scholarly journals Plasma Lipoprotein(a) Levels as Determinants of Arterial Stiffening in Hypertension

Biomedicines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1510
Author(s):  
Gabriele Brosolo ◽  
Andrea Da Porto ◽  
Luca Bulfone ◽  
Antonio Vacca ◽  
Nicole Bertin ◽  
...  

Previous studies have shown that plasma lipoprotein(a) (Lp(a)) plays an important role in the development of hypertensive organ damage. The aim of the present study was to investigate the relationship of Lp(a) with markers of arterial stiffening in hypertension. In 138 essential hypertensive patients free of diabetes, renal failure and cardiovascular complications, we measured plasma lipids and assessed vascular stiffness through the use of pulse wave analysis and calculation of the brachial augmentation index (AIx), and measured the pulse wave velocity (PWV). Plasma Lp(a) levels were significantly and directly related to both AIx (r = 0.490; P < 0.001) and PWV (r = 0.212; P = 0.013). Multiple regression analysis showed that AIx was independently correlated with age, C-reactive protein, and plasma Lp(a) (beta 0.326; P < 0.001), while PWV was independently and directly correlated with age, and inversely with HDL, but not with plasma Lp(a). Logistic regression indicated that plasma Lp(a) could predict an AIx value above the median for the distribution (P = 0.026). Thus, in a highly selective group of patients with hypertension, plasma Lp(a) levels were significantly and directly related to markers of vascular stiffening. Because of the relevance of vascular stiffening to cardiovascular risk, the reduction of Lp(a) levels might be beneficial for cardiovascular protection in patients with hypertension.

2016 ◽  
Vol 13 (4) ◽  
pp. 303-306 ◽  
Author(s):  
Xiao Zhang ◽  
Jian Jun Liu ◽  
Chee Fang Sum ◽  
Yeoh Lee Ying ◽  
Subramaniam Tavintharan ◽  
...  

Objective: To examine the relationship between inflammation and central arterial stiffness in a type 2 diabetes Asian cohort. Method: Central arterial stiffness was estimated by carotid-femoral pulse wave velocity and augmentation index. Linear regression model was used to evaluate the association of high-sensitivity C-reactive protein and soluble receptor for advanced glycation end products with pulse wave velocity and augmentation index. High-sensitivity C-reactive protein was analysed as a continuous variable and categories (<1, 1–3, and >3 mg/L). Results: There is no association between high-sensitivity C-reactive protein and pulse wave velocity. Augmentation index increased with high-sensitivity C-reactive protein as a continuous variable ( β = 0.328, p = 0.049) and categories ( β = 1.474, p = 0.008 for high-sensitivity C-reactive protein: 1–3 mg/L and β = 1.323, p = 0.019 for high-sensitivity C-reactive protein: >3 mg/L) after multivariable adjustment. No association was observed between augmentation index and soluble receptor for advanced glycation end products. Each unit increase in natural log–transformed soluble receptor for advanced glycation end products was associated with 0.328 m/s decrease in pulse wave velocity after multivariable adjustment ( p = 0.007). Conclusion: Elevated high-sensitivity C-reactive protein and decreased soluble receptor for advanced glycation end products are associated with augmentation index and pulse wave velocity, respectively, suggesting the potential role of systemic inflammation in the pathogenesis of central arterial stiffness in type 2 diabetes.


Author(s):  
S. V. Nedogoda ◽  
E. V. Chumachek ◽  
V. V. Tsoma ◽  
A. S. Salasyuk ◽  
V. O. Smirnova ◽  
...  

Aim. To assess the possibility of azilsartan medoxomil to achieve target blood pressure (BP) (less than 130/80 mm Hg), to study angioprotective features and reduction of adipokines levels and inflammatory markers in patients with hypertension and previous therapy with other ARBs.Material and methods. In open observational study with 24 weeks follow-up were included 60 patients with previous therapy (losartan or valsartan or telmisartan).All patients underwent ambulatory BP monitoring, applanation tonometry (determination of the augmentation index and central BP), measurement of the pulse wave velocity, laboratory tests (lipid profile, uric acid, fasting glucose, Homeostasis Model Assessment, homocysteine, leptin, adiponectin, highly sensitive C-reactive protein, tumor necrosis factor alpha, interleukin-6).Results. Azilsartan provided the systolic BP (29,05%, 22,5% and 8,9%) and diastolic BP reduction 18,82%, 20,46% and 8,54% (p<0,05) in patients previously treated with losartan, valsartan or telmisartan, respectively. Central systolic BP (by 25,95%, 8,78%, 11,94%), central pulse BP (by 40%, 18,38% and 19,6%), augmentation index (by 28,87%, 20,69% and 14,29%) and pulse wave velocity (by 21,57%, 24,56% and 24,92%) were decreased (p<0,05). There were positive changes in leptin, C-reactive protein, IL-6, adiponectin levels in all patients with losartan, valsartan or telmisartan initial therapy (p<0,05).Conclusion. Azilsartan medoxomil has advantages in BP control, the arterial elasticity improving, reducing of insulin-resistance and inflammation.


2020 ◽  
pp. 204748731989802 ◽  
Author(s):  
Dimitris Tousoulis ◽  
Petros Fountoulakis ◽  
Evangelos Oikonomou ◽  
Charalambos Antoniades ◽  
Gerasimos Siasos ◽  
...  

Background Diesel exhaust fumes represent one of the most common toxic pollutants. The prolonged effects of acute exposure to this pollutant on inflammatory status and vascular properties are unknown. Methods During a 2-h session, 40 healthy subjects were exposed to diesel exhaust fumes and/or filtered air. Endothelial function was assessed with flow mediated dilation, arterial stiffness with pulse wave velocity and reflected waves with augmentation index. C-reactive protein, fibrinogen, protein C levels and protein S activity were also measured. Standard deviation of normal to normal R–R intervals (SDNN) was used to assess heart rate variability. Measurements were assessed before exposure and 2 and 24 h after diesel exposure. Results Compared with filtered air, exposure to diesel exhaust fumes decreased flow mediated dilation and increased pulse wave velocity and augmentation index up to 24 h after the exposure ( p < 0.001 for all). Similarly, compared with filtered air, diesel exhaust exposure impaired SDNN during the 24-h study period ( p = 0.007). C-reactive protein and fibrinogen levels were significantly increased after diesel exhaust exposure while protein C levels and protein S activity decreased ( p < 0.01 for all). Exposure to diesel exhaust fumes resulted in higher C-reactive protein concentration in smokers compared with non-smokers ( p < 0.001). Conclusion Short-term exposure to diesel exhaust fumes has a prolonged adverse impact on endothelial function and vascular wall properties, along with impaired heart rate variability, abnormal fibrinolytic activity and increased markers of inflammation. These findings give insights into the mechanisms underlining the increased cardiovascular risk of subjects regularly exposed to diesel exhaust fumes.


VASA ◽  
2014 ◽  
Vol 43 (6) ◽  
pp. 423-432 ◽  
Author(s):  
Qingtao Meng ◽  
Si Wang ◽  
Yong Wang ◽  
Shixi Wan ◽  
Kai Liu ◽  
...  

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.


VASA ◽  
2015 ◽  
Vol 44 (5) ◽  
pp. 341-348 ◽  
Author(s):  
Marc Husmann ◽  
Vincenzo Jacomella ◽  
Christoph Thalhammer ◽  
Beatrice R. Amann-Vesti

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.


2007 ◽  
Vol 211 (S 2) ◽  
Author(s):  
B Schiessl ◽  
M Burgmann ◽  
V Sauer ◽  
A Neubauer ◽  
F Kainer ◽  
...  

2020 ◽  
Vol 23 (1) ◽  
pp. 7-11
Author(s):  
P. Nikolov

The PURPUSE of the present study is changes in function and structure of large arteries in individuals with High Normal Arterial Pressure (HNAP) to be established. MATERIAL and METHODS: Structural and functional changes in the large arteries were investigated in 80 individuals with HNAP and in 45 with optimal arterial pressure (OAP). In terms of arterial stiffness, pulse wave velocity (PWV), augmentation index (AI), central aortic pressure (CAP), pulse pressure (PP) were followed up in HNAP group. Intima media thickness (IMT), flow-induced vasodilatation (FMD), ankle-brachial index (ABI) were also studied. RESULTS: Significantly increased values of pulse wave velocity, augmentation index, central aortic pressure, pulse pressure are reported in the HNAP group. In terms of IMT and ABI, being in the reference interval, there is no significant difference between HNAP and OAP groups. The calculated cardiovascular risk (CVR) in both groups is low. CONCLUSION: Significantly higher values of pulse wave velocity, augmentation index, central aortic pressure and pulse pressure in the HNAP group are reported.


2019 ◽  
Vol 34 (3) ◽  
pp. 40-44
Author(s):  
E. Yu. Gubareva ◽  
I. V. Gubareva

The authors’ report presents a brief review of the key studies, providing the reason for the use of vascular endothelial growth factor as a marker for stratification of the risk of cardiovascular complications in patients with essential hypertension.


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