4 Day in dry immersion reproduces partially the aging effect on the arteries as observed during 6 month spaceflight or confinement

The objectives of this study were to determine whether 4 days of dry immersion (DI) induced similar arterial aging as spaceflight and to test the impact of thigh cuffs. Eighteen subjects underwent DI; nine wore thigh cuffs. Cardiac and arterial targets were assessed by ultrasound. No significant differences were found between the groups. The left ventricle volume, stroke volume (SV), and ejection fraction decreased with DI (p < 0.001). Carotid distensibility reduced (p < 0.05), carotid to femoral arterial tree became stiffer in 33% of the subjects, and femoral artery intima media thickness increased (p < 0.05). A reduction in plasma volume is likely to have caused the observed cardiac changes, whereas the arterial wall changes are probably best explained by hypokinesia and/or environmental stress. These changes are similar but lower in amplitude than those observed in spaceflight and mimic the natural aging effect on earth. The daytime-worn thigh cuffs had no acute or chronic impact on these arterial-focused measurements.

Midlife Aerobic Exercise and Dynamic Cerebral Autoregulation: Associations with Baroreflex Sensitivity and Central Arterial Stiffness

Midlife aerobic exercise may significantly impact age-related changes in the cerebro- and cardiovascular regulations. This study investigated the associations of midlife aerobic exercise with dynamic cerebral autoregulation (dCA), cardiovagal baroreflex sensitivity (BRS), and central arterial stiffness. Twenty middle-aged athletes (MA) who had aerobic training for >10 years were compared with 20 young (YS) and 20 middle-aged sedentary (MS) adults. Beat-to-beat cerebral blood flow velocity, blood pressure (BP), and heart rate were measured at rest and during forced BP oscillations induced by repeated sit-stand maneuvers at 0.05 Hz. Transfer function analysis was used to calculate dCA and BRS parameters. Carotid distensibility was measured by ultrasonography. MA had the highest peak oxygen uptake (VO2peak) among all groups. During forced BP oscillations, MS showed lower BRS gain than YS, but this age-related reduction was absent in MA. Conversely, dCA was similar among all groups. At rest, BRS and dCA gains at low frequency (~0.1 Hz) were higher in the MA compared with MS and YS groups. Carotid distensibility was similar between MA and YS groups, but it was lower in the MS. Across all subjects, VO2peak was positively associated with BRS gains at rest and during forced BP oscillations (r=0.257~0.382, p=0.003~0.050) and carotid distensibility (r=0.428~0.490, p=0.001). Furthermore, dCA gain at rest and carotid distensibility were positively correlated with BRS gain at rest in YS and MA groups (all p<0.05). These findings suggest that midlife aerobic exercise improves central arterial elasticity and BRS which may contribute to CBF regulation through dCA.

Abstract P146: Sex Differences In The Association Between Systolic Blood Pressure And Carotid Distensibility In Adults

Background and Aim: We explored sex differences in the association between systolic and diastolic blood pressure (SBP), in early adulthood with carotid plaques, carotid IMT and carotid distensibility (CD) in mid-adulthood. Methods: Participants in the Childhood Determinants of Adult Health study at ages 26-36 years were followed-up at ages 39-49 years. Systolic BP and diastolic BP and carotid ultrasound measures (plaques, IMT and CD) were performed in clinics. We used log binomial and linear regression models with risk factor*gender interactions for predicting these carotid measures. Sex-stratified models adjusted for sociodemographic, health-related behavior and biomedical factors were fitted when likelihood ratio tests suggested the effect of risk factors on outcomes differed by sex. Results: Among 1,286 participants (53% women), men, compared to women, had higher prevalence of carotid plaques (17% vs. 10%), thicker carotid IMT (Mean 0.66 ± 0.09 vs. 0.61 ± 0.07) and lower CD (Mean 1.87 ± 0.60 vs. 2.37 ± 0.77). In women, greater SBP in early adulthood was sharply associated with significantly smaller CD (β -0.016 95%CI -0.023, -0.010 vs. β -0.006 95%CI -0.012, -0.001) than men in mid-adulthood adjusted for sociodemographic factors (Figure 1a). In analyses restricted to women, the effect of SBP on CD has decreased after adjusting for age, education, occupation, DBP and use of contraceptives (β -0.009 95%CI -0.019, 0.000) (Figure 1b). Conclusion: CV health was worse in men than women. However, elevated SBP in women put them at greater risk of poorer CV health compared to men, which was partly explained by sociodemographic, biomedical and female-specific factors.

Arterial stiffness and carotid distensibility following acute formaldehyde exposure in female adults

Formaldehyde (FA) is a ubiquitous organic preservative used in several industries and represents an occupational health hazard. Short-term exposure to FA can increase oxidative stress and cause a decrease in conduit vessel function. These decrements in vascular function may extend to the arterial architecture, predisposing individuals to increased risk of cardiovascular disease. The purpose of this study was to investigate the impact of an acute 90-minute FA exposure period (259 ± 95 ppb) on indices of arterial architecture. Arterial stiffness and carotid distensibility as determined by central pressures, augmentation index (AIx), and carotid-femoral pulse wave velocity (cfPWV) ( n=13F, 24 ± 1 year) as well as carotid stiffness and intima media thickness (IMT) ( n = 9F, 23 ± 1 year) were assessed prior to (Pre-FA) and immediately following (Post-FA) exposure to FA in human cadaver dissection laboratories. Central pressures and cfPWV (Pre-FA: 5.2 ± 0.8 m.s−1, Post-FA: 5.2 ± 1.1 m s−1) were unchanged by acute FA exposure ( p > 0.05). Carotid stiffness parameters and distension were unchanged by acute FA exposure ( p > 0.05), although distensibility (Pre-FA: 33.9 ± 10.5[10–3*kPa−1], Post-FA: 25.9 ± 5.5[10–3*kPa-1], p < 0.05), and IMT (Pre-FA: 0.42 ± 0.05 mm, Post-FA: 0.51 ± 0.11 mm, p < 0.05) decreased and increased, respectively. Individual Pre- to Post-FA changes in these markers of arterial architecture did not correlate with levels of FA exposure ([FA]: 20–473 ppb) ( p > 0.05). Our group previously found vascular function decrements following acute FA exposure in human cadaver laboratories; here we found that carotid distensibility and intima media thickness are altered following FA exposure.

Assessment of Carotid Artery Distensibility and Elasticity in Patients with Asthma

As asthma and atherosclerosis have similar pathophysiological mechanisms and risk factors, asthmatic patients may have an increased risk of atherosclerosis. This study aimed to determine the possibility of a higher risk of atherosclerosis in asthma patients compared with healthy controls by measuring carotid elasticity and distensibility. This was a cross-sectional study on 326 participants including 221 patients (129 [58.37%] females) with persistent asthma, aged 46.47±11.58 years, body mass index (BMI) of 29.74±3.99, and 105 healthy control subjects (60 [57.14%] females) aged 46.08±11.35 years, and BMI of 29.42±3.76. Of the 221 patients with asthma, 75 (33.93%) had mild, 74 (33.48%) had moderate and 72 (32.57%) had severe asthma. The carotid distensibility and elasticity were recorded and compared in both patients and control groups. There was no statistically significant difference between the patients and healthy control groups in terms of age, BMI and gender (p=0.775, p=0.482, and p=0.834, respectively). A statistically significant difference was determined between the patient and control groups in respect of both distensibility and elasticity (10.93±1.64 vs. 11.5±1.31, p=0.002 and 0.21±0.03 vs. 0.22±0.04, p=0.001, respectively). Statistically significant differences were determined between the control group and the asthma subgroups in respect of distensibility and elasticity (p<0.001, for both comparisons). The results showed that the difference was mainly due to the patients with severe asthma. Carotid distensibility and elasticity were decreased in asthmatic patients, and the main reason for this decrease was the patients in the severe asthma group. These results may suggest that the risk of subclinical carotid atherosclerosis is increased in patients with asthma, especially those with severe asthma.

Nighttime Home Blood Pressure in Children

This study aimed to investigate a novel technique for nighttime blood pressure evaluation using a home blood pressure (HBP) monitor in children and adolescents, in terms of association with ambulatory blood pressure (ABP) and preclinical organ damage. Children and adolescents (aged 6–18 years) referred for elevated blood pressure were evaluated with ABP (24 hours) and HBP monitoring during daytime (7 days, duplicate morning and evening measurements) and nighttime (automated asleep measurements for 3 nights with 3 hourly measurements/night; Microlife WatchBP Home N). Preclinical organ damage was assessed by echocardiographic left ventricular mass index, carotid intima-media thickness, carotid distensibility coefficient, and carotid-femoral pulse wave velocity. Ninety-one individuals were analyzed (mean age 13.3±2.8 years; 54 men; 17 with elevated ABP). There was a close association between daytime (awake) ABP and HBP (r=0.81/0.77, systolic/diastolic) and between nighttime (asleep) values (r=0.78/0.60) (all P <0.05). Daytime HBP was slightly lower than daytime ABP (difference, −2.0±6.5/−0.9±5.1 mm Hg, systolic/diastolic, P <0.01/NS), whereas nighttime HBP was slightly higher than nighttime ABP (2.6±7.2/2.2±6.1 mm Hg, P <0.01 for both). Nighttime systolic ABP and HBP were correlated with left ventricular mass index (r=0.37 and 0.29, respectively), carotid intima-media thickness (0.45, 0.47), carotid distensibility coefficient (−0.22, −0.20), and carotid-femoral pulse wave velocity (0.47, 0.53) ( P =NS for comparisons between methods). The agreement between nighttime HBP and ABP in identifying individuals with nighttime hypertension (≥95th percentile for nighttime ABP) was 82% (κ=0.49; P <0.01) and nondippers 57% (κ=0.19; P =0.03). In conclusion, in children and adolescents, nighttime HBP monitoring is feasible, is closely associated with nighttime ABP and similarly associated with preclinical organ damage.

Long-term trajectories of BMI predict carotid stiffness and plaque volume in type 2 diabetes older adults: a cohort study

Background High body mass index (BMI) is a risk factor for type 2 diabetes and cardiovascular disease. However, its relationships with indices of carotid stiffness and plaque volume are unclear. We investigated associations of long-term measurements of BMI with indices of carotid stiffness and atherosclerosis among non-demented diabetes patients from the Israel Diabetes and Cognitive Decline (IDCD) study. Methods Carotid ultrasound indices [carotid intima media thickness (cIMT), distensibility, elastography and plaque volume] were assessed in N = 471 participants. Mean BMI across all MHS diabetes registry measurements and trajectories of BMI were calculated. BMI was categorized into three trajectory groups representing: a relatively stable normal weight (n = 185, 44%), overweight trajectory (n = 188, 44.8%) and a trajectory of obesity (n = 47, 11.2%). Linear and logistic regressions estimated associations of carotid indices with mean BMI and BMI trajectories. Results Compared to the normal weight trajectory, an obesity trajectory was associated with carotid distensibility (β = − 3.078, p = 0.037), cIMT (β = 0.095, p = 0.004), and carotid elastography (β = 0.181, p = 0.004) but not with plaque volume (β = 0.066, p = 0.858). Compared with the normal weight trajectory, an obesity trajectory was associated with increased odds for impaired carotid distensibility (OR = 2.790, p = 0.033), impaired cIMT (OR = 5.277, p = 0.001) and large carotid plaque volume (OR = 8.456, p = 0.013) but not with carotid elastography (OR = 1.956, p = 0.140). Mean BMI was linearly associated with Distensibility (β = − 0.275, p = 0.005) and cIMT (β = 0.005, p = 0.026). Conclusions Long-term measurements of adiposity are associated with indices of carotid stiffness and plaque volume among older type 2 diabetes adults.

Long-Term Trajectories of BMI Predict Carotid Stiffness and Plaque Volume in Type 2 Diabetes Older Adults: a Cohort Study.

Background: High body mass index (BMI) is a risk factor for type 2 diabetes and cardiovascular disease. However, its relationships with indices of carotid stiffness and plaque volume are unclear. We investigated associations of long-term measurements of BMI with indices of carotid stiffness and atherosclerosis among non-demented diabetes patients from the Israel Diabetes and Cognitive Decline (IDCD) study. Methods: Carotid ultrasound indices [carotid intima media thickness (cIMT), distensibility, elastography and plaque volume] were assessed in N=471 participants. Mean BMI across all MHS diabetes registry measurements and trajectories of BMI were calculated. BMI was categorized into three trajectory groups representing: a relatively stable normal weight (n=185, 44%), overweight trajectory (n=188, 44.8%) and a trajectory of obesity (n=47, 11.2%). Linear and logistic regressions estimated associations of carotid indices with mean BMI and BMI trajectories. Results: Compared to the normal weight trajectory, an obesity trajectory was associated with carotid distensibility (β=-3.078, p=0.037), cIMT (β=0.095, p=0.004), and carotid elastography (β=0.181, p=0.004) but not with plaque volume (β=0.066, p=0.858). Compared with the normal weight trajectory, an obesity trajectory was associated with increased odds for impaired carotid distensibility (OR=2.790, p=0.033), impaired cIMT (OR=5.277, p=0.001) and large carotid plaque volume (OR=8.456, p=0.013) but not with carotid elastography (OR=1.956, p=0.140). Mean BMI was linearly associated with Distensibility (β=-0.275, p=0.005) and cIMT (β=0.005, p=0.026).Conclusions: Long-term measurements of adiposity are associated with indices of carotid stiffness and plaque volume among older type 2 diabetes adults.

Haptoglobin 1-1 is Associated with Larger Carotid Plaque Volume Among Elderly with Type 2 Diabetes: The IDCD Study.

Background and aims: The haptoglobin (Hp) genotype (Hp 1-1, 1-2, or 2-2) is associated with type 2 diabetes complications. The Hp2-2 genotype has been linked to elevated CHD risk while the 1-1 genotype has been recently related to cerebral small vessel disease. This study investigated whether Hp phenotype is associated with carotid atherosclerotic structure and function among type 2 diabetes elderly patients participating in the Israel Diabetes and Cognitive Decline (IDCD) study. Methods: IDCD participants (n=472) underwent a battery of carotid atherosclerosis ultrasound assessments with measurements of carotid intima media thickness (cIMT), distensibility, elastography, and carotid plaque volume. Ordinal regression models adjusting for demographic and cardiovascular risk factors assessed the associations of categorical measures of carotid plaque volume with Hp phenotype . Logistic regression models were used to assess the association of Hp phenotype with impaired cIMT, carotid distensibility and elastography. Results: Participants averaged 76.4±4.4 years old, 42% were female, mean HbA1c was 6.7±0.7% (50±7.7 mmol/mol). Hp phenotype distribution was 46 (10.4%) Hp 1-1, 186 (40.7%) Hp 2-1 and 209 (45.7%) Hp 2-2 carriers. Carotid plaque volume was categorized into 4 groups: including no plaque (n=128) and tertiles of plaque volume: small plaque (volume ≤122 mm3, n=110), medium plaque (volume 122-273 mm3, n=106) and large plaque (volume≥274 mm3, n=104). The prevalence of Hp 1-1 phenotype increased with greater carotid plaque volume (6.5%, 10.6%, 8.8% and 16.5% in the no, small, medium, and large plaque groups respectively; p=0.027). Compared to Hp-1 carriers, non-carriers (i.e. Hp 2-1 and Hp 2-2) had approximately 30% lower risk for large carotid plaque volume, as estimated using ordinal regression (OR: 0.713 [0.496, 1.03], 0.694 [0.484, 0.997] for Hp 2-1, Hp 2-2 respectively). No associations were found between Hp phenotype and level of carotid stenosis, cIMT, carotid distensibility and carotid elastography.Conclusion: Our findings suggest that among non-demented elderly patients with type 2 diabetes, the Haptoglobin 1-1 phenotype is associated with greater carotid atherosclerosis. These findings add evidence for the involvement of the Hp 1-1 phenotype in the pathophysiology of cerebrovascular disease.