bluuebunny/crossref_metadata_2025 huggingface dataset:
ARTERIAL STIFFNESS IS ASSOCIATED WITH A PROTHROMBOTIC STATE IN NON-DIABETIC ESSENTIAL HYPERTENSIVE PATIENTS
Authors: Bulfone Luca , Catena Cristiana , Da Porto Andrea , Colussi Gianluca , Frangipane Alessandro , Duratti Andrea , Cavarape Alessandro , Sechi Leonardo A.
Published: April 2021

Objective:

Previous studies reported that a prothrombotic state is associated with early subclinic damage in arterial hypertension. Arterial stiffening can be estimated by measurement of the pulse wave velocity (cfPWV) and the augmentation index (AIx) and predicts cardiovascular events in general population and in hypertension. Previous assessments of the impact of the coagulative system on arterial stiffness reported inconsistent results. We examined the relationships among the AIx and cfPWV, and hemostatic system, in non-diabetic essential hypertensive (EH) patients.

Design and method:

In 147 EH subjects (age 52 ± 13 years, 72 men) we evaluated clinical characteristics, renal function, plasma levels of glucose, lipids, fibrinogen, D-dimer, plasminogen activator inhibitor-1 (PAI-1), tissue-plasminogen activator (t-PA), prothrombin fragment 1+2 (F1+2), von Willebrand Factor antigen (vWF Ag), antithrombin III (ATIII), coagulation C and S proteins, and we measured the AIx and cfPWV.

Results:

At univariate analysis the AIx was significantly and directly related to fibrinogen (r = 0.300, P < 0.001), D-dimer (r = 0.277, P = 0.001) and PAI-1 (r = 0.268, P = 0.009). The cfPWV was significantly and directly related to fibrinogen (r = 0.273, P = 0.001), D-dimer (r = 0.285, P < 0.001), F1+2 (r = 0.267, P = 0.014) and PAI-1 (r = 0.368, P < 0.001). At multivariate analysis AIx was independently associated with levels of fibrinogen (B = 0.224, P = 0.004), D-dimer (B = 0.170, P = 0.037) and PAI-1 (B = 0.341, P = 0.001), and cfPWV was independently associated with levels of D-dimer (B = 0.207, P = 0.005) and PAI-1 (B = 0.208, P = 0.048). Logistic regression indicated that AIx above the median value was significantly associated with levels of D-dimer and PAI-1.

Conclusions:

In non-diabetic patients with EH, arterial stiffening is associated with evidence of a prothrombotic state suggesting that measurement of some hemostatic variables might be useful to identify subjects at increased risk of vascular damage.
WHITE COAT HYPERTENSION AND ARTERIAL STIFFNESS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Antza Christina , Vazakidis Polychronis , Doundoulakis Ioannis , Stabouli Stella , Kotsis Vasilios
Published: April 2021

Objective:

Arterial damage of large arteries, addressed as carotid-femoral pulse wave velocity (c-f PWV), is recognized as independent predictor for future cardiovascular disease. The aim of this study was to investigate the impact of white coat hypertension on c-f PWV, in an untreated population.

Design and method:

PubMed and Cochrane Library were searched systematically to identify studies comparing c-f PWV levels between normotensives, hypertensives and white-coat hypertensives (WCH). Meta-analysis was performed to compare the difference c-f PWV levels between these groups. New Castle Ottawa quality assessment scale for case-control studies was used to assess study quality.

Results:

WCH patients had significantly increased c-f PWV values compared to the normotensive groups (d = 0.87 95% CI: 0.52 to 1.21, P < 0.01). Moreover, the hypertensive population was found to have statistically significant increased values of c-f PWV compared to WCH population (d = -0.74, 95% CI: -1.43 to -0.05, P < 0.01). Finally, there was no statistically significant difference between masked hypertension and WCH population (d = 0.06, 95% CI: -1.04 to 1.15, P < 0.001).

Conclusions:

WCH population have statistically significant increased values of c-f PWV compared to the normotensive group. These results demonstrate that WCH is not clinically innocent, in the untreated population.
ELEVATED EXCESS PRESSURE INTEGRAL IS ASSOCIATED WITH VASCULAR BIOMARKERS OF SUBCLINICAL ATHEROSCLEROSIS IN OLDER ADULTS
Authors: Aizawa Kunihiko , Casanova Francesco , Mawson Dave M. , Gooding Kim M. , Strain W. David , Gates Phillip E. , Östling Gerd , Khan Faisel , Colhoun Helen M. , Palombo Carlo , Parker Kim H. , Nilsson J. , Shore Angela C. , Hughes Alun D.
Published: April 2021

Objective:

Altered central artery haemodynamics could have an unfavourable influence on the vasculature. A previous study has suggested that elevated excess pressure integral (INTXSP), derived from reservoir-excess pressure analysis, could reflect circulatory dysfunction and predispose to developing atherosclerosis. In this study, we aimed to determine whether an alteration in parameters derived from the reservoir-excess pressure analysis would be associated with vascular biomarkers of subclinical atherosclerosis in older adults.

Design and method:

The data from 958 older adults (69.0 ± 8.2yrs, 351 female, 456 with known cardiovascular disease) were analysed. Using radial artery tonometry, the parameters derived from the reservoir-excess pressure analysis including reservoir pressure integral, INTXSP, systolic rate constant (SRC) and diastolic rate constant were obtained. Common carotid artery intima-media thickness (CA-IMT), carotid bulb intima-media thickness (BL-IMT), common carotid artery wall-to-lumen ratio (CA-WLR) were also obtained using an ultrasound system.

