Carotid Artery Stiffening With Aging: Structural Versus Load-Dependent Mechanisms in MESA (the Multi-Ethnic Study of Atherosclerosis)

Hypertension ◽  
2021 ◽  
Author(s):  
Ryan J. Pewowaruk ◽  
Yacob Tedla ◽  
Claudia E. Korcarz ◽  
Matthew C. Tattersall ◽  
James H. Stein ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Carotid Artery ◽  
Antihypertensive Medication ◽  
Elastic Moduli ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Age Groups ◽  
Structural Stiffness ◽  
Ethnic Study

Elastic arteries stiffen via 2 main mechanisms: (1) load-dependent stiffening from higher blood pressure and (2) structural stiffening due to changes in the vessel wall. Differentiating these closely coupled mechanisms is important to understanding vascular aging. MESA (Multi-Ethnic Study of Atherosclerosis) participants with B-mode carotid ultrasound and brachial blood pressure at exam 1 and exam 5 (year 10) were included in this study (n=2604). Peterson and Young elastic moduli were calculated to represent total stiffness. Structural stiffness was calculated by adjusting Peterson and Young elastic moduli to a standard blood pressure of 120/80 mm Hg with participant-specific models. Load-dependent stiffness was the difference between total and structural stiffness. Changes in carotid artery stiffness mechanisms over 10 years were compared by age groups with ANCOVA models adjusted for baseline cardiovascular disease risk factors. The 75- to 84-year age group had the greatest change in total, structural, and load-dependent stiffening compared with younger groups ( P <0.05). Only age and cessation of antihypertensive medication were predictive of structural stiffening, whereas age, race/ethnicity, education, blood pressure, cholesterol, and antihypertensive medication were predictive of increased load-dependent stiffening. On average, structural stiffening accounted for the vast majority of total stiffening, but 37% of participants had more load-dependent than structural stiffening. Rates of structural and load-dependent carotid artery stiffening increased with age. Structural stiffening was consistently observed, and load-dependent stiffening was highly variable. Heterogeneity in arterial stiffening mechanisms with aging may influence cardiovascular disease development.

scholarly journals May Measurement Month 2019: an analysis of blood pressure screening results from Tunisia

2021 ◽  
Vol 23 (Supplement_B) ◽  
pp. B144-B146
Author(s):  
Sina Haj Amor ◽  
Thomas Beaney ◽  
Olfa Saidi ◽  
Jonathan Clarke ◽  
Neil R Poulter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Antihypertensive Medication ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Population Based ◽  
Intervention Programme ◽  
And Control ◽  
Adult Volunteers

Abstract We performed a May Measurement Month (MMM) screening campaign among adult volunteers aged 18 years old and over in Tunisia. The objective was to raise awareness, and to estimate the prevalence, awareness, treatment, and control of hypertension, one of the main cardiovascular risk factors. Following the MMM protocol, three blood pressure (BP) measurements were taken by physicians and standard interviewing procedures were used to record medical history, socio-demographic, and cardiovascular disease risk factors. Hypertension was defined as a systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg or treatment with antihypertensive medication. From 11 271 adults screened, the prevalence of hypertension was 38.1%. Among those with hypertension, 72.5% were aware of their diagnosis, and 67.5% were treated. BP control was achieved in only 38.2% of all those with hypertension. The study highlights the magnitude of hypertension in Tunisia. There is an urgent need for implementing a comprehensive integrated population-based intervention programme to ameliorate the growing problem of hypertension.

Abstract P335: Using Cardiovascular Disease Risk Versus Blood Pressure To Guide The Initiation Of Antihypertensive Medication Among Us Adults

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Swati Sakhuja ◽  
Shakia T Hardy ◽  
Philip Akinyelure ◽  
Byron C Jaeger ◽  
Daichi Shimbo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Antihypertensive Medication ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Mortality Rates ◽  
Cvd Risk ◽  
Relative Risks ◽  
All Cause Mortality ◽  
Using Data

Introduction: The primary goal of initiating antihypertensive medication is to prevent cardiovascular disease (CVD). It has been hypothesized that using CVD risk to guide the decision to initiate antihypertensive medication may prevent more CVD events than treatment guided by blood pressure (BP) alone. Methods: We estimated the number of CVD and all-cause deaths that could be prevented among US adults through the initiation of antihypertensive medication based on high CVD risk versus high BP. CVD and all-cause mortality rates were calculated using data from 4,390 participants 40 to 79 years of age not taking antihypertensive medication from the 1999 to 2004 National Health and Nutrition Examination Survey (NHANES) mortality follow-up study. High BP was defined by systolic BP ≥ 140 mm Hg or diastolic BP ≥ 90 mm Hg. High CVD risk was defined by 10-year predicted CVD risk ≥10% using the Pooled Cohort risk equations or a history of CVD. Relative risks and 95% confidence limits for CVD and all-cause mortality with antihypertensive medication of 0.75 (0.57-0.98) and 0.76 (0.63-0.91), respectively, were obtained from the Blood Pressure Lowering Treatment Trialists Collaboration. Results: Among US adults not taking antihypertensive medication, 19.4% (23.5 million) had high BP and 25.5% (30.9 million) had high CVD risk. CVD mortality rates were 5.3 and 3.9 per 1,000 person-years among US adults with high CVD risk versus high BP, respectively (Table). Using high CVD risk to guide antihypertensive medication initiation is projected to prevent 403,093 deaths from CVD over 10 years compared with 224,312 deaths from CVD projected to be prevented using a BP-guided treatment approach. More all-cause deaths are projected to be prevented by using high CVD risk (2.2 million deaths) rather than high BP (1.1 million deaths) to guide the decision to initiate antihypertensive medication. Conclusions: Using predicted CVD risk instead of BP alone to guide antihypertensive medication initiation is projected to prevent more CVD and all-cause deaths.

