fridrik Sigurdsson

Keyword(s):

Sex Differences ◽

Coping Strategies ◽

Multiple Regression ◽

Sex Difference ◽

Test Scores ◽

Self Esteem ◽

Stressful Situation ◽

Men And Women ◽

Relationship Of ◽

The Relationship

Summary: The Gudjonsson Compliance Scale (GCS), the COPE Scale, and the Rosenberg Self-Esteem Scale were administered to 212 men and 212 women. Multiple regression of the test scores showed that low self-esteem and denial coping were the best predictors of compliance in both men and women. Significant sex differences emerged on all three scales, with women having lower self-esteem than men, being more compliant, and using different coping strategies when confronted with a stressful situation. The sex difference in compliance was mediated by differences in self-esteem between men and women.

Download Full-text