Results:

Multivariate regression analysis revealed that INTXSP was directly associated with CA-IMT [B = 0.081 (95%CI: 0.029, 0.133)] and CA-WLR [B = 0.010 (95%CI: 0.002, 0.017)] after accounting for conventional cardiovascular risk factors and renal function. SRC was also inversely associated with CA-IMT [B = -0.056 (95%CI: -0.099, -0.012)] and CA-WLR [B = -0.009 (95%CI: -0.017, 0.000)] after accounting for conventional cardiovascular risk factors and renal function. When both INTXSP and SRC were entered into the same regression model together, only INTXSP was associated with those parameters. The observed association was independent of carotid-femoral pulse wave velocity and aortic systolic pressure. BL-IMT did not show any association with reservoir-excess pressure parameters.

Conclusions:

INTXSP was significantly associated with vascular biomarkers of subclinical atherosclerosis in older adults, suggesting that an elevated INTXSP is linked to the development of atherosclerosis.
RELATIONSHIPS HOMOCYSTEINE AND ARTERIAL STIFFNESS IN PATIENTS WITH H-TYPE ARTERIAL HYPERTENSION
Authors: Rekovets Oksana , Sirenko Yuriy , Torbas Olena , Kushnir Svitlana , Primak Galina , Krushynska Nina , Sirenko Olexandr , Granich Volodymyr , Sydorenko Petro , Polischuk Sergiy , Radchenko Ganna , Zhivilo Iryna
Published: April 2021

Objective:

The aim of our study was to evaluate the prevalence of hyperhomocystinemia in patients with mild to moderate hypertension, to investigate the relationship between hyperhomocystinemia with arterial stiffness.

Design and method:

In the study was included 40 patients with mild and moderate hypertension. Performed measurements of office SBP, DBP, (24AMBP), determination of pulse wave velocity in arteries of elastic (PWVel) and muscular (PWVm) types, central SBP, biochemical blood test with homocysteine. Homocysteine > = 10 μmol / l), the called H-type hypertension. Patients treatment mono-, dual or triple combination (telmisartane, amlodipine, hydrochlortiazide). All tests was performed before and after 6 month therapy. Statistical results was performed using the software IBM Statistics SPSS 21.

Results:

The mean age of patients was 55.85 ± 2.09 (26 – 74) years. The average body weight was 87.3 ± 2.77 kg. The average BMI is 29.41 ± 0.63 kg / m2. The average office SBP/DBP at the beginning of the study were 155.88 ± 1.63/92.60 ± 1.43 mm Hg. The average office heart rate 71.40 ± 1.29 beats / min. Mean 24 SBP/DBP monitoring were 139.37 ± 1.49/82.47 ± 1.84 mm Hg. The average daily heart rate 71.38 ± 1.32 beats / min. We found that at the beginning of the study, 75% (30 patients with mild and moderate hypertension) had elevated of blood homocysteine more than 10 μmol / l). PWV was associated after regression analyses with homocysteine. PWV el after treatment (r = 0,307, p = 0,001). PWV m after treatment (r = - 0,733, p = 0,001). Office SBP after treatment (r = 0,423, p < 0,001). Office DBP after treatment (r = - 0,675, p = 0,001). CKD-EPI after treatment (r = - 0,342, p = 0,005). BMI after treatment (r = 0,227, p = 0,026). Creatinine before treatment (r = -0,411, p = 0,003). Creatinine after treatment (r = 0,572, p = 0,011).

Conclusions:

Homocysteine associated with vascular stiffness, independent of the blood pressure reduction during treatment.
INTERDEPENDENCE BETWEEN LEFT VENTRICULAR DIASTOLIC DYSFUNCTION AND ARTERIAL ELASTICITY ALTERATION
Authors: Sapojnic Nadejda , Caraus Alexandru , Moscalu Vitalie , Durnea Aliona , Bitca Alina , Moiseeva Anna , Ciobanu Nicolae
Published: April 2021

Objective:

In HT, both arterial elasticity of the central arteries (C1) and of the distal circulation (C2) has been reported to be reduced and this condition favours the development of other cardiovascular diseases. Diastolic dysfunction (DD) identifies hypertensives with high cardiovascular risk independent of LV mass and BP level. Several studies have shown that the extent of diastolic function's impairment could be interdependent on the level of arterial elasticities’ alteration.

PURPOSE:

To evaluate the correlation between the elasticity of large and small arteries and DD

Design and method:

Arterial elasticity indices (C1, C2) were derived from pulse wave analysis based on a modified Windkessel model in 101 hypertensive subjects, (mean age 51.08 ± 0.79 yrs; 48.51% of men, SBP/DBP: 202.49 ± 7.41/106.7 ± 5.54 mmHg, BMI- 29.38 ± 0.22 kg/m2), without other co-morbidities. Ambulatory blood pressure monitoring (ABPM), transthoracic echocardiography (TE)were performed at baseline and after 6, 12- months period of treatment. DD patterns were appreciated according to ASE/EACVI 2016 guidelines. Altered arterial elasticity was considered for C1 < 10 ml/mm Hg × 10, C2 < 6 ml/mm Hg × 1. Correlation analysis was performed using Pearson's test. The correlation coefficient was considered weak at < 0.3, medium-0.3–0.7 and strong > 0.7–1.0. Statistical significance was appreciated at a P-value < 0.05 and highly significant at a P-value < 0.001

Results:

Diastolic dysfunction and C1 and C2 indices demonstrated a statistically significant correlation (p < 0.001). More advanced patterns of diastolic dysfunction were associated with higher C1 and C2 abnormalities (Tab. 1,).

