scholarly journals Assessment of Arterial Stiffness Using the Cardio-Ankle Vascular Index – What We Know and What We Strive for

2021 ◽  
Vol 17 (4) ◽  
pp. 619-627
Author(s):  
A. N. Sumin ◽  
A. V. Shcheglova
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Diseases ◽  
Arterial Stiffness ◽  
Vascular Function ◽  
Cardiovascular Events ◽  
Dynamic Assessment ◽  
Geriatric Medicine ◽  
Stiffness Index ◽  
Vascular Aging

Currently, the importance of assessing arterial stiffness as an integral indicator of cardiovascular risk, an indicator of arteriosclerosis, and a predictor of cardiovascular events has been demonstrated. The traditional indicator of arterial stiffness-pulse wave velocity-depends on the level of blood pressure, which makes it difficult to use it for dynamic assessment. The proposed new arterial stiffness index-the cardio-ankle vascular index (CAVI), does not depend on the level of blood pressure and is more convenient in practical use. CAVI has been widely used in clinical medicine for the past 15 years as an index for assessing cardiovascular diseases and risk factors, which has allowed for the expansion and deepening of research on this topic. This review focuses primarily on recent publications and new opportunities for evaluating vascular function using CAVI. The review provides information on solving methodological problems in evaluating CAVI, highlights the relationship between CAVI and future cardiovascular events, and provides cross-sectional data on the Association of CAVI with the presence of cardiovascular diseases and their risk factors. The results of studies on the effect of drug therapy and measures to control risk factors for cardiovascular diseases on CAVI are presented. While it remains unclear how much changes in CAVI over time can affect the forecast, research is currently being conducted in this direction. The use of CAVI also opens up new perspectives in the assessment of cardiovascular interactions, the study of vascular function in vasculitis and vascular injuries, as well as in geriatric medicine (concepts of premature vascular aging and excess vascular aging).

Arterial Stiffness and Cardiovascular Risk in Hypertension

2021 ◽  
Vol 128 (7) ◽  
pp. 864-886 ◽  
Author(s):  
Pierre Boutouyrie ◽  
Phil Chowienczyk ◽  
Jay D. Humphrey ◽  
Gary F. Mitchell
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Arterial Stiffness ◽  
Diastolic Pressure ◽  
Left Ventricular ◽  
Lipid Lowering ◽  
Coronary Perfusion ◽  
Vascular Aging ◽  
Excessive Pressure ◽  
Pressure Independent

Arterial stiffness, a leading marker of risk in hypertension, can be measured at material or structural levels, with the latter combining effects of the geometry and composition of the wall, including intramural organization. Numerous studies have shown that structural stiffness predicts outcomes in models that adjust for conventional risk factors. Elastic arteries, nearer to the heart, are most sensitive to effects of blood pressure and age, major determinants of stiffness. Stiffness is usually considered as an index of vascular aging, wherein individuals excessively affected by risk factor exposure represent early vascular aging, whereas those resistant to risk factors represent supernormal vascular aging. Stiffness affects the function of the brain and kidneys by increasing pulsatile loads within their microvascular beds, and the heart by increasing left ventricular systolic load; excessive pressure pulsatility also decreases diastolic pressure, necessary for coronary perfusion. Stiffness promotes inward remodeling of small arteries, which increases resistance, blood pressure, and in turn, central artery stiffness, thus creating an insidious feedback loop. Chronic antihypertensive treatments can reduce stiffness beyond passive reductions due to decreased blood pressure. Preventive drugs, such as lipid-lowering drugs and antidiabetic drugs, have additional effects on stiffness, independent of pressure. Newer anti-inflammatory drugs also have blood pressure independent effects. Reduction of stiffness is expected to confer benefit beyond the lowering of pressure, although this hypothesis is not yet proven. We summarize different steps for making arterial stiffness measurement a keystone in hypertension management and cardiovascular prevention as a whole.

Abstract P402: Cardiovascular Diseases and Cancer: Is it Possible a Unique Prevention?