scholarly journals Age modification of ozone associations with cardiovascular disease risk in adults: a potential role for soluble P-selectin and blood pressure

2018 ◽  
Vol 10 (7) ◽  
pp. 4643-4652 ◽  
Author(s):  
Drew B. Day ◽  
Merlise A. Clyde ◽  
Jianbang Xiang ◽  
Feng Li ◽  
Xiaoxing Cui ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Potential Role ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Soluble P

scholarly journals Dietary Patterns in a Population Cohort in Uruguay and Associations with Markers of Cardiovascular Disease Risk

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 548-548
Author(s):  
Paula Moliterno ◽  
Carmen Donangelo ◽  
Juan Vanerio ◽  
Romina Nogara ◽  
Matias Pecora ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Dietary Patterns ◽  
Calcium Intake ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Age Groups ◽  
Outcome Variable ◽  
High Density Lipoproteins ◽  
Blood Lipid Profile ◽  
The Impact

Abstract Objectives The impact of habitual diet on chronic diseases has not been extensively characterized in South America. We aimed to identify major dietary patterns (DP) in a population adult cohort in Uruguay (Genotype Phenotype and Environment of Hypertension Study - GEFA-HT-UY) and to assess associations with metabolic and anthropometric markers of cardiovascular disease risk. Methods In a subsample (n = 295), DP were derived by principal component analysis based on 27 food groups (food frequency questionnaire). Total cholesterol, triglycerides (TG), low and high-density lipoproteins cholesterol (LDL, HDL), fasting glucose and insulin (HOMA), 25(OH)D, neutrophils and lymphocytes were measured in blood. Body weight, height, waist and blood pressure (BP) were measured. Multivariable linear regression models were used to estimate by tertile of DP load the adjusted changes of each outcome variable (relative to tertile 1), according to age (splitting by median age, 54 y). The models included sex, smoking, alcohol drinking, BMI, and season for 25(OH)D, as covariables. Results Three DP were identified: Meat (MDP), Prudent (PDP), and Cereal and Mate (CMDP), explaining 22.6% of total variance. MDP was characterized by higher loads for red, processed and barbecued meat; PDP by higher loads for vegetables, fish and nuts; and CMDP by higher loads for cereals and mate (traditional infused drink). Protein, sodium and alcohol intake increased, and fibre, mono and polyunsaturated fatty acids (MUFA, PUFA) intake decreased, by MDP tertile. Protein, fat (MUFA), fibre and calcium intake increased by PDP tertile. Carbohydrate, sodium and energy intake increased, and PUFA and calcium intake decreased, by CMDP tertile. MDP was associated with lower HDL (−3.1 mg/dl) and 25(OH)D (−3.5 ng/ml), and higher TG/HDL ratio (0.8) and HOMA (0.5), in the older group (P &lt; 0.05). PDP was associated with higher 25(OH)D in both age groups (2.9 and 7.7 ng/ml; P &lt; 0.002). CMDP was associated with higher neutrophils/lymphocytes ratio (0.35) in the younger group, and higher LDL (18.2 mg/dl), systolic BP (5.9 mm Hg) and waist/height ratio (0.024) in the older group (P &lt; 0.05). Conclusions Meat DP was associated with worse blood lipid profile in younger adults, Cereal and Mate DP with worse cardiovascular risk markers in older adults, and Prudent DP with higher 25(OH)D in both age groups. Funding Sources CSIC, ANII, Uruguay.

scholarly journals Vitamin D Receptor Activation Mitigates the Impact of Uremia on Endothelial Function in the 5/6 Nephrectomized Rats

2010 ◽  
Vol 2010 ◽  
pp. 1-10 ◽  
Author(s):  
J. Ruth Wu-Wong ◽  
William Noonan ◽  
Masaki Nakane ◽  
Kristin A. Brooks ◽  
Jason A. Segreti ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Heart Rate ◽  
Vitamin D ◽  
Endothelial Function ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Receptor Activation ◽  
The Impact

Endothelial dysfunction increases cardiovascular disease risk in chronic kidney disease (CKD). This study investigates whether VDR activation affects endothelial function in CKD. The 5/6 nephrectomized (NX) rats with experimental chronic renal insufficiency were treated with or without paricalcitol, a VDR activator. Thoracic aortic rings were precontracted with phenylephrine and then treated with acetylcholine or sodium nitroprusside. Uremia significantly affected aortic relaxation (% in NX rats versus % in SHAM at 30 M acetylcholine). The endothelial-dependent relaxation was improved to –%, –%, and –% in NX rats treated with paricalcitol at 0.021, 0.042, and 0.083 g/kg for two weeks, respectively, while paricalcitol at 0.042 g/kg did not affect blood pressure and heart rate. Parathyroid hormone (PTH) suppression alone did not improve endothelial function since cinacalcet suppressed PTH without affecting endothelial-dependent vasorelaxation. N-omega-nitro-L-arginine methyl ester completely abolished the effect of paricalcitol on improving endothelial function. These results demonstrate that VDR activation improves endothelial function in CKD.

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