Conclusions:

Diastolic dysfunction is associated with arterial elasticity's alteration, and this association appears to have a particularly strong relationship with the extent of diastolic function's impairment. The more advanced patterns of diastolic dysfunction occurred, the stronger is the interdependence with arterial elasticity abnormalities.
DATA FROM A POPULATION INTERVENTION STUDY FOR THE REDUCTION OF SALT INTAKE AND ACQUISITION OF HEALTHY FOOD HABITS
Authors: Polonia Jorge , Ismael Shamila , Mota Ines , Morais Juliana , Rodrigues Catarina , Castela Ines , Mendes Ines , Soares Maria Ines , Costa Luis , Oliveira Catarina B. , Henriques Tiago , Pinto Patricia , Pita Debora , Oliveira Catarina M. , Maciel Janaina , Serafim Thaina , Calhau Conceicao , Rosario Andre
Published: April 2021

Objective:

Salt restriction and potassium (K) intake can lower blood pressure (BP) and reduce the risk for cardiovascular (CV) diseases. However, it is still unclear which approaches are most effective in changing diet behavior. We evaluated the impact of two education prevention programs in promoting healthy eating habits in the general population.

Design and method:

A total of 311 adults (20–70 years) responsible for acquiring and making their meals were randomly assigned to one of the 2 multi-component educational programs (intervention and healthy lifestyle) during 12 weeks, consisting in face-to-face sessions, e-learning and telephone contacts. The healthy lifestyle program was an integrated approach addressing healthy food and lifestyle habits, including increase in K intake, while intervention was based on education and motivation strategies for reducing salt consumption. Training and clinical evaluation sessions occurred every 4 weeks and 24-h urine samples were collected at beginning and after 12 weeks.

Results:

269 subjects completed the study (71% women, mean age of 45 years). Groups were similar (mean values) at baseline: weight 75 Kg, BMI 27 kg/m2, waist 86 cm, salt intake 9.2 g/d, K+ 1.9 g/d and BP 116/74 mmHg. After 12 weeks the intake per week of vegetables and legumes doubled, while consumption increased of fruits and fish (50%) and of shellfish (30%) along with reduction of salty (6%) and processed foods (20%). After 12 weeks clinical improvements were similarly observed with both programs: reduction of BP by 2/2 ± 11/7 mmHg P < 0.01, body weight by 0.3 ± 2.1 Kg, P = 0.007) and Na/K ratio by 0.05 ± 0.36, P = 0.027). Benefits were greater in subjects eating salt above mean (from 10.3 g/d salt/d salt intake reduced by 0.6 ± 1.5 g/d; P = 0.001), eating K+ bellow the median (from 2.1 g/d K intake increased 0.1 ± 0.2 g/d; P < 0.001) and with BP above 130/85 mmHg (from 136/88, BP reduced 6/5 ± 14/8 mmHg P = 0.001).

Conclusions:

Both education programs showed a positive impact in weight, salt and K+ intakes and BP. Subjects with higher BP and / or salt intake were those who benefited most from these dietary approaches.
RETINAL WALL TO LUMEN RATIO IN PATIENTS WITH ANGINA AND NO CORONARY ARTERY DISEASE. AN EYE TO THE HEART
Authors: Muiesan Maria Lorenza , Paini Anna , De Ciuceis Carolina , Rosei Claudia Agabiti , Guarinoni Vittoria , Rossini Claudia , Salvetti Massimo , Bertacchini Fabio , Aggiusti Carlo , Rizzoni Damiano , Giubbini Raffaele , Curello Salvatore , Metra Marco
Published: April 2021

Objective:

The vasculature of the eye and of the heart share several common characteristics. Therefore, the easily accessible vessels of the eye may be considered, to some extent, a “window” to the heart. Aim of this study was to evaluate retinal arterioles morphological changes in patients with angina and nonobstructive coronary artery disease.

Design and method:

In 19 patients (M:W 11:8, mean age 71 + 6 years) with microvascular angina (MA), confirmed by normal coronary angiography and SPECT stress hypoperfusion and in 18 controls (C) (M:W 10:8, mean age 69 ± 6 years) with normal SPECT response, direct measurement of wall to lumen of retinal arterioles (W/L) using an adaptive optics (AO) imaging system (Imagine Eyes, Orsay, France) was performed. All subjects also underwent BP measurement with an automated oscillometric device (Omron HEM 9000Ai, mean of 3 measurements).

Results:

No differences in demographic and hemodynamic characteristics were observed between MA patients and C, except for BMI (BMI 30 ± 4.2 vs 24 ± 4 kg/m2, in MA and C respectively, p = 0.001). Retinal arterioles wall thickness (11.75 ± 1.45 vs 13.9 ± 1.53 microm), W/L ratio (0.29 ± 0.05 vs 0.25 ± 0.03 in MA and C respectively, p = 0.008) and wall cross sectional area (WCSA) (4876 ± 976 vs 4004 ± 872 microm2, respectively in MA and C, p = 0.012) were higher in MA patients as compared with C. Differences were confirmed after adjustment for BMI.