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Luigi Palmieri ◽  
Chiara Donfrancesco ◽  
Silvia Rossi ◽  
Fabio Pannozzo ◽  
Susanna Busco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Diseases ◽  
Cancer Risk ◽  
Educational Level ◽  
Cardiovascular Events ◽  
Risk Profile ◽  
Individual Level ◽  
Cancer Register ◽  
Common Risk Factors

Background: Cardiovascular diseases (CVD) and cancer together cause more than 70% of all deaths. Both the pathologies are caused by the interaction of environmental, behavioral and genetic risk factors. For some recognized CVD risk factors (e.g. smoking and obesity) recent studies found a relation also with several cancers. It’s rare to find studies including both CVD and cancer, fatal and non fatal events. Aim: To pool data from CVD longitudinal study and cancer register to investigate possible common risk factors and verify if cardiovascular favourable risk profile is protective also for cancer in order to implement common preventive strategies at population and individual level. Methods: Men and women (ages 20–75 years) data from the Italian Progetto CUORE cohorts and from the Cancer Register implemented in the area of Latina, were pooled. Risk factors were measured and collected using the same standardized procedures and methodologies: body mass index (BMI), diabetes, metabolic syndrome (MS) (ATP-III definition), total and HDL cholesterol, triglycerides, systolic and diastolic blood pressure, smoking habit, alcohol consumption, educational level. In women, menopausal status and parity were included. Follow-up was conducted until December 2004 for both CVD and cancer, fatal and non fatal events. All Cox regression Hazard Ratios (HR) were adjusted by age, gender, educational level, and study. Results: In 9752 persons (5153 women and 4599 men without cardiovascular events and cancer at baseline) 628 cancer events in men and 531 in women, 504 cardiovascular events in men and 274 in women were identified during a median f-u of 18 years. Smoking resulted significantly associated with cancer risk, also when adjusted by BMI, alcohol, and MS in men (current smokers HR=1.74). In women, MS was positively associated with cancer risk, but not significantly. Persons with favorable risk profile (no smoking, BMI<25 kg/m 2 , Total Cholesterol<200 mg/dl, Blood Pressure<120/80 mmHg, no diabetes) resulted at low risk for all cause, CVD and cancer mortality. Conclusions: There are important common risk factors for cardiovascular diseases and cancers. People with favourable risk profile live longer and cost less to the Heath System. This could be a first step to identify and implement common preventive actions at population and individual level in order to reduce both cardiovascular and cancer diseases.

scholarly journals Supernormal vascular aging — prevalence and determinants at population level (the ESSE-RF data)

2020 ◽  
Vol 26 (2) ◽  
pp. 170-183
Author(s):  
K. M. Tolkunova ◽  
O. P. Rotar ◽  
A. M. Erina ◽  
M. A. Boiarinova ◽  
A. S. Alievа ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Arterial Stiffness ◽  
Blood Pressure Measurement ◽  
Population Level ◽  
Age Group ◽  
Vascular Aging ◽  
Lower Prevalence ◽  
Obesity Prevalence ◽  
Observation Study

Background. Arterial stiffness, which is a marker of vascular damage and cardiovascular disease independent predictor, can be used as an indicator of vascular aging. Vascular changes may occur in some individuals earlier than it comes according to chronological age (early vascular aging syndrome) or later (healthy aging). SUPERNOVA (supernormal vascular aging) is a new protective phenotype in which very low arterial stiffness values are recorded regardless of the level of risk factors exposure.Objective. To assess the prevalence of SUPERNOVA phenomenon and risk factors in St Petersburg population-based sample.Design and methods. The survey of 1600 St Petersburg residents aged 24-65 years was performed in terms of the epidemiological observation study ESSE-RF (2012-2013). Anthropometry and fasting blood sampling for lipids and glucose detection and blood pressure measurement according to standard methods were performed. Pulse wave velocity (PWV) assessed by SphygmoCor (Australia) was performed in 524 people. 485 participants were selected without cardiovascular complications history. The participants were divided by age into 5 groups: persons under 30 years, 30-39 years, 40-49 years, 50-59 years, 60 years and older. PWV < 10th percentiles for healthy individuals PWV (Reference Values for Arterial Stability’s Collaboration, 2010) was detected as SUPERNOVA phenomenon in each age group. Mathematical and statistical data analysis was implemented using IBM SPSS Statistics 20.0.Results. SUPERNOVA phenomenon prevalence was 9,8 % (48 participants): 11,9 % women (32 participants) and 7,4 % men (16 participants). Among women systolic blood pressure (SBP) levels (p = 0,01) and body mass index (BMI) (p = 0,055) were significantly lower. Subjects with SUPERNOVA showed significantly lower SBP and diastolic blood pressure (DBP), BMI, glucose, triglycerides and lower prevalence of arterial hypertension (HTN), obesity, hypercholesterolemia and hypertriglyceridemia. In participants younger 30 years only obesity prevalence was significantly lower in respondents with SUPERNOVA, based on BMI criterion (p = 0,046). Participants aged 30-39 years showed no significant differences. In the group aged 40-49 years BMI (p = 0,02), abdominal obesity prevalence (p = 0,05), as well as SBP levels (p = 0,03) and DBP (p = 0,05) was significantly lower in individuals with SUPERNOVA. In the group aged 50-59 with SUPERNOVA significantly lower HTN prevalence (p = 0,03), glucose levels (p = 0,005) and BMI (p = 0,04) were found. In the older age group of 60-65 years subjects with SUPERNOVA have significantly lower levels of SBP (p = 0,014) and DBP (p = 0,014), as well as significantly lower prevalence of HTN (p = 0,03).Conclusions. At population level the phenomenon of supernormal vascular aging occurs in about 10 % without significant gender prevalence. HTN, obesity and metabolic factors are the determining factors of vascular aging. Ideal vascular health is associated with age-specific features.

scholarly journals Effects of olive oil on blood pressure: A systematic review and meta-analysis

2018 ◽  
Vol 69 (4) ◽  
pp. 272 ◽  
Author(s):  
F. Zamora-Zamora ◽  
J. M. Martínez-Galiano ◽  
J. J. Gaforio ◽  
M. Delgado-Rodríguez
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Blood Pressure ◽  
Cardiovascular Diseases ◽  
Olive Oil ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Virgin Olive Oil ◽  
Extra Virgin Olive Oil ◽  
Factors Associated

Hypertension is one of the most important risk factors associated with the development of cardiovascular diseases. Numerous studies have revealed that a diet enriched in olive oil can have a beneficial effect on blood pressure. This systematic review includes the effects of olive oil on blood pressure in individuals without previous cardiovascular events. Liquid oil shows a decrease in blood pressure, while capsules have not produced any effect. Diastolic blood pressure decreased after the consumption of olive oil, -0.73 mm Hg, 95% CI (-1.07, -0.40); p < 0.001, I2 = 86.9%, with high heterogeneity among the included studies. This reduction was mainly due to extra virgin olive oil (EVOO) from 10 ml to 50 ml/day: -1.44 mm Hg, 95% CI (-1.89, -1.00); p < 0.001. Regarding systolic blood pressure the observed decrease is not statistically significant. Further studies on the consumption of EVOO are needed to confirm these results.

scholarly journals Vascular age concept: role in assessing risk and choosing therapy

2020 ◽  
pp. 51-57
Author(s):  
S. R. Gilyarevsky ◽  
M. V. Golshmid ◽  
N. G. Bendeliani ◽  
I. M. Kuzmina ◽  
G. Y. Zaharova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Diseases ◽  
Arterial Stiffness ◽  
Lower Blood Pressure ◽  
Lower Blood ◽  
Combination Drugs ◽  
Vascular Age ◽  
The Relationship

The article discusses the vascular age concept and modern approaches to assessing vascular age. It describes modern methods for measuring arterial stiffness (applanation tonometry or ultrasonic Doppler examination) as the most frequently used index of vascular age. The authors discuss the role of antihypertensive therapy and statins in preventing early vascular aging, and the relationship between the role of achieving lower blood pressure levels and the choice of certain antihypertensive agents to reduce arterial stiffness and ensure optimal vascular age. Increased arterial stiffness has been reported to be a marker of risk for developing severe complications of cardiovascular diseases, in particular, a meta-analysis showed that after taking into account the known risk factors for developing cardiovascular complications, higher carotid stiffness was associated with an increased risk of stroke. It is stated that in addition to biological age, vascular age may increase due to the cumulative effect of such risk factors as high blood pressure, impaired glucose homeostasis, obesity and hypercholesterolemia. Modern approaches to the preservation and maintenance of vascular age are discussed. The key role of achieving lower blood pressure levels is considered. It is emphasized that the role of combination drugs in preventing complications of cardiovascular diseases is strengthened, and approaches to choosing the optimal components of such combination drugs are also considered. The relationship between increased arterial stiffness and the development of cognitive disorders is discussed. The article describes the role of statins and effectiveness of the concomitant use of statins and combination antihypertensive therapy in reducing the pulse wave velocity.

Fibrinogen and Factor Vllag in Healthy Adolescents: The Floren-teen (Florence Teenager) Study

1996 ◽  
Vol 75 (05) ◽  
pp. 778-781 ◽  
Author(s):  
Domenico Prisco ◽  
Sandra Fedi ◽  
Tamara Brunelli ◽  
Anna Paola Cellai ◽  
Mohamed Isse Hagi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Healthy Subjects ◽  
Cardiovascular Events ◽  
Independent Risk Factor ◽  
Factor Vii ◽  
Coronary Heart Disease Prevention ◽  
Familial History ◽  
Clear Cut ◽  
Adolescent Population

SummaryAt least five studies based on more than twenty thousand healthy subjects indicated that fibrinogen is an independent risk factor for cardiovascular events; less clear-cut is the relation between factor VII and risk for arterial thrombotic disorders, which was demonstrated in two of the three studies investigating this association. However, no study has investigated the behaviour of fibrinogen and factor VII in an adolescent population. In a study of Preventive Medicine and Education Program, fibrinogen (clotting method) and factor Vllag (ELISA), in addition to other metabolic parameters, life-style and familial history, were investigated in 451 students (313 females and 138 males, age 15-17 years) from two high schools of Florence. Fibrinogen levels were significantly higher in women than in men, whereas factor Vllag levels did not significantly differ. Both fibrinogen and factor Vllag significantly correlated with total cholesterol (p <0.05) while only fibrinogen correlated with body mass index (p <0.01). Factor Vllag was significantly correlated with systolic blood pressure (p <0.001). This study provides information on coagulation risk factors in a population of adolescents which may be of importance in planning coronary heart disease prevention programs.

scholarly journals Early vascular aging risk assessment in patients with metabolic syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Salasyuk ◽  
S Nedogoda ◽  
I Barykina ◽  
V Lutova ◽  
E Popova
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Risk Assessment ◽  
Metabolic Syndrome ◽  
Vascular Aging ◽  
Clinical Markers ◽  
Cvd Risk ◽  
Vascular Age

Abstract Background Metabolic syndrome (MetS) and abdominal obesity are one of the most common CVD risk factors among young and mature patients. However, the currently used CVD risk assessment scales may underestimate the CV risk in people with obesity and MS. Early vascular aging rather than chronological aging can conceptually offer better risk prediction. MetS, as accumulation of classical risk factors, leads to acceleration of early vascular aging. Since an important feature of MetS is its reversibility, an adequate risk assessment and early start of therapy is important in relation to the possibilities of preventing related complications. Purpose To derive a new score for calculation vascular age and predicting EVA in patients with MetS. Methods Prospective open cohort study using routinely collected data from general practice. The derivation cohort consisted of 1000 patients, aged 35–80 years with MetS (IDF,2005 criteria). The validation cohort consisted of 484 patients with MetS and carotid-femoral pulse wave velocity (cfPWV) values exceeding expected for average age values by 2 or more SD (EVA syndrome). Results In univariate analysis, EVA was significantly correlated with the presence of type 2 diabetes and clinical markers of insulin resistance (IR), body mass index (BMI), metabolic syndrome severity score (MetS z-score), uric acid (UA) level, hsCRP, HOMA-IR, total cholesterol (TC), triglycerides (TG), heart rate (HR), central aortic blood pressure (CBP), diastolic blood pressure (DBP). Multiple logistic regression shown, that presence of type 2 diabetes and IR were associated with greater risk of EVA; the odds ratios were 2.75 (95% CI: 2.34, 3.35) and 1.57 (95% CI: 1.16, 2.00), respectively. In addition, the risk of having EVA increased by 76% with an increase in HOMA-IR by 1 unit, by 17% with an increase in hsCRP by 1 mg/l, by 4% with an increase in DBP by 1 mm Hg, and by 1% with each 1 μmol / L increase in the level of UA. The area under the curve for predicting EVA in patients with MetS was 0,949 (95% CI 0,936 to 0,963), 0,630 (95% CI 0,589 to 0,671), 0,697 (95% CI 0,659 to 0,736) and 0,686 (95% CI 0,647 to 0,726), for vascular age, calculated from cfPWV, SCORE scale, QRISK-3 scale and Framingham scale, respectively. Diabetes mellitus and clinical markers of IR (yes/no), HOMA-IR and UA level were used to develop a new VAmets score for EVA prediction providing a total accuracy of 0.830 (95% CI 0,799 to 0,860). Conclusion cfPWV at present the most widely studied index of arterial stiffness, fulfills most of the stringent criteria for a clinically useful biomarker of EVA in patients with MetS. Although, parallel efforts for effective integration simple clinical score into clinical practice have been offered. Our score (VAmets) may accurately identify patients with MetS and EVA on the basis of widely available clinical variables and classic cardiovascular risk factors can prioritize using of vascular age in routine care. ROC-curves for predicting EVA in MetS Funding Acknowledgement Type of funding source: None

scholarly journals Effects of Cranberry Juice Supplementation on Cardiovascular Disease Risk Factors in Adults with Elevated Blood Pressure: A Randomized Controlled Trial

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2618
Author(s):  
Chesney K. Richter ◽  
Ann C. Skulas-Ray ◽  
Trent L. Gaugler ◽  
Stacey Meily ◽  
Kristina S. Petersen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Systolic Blood Pressure ◽  
Vascular Function ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Lipoprotein Profile ◽  
Cranberry Juice ◽  
Central Systolic Blood Pressure

Emerging cardiovascular disease (CVD) risk factors, including central vascular function and HDL efflux, may be modifiable with food-based interventions such as cranberry juice. A randomized, placebo-controlled, crossover trial was conducted in middle-aged adults with overweight/obesity (n = 40; mean BMI: 28.7 ± 0.8 kg/m2; mean age: 47 ± 2 years) and elevated brachial blood pressure (mean systolic/diastolic BP: 124 ± 2/81 ± 1 mm Hg). Study participants consumed 500 mL/d of cranberry juice (~16 fl oz; 27% cranberry juice) or a matched placebo juice in a randomized order (8-week supplementation periods; 8-week compliance break), with blood samples and vascular measurements obtained at study entry and following each supplementation period. There was no significant treatment effect of cranberry juice supplementation on the primary endpoint of central systolic blood pressure or central or brachial diastolic pressure. Cranberry juice significantly reduced 24-h diastolic ambulatory BP by ~2 mm Hg compared to the placebo (p = 0.05) during daytime hours. Cranberry juice supplementation did not alter LDL-C but significantly changed the composition of the lipoprotein profile compared to the placebo, increasing the concentration of large LDL-C particles (+29.5 vs. −6.7 nmol/L; p = 0.02) and LDL size (+0.073 vs. −0.068 nm; p = 0.001). There was no effect of treatment on ex vivo HDL efflux in the total population, but exploratory subgroup analyses identified an interaction between BMI and global HDL efflux (p = 0.02), with greater effect of cranberry juice in participants who were overweight. Exploratory analyses indicate that baseline C-reactive protein (CRP) values may moderate treatment effects. In this population of adults with elevated blood pressure, cranberry juice supplementation had no significant effect on central systolic blood pressure but did have modest effects on 24-hr diastolic ambulatory BP and the lipoprotein profile. Future studies are needed to verify these findings and the results of our exploratory analyses related to baseline health moderators.

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