[Relationship between physical activity and hemodynamic parameters in adults]. / Relación entre la actividad física y parámetros hemodinámicos en adultos.

OBJECTIVES: To analyze the relationship between physical activity, as assessed by accelerometer, with central and peripheral augmentation index and carotid intima media thickness (IMT) in adults. METHODS: This study analyzed 263 subjects who were included in the EVIDENT study. Physical activity was assessed during 7 days using the ActigraphGT3X accelerometer (counts/min). Carotid ultrasound was used to measure carotid IMT. The Sphygmo Cor System was used to measure central and peripheral augmentation index (CAIx and PAIx). RESULTS: Mean age 55.85±12 years; 59.30% female; 26.7 body mass index and blood pressure 120/77mmHg. Mean physician activity counts/min was 244.37 and 2.63±10.26min/day of vigorous or very vigorous activity. Physical activity showed an inverse correlation with PAIx (r=-0.179; P<.01) and vigorous activity day time with IMT(r=-0.174; P<.01), CAIx (r=-0.217; P<.01) and PAIx (r=-0.324; P<.01). After adjusting for confounding factors in the multiple regression analysis, the inverse association of CAIx with counts/min and the time spent in vigorous/very vigorous activity was maintained. CONCLUSION: The results suggest that both physical activity and time spent in vigorous or vigorous activity are associated with the central augmentation index in adults.

Glycemic index, glycemic load, and pulse wave reflection in adults.

BACKGROUND AND AIMS: Diets with a high glycemic index (GI), high glycemic load (GL), or both, increase the risk of cardiovascular disease. This study examined the association of GI and GL in a regular diet with the peripheral augmentation index (i.e., a marker of vascular aging) in a sample of adults. METHODS AND RESULTS: Cross-sectional study. The findings presented in this manuscript are a subanalysis of the EVIDENT study whose purpose was to analyze the relationship between lifestyle and arterial aging. For the sample population, 1553 individuals aged 20-80 years were selected through random sampling from the patients of general practitioners at six health centers in Spain. GI and GL for each patient's diet were calculated from a previously validated, semi-quantitative, 137-item food frequency questionnaire. The peripheral augmentation index corrected for a heart rate of 75 bpm (PAIx75) was measured with pulse-wave application software (A-Pulse CASP). Based on a risk factor adjusted regression model, for every 5 unit increase in GI, the PAIx75 increased by 0.11 units (95% CI: 0.04-0.19). Similarly, for every increase in 10 units in GL, the PAIx75 increased by 1.13 (95% CI: 0.21-2.05). High PAIx75 values were observed in individuals with diets in the third GI tertile (i.e., the highest), and lower PAIx75 values in those with diets in the first tertile (i.e., the lowest), (93.1 vs. 87.5, respectively, p = 0.001). CONCLUSIONS: GI and GL were directly associated with PAIx75 values in adults without cardiovascular diseases regardless of age, gender, physical activity, and other confounders.

Relationship between electrocardiographic left ventricular hypertrophy criteria and vascular structure and function parameters in hypertensive patients.

The objective of this study was to determine the electrocardiographic left ventricular hypertrophy (LVH) criterion that best correlated with vascular structure and function parameters in hypertensive patients. A cross-sectional study involving 347 hypertensive patients was performed. The mean age of the subjects was 54.9±11.8 years, and 61% were male. Electrocardiography was used to detect LVH based on the evaluation of 10 criteria, and we defined the voltage-duration product (VDP) complex criterion. The vascular structure was evaluated according to carotid intima-media thickness (C-IMT), and vascular function was evaluated according to pulse wave velocity (PWV), the ambulatory arterial stiffness index (AASI), the home arterial stiffness index, and the peripheral (PAIx) and central (CAIx) augmentation indices. LVH according to at least some electrocardiographic criteria was recorded in 29.10% of the patients (34.10% of females; 25.90% of males). The vascular structure and function parameters showed higher values in the hypertensive patients with LVH. The criterion most closely correlated with C-IMT was Lewis-VDP (r=0.257); with PWV and AASI, the criterion was the Framingham-adjusted Cornell voltage (r=0.228 and r=0.195, respectively); and with CAIx and PAIx, the criterion was Novacode (r=0.226 and r=0.277, respectively). In the multivariate analysis, the association of the vascular structure and function parameters, the VDP complex (multiple linear regression) and the presence of LVH (logistic regression) disappeared after adjusting for age, sex and antihypertensive drugs. The relationship between the electrocardiographic criteria used to detect LVH in hypertensive patients and the vascular structure and function parameters were fundamentally conditioned by age and antihypertensive drug treatment.

[Mild cognitive impairment: early detection and new perspectives]. / Deterioro cognitivo leve: deteccion temprana y nuevas perspectivas.

INTRODUCTION. Along past years, interest in mild cognitive impairment (MCI) research and its early detection has been increased. Unlike first theories, international current proposals suggest that MCI is a syndrome characterized by an impairment in one or more cognitive functions without interfering in daily functional abilities and it is also accompanied by a concern because of the cognitive change. Although early MCI detection is usually made by cognitive screening tests, most of them do not seem to correctly detect MCI, but dementia. AIM. To expose an analysis of the cognitive screening tests more suitable for clinical MCI detection, according to current researches. DEVELOPMENT AND CONCLUSIONS. There are three kind of cognitive screening tests: general cognitive screening tests, specific cognitive screening tests and MCI-subtype cognitive screening test. We observe that most of the tests don't follow current MCI criteria. In this respect we propose to jointly apply tests, as well as the necessity of a carefully test choice to effectively detect MCI in clinical practice.

[The increase in the speed of the pulse wave is not associated with elevated central blood pressure in hypertensive patients with kidney disease]. / El aumento de la velocidad de la onda de pulso no seasocia con la elevación de la presión arterial centralen hipertensos con enfermedad renal.

OBJECTIVE: To analyze the relationship between pulse wave velocity (PWV) and central blood pressure evaluated by augmentation index (AIx) in hypertensive patients with kidney disease. METHODS: 406 hypertensive patients with normal renal function and 72 with kidney disease. Arterial stiffness was estimated with the PWV and the AIx. We followed the 2007 European Guidelines of Hypertension criteria to assess the presence or absence of kidney disease. RESULTS: PWV was 8.98 ± 2.15 and 10.17 ± 3.01 m/s (p <0.05) and AIx 30.06% ± 12.46 and 30.23% ± 12.56 (p >0.05) in hypertensive patients with normal renal function and kidney disease, respectively. Multiple regression analysis showed the renal function as an important determinant of PWV, but not AIx. CONCLUSION: In hypertensive patients with renal disease PWV is increased, but not the AIx. We believe that the AIx is not a reliable measure of arterial stiffness in hypertensive patients with kidney disease.