Conclusions:

Our findings suggest that in patients with angina and normal coronary arteries retinal structural changes may be observed.
MASKED HYPERTENSIVES AS ASSESSED WITH LASER SPECKLE CONTRAST IMAGING EXHIBIT IMPAIRED SKIN MICROVASCULAR REACTIVITY SIMILAR TO ESSENTIAL HYPERTENSIVE INDIVIDUALS
Authors: Lazaridis Antonios , Gkaliagkousi Eugenia , Triantafyllou Areti , Dipla Konstantina , Koletsos Nikolaos , Anyfanti Panagiota , Nikolaidou Barbara , Douma Stella
Published: April 2021

Objective:

Laser Speckle Contrast Imaging (LSCI) is a novel method to dynamically assess skin microcirculation with very high resolution and reproducibility compared to other laser methods. Skin microcirculation has been proposed as a model of generalized microvascular function and a potential biomarker in cardiovascular prognosis. Masked hypertension is considered a hypertension phenotype of substantial cardiovascular risk similar to essential hypertension (EH). In this study we evaluated skin microvascular reactivity in masked hypertensives as compared to hypertensives and healthy, normotensive individuals using LSCI coupled with post-occlusive reactive hyperemia (PORH) test.

Design and method:

We included 20 newly diagnosed masked hypertensives aged 50.0 ± 9.0 and compared them to 70 never treated, newly diagnosed patients with EH aged 49.5 ± 8.7 and 40 healthy, normotensive individuals aged 48.5 ± 8.5 years. Hypertension phenotypes were defined according to standard office and ambulatory blood pressure monitoring (ABPM) criteria. The Mobil-O-Graph-NG (IEM, Stolberg, Germany) device was used for ABPM. All subjects underwent forearm skin perfusion recording under standardized conditions using a LSCI device (PeriCam PSI NR System, Perimed, Järfälla, Sweden) coupled with PORH. Data were analyzed by manufacturer's software (PIMSoft, Perimed). Results were expressed as i) the percentage increase of perfusion from baseline to peak condition (%), and ii) the amplitude of PORH response expressed as the peak cutaneous vascular conductance (CVC) minus baseline CVC. The CVC was calculated as the flux of each time interval divided by mean arterial pressure (perfusion units [PU]/mmHg).

Results:

Masked hypertensives showed significantly lower percentage increase of perfusion from baseline to peak condition as compared to controls (155.4 ± 48.11 vs 190.54 ± 45.88, p = 0.013) but not compared to hypertensives (155.4 ± 48.11 vs 150.6 ± 41.93, p = NS), respectively. In addition, PORH amplitude was significantly lower in masked hypertensives as compared to controls (0.62 ± 0.2 vs 0.76 ± 0.2, p = 0.02) but no difference was found compared to hypertensives (0.62 ± 0.2 vs 0.52 ± 0.1, p = NS), respectively.

Conclusions:

Masked hypertensives, when assessed with LSCI coupled with PORH, present impaired skin microvascular reactivity as compared to healthy controls. However, their skin microvascular responses were similar to those of hypertensives, highlighting a state of increased microvascular damage in this hypertension phenotype.
RADIAL-FINGER PULSE WAVE VELOCITY: RESPONSE OF PERIPHERAL SMALLER ARTERIES TO NITROGLYCERIN
Authors: Fortier Catherine , Obeid Hasan , Garneau Charles-Antoine , Paré Mathilde , Marquis Karine , Agharazii Mohsen
Published: April 2021

Objective:

We previously demonstrated a different regional stiffness response of elastic and muscular arteries after the administration of nitroglycerin, leading to an alteration of aortic-brachial stiffness gradient. Peripheral smaller arteries may also respond differently to nitroglycerin. The objectives of this study were 1- to assess the feasibility of measuring arterial stiffness of the hand, i.e. radial-finger pulse wave velocity (RF-PWV) using piezoelectric sensors, and 2- to measure RF-PWV and its response to nitroglycerin.

Design and method:

This study was conducted in 29 healthy participants (66% were women, mean age was 40.0 ± 15.1 yrs). Piezoelectric sensors (Complior) were place simultaneously on carotid and radial arteries, and tip of the index and/or third finger, to obtain carotid-radial PWV (CR-PWV) and RF-PWV. These measurements were repeated with a subgroup of 11 subjects after 4 minutes of 0.4mg NTG sublingual spray. Raw data were analyzed using Matlab to ensure good quality of signals and adequacy of the foot-to-foot method.

Results:

Visually, pressure curves at both fingers were obtained with an excellent quality, similar to radial and carotid pressure curves. Identification of the feet of the finger pulse waveforms was optimal with the second derivative algorithm. RF-PWV intra-session coefficient of variation was 7.3%. At baseline, mean CR-PWV and RF-PWV were respectively of 8.21 ± 1.44 m/sec and 4.65 ± 1.42m/sec. After NTG, CR-PWV decreased (7.75 ± 1.32 m/s) and RF-PWV increased (6.75 ± 2.58 m/s), both significantly (p<0.01). However, stiffness of the whole upper limb (carotid-finger PWV) did not change significantly (7.37 ± 0.87 m/s vs 7.29 ± 1.08 m/s, p=0.605).

