Biomarcadores vasculares em pacientes hipertensos / Vascular biomarkers in hypertensive patients

Fundamento: Avaliação da dinâmica vascular tem sido associada a uma melhor quantificação do risco cardiovascular de pacientes hipertensos. Objetivo: Avaliar a rigidez arterial em pacientes hipertensos acompanhados no ambulatório escola da Universidade Iguaçu, avaliar a dinâmica vascular e rigidez arterial desta população e propor estratégias para uma maior proteção cardiovascular destes pacientes. Métodos: Estudo prospectivo, aberto, avaliando a taxa de pacientes com pressão arterial sistólica central ≥120mmHg e ≤120mmHg; e a velocidade de onda pulso ≥10m/s e ≤10m/s através da avaliação de pacientes consecutivos atendidos no ambulatório escola, com >18 anos, no período de agosto/2019 a março/2020. Análise de dados demográficos, condições clínicas associadas e presença de outros fatores de risco. Todos os pacientes foram submetidos à avaliação dos parâmetros centrais e de rigidez arterial pela técnica oscilométrica. Análise estatística: análise descritiva dos dados em média com desvio padrão para as variáveis contínuas, epercentual do número total para as demais variáveis. As análises foram feitas com software Excel, versão 2101 (build 13628.20448 Microsoft Store). Resultados: 56 pacientes (44 femininos); média idade 56,08±12,24anos. Média de PA 135,08±15,73/85,39±10,30mmHg. Pacientes com pressão sistólica central ≥ 120mmHg: 32,14%; pacientes com a velocidade de onda de pulso ≥ 10m/s: 26,78%. Quantidade de medicamentos anti--hipertensivos por paciente com PASc ≥ 120mmHg: 1 droga (38,88%), 2 drogas (61,11%), 3 drogas (0%), > 3 drogas (0%). Quantidade de medicamentos anti-hipertensivos utilizados pelos pacientes com VOP ≥ 10m/s: 1 droga (26,66%), 2 drogas (66,67%), 3 drogas (6,67%), > 3 drogas (0%). Conclusão: Mais de um quarto da população apresentava elevação da PASc e da VOP. Cerca de 30% dos participantes que apresentavam VOP ≥10m/s estavam em sua maioria (74,34%) usando dois ou mais fármacos anti-hipertensivos em combinação livre. Estas informações implicam na n necessidade de reavaliação da estratégia terapêutica objetivando não apenas o alcance das metas de PA, mas a efetiva proteção CV (AU).

Background: Assessment of vascular dynamics has been associated with better quantification of cardiovascular risk in hypertensive patients. Objective: To evaluate arterial stiffness in hypertensive patients followed up at the Iguaçu University outpatient clinic, to evaluate the vascular dynamics and arterial stiffness of this population and to propose strategies for greater cardiovascular protection in these patients. Methods: Prospective, open study, evaluating the rate of patients with central systolic blood pressure ≥120mmHg and ≤120mmHg; and pulse wave velocity ≥10m/s and ≤10m/s through the evaluation of consecutive patients treated at the school outpatient clinic, aged >18 years, from August/2019 to March/2020. Analysis of demographic data, associated clinical conditions and presence of other risk factors. All patients underwent assessment of central parameters and arterial stiffness using the oscillometric technique. Statistical analysis:descriptive analysis of data in mean with standard deviation for continuous variables, and percentage of the total number for other variables. Analyzes were performed using Excel software, version 2101 (build 13628.20448 Microsoft Store) Results: 56 patients (44 female); mean age 56.08±12.24 years. Mean BP 135.08±15.73/85.39±10.30mmHg. Patients with central systolic pressure ≥ 120mmHg: 32.14%; patients with pulse wave velocity ≥ 10m/s: 26.78%. Number of antihypertensive drugs per patient with SBP ≥ 120mmHg: 1 drug (38.88%), 2 drugs (61.11%), 3 drugs (0%), > 3 drugs (0%). Number of antihypertensive drugs used by patients with PWV ≥ 10m/s: 1 drug (26.66%), 2 drugs (66.67%), 3 drugs (6.67%), > 3 drugs (0%) (AU).,

Current Status and Prospects of Non-Invasive Central Arterial Pressure Measurement / 医用生物力学

Cardiovascular disease is one of the important factors that threaten the health of residents, ranking the first among various causes of death, so the monitoring and diagnosis of human cardiovascular health is particularly important. Compared with traditional brachial artery pressure, central arterial pressure (CAP) has a higher correlation with the occurrence of many cardiovascular events. The measurement of CAP can more accurately reflect the real situation of human blood pressure, and provide an important basis for diagnosis and disease prevention. Therefore, the realization of high-precision, high-generalization ability and low-cost non-invasive measurement of CAP has always been the research focus in this field. This article combines the relevant literature in China and abroad to summarize the current status of CPA measurement, introduces related research progress from two aspects, namely parameter measurement and waveform measurement, and discusses the characteristics of the existing methods and the future development.

Relationship between body mass index and central haemodynamic indices / 上海交通大学学报（医学版）

Objective • To investigate the relationship between body mass index (BMI) and central haemodynamic indices in physical examination population. Methods • From December 2017 to June 2018, a total of 287 subjects undergoing health examination (164 males, accounting for 57.1%) in the Physical Examination Center, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine were included. According to BMI, the subjects were divided into normal BMI group (BMI<24 kg/m2), overweight group (24 kg/m2 ≤ BMI<28 kg/m2), and obesity group (BMI ≥ 28 kg/m2). The peripheral systolic blood pressure (PSP), the peripheral diastolic blood pressure (PDP), the peripheral pulse pressure (PPP), and the mean arterial pressure (P-MAP) were measured, respectively. The central arterial pressures were measured by pulse wave analysis, including central systolic blood pressure (CSP), central diastolic blood pressure (CDP), central pulse pressure (CPP), central augmentation pressure (AP), and central augmentation index (AIx). The amplification index of pulse pressure was PPP/CPP. Results • ① The differences of PDP, CDP, P-MAP, AP, AIx and PPP/CPP among the three groups were statistically significant (P<0.05). ② Pearson correlation analysis showed that BMI was negatively correlated with AP and AIx (r=-0.140, r=-0.149, P<0.05), but positively correlated with PDP, CDP and PPP/CPP (r=0.151, r=0.155, r=0.124, P<0.05). ③ Multiple linear regression analysis showed that BMI was not an independent related factor for CSP. Conclusion • With the increase of BMI, AP and AIx show a downward trend, but PDP, CDP, and PPP/ CPP show an upward trend; BMI and CSP have no significant correlation.

Effects of acute aerobic exercise and resistance training on central aortic pressure / 中华物理医学与康复杂志

Objective To explore the effects of aerobic exercise and resistance training on center arterial blood pressure.Methods Fifteen healthy men who had not practiced aerobic exercise or resistance training within the previous 6 months were enrolled in this study.A self-matched pairs design was adopted.All of the subjects performed moderate intensity aerobic exercise,for 30 min initially,and after 2 weeks,performed resistance training at 60％ of their l-repeat maximum effort (1-RM).Their central aortic systolic blood pressure (CSBP) before and after aerobic exercise and resistance training were measured and compared,respectively.The changes in CSBP and an augmentation index (AI) of radial artery and relative blood pressure were compared between the two interventions.Results CSBP decreased significantly after both sorts of training.The two types of training showed no significant difference in their effects on CSBP.However,after a 20 min recovery,systolic blood pressure and pulse pressure were significantly lower after aerobic exercise than after resistance training.The significant difference persisted after 20 min and 40 min of re-covery.The AI of the radial artery was also significantly lower 5 min after aerobic exercise than after resistance train-ing.Conclusions After moderate aerobic exercise and resistance training,CBSP,AI and systolic pressure all display favorable changes.However,moderate intensity aerobic exercise provides the better effect in improving blood pressure.

Effect of Metoprolol Tartrate on Central and Peripheral Arterial Pressure in Patients with Hypertension / 中华高血压杂志

Backgroud Various antihypertensive drugs decreased peripheral arterial pressure similarly,while their effects on central arterial pressure may be at variance.The studies of the effect on central arterial pressure of antihypertensive drugs,especially the effect ? adrenoreceptor blockers was paucity.Objective To investigate the effect of ? adrenoreceptor blocker metoprolol tartrate on central and peripheral arterial pressure in patients with hypertension.Methods Fifty patients with primary hypertension who underwent percutaneous coronary angiography were recruited.Radial arterial and ascending aortal pressure as peripheral and central blood pressure were determined.Patients were chewing 25-50 mg metoprolol tartrate or 10 mg nifedipine during the catheterization.Results After administering metoprolol tartrate,the magnitude of decreases in peripheral arterial pressure were significantly(P0.025).Both peripheral and central arterial pressure decreased significantly after administering nifedipine(P0.025).Conclusion Despite similar decrease of peripheral arterial pressure,the decrease magnitude of central arterial pressure by metoprolol tartrate was significantly smaller than that by nifedipine.