Associations between measurements of central blood pressure and target organ damage in high-risk patients

Background It is not well-known which components of central blood pressure (CBP) are more influential to target organ damage (TOD). This study aimed to determine the relationship between CBP measurements and various types of TOD in high-risk patients. Methods A total of 148 patients who had documented atherosclerotic cardiovascular disease or its multiple risk factors were prospectively enrolled. CBP was measured by using applanation tonometry of the radial artery. The following nine TOD parameters were evaluated: left ventricular mass index, relative wall thickness, septal e′ velocity, septal E/e′, brachial-ankle pulse wave velocity, ankle-brachial index, estimated glomerular filtration rate, urine protein and obstructive coronary artery disease. Results The mean age of the study population was 67.1 ± 9.0 years and 108 (73 %) were male. Among four CBP measurements (systolic, diastolic, mean, and pulse pressures), central pulse pressure (CPP) was associated with the largest number of TOD parameters. As CPP increased, the number of TOD increased (P = 0.010), but this association was not observed in other CBP measurements (P > 0.05 for each). Conclusions CPP had a stronger correlation with TOD than other CBP measurements. Non-invasive CPP could be a useful indicator for predicting TOD in patients at high coronary risk.

Observation of the Clinical Correlation between Carotid Artery Intima-Media Thickness and Cardiovascular Risk Factors in Hypertensive Patients under Microscope Images

With the development of social science and technology and people’s demand for exploring the micro world, digital microscope technology came into being. Microscope image processing technology has been widely used in industrial micromanipulation, biomedicine, and cultural relic identification and preservation. In order to in-depth study the use of microscope image technology to observe the thickness of the carotid artery intima-media in hypertensive patients to find out whether it is feasible to explore many risk factors for cardiovascular development, this article uses data analysis, concept analysis, and graphic construction methods to collect samples, analyzed the image, streamlined the algorithm, and created a microscope image that can study its risk factors. The severity of hypertension, diabetes, and other factors affects the thickness of carotid arteries and cardiovascular diseases. The results show that the longer the duration of hypertension, the higher the central and peripheral blood pressure, the higher the height, and the higher the central blood pressure, which is relatively low. The detection rate of elevated central blood pressure is higher (76.8%). The second group (53.6%) and the third group (49.2%) ( P < 0.008 ); older age, the central blood pressure is relatively high, and the detection rate of central blood pressure increases (75.5%). It is higher than normal blood pressure (24.5%), so it can be concluded that hypertension not only affects central blood pressure but also peripheral blood; height and age are independent factors that affect central blood pressure. It is basically realized that starting from the microscope image, many risk factors of cardiovascular disease have been successfully analyzed.

Correlation arterial stiffness and central blood pressure with obstructive sleep apnea in patients with resistant arterial hypertension

The aim assess correlation the arterial stiffness in patients with resistant arterial hypertension (AH) and obstructive sleep apnea (OSA) Design 185 patients with AH were enrolled into the study. They were divided on 2 groups: OSA group – 148 patients were found to have OSA, indicated by at mean AHI of 38.1±2.5 h–1, and control group – 37 patients without OSA, mean AHI 3.02±0.25 h–1 (P&lt;0.001). Patients of both groups were comparable on age, growth, total cholesterol level and office systolic blood pressure (SBP) and diastolic blood pressure (DBP). Results Patients with RAH and OSA (mean apnea-hypopnea index (AHI) 36.5±2.7 event/h) in comparison with patients with RAH without OSA (mean AHI 3.4±0.2 event/h) had significantly higher body mass index (34.2±0.7 vs 31.6±0.7 kg/m2, P&lt;0.05), uric acid level (6.7±0.1 vs 5.6±0.4 mg/dl, P&lt;0,05), higher carotid-femoral pulse wave velocity (PWVcf) (12.1±0.5 vs 10.2 m/s, P&lt;0,05) and central systolic blood pressure (CSBP) (143.8±2.7 vs 136.2±3.4 mm Hg, P&lt;0,05). Patients of both groups had comparable office blood pressure (SBP 145.6±1.67 vs 138.4±3.66 mm Hg, P=0.057 and DBP 93.6+±1.18 vs 89.1±2.11 mm Hg, P=0.073), but significantly higher 24-h systolic and diastolic blood pressure. We suggest that in the study some patients with OSA had masked arterial hypertension. Daytime sleepiness in OSA patients was associated with structural remodeling of the left ventricle myocardium and more expressed arterial stiffness: ESS score was independently correlated with snoring duration (β=−0.008; P=0.021), interventricular septum thickness (β=0.023; P=0.026), LVMI (β=−0.037; P=0.039) and indexes of central pulse wave: ejection duration (ED) (β=−0.020; P&lt;0.001) and subendocardial viability ratio (SEVR) (β=−0.224; P=0.012). Nocturnal hypoxemia in OSA patients was associated with increased aortic stiffness and higher central blood pressure: desaturation index was independently correlated with Aix (β=4.167; P=0.009), Aix75 (β=−3.929; P=0.006) and central DBP (β=0.151; P=0.004). Conclusion In patients with RH and OSA nocturnal hypoxemia correlation with increased aortic stiffness and higher central blood pressure. FUNDunding Acknowledgement Type of funding sources: None.

Higher habitual dietary flavonoid intake associates with lower central blood pressure and arterial stiffness in healthy older adults

Flavonoids have shown anti-hypertensive and anti-atherosclerotic properties: the impact of habitual flavonoid intake on vascular function, central hemodynamics and arterial stiffness may be important. We investigated the relationship between habitual flavonoid consumption and measures of central blood pressure and arterial stiffness. We performed cross-sectional analysis of 381 non-smoking healthy older adults (mean ± SD age, 66.0 ± 4.1 years; BMI, 26.4 ± 4.41 kg/m2; 41% male) recruited as part of the Australian Research Council Longevity Intervention (ARCLI) study. Flavonoid intake [i.e., flavonols, flavones, flavanones, anthocyanins, isoflavones, flavan-3-ol monomers, proanthocyanidins, theaflavins/thearubigins and total consumption] was estimated from food-frequency questionnaires using the US Department of Agriculture food composition databases. Measures of central hemodynamics and arterial stiffness included systolic blood pressure (cSBP), diastolic blood pressure (cDBP), mean arterial pressure (cMAP), and augmentation index (cAIx). After adjusting for demographic and lifestyle confounders, each standard deviation (SD)/day higher intake of anthocyanins (SD=44.3 mg/day) was associated with significantly lower cDBP (−1.56 mmHg, 95% CI: −2.65, −0.48) and cMAP (−1.62 mmHg, 95% CI: −2.82, −0.41). Similarly, each SD/day higher intake of flavanones (SD=19.5 mg/day) was associated with ˜1% lower cAIx (−0.93%, 95% CI: −1.77, −0.09). These associations remained significant after additional adjustment for 1) a dietary quality score and 2) other major nutrients that may affect blood pressure or arterial stiffness (i.e., sodium, potassium, calcium, magnesium, omega-3, total protein and fibre). This study suggests a possible benefit of dietary anthocyanin and flavanone intake on central hemodynamics and arterial stiffness; these findings require corroboration in further research.

The Importance of Calibration Method in Determining the Association between Central Blood Pressure with Left Ventricular and Left Atrial Strain.

PurposeAfterload is an important determinant of left ventricular(LV) and atrial(LA) function, including myocardial strain. Central blood pressure(CBP) is the major component of cardiac afterload and independently associated with cardiovascular risk. However, the optimal means of calibrating CBP is unclear - standard CBP assessment uses systolic(SBP) and diastolic blood pressure(DBP) from brachial waveforms, but calibration with mean pressure(MAP) and DBP purports to be more accurate. Therefore, we sought to determine which CBP is best associated with LA and LV strain.MethodsCBP was measured using both standard and MAP based calibration methods in 546 participants(age 70.7±4.7 years, 45% male) with risk factors for heart failure. Echocardiography was performed in all patients and strain analysis conducted to assess LA/LV function. The associations of CBP with LA and LV strain were assessed using linear regression. ResultsMAP-derived CSBP(150±20mmHg) was higher than standard CSBP(128±15mmHg) and brachial SBP(140±17mmHg, p<0.001), whereas DBPs were similar(84±10, 83±10, and 82±10 mmHg). MAP-derived CSBP was not independently associated with LV strain(p>0.05), however was independently associated with LA reservoir strain(p<0.05). Brachial and central DBP were more strongly associated with LA reservoir/conduit and LV strain than brachial and central SBP. LA pump strain was not independently associated with any SBP or DBP parameter(p>0.05). MAP-derived CBP was more accurate in identifying patients with abnormal LA and LV strain than brachial SBP and standard CBP calibration. ConclusionCBP calibrated using MAP and DBP may be more accurate in identifying patients with abnormal LA and LV function than standard brachial calibration methods.