scholarly journals Аrterial stiffness and diastolic function of the left ventricle in patients with arterial hypertension and frailty

2021 ◽  
pp. 118-123
Author(s):  
E. S. Fomina ◽  
V. S. Nikiforov
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Left Ventricle ◽  
Arterial Hypertension ◽  
Systolic Blood Pressure ◽  
Diastolic Function ◽  
Pulse Pressure ◽  
Filling Pressure ◽  
Left Shoulder ◽  
Average Blood Pressure

Introduction. Increased arterial stiffness is one of the key links in the formation of cardiovascular pathology in older age groups. At the same time, the effect of vascular stiffness on myocardial function in cardiac patients with frailty remains insufficiently studied.Aim of study. Тo analyze the data of arterial stiffness and diastolic function of left ventricle (LV) in patients older than 65 years with arterial hypertension and frailty.Materials and methods. The study included 90 outpatient and inpatient patients older than 65 years with the presence of arterial hypertension. All patients were divided into two groups: with the presence and absence of frailty. To identify frailty, we used the questionnaire “Age is not a hindrance”, a short battery of physical activity tests. Methods of volumetric sphygmometry, echocardiography, including tissue Doppler were used. The obtained data were analyzed using a package of statistical programs.Results. The results of a comparative simultaneous non-randomized descriptive study of two groups of patients are presented. The study found that the systolic function, diastolic dysfunction of the left ventricle by the type of slowing down of LV relaxation in both groups did not significantly differ in their indicators. In the group of patients with frailty, LV diastolic dysfunction was significantly more often detected by the type of pseudonormalization – with an increase in filling pressure. When analyzing data of arterial stiffness, differences were obtained in both groups in the left cardio-ankle vascular index (LCAVI), systolic blood pressure (LB SAD), pulse pressure (LB PD) in the left shoulder area, and the delta of average blood pressure in the left ankle area (LA% IDA), which were significantly higher in patients with frailty.Conclusion. In the group of patients with hypertension older than 65 years with frailty, a violation of the LV diastolic function by the  type of  pseudonormalization with an increase in  filling pressure prevails. An increase in  filling pressure in  the  group of patients older than 65 years with hypertension and the presence of frailty is associated with an increase in the complex of indicators characterizing arterial stiffness – the cardio-ankle vascular index, systolic blood pressure, pulse pressure in the left shoulder area, the delta of average blood pressure in the left ankle area.

scholarly journals Blood pressure circadian rhythm and obesity: Blood pressure variations and obesity

2002 ◽  
Vol 55 (9-10) ◽  
pp. 419-421 ◽  
Author(s):  
Nebojsa Despotovic
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Circadian Rhythm ◽  
Arterial Hypertension ◽  
Systolic Blood Pressure ◽  
Body Mass ◽  
Pathophysiological Mechanism ◽  
Obese People ◽  
Pressure Pattern ◽  
Average Blood Pressure

Introduction The association between obesity and arterial hypertension has been established in a great number of studies. Our objective was to investigate whether circadian rhythm of blood pressure is disturbed among obese people. Material and methods In this cross-sectional, randomized study, Schiller BR-102 device was used for ambulatory blood pressure monitoring. One hundred and twenty outpatients were divided into three randomized groups: obese body mass index 30 kg/m2 (52 patients), overweight (28 patients), with body mass index 25,0-29,9 kg/m2 and normal weight (control group) (48 patients), with body mass index 18,5-24,9 kg/m2. In all patients we investigated the following blood pressure parameters: average blood pressure (total, day-time and night-time), maximal blood pressure and dipping or non-dipping blood pressure pattern during night (for systolic and diastolic blood pressure, respectively). Results In body mass index beyond 30 kg/m2 only systolic blood pressure parameters were significantly higher - average blood pressure - during daytime (P=0.034) and during night (P=0.014); maximal blood pressure (P=0.001). In body mass index beyond 30 kg/m2, absence of normal blood pressure during night was significantly more often registered (P=0.007). Discussion and Conclusion The non-dipping blood pressure pattern and increase of systolic blood pressure only reveal hyper activation of sympathetic nervous system as a leading pathophysiological mechanism causing arterial hypertension in obese patients.

scholarly journals Effect of Aquatic Exercise Training on Aortic Hemodynamics in Middle-Aged and Elderly Adults

2021 ◽  
Vol 8 ◽  
Author(s):  
Marina Fukuie ◽  
Takayuki Yamabe ◽  
Daisuke Hoshi ◽  
Tatsuya Hashitomi ◽  
Yosuke Nomura ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Exercise Training ◽  
Arterial Stiffness ◽  
Systolic Blood Pressure ◽  
Pulse Pressure ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Aquatic Exercise ◽  
Middle Aged ◽  
Aortic Hemodynamics

