Central blood pressure and vascular stiffness in Mexican population / Presión central aórtica y rigidez vascular en mexicanos

Abstract Introduction: Central blood pressure (CBP) is considered a measure of prognostic value for cardiovascular risk. In turn, the aortic pulse wave velocity (PWVAo) and augmentation index (Aix) have been related to arterial stiffness and cardiovascular risk. Controversies exist regarding the reference values in different ethnic groups, ages, and anthropometrics. The objective of this study is to evaluate the CBP and arterial stiffness parameters in a Mexican population by age, gender, and anthropometry. Methods: Between 2015 and 2016, 1009 apparently healthy subjects were recruited in the Instituto Nacional de Cardiología Ignacio Chávez. Using the Arteriograph (TensioMed) equipment with an oscillometric technique, CBP, central pulse pressure (cPP), PWVAo, and Aix were acquired. All results were automatically obtained by computer software version 3.0.0.4. Results: Female sex was prevalent (72%), mean age was 47 ± 12 years; 26% had normal weight, 43% were overweight, and 30% had obesity. The reference values were higher than those reported in other populations. PWVAo and Aix were always found to be higher in females. A central-brachial pressure gradient was observed in < 40 years with lower CBP. Body mass index (BMI) presented a direct and positive correlation with CBP (p < 0.001); however, PWVAo and Aix were not modified. Conclusion: CBP, cPP, PWVAo, and Aix parameters should be considered based on age, gender, and BMI. In Mexican population, CBP and cPP values were higher compared with other previously reported values, especially in women, the elderly, and obese. PWVAo and Aix are higher in older women; however, they are not modified by BMI.

Resumen Introducción: La presión central aórtica (PCA) se considera una medida del valor pronóstico. A su vez, la velocidad de la onda del pulso aórtico (VOPA) y el índice de aumento (IA) se han relacionado con la rigidez arterial y riesgo cardiovascular. Existen controversias sobre los valores de referencia en diferentes grupos. El objetivo de este estudio es evaluar estos parámetros en una población mexicana por edad, género y antropometría. Métodos: Entre 2015 y 2016 se reclutaron 1,009 sujetos aparentemente sanos en el Instituto Nacional de Cardiología Ignacio Chávez. Usando el equipo de Arteriograph (TensioMed) con técnica oscilométrica, se adquirieron: PCA, presión de pulso central, VOPA e IA. Todos los resultados fueron obtenidos automáticamente. Resultados: El sexo femenino fue prevalente (72%), edad de 47 ± 12 años; 26% con peso normal, 43% con sobrepeso y 30% con obesidad. Todos los valores fueron superiores a los reportados en otras poblaciones. VOPA e IA siempre fueron más altos en mujeres. Se observó un gradiente de presión central-braquial en < 40 años, con menor PCA. El IMC presentó una correlación directa y positiva con la PCA (p < 0,001), sin embargo, VOPA e IA no se modificaron. Conclusión: Los parámetros de PCA, VOPA e IA deben considerarse en función de edad, género e IMC. En una población mexicana, los valores de PCA fueron más altos en comparación con informados previamente (Europa y Asia), especialmente en mujeres, ancianos y obesos. VOPA e IA son más altos en mujeres mayores; sin embargo, no son modificados por el IMC.

Arterial Stiffness Is Not Independently Associated With Nighttime Sleep Duration In Community-Dwelling Older Adults. Results From The Atahualpa Project / La Rigidez Arterial No Se Encuentra Asociada Con La Duración Del Sueño Nocturno En Adultos Añosos Que Viven En La Comunidad. Resultados Del Proyecto Atahualpa

ABSTRACT Objectives: We aimed to assess the association between arterial stiffness and nighttime sleep duration in community-dwelling older adults living in rural Ecuador. Methods: Aortic pulse wave velocity (PWV) determinations were used to assess arterial stiffness. Nighttime sleep duration was assessed by a single question. A generalized linear model - adjusted for demographics, cardiovascular risk factors and psychological distress - was fitted to assess the independent association between the aortic PWV and nighttime sleep duration (dependent variable). Results: A total of 303 individuals were enrolled. Univariate analysis showed a significant association between the aortic PWV and long sleep duration (p=0.034), which vanished in a multivariate linear model (p=0.524). The single covariable remaining significant was anxiety (p=0.013). Conclusion: Lack of independent association between arterial stiffness and nighttime sleep duration might be more likely related to lack of reliability of evaluation of sleep duration by means of a single question.

RESUMEN Objetivos: En el presente estudio se evaluó la asociación entre rigidez arterial y duración del sueño nocturno en adultos mayores que viven en la comunidad en una zona rural de la costa Ecuatoriana. Métodos: Se utilizaron determinaciones de velocidad de onda de pulso aórtico (PWV) para evaluar la rigidez arterial. La duración del sueño nocturno se evaluó mediante una sola pregunta. Un modelo lineal generalizado, ajustado por variables demográficas, factores de riesgo cardiovascular y distress psicológico, evaluó la asociación independiente entre el PWV aórtico y la duración del sueño nocturno (variable dependiente). Resultados: Se registraron un total de 303 individuos. El análisis univariado mostró una asociación significativa entre el PWV aórtico y larga duración del sueño (p=0.034), que desapareció en un modelo lineal multivariado (p=0.524). La única covariable que permaneció significativa fue la ansiedad (p=0.013). Conclusión: La falta de asociación independiente entre rigidez arterial y duración del sueño nocturno podría estar relacionada con la falta de confiabilidad de la evaluación de la duración del sueño mediante una sola pregunta.

The Impact of the Aortic Pulse Wave Velocity on the Cardiovascular Outcomes of Hemodialysis Patients

The aims of our study were to identify the risk factors for an increased aortic pulse wave velocity (AoPWV) and to assess the impact of the AoPWV on the cerebro-cardiovascular (CV) outcomes of hemodialysis (HD) patients. Seventy two HD patients were included, and the AoPWV, the echocardiography and the biochemical parameters were measured. After dividing the patients into tertiles according to the AoPWV values, we defined the low, the middle and the high AoPWV groups. The patients in the high AoPWV group showed a significantly higher age and high-sensitivity C-reactive protein level, a greater prevalence of diabetes and statin use, left ventricular hypertrophy, average pulse pressure (PP), AoPWV and left ventricular mass index and a lower serum albumin level than those in the low AoPWV group (p<0.05). On multivariate regression analysis of the AoPWV, age and the average PP were independently related to the AoPWV (p<0.05). On the multivariate Cox analysis for CV outcomes, the AoPWV and the average PP remained significant independent predictors of CV events. Our data suggest that an increased AoPWV is an independent predictor for the CV outcomes of HD patients.

Effects of habitual physical exercise and aortic distensibility on systolic blood pressure in males. A study using aortic pulse wave velocity / 体力科学

The authors hypothesized that habitual physical exercise and aortic distensibility would be the major factors which influence systolic blood pressure. This study was designed to analyze the relationships among systolic blood pressure (SBP) and parameters determined at medical checks, including age, diastolic blood pressure (DBP), aortic pulse wave velocity (APWV) index (APWVI : APWV standardized by the diastolic blood pressure), plasma lipid profiles (IC, TG), plasma glucose during an oral glucose tolerance test (2 h-OGTT), percentage body fat (%Fat), cigarette smoking habit (Cigarettes), alcohol consumption (Alcohol), and physical activity index (PAI) using a questionnaire, in 678 males aged 30 to 69 years, who visited a hospital for a thorough medical check-up. For analysis of factorial structure in the subjects, principal factor analysis was applied to the correlation matrix which was calculated with 12 variables. Correlational analysis and path analysis were applied to confirm the hypothetical model. The results demonstrated that DBP and APWVI were the major factors which significantly affected the SBP. The PAI was significantly and inversely correlated not only with the APWVI, but also with %Fat, which was significantly and positively correlated with the DBP. In conclusion, aortic wall stiffness may be an independent factor in the manifestation of systolic hypertension, and habitual physical exercise may decrease the SBP through direct reduction of aortic wall stiffness and indirectly decreasing the DBP.