Conclusions:

This first attempt to measure regional stiffness of small arteries shows that it is possible to measure hand PWV. Again, we observed opposite changes in regional stiffness of different vascular territories with a vasodilator drug. These results may open up the path to a better understanding of microcirculation consequences of an altered stiffness gradient.
THE ROLE OF MANIDIPINE IN HYPERTENSIVE PATIENTS WITH MICROALBINURIA
Authors: Tsoutsouli Vasiliki , Paskalis Georgios-Charis , Sachla Zacharo , Koursioumbas Georgios , Foutsitsakis Dimos , Gkogkos Konstantinos
Published: April 2021

Objective:

Microalbuminuria is frequent in patients with established hypertension, and predicts increased cardiovascular risk in hypertensive patients and probably renal dysfunction. It is considered a routine measurement in hypertensive patients and treatment aims to decrease its prevalence. We aim to evaluate the possible role of CCB inhibitors on hypertension and microalbuminuria.

Design and method:

283 patients with hypertension and microalbuminuria were enrolled in the study, 130 men and 153 women, aged 40 to 70 years. Patients with diabetes mellitus were excluded. Manidipine 10 mg/daily was added for 6months to all patients, regardless if they received or not other anti-hypertension regimen and microalbuminuria was measured before the beginning of the treatment and after 6 months. Microalbuminuria levels were measured by 24-hour urine collection. Excretion between 30 mg/dL and 300 mg/dL was considered microalbuminuria.

Results:

The albumin excretion rate was decreased after 6 months of treatment by 24%. Microalbumin in 24-hour urine was reduced from a mean of 182 mg/dL to 138 mg/dL and in 15 patients (5%) microalbuminuria was not present in the second measurement (microalbumin < 30 mg/dL). Blood pressure was also reduced achieving blood-pressure goals in 40% of the patients.

Conclusions:

This study confirms that CCB inhibitors can play a role in the management of microalbuminuria, along with their well-known blood-pressure reduction effect. Study design did not allow subgroup analysis of the results according to other medication they received. The clinical significance of this level of reduction and its effect in reducing long-term renal damage or other clinical end-points has to be evaluated in further studies.
EVIDENCE HOW EPITHELIAL SODIUM CHANNEL PROMOTES STIFFNESS IN HUMAN AND MOUSE ENDOTHELIAL CELLS
Authors: Shah Vikash Kumar , Fronius Martin
Published: April 2021

Objective:

The epithelial sodium channels (ENaCs) in the kidney maintain body salt/water balance and contributes to blood pressure regulation and hypertension. Recent finding suggests that ENaCs in endothelial cells are potential players mediating endothelial cell stiffness (ECS). Increased ECS is an important determinant of hypertension that coincides with altered endothelial nitric oxide (NO) production and endothelial dysfunction. Herein, we aim to uncover the molecular mechanism how ENaC influences ECS. I hypothesize that F-actin changes as a potential target through which ENaC mediates its effect.

Design and method:

ENaC subunit protein levels in Human Umbilical Vein Endothelial Cells (HUVECs) and Mouse Myocardial Endothelial Cells (MyEnd) cells were quantified by Western blotting. Aldosterone was used to increase ENaC expression. Changes in ECS assessed with Atomic Force Microscopy (AFM). If changes in F-actin cell cytoskeleton is correlated with ENaC expression and ECS, immunofluorescence microscopy was used and quantified.

Results:

Aldosterone was observed to significantly increase alpha-ENaC (both in human and mouse cells) and delta-ENaC (human specific) protein levels which were reversed by the additional incubation with amiloride (ENaC blocker). The elevated ENaC expression with aldosterone was associated with an increased Young's modulus that is indicative of elevated ECS observed in both human and mouse endothelial cells. The upregulated ENaC expression and increased stiffness was also translated into increased F-actin in response to aldosterone.

Conclusions:

Taken together, our study provides experimental evidence of increased ENaC protein level with increased F-actin cell cytoskeleton in endothelial cells that may promote ECS. This is a new mechanism through which ENaC mediate ECS and contributes to endothelial dysfunction and hypertension.
RELATION OF SUBCUTANEOUS, VISCERAL, PERIAORTIC, EPICARDIAL ADIPOSE TISSUE WITH CAROTID ARTERY INTIMA-MEDIA THICKNESS IN YOUNG PEOPLE WITH ABDOMINAL OBESITY
Authors: Zheleznova Ekaterina , Zhernakova Yu , Chazova I. , Pogorelova O. , Tripoten M. , Balakhonova T. , Shariya M. , Blinova N. , Azimova M. , Gorieva Sh , Maslov A.
Published: April 2021

Objective:

The main aim of study was to investigate the association between subcutaneous (SF), visceral (VF), periaortic (PF), epicardial (EF) fat and carotid artery intima-media thickness (CIMT) in patients with abdominal obesity (AO) and whith metabolic syndrome (MS).

Design and method:

127 patients 18–45 y.o. (average age 38,4 ± 6,0) with AO (men (M) – 58,3%) were enrolled in study. Height, weight, BMI, waist circumference, blood tests (fast glucose (FG) and glucose tolerance (GT), lipid profile) were measured. MS was defined as AO (cut-off of > 80 cm in women (W) and > 94 cm in M) plus > 1 sign: HDL < 1,30 (w)/1,04 (m)mmol/l; triglycerides > 1,7mmol/l; FG > 5,6mmol/l; violation GT; BP > 140/90mmHg. The averaged TIM was measured on both sides in a longitudinal section in the distal third of thein left and right carotid artery at a distance of 1 cm proximal to the bifurcation, calculated as the maximum value of the two average values obtained during two successive measurements and direct access two consecutive measurements lateral access. SF, VF, PF, EF (range: -150 to -30 HU) was measured by computed tomography. We calculated ratio subcutaneous to visceral fat (RSV). 24 hour blood pressure monitoring was performed. We formed 2 groups: AO (AO plus 1 or less sing of MS) and MS.

Results:

No statistically significant difference between the groups was found in the assessment of TIM.Tab. 1. Correlations CIMT with age r = 0,406 (p = 0,000), BMI r = 0,225 (p = 0,000), WC r = 0,031 (p = 0,000), TG r = 0,215 (p = 0,013), daytime SBPm r = 0,187 (p = 0,031), with volume of VF r = 0,326 (p = 0,000), EF r = 0,329 (p = 0,000), PF r = 0,440 (p = 0,000), LDL r = 0,182 (p = 0,037) were found. An inverse correlation was found with RSV r = -0,241 (p = 0,005) and with HDL r = -0,239 (p = 0,005).

Conclusions:

This study shows the role of PVT and other fat depots in the development of structural and functional disorders of the vascular wall in young people. The revealed correlations prove the existence of a close pathogenetic relationship between obesity, lipid metabolism disorders and the state of the vascular wall.
A STUDY OF DETERMINANT OF BLOOD PRESSURE IN 6–9 YEAR OLD CHILDREN IN THE EASTERN CAPE OF SOUTH AFRICA
Authors: Nkeh-Chungag Benedicta Ngwenc , Matjuda Edna
Published: April 2021

Objective:

Objective: The objective of this study was to investigate the contribution of both anthropometric measurements and selected urinary markers of oxidative stress and endothelial function to blood pressure parameters in 6–9 year old children.

Design and method:

Study design: A cross sectional study design was used.

Methods:

306 male and female school children aged 6–9 years old were recruited for the study. Anthropometry was performed, followed by blood pressure and pulse wave velocity (PWV) measurements and collection of urine for determination of albumin-creatinine ratio (ACR), concentration of 8-Hydroxy-2’-deoxyguanosine (8-OHdG) and asymmetric dimethyl arginine (ADMA).

Results:

Results: Besides neck circumference (p less than 0.0001), PWV (p less than 0.01) and albumin-creatinine ratio (ACR) (p less than 0.0001), there were no differences in all measured parameters between boys and girls. The prevalence of overweight/obesity and hypertension/pre-hypertension in the cohort were 19.2% and 42.2% respectively. In girls systolic blood pressure (SBP) correlated with BMI (r = 0.43); NEC (r = 0.37); mid upper arm circumference (MUAC) (r = 0.51) and WC (r = 0.47) while diastolic blood pressure (DBP) correlated with NEC (r = 0.34); MUAC (r = 0.26), WC (r = 0.27). Heart rate (HR) correlated with SBP (r = 0.26). Pulse wave velocity correlated with SBP (r = 0.26); DBP (r = 0.31); DBP (r = 0.31). In boys however, the only correlation was between PWV and DBP (r = 0.29). Linear regression analysis showed that for every unit increase in mid upper arm circumference, SBP increased by 2.056 mmHg in the cohort. In females additionally, every unit increase in8-OHdG increased SBP by 0.171 mmHg.

Conclusions:

Conclusion: Neck circumference, PWV and ACR were different between boys and girls showing subtle difference in risk factors for hypertension even in these young children. The higher ACR values corresponded with higher PWV in boys though MUAC seemed to be the best predictor of blood pressure in the cohort.
ALTERATIONS IN ANTHROPOMETRIC, PHYSIOLOGICAL AND BIOCHEMICAL PARAMETERS DURING A COMPLEX EXERCISE AND DIETARY TREATMENT PROGRAM FOR OBESE PATIENTS WITH CONTROLLED HYPERTENSION
Authors: Jenei Zoltán , Horváth Ágnes , Nagy Adél , Seres Ildikó , Paragh György , Fülöp Péter
Published: April 2021

Objective:

Obesity and hypertension are considered as major risk factors of for cardiovascular diseases. Besides unfavorable metabolic processes, altered levels of pro-inflammatory factors and adipokines produced by the white adipose tissue have various role in atherogenesis. In our study, we aimed to investigate the impact of exercise and dietary therapies on these unfavorable processes in obese, controlled hypertensive patients.

Design and method:

Forty-two obese subjects with controlled hypertension were enrolled in our six-week self-controlled clinical trial. The load capacity was assessed by ergospirometry and the maximum VO2 uptake (VO2max), respiratory anaerobic threshold (V-slope) and maximum metabolic equivalent (MET) were determined. Body composition analysis and six- minute walking test (6MWT) were also performed. We also investigated serum lipid parameters, high-sensitivity C-reactive protein (hsCRP) levels, oxidized low-density lipoprotein (oxLDL) concentrations, paraoxonase (PON1) activities and calculated the homeostatic model assessment (HOMA)-insulin resistance (HOMA-IR). Serum adipokine levels including leptin, adiponectin, tumor necrosis factor (TNF)-alfa, chemerin, resistin, lipocalin-2 concentrations were also measured. All of our tests were repeated at the end of the six-week program, during which, the patients received 3 x 50 minutes of exercise training. Dietotherapy was also provided twice a week.

Results:

Each patient completed the program (age: 58.12 ± 10.4 years, M/F: 9/33, initial mean body mass index /BMI/: 44.24 ± 7.22 kg/m2, mean blood pressure /BP/: 132,21 ± 5,74 mmHg). At the end of the program, BMI and BP were significantly reduced (p < 0.00001, p < 0.01, respectively), with improvement in all functional tests (p < 0.0001), VO2max (p < 0.000002) and in V-slope (p = 0.001). LDL-cholesterol and oxLDL concentrations decreased significantly (p = 0.0005, p = 0.0009, respectively), while high-density lipoprotein (HDL)-cholesterol levels showed a significant increase (p = 0.0028). HOMA-IR also improved significantly (p = 0.006) and the percentage of body fat mass was reduced significantly (p = 0.000036). Among the adipokines, only the circulating concentrations of lipocalin-2 and leptin were significantly decreased (p = 0.036, p < 0.000001, respectively). HsCRP concentration and PON activity were also found to be significantly reduced (p < 0.00001, p = 0.0032, respectively).

Conclusions:

Besides its beneficial physiological effects, an aerobic exercise program combined with dietotherapy improves pro-atherogenic, pro-inflammatory and metabolic factors in obese patients with controlled hypertension.
AFRICAN'S LEAF (VERNONIA AMYGDALINA) EXTRACT EFFECT FOR TRYGLICERIDE LEVEL ON WISTAR RAT WITH METABOLIC SYNDROME
Authors: Kresna Deva Bayu , Widiasih Alifah Wahyu , Imani Namira Putri , Budiani Dyah Ratna , Hermawan Danus
Published: April 2021

Objective:

This study was designed to determine the effect of African's leaf (Vernonia amygdalina) extract towards triglyceride level of Wistar rats (Rattus norvegicus) with metabolic syndrome model.

Design and method:

The research was laboratory experimental research using pretest- posttest control group design. It included 30 male Wistar rats that were divided into 5 groups of normal control group (KKn), positive control group (KKp), and treatment groups (KP1, KP2, KP3). KKp, KP1, KP2 and KP3 were metabolic syndrome induced, fed with high fat high fructose diet and were given with STZ- Na injection. KP1, KP2 and KP3 were given treament of ethanolic extract of Vernonia amygdalina with dosage 50 mg/KgBW, 100 mg/KgBW, and 150 mg/KgBW respectively. Metabolic syndrome induction were done with high fat high fructose diet for 31 days and injection of STZ-Na on the 28th. Treatment groups got the extract of Vernonia amygdalina for 28 days subsequent to metabolic syndrome induction. The result data of trygliceride level were analyzed using one way ANOVA and Post-Hoc Tukey.

Results:

There was a significant differences of trygliceride level between day 32th and 61st with p = 0.000 (p < 0,05) on all groups. Decreased level of trygliceride were showed the highest on KP3 with mean different value 28,7476 mg/dL, followed by KP1 with 23,7983 mg/dL, and KP2 with 20,8933 mg/dL.

Conclusions:

Extract of African's leaf (Vernonia amygdalina) has a significant effect of lowering trygliceride level.
OBESITY-RELATED CHANGES IN DIASTOLIC FUNCTION AND LEFT ATRIAL IN PATIENTS WITH RECURRENT ATRIAL FIBRILLATION AND PRESERVED EJECTION FRACTION: DOES GENDER MATTER?
Authors: Kokhan Elizaveta , Kiyakbaev Gayrat , Kobalava Zhanna
Published: April 2021

Objective:

Both diastolic dysfunction (DD) and left atrial (LA) remodeling are closely associated with each other as well as with atrial fibrillation (AF) and heart failure with preserved ejection fraction. Obesity was traditionally considered to be a state of chronic volume overload, neurohumoral activation and, therefore, heart remodeling. But the data concerning relationship between obesity, DD and LA remodeling depending on gender is scarce. We aimed to evaluate the impact of gender on the association between body mass index (BMI), the presence of obesity and DD, LA remodeling in patients with recurrent AF, hypertension and preserved ejection fraction.

Design and method:

Twenty seven men and 28 women (median age of 65 [60;72]) with recurrent AF, hypertension and preserved ejection fraction (>50%) were enrolled in this study. Beyond conventional echocardiographic protocol, global peak LA longitudinal strain (PALS, %) in the reservoir (r) and contractile (c) phases was measured using two-dimensional speckle tracking echocardiography.

Results:

There were no significant differences between women and men in most clinical and demographic parameters including, duration of hypertension (65 vs 67 moths, respectively; p = 0.88) and AF (37 vs 42 moths, respectively; p = 0.83). DD was significantly more pronounced in women [E/E’ (13 vs 11.2; p = 0.03), but both groups had similar LA-volume index (41 vs 41 ml/m2; p = 0.97), PALSr (12.6 vs 12.4% p = 0.64) and PALSc (-12.9 vs -12.4% p = 0.65). Women, but not men, had significant association between BMI and PALSc (r = 0.6; p < 0.001 vs r = 0.2; p = 0.24), E’ (r = -0.41; p = 0.03 vs r = -0.04; p = 0.84); interaction p for PALSc = 0.043 and for E’ = 0.1. Only in women subgroups of patients with and without obesity differed by LA size (45 vs 36 mm p = 0.006), PALSr (11.7 vs 14.8% p = 0.03), PALSc (-12.5 vs -16.2% p = 0.002) and E’ (0.05 vs 0.07 m/s p = 0.02).

Conclusions:

Patients of both genders had similar patterns of LA remodeling. But only in women was diastolic relaxation and left atrial structural and functional parameters significantly related to BMI and the presence of obesity. It might indicate a higher susceptibility of the women's heart to remodeling associated with overweight.
LOW DOSE-EPLERENONE TREATMENT DECREASES AORTIC STIFFNESS IN PATIENTS WITH METABOLIC SYNDROME
Authors: Kannenkeril Dennis , Bosch Agnes , Kolwelter Julie , Striepe Kristina , Ott Christian , Schiffer Mario , Schmieder Roland E.
Published: April 2021

Objective:

Metabolic syndorme is a well-established cardiovascular risk factor with increasing prevalence and incidence globally. Our aim in this study was to analyse the effect of a low dose steroidal mineralocorticoid receptor antagonist on metabolic parameters, aortic stiffness parameters and endothelial function (as assessed by measuring baseline nitric oxide activity) of the macrovasculature in patients with metabolic syndrome.

Design and method:

Patients with mild uncomplicated primary arterial hypertension and at least 2 of the following traits of the metabolic syndrome (Adult Treatment Panel III criteria: abdominal obesity (abdominal girth > 102 cm in males), triglyceride level > 150 mg/dL or treatment for elevated triglycerides, HDL < 40 mg/dL or treatment for low HDL, fasting blood glucose > 100 mg/dL and < 126 mg/dl) were included in the study. After the wash-out of antihypertensive medication (if applicable), patients were treated with eplerenone (EPL) 25 mg for the next 10 weeks. Pulse wave analysis was performed before and after infusion of L-NMMA (=nitric oxide-synthase inhibitor) at baseline and after treatment with EPL.

Results:

In patients with metabolic syndrome (n = 23), HbA1c (5.8 ± 0.3 vs. 6.0 ± 0.3 %; p = 0.012) and HDL (41.5 ± 8.1 vs. 44.1 ± 10 mg/dl; p = 0.046) increased significantly with EPL treatment. Central systolic pressure (132 ± 11.6 vs. 124.8 ± 12.9 mmHg; p = 0.015), augmentation pressure (15.2 ± 26.9 vs. 11.9 ± 23.1 mmHg; p = 0.011), augmentation index (22.5 ± 7.8 vs. 18 ± 11.1 %; p = 0.028, independent of systolic office blood pressure (BP) reduction), and augmentation index normalized to heart rate of 75/min (18.6 ± 7.8 vs. 14.5 ± 8.8 %; p = 0.006, independent of systolic office BP reduction) reduced significantly with EPL treatment. Augmentation index normalized to heart rate of 75/min increased significantly with infusion of L-NMMA after treatment with EPL (14.7 ± 8.8 vs. 17.6 ± 8.3 %; p = 0.004), whereas no such difference could be noticed at baseline (p = 0.230) thereby indicating an increased nitric oxide availability.

Conclusions:

Our data show that EPL beneficially affects markers of arterial stiffness in patients with metabolic syndrome, independent of systolic office BP reduction. Whether the observed benefits could be noticed with nonsteroidal mineralocorticoid receptor antagonists without change in metabolic parameters warrants further investigation.
PROVINCIAL DISPARITIES IN THE BURDEN OF CARDIOVASCULAR DISEASES ATTRIBUTABLE TO GENERAL, ABDOMINAL AND VISCERAL ADIPOSITY: RESULT FROM A RECENT NATIONAL REPRESENTATIVE STUDY
Authors: Kang Yuting , Wang Xin , Chen Zuo , Jiang Linlin , Zheng Congyi , Yin Peng , Dong Wenlan , Zhang Linfeng , Zhou Maigeng , Wang Zengwu , Gao Runlin
Published: April 2021

Objective:

Recent data suggest that the burden of cardiovascular diseases (CVD) attributable to adipose differed by regions, while the disparity have not been fully discussed before in Chinese population.

Design and method:

Data on participants aged 35 years or over selected from China Hypertension Survey (CHS) was used to calculate prevalence of adipose. Meanwhile, cohort data selected randomly from CHS was used to calculate the multivariable-adjusted HRs by Cox regression. HRs along with the adipose prevalence were used to calculate the PAF.

Results:

During a mean of 4.56 years of follow up, 1,109 participants experienced at least a cardiovascular event. At national level, the PAF of CVD was 6.20 % [95% confidential interval (CI): 6.16%-6.24%] for overweight, 7.08% (95%CI: 6.99%-7.17%) for obesity, 13.30% (95%CI: 13.21%-13.37%) for abdominal obesity, 8.99% (95%CI: 8.94%-9.04%) for body fat percentage, and 5.14% (95%CI: 5.07%-5.21%) for visceral adipose index. At province level, the PAFs for obesity ranged from 13.31% in Tianjin to 2.37% in Hainan, from 20.78% in Tianjin to 5.38% in Hainan for abdominal obesity, with highest PAFs being in north and and west provinces, lowest in south and costal provinces.

Conclusions:

Our estimates are strikingly different across geographic regions, with a large proportion of CVD in China are attributable to adipose, including body fat percentage. Our findings support developing both national and provincially-specific strategies to reduce the burden of CVD and disparity in China.
THE ROLE OF ANGIOTENSIN II RECEPTOR BLOCKERS IN THE FUNCTION AND MORPHOLOGY OF PLATELETS IN HYPERTENSIVE PATIENTS
Authors: Konstantinou K. , Tsioufis K. , Kouremeti M. , Mantzouranis M. , Leontsinis I. , Tolis P. , Anastasiou A. , Iliakis P. , Tