Twenty-Four-Hour Central Hemodynamic Load in Adults With and Without a History of COVID-19.

BACKGROUND: Although hypertension is a risk factor for severe Coronavirus Disease 2019 (COVID-19) illness, little is known about the effects of COVID-19 on blood pressure (BP). Central BP measures taken over a 24-hour period using ambulatory blood pressure monitoring (ABPM) adds prognostic value in assessing cardiovascular disease (CVD) risk compared with brachial BP measures from a single time point. We assessed CVD risk between adults with and without a history of COVID-19 via appraisal of 24-hour brachial and central hemodynamic load from ABPM. METHODS: Cross-sectional analysis was performed on 32 adults who tested positive for COVID-19 (29 ± 13 years, 22 females) and 43 controls (28 ± 12 years, 26 females). Measures of 24-hour hemodynamic load included brachial and central systolic and diastolic BP, pulse pressure, augmentation index (AIx), pulse wave velocity (PWV), nocturnal BP dipping, the ambulatory arterial stiffness index (AASI), and the blood pressure variability ratio (BPVR). RESULTS: Participants who tested positive for COVID-19 experienced 6 ± 4 COVID-19 symptoms, were studied 122 ± 123 days after testing positive, and had mild-to-moderate COVID-19 illness. The results from independent samples t-tests showed no significant differences in 24-hour, daytime, or nighttime measures of central or peripheral hemodynamic load across those with and without a history of COVID-19 (P > 0.05 for all). CONCLUSIONS: No differences in 24-hour brachial or central ABPM measures were detected between adults recovering from mild-to-moderate COVID-19 and controls without a history of COVID-19. Adults recovering from mild-to-moderate COVID-19 do not have increased 24-hour central hemodynamic load.

The Inverse Association of Muscular Strength with Carotid Intima-media and Extra-media Thickness in Women.

The purpose of this study was to determine the relationship between strength and atherosclerotic cardiovascular disease (CVD) risk in young women. Carotid intima-media thickness (IMT) and extra-media thickness (EMT) were used as measures of subclinical atherosclerosis and CVD risk. Muscular strength, IMT, and EMT were measured in 70 young women (mean age=21±4 years). Strength was determined using a handgrip dynamometer and expressed relative to body mass. IMT and EMT were measured using ultrasonography of the left common carotid artery. Objectively measured moderate-vigorous physical activity (MVPA) was assessed with accelerometry. Higher relative handgrip strength was associated with lower IMT (r=-0.23; p<0.05) and lower EMT (r=-0.27; p<0.05). Associations between relative handgrip strength and IMT (r=-0.24) as well as EMT (r=-0.25) remained significant after adjusting for potential confounders including traditional CVD risk factors and MVPA (p<0.05). These results show that there is an inverse association between handgrip strength with carotid IMT and EMT in young women. Muscular strength may reduce CVD risk in young women via favorable effects on subclinical carotid atherosclerosis independent of physical activity.

Sex differences in the association between PTSD symptoms with cardiac autonomic function and subclinical atherosclerotic risk.

BACKGROUND: Post-traumatic stress disorder (PTSD) is a public health concern that may elevate the risk for cardiovascular disease (CVD). There are established sex differences in both PTSD risk and CVD risk. PURPOSE: To examine sex-specific associations between subclinical PTSD symptom severity and subclinical CVD risk in young men and women. METHODS: A total of 61 young adults (women: n = 29, mean age: 26 ± 7 years) completed the post-traumatic stress disorder civilian checklist (PCL) and the Center for Epidemiologic Studies Depression Scale (CES-D). Aortic stiffness was measured as carotid-femoral pulse wave velocity (cfPWV). Peripheral vasomotor function was measured as flow-mediated slowing (FMS) of carotid-radial PWV following 5-min forearm occlusion. Heart rate variability was used to assess sympathovagal balance as LF/HF ratio. RESULTS: PCL score was positively correlated with CES-D score (r = 0.79, p < .001), cfPWV (r = 0.33, p = .03) and LF/HF ratio (r = 0.42, p = .009) in men. PCL score was positively correlated to CES-D score (r = 0.80, p < .001) in women, but was inversely correlated to cfPWV (r = -0.38, p = .02) and LF/HF ratio (r = -0.34, p = .04). PCL score was also inversely associated with FMS in women (r = -0.49, p = .01). CONCLUSION: There are sex differences in the association of PTSD symptoms and subclinical atherosclerosis. In men, increased PTSD symptoms may increase CVD risk by increasing sympathovagal balance and aortic stiffness. In women, increased PTSD symptoms may increase CVD risk via reducing vasomotor function.

Racial Differences in Left Ventricular Mass and Wave Reflection Intensity in Children.

The burden of heart failure is disproportionately higher in African Americans, with a higher prevalence seen at an early age. Examination of racial differences in left ventricular mass (LVM) in childhood may offer insight into risk for cardiac target organ damage (cTOD) in adulthood. Central hemodynamic load, a harbinger of cTOD in adults, is higher in African Americans. The purpose of this study was to examine racial differences in central hemodynamic load and LVM in African American and non-Hispanic white (NHW) children. Two hundred sixty-nine children participated in this study (age, 10 ± 1 years; n = 149 female, n = 154 African American). Carotid pulse wave velocity (PWV), forward wave intensity (W1) and reflected wave intensity (negative area, NA) was assessed from simultaneously acquired distension and flow velocity waveforms using wave intensity analysis (WIA). Wave reflection magnitude was calculated as NA/W1. LVM was assessed using standard 2D echocardiography and indexed to height as LVM/[height (2.16) + 0.09]. A cutoff of 45 g/m (2.16) was used to define left ventricular hypertrophy (LVH). LVM was higher in African American vs. NHW children (39.2 ± 8.0 vs. 37.2 ± 6.7 g/m (2.16), adjusted for age, sex, carotid systolic pressure and socioeconomic status; p < 0.05). The proportion of LVH was higher in African American vs. NHW children (25 vs. 12 %, p < 0.05). African American and NHW children did not differ in carotid PWV (3.5 ± 4.9 vs. 3.3 ± 1.3 m/s; p > 0.05). NA/W1 was higher in African American vs. NHW children (8.5 ± 5.3 vs. 6.7 ± 2.9; p < 0.05). Adjusting for NA/W1 attenuated racial differences in LVM (38.8 ± 8.0 vs. 37.6 ± 7.0 g/m (2.16); p = 0.19). In conclusion, racial differences in central hemodynamic load and cTOD are present in childhood. African American children have greater wave intensity from reflected waves and higher LVMI compared to NHW children. WIA offers novel insight into early life origins of racial differences in central hemodynamic load and cTOD.