Aquatic exercise is an attractive form of exercise that utilizes the various properties of water to improve physical health, including arterial stiffness. However, it is unclear whether regular head-out aquatic exercise affects aortic hemodynamics, the emerging risk factors for future cardiovascular disease. The purpose of this study was to investigate whether head-out aquatic exercise training improves aortic hemodynamics in middle-aged and elderly people. In addition, to shed light on the underlying mechanisms, we determined the contribution of change in arterial stiffness to the hypothesized changes in aortic hemodynamics. Twenty-three middle-aged and elderly subjects (62 ± 9 years) underwent a weekly aquatic exercise course for 15 weeks. Aortic hemodynamics were evaluated by pulse wave analysis via the general transfer function method. Using a polar coordinate description, companion metrics of aortic pulse pressure (PPC = √{(systolic blood pressure)2 + (diastolic blood pressure)2}) and augmentation index (AIxC = √{(augmentation pressure)2 + (pulse pressure)2}) were calculated as measures of arterial load. Brachial-ankle (baPWV, reflecting stiffness of the abdominal aorta and leg artery) and heart-ankle (haPWV, reflecting stiffness of the whole aortic and leg artery) pulse wave velocities were also measured. The rate of participation in the aquatic training program was 83.5 ± 13.0%. Aortic systolic blood pressure, pulse pressure, PPC, AIxC, baPWV, and haPWV decreased after the training (P < 0.05 for all), whereas augmentation index remained unchanged. Changes in aortic SBP were correlated with changes in haPWV (r = 0.613, P = 0.002) but not baPWV (r = 0.296, P = 0.170). These findings suggest that head-out aquatic exercise training may improve aortic hemodynamics in middle-aged and elderly people, with the particular benefits for reducing aortic SBP which is associated with proximal aortic stiffness.

Myocardial deformation and parameters of diastolic function of the left ventricle in workers of coal mining enterprises in the South of Kuzbass with arterial hypertension

2020 ◽  
pp. 151-156
Author(s):  
O. Yu. Korotenko ◽  
E. S. Filimonov
Keyword(s):  
Blood Pressure ◽  
Left Ventricle ◽  
Arterial Hypertension ◽  
Diastolic Function ◽  
Left Ventricular ◽  
Coal Industry ◽  
Myocardial Deformation ◽  
Longitudinal Deformation ◽  
The South ◽  
Coal Miners

Introduction. Long-term persistent hypertension can lead to heart failure. The study of its early markers, which include diastolic dysfunction of the left ventricle and reduction of longitudinal myocardial deformation, is of importance for workers engaged in harmful and dangerous working conditions.The aim of the study is to evaluate the parameters of myocardial deformation and diastolic function of the left ventricle, as well as their interrelation with arterial hypertension in workers of the coal mining industry in the South of Kuzbass.Materials and methods. 384 people were examined (men), including 266 workers of coal mines in the South of Kuzbass (drifters, stope miners, operators of rock removing machines) and 118 persons who were not employed in the coal industry, aged from 40 to 55 years. Arterial hypertension was detected according to the clinical recommendations for the diagnosis and treatment of arterial hypertension in 2019. The structural and functional state of the heart was studied by echocardiography with evaluation of the longitudinal deformation of the left ventricle by 2D-strain method and its diastolic function using pulse-wave and tissue dopplerography.Results. The prevalence of persons with arterial hypertension in the group of workers employed in the coal industry was established: 43.2% against 26.3% in the comparison group (p=0.002). Longitudinal deformation of the left ventricular myocardium in all subjects was significantly less in the presence of high blood pressure: -21.0±0.18 vs. -19.2±0.22% (p<0.001) in the main group and -21.54±0.22 vs. -19.84±0.38% (p<0.001) in the comparison group. It should also be noted that there is a tendency to differ in subgroups of subjects without arterial hypertension towards a greater reduction in longitudinal myocardial deformation in coal miners (-21.54±0.22 and -21.0±0.18%, p=0.062). In miners, diastolic left ventricular dysfunction was significantly more common than in the group without occupational hazards: 52.5 and 39.3%, respectively, p=0.021. Its presence in the cohort of coal miners with arterial hypertension was detected significantly more often (58.9%) than in individuals with normal blood pressure (25.9%), p<0.0001. In turn, in the group of people not employed in the coal industry, diastolic dysfunction of the left ventricle was also more common in the presence of arterial hypertension: in 42.6 and 13.9% of cases, respectively (p<0.001).Conclusions. The incidence of arterial hypertension among coal miners was significantly higher than in people who do not work at coal mining enterprises. In all patients with arterial hypertension, the longitudinal deformation of the left ventricular myocardium with the preserved ejection fraction was lower than in those with normal blood pressure. Diastolic myocardial dysfunction of the left ventricle was significantly more common among those examined with underground working conditions, especially in the group of people with arterial hypertension.The authors declare no conflict of interests.

scholarly journals Higher blood pressure in elderly hypertensive females, with increased arterial stiffness and blood pressure in females with the Fibrillin-1 2/3 genotype

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ida Åström Malm ◽  
Urban Alehagen ◽  
Peter Blomstrand ◽  
Ulf Dahlström ◽  
Rachel De Basso
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Stiffness ◽  
Arterial Pressure ◽  
Elderly Patients ◽  
Systolic Blood Pressure ◽  
Pulse Pressure ◽  
Augmentation Index ◽  
Aortic Pulse Wave Velocity ◽  
Fibrillin 1

Abstract Background Elderly patients have a relatively high cardiovascular risk due to increased arterial stiffness, elevated blood pressure and decreased amounts of elastin in the arteries. The composition of the media layer in the arterial wall, comprising elastin, collagen, smooth muscle cells, proteoglycans, fibronectin and fibrillin-1, influences its mechanical properties. Mutations in the fibrillin-1 gene leads to increased aortic stiffness, elevated pulse pressure and aortic root dilatation. This study investigates whether there is a sex difference among hypertensive elderly patients regarding blood pressure, arterial stiffness and fibrillin-1 genotypes. Methods A total of 315 hypertensive subjects (systolic blood pressure > 140 mmHg) were included in this study (155 men and 160 women aged 71–88 years). Aortic pulse wave velocity and augmentation index were determined using SphygmoCor, and brachial blood pressure was measured using an oscillometric technique. Fibrillin-1 was genotyped by polymerase chain reaction and with a capillary electrophoresis system. Results Females showed a significantly higher peripheral mean arterial pressure (females; 107.20 mmHg, males 101.6 mmHg, p = 0.008), central mean arterial pressure (females; 107.2 mmHg, males 101.6 mmHg p = 0.008), central systolic blood pressure (females; 148.1 mmHg, males 139.2 mmHg, p <  0.001) and central pulse pressure (females; 68.9 mmHg, males 61.6 mmHg, p = 0.035) than males. Females with the Fibrillin-1 2/3 genotype showed a significantly higher augmentation index (FBN1 2/3; 39.9%, FBN1 2/2 35.0%, FBN1 2/4 35.8, p = 0.029) and systolic blood pressure (FBN1 2/3; 174.6 mmHg, FBN1 2/2168.9 mmHg, FBN1 2/4169.9 mmHg, p = 0.025) than females with the 2/2 and 2/4 genotypes. Conclusion The findings of this study may indicate that hypertensive elderly females, especially elderly females with Fibrillin-1 2/3, have increased systolic blood pressure and arterial stiffness.

scholarly journals Association between Objectively Measured Physical Activity and Arterial Stiffness in Children with Congenital Heart Disease

2021 ◽  
Vol 10 (15) ◽  
pp. 3266
Author(s):  
Laura Willinger ◽  
Leon Brudy ◽  
Renate Oberhoffer-Fritz ◽  
Peter Ewert ◽  
Jan Müller
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Heart Rate ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Arterial Stiffness ◽  
Systolic Blood Pressure ◽  
Congenital Heart ◽  
Z Score ◽  
Objectively Measured

Background: The association between physical activity (PA) and arterial stiffness is particularly important in children with congenital heart disease (CHD) who are at risk for arterial stiffening. The aim of this study was to examine the association between objectively measured PA and arterial stiffness in children and adolescents with CHD. Methods: In 387 children and adolescents with various CHD (12.2 ± 3.3 years; 162 girls) moderate-to-vigorous PA (MVPA) was assessed with the “Garmin vivofit jr.” for 7 consecutive days. Arterial stiffness parameters including pulse wave velocity (PWV) and central systolic blood pressure (cSBP) were non-invasively assessed by oscillometric measurement via Mobil-O-Graph®. Results: MVPA was not associated with PWV (ß = −0.025, p = 0.446) and cSBP (ß = −0.020, p = 0.552) in children with CHD after adjusting for age, sex, BMI z-score, peripheral systolic blood pressure, heart rate and hypertensive agents. Children with CHD were remarkably active with 80% of the study population reaching the WHO recommendation of average 60 min of MVPA per day. Arterial stiffness did not differ between low-active and high-active CHD group after adjusting for age, sex, BMI z-score, peripheral systolic blood pressure, heart rate and hypertensive agents (PWV: F = 0.530, p = 0.467; cSBP: F = 0.843, p = 0.359). Conclusion: In this active cohort, no association between PA and arterial stiffness was found. Longer exposure to the respective risk factors of physical inactivity might be necessary to determine an impact of PA on the vascular system.

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