Superiority of 24-Hour Aortic Over 24-Hour Brachial Pressure to Associate With Carotid Arterial Damage on the Basis of Pressure Amplification Variability: the SAFAR Study

Hypertension ◽  
2022 ◽  
Author(s):  
Antonios A. Argyris ◽  
Dimitrios Mouziouras ◽  
Stamatia Samara ◽  
Yi Zhang ◽  
Marios K. Georgakis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Systolic Blood Pressure ◽  
Disease Risk ◽  
Multivariable Analysis ◽  
Area Under The Curve ◽  
Left Ventricular ◽  
Pressure Amplification ◽  
Brachial Systolic Blood Pressure ◽  
Arterial Damage

Background: Evidence suggests marginal superiority of static aortic systolic blood pressure (aSBP) compared with brachial SBP regarding the association with organ damage and prognosis of cardiovascular disease. The noninvasive 24-hour aSBP assessment is feasible and associates better with presence of left ventricular hypertrophy compared with 24-hour brachial systolic blood pressure. We aimed at comparing the association of 24-hour aSBP and 24-hour brachial systolic blood pressure with indices of arterial damage and examining the role of 24-hour SBP amplification variability (within-subjects’ SD) in this association. Methods: Consecutive subjects referred for cardiovascular disease risk assessment underwent 24-hour aortic and brachial ambulatory BP monitoring using a validated oscillometric device (Mobil-O-Graph). Arterial damage was assessed by carotid intima-media thickness and detection of carotid and femoral atheromatosis (plaque presence). Results: Cross-sectionally 501 individuals (aged 54±13 years, 57% men, 80% hypertensives) were examined. Multivariable analysis revealed superiority of 24-hour aSBP regarding the association with intimal-medial thickness, carotid hypertrophy and carotid—but not femoral—atheromatosis. In receiver operator characteristics analysis, 24-hour aBP displayed a higher discriminatory ability—compared to 24-hour brachial systolic blood pressure—for the detection of both carotid hypertrophy (area under the curve, 0.662 versus 0.624, P <0.05) and carotid atheromatosis (area under the curve, 0.573 versus 0.547, P <0.05). This effect was more prominent in individuals with above-median 24-hour SD of SBP amplification. Conclusions: Our results suggest that 24-hour aSBP assessment may be of significant value in clinical practice to detect site-specific arterial damage on the basis of pressure amplification variability and should be prospectively examined in clinical trials.

scholarly journals Left Ventricular Mass Index Is Associated With Cognitive Function in Middle-Age

2020 ◽  
Vol 13 (8) ◽  
Author(s):  
Alexander C. Razavi, ◽  
Camilo Fernandez ◽  
Jiang He ◽  
Tanika N. Kelly ◽  
Marie Krousel-Wood ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Cognitive Function ◽  
Systolic Blood Pressure ◽  
Middle Age ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Left Ventricular ◽  
Lv Mass ◽  
Lv Remodeling

Background: Elevated cardiovascular disease risk factor burden is a recognized contributor to poorer cognitive function; however, the physiological mechanisms underlying this association are not well understood. We sought to assess the potential mediation effect of left ventricular (LV) remodeling on the association between lifetime systolic blood pressure and cognitive function in a community-based cohort of middle-aged adults. Methods: Nine hundred sixty participants of the Bogalusa Heart Study (59.2% women, 33.8% black, aged 48.4±5.1 years) received 2-dimensional echocardiography to quantify relative wall thickness, LV mass, and diastolic and systolic LV function; and a standardized neurocognitive battery to assess memory, executive functioning, and language processing. Multivariable linear regression assessed the association of cardiac structure and function with a global composite cognitive function score, adjusting for traditional cardiovascular disease risk factors. Mediation analysis assessed the effect of LV mass index on the association between lifetime systolic blood pressure burden and cognitive function. Results: There were 233 (24.3%) and 136 (14.2%) individuals with concentric LV remodeling and concentric LV hypertrophy, respectively. Each g/m 2.7 increment in LV mass index was associated with a 0.03 standardized unit decrement in global cognitive function ( P =0.03). Individuals with concentric LV remodeling and isolated diastolic dysfunction had the poorest cognitive function, and a greater ratio between early mitral inflow velocity and early diastolic mitral annular velocity (E/e’) was associated with poorer cognitive function, even after adjustment for LV mass index (B=−0.12; P =0.03). A total of 18.8% of the association between lifetime systolic blood pressure burden and midlife cognitive function was accounted for by LV mass index. Conclusions: Cardiac remodeling partially mediates the association between lifespan systolic blood pressure burden and adult cognition in individuals without dementia or clinical cardiovascular disease. Slowing or reversing the progression of cardiac remodeling in middle-age may be a novel therapeutic approach to prevent cognitive decline.

scholarly journals Effect of change in systolic blood pressure between clinic visits on estimated 10-year cardiovascular disease risk

2014 ◽  
Vol 8 (3) ◽  
pp. 159-165 ◽  
Author(s):  
Siqin Ye ◽  
Y. Claire Wang ◽  
Daichi Shimbo ◽  
Jonathan D. Newman ◽  
Emily B. Levitan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Systolic Blood Pressure ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Clinic Visits

Abstract 15670: Age-related Differences in the Contribution of Systolic Blood Pressure and Biomarkers to Cardiovascular Disease Risk Prediction: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mahmoud Al Rifai ◽  
Chiadi E Ndumele ◽  
James A De Lemos ◽  
Caroline Sun ◽  
Ron C Hoogeveen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Systolic Blood Pressure ◽  
Risk Prediction ◽  
Middle Age ◽  
Disease Risk ◽  
Older Individuals ◽  
Prediction Equations ◽  
Cvd Risk ◽  
C Statistic

I ntroduction: Systolic blood pressure (SBP) is an important component of all cardiovascular disease (CVD) risk prediction equations but its biological variability and impact on estimated risk is a concern. Furthermore, predictive value of SBP may differ in older individuals where traditional risk factors (TRF) are less predictive. Hypothesis: Biomarkers reflecting hypertension-related end organ injury (hsTnT, NT-proBNP, eGFR), improve CVD risk prediction in older but not middle age adults as compared to SBP. Methods: Using data from visits 2 (1990-92) and 5 (2011-13) of ARIC, we developed 3 models- Model 1 included all TRF; Model 2- all TRF except SBP + individual biomarkers and Model 3 all TRF + individual biomarkers. C-statistics were used to assess risk discrimination for coronary heart disease, stroke, heart failure, and CVD. Results: After excluding those with prevalent CVD, there were 12,567 individuals at visit 2 (mean age 57, SD 6 years; 43% men) and 4,508 individuals at visit 5 (mean age 76, SD 5 years; 37% men). Over a median (IQR) follow-up time of 22 (12.4–26.7) years and 6.2 (5.4–6.8) years, the incidence rates of CVD events (per 1000 person-years) were 19.0 and 21.8 at visits 2 and 5, respectively. At visit 2, the model with SBP and biomarkers resulted in the largest improvement in C-statistic and SBP contributed to all models. However, at visit 5, removing SBP from the models with the biomarkers had no impact on C-statistic while the addition of the biomarkers (especially hsTnT and NT-proBNP) significantly improved C-statistics for most outcomes ( Table ). Among the biomarkers eGFR had the least additive value. Conclusions: HsTnT and NT-proBNP significantly improve risk discrimination of CHD, stroke, and HF among middle and older adults, while SBP has value in middle age but not in older age. Biomarkers should be considered in risk prediction equations in older individuals where the value of TRF such as SBP decrease.

scholarly journals The Association of Body Composition Parameters and Simultaneously Measured Inter-Arm Systolic Blood Pressure Differences

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 384
Author(s):  
Serkan Yüksel ◽  
Metin Çoksevim ◽  
Murat Meriç ◽  
Mahmut Şahin
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Body Composition ◽  
Systolic Blood Pressure ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Bioelectrical Impedance ◽  
The Body ◽  
Increased Risk ◽  
Group 2

Background and Objectives: An inter-arm systolic blood pressure difference (IASBPD) is defined as a blood pressure (BP) disparity of ≥10 mmHg between arms. IASBPDs are associated with an increased risk of cardiovascular disease (CVD). Similarly, visceral fat accumulation (VFA) is clinically important because it is associated with higher cardiovascular disease risk. Accordingly, this study compared the body composition parameters of IASBPD individuals with individuals who did not express an IASBPD. Materials and Methods: The analysis included 104 patients. The blood pressures of all participants were measured simultaneously in both arms using automated oscillometric devices. Then patients were divided into two groups according to their IASBPD status: Group 1 (IASBPD- (<10 mmHg)); Group 2 (IASPPD+ (≥10 mmHg)). Body composition parameters were measured using bioelectrical impedance analysis. Results: In 42 (40%) patients, the simultaneously measured IASBPD was equal to or higher than 10 mmHg. The right brachial SBP was higher in 63% of patients. There were no differences between the groups in terms of demographic and clinical characteristics. Regarding the two groups’ body composition parameter differences, VFA was significantly higher in group 2 (p = 0.014). Conclusions: The IASBPD is known to be associated with an increased risk of cardiovascular events. Although the body mass indexes (BMIs) of the two groups were similar, VFA levels in those with a greater than 10 mmHg IASBPD were found to be significantly higher. This finding may explain the increased cardiovascular risk in this group.

Sign in / Sign up

Export Citation Format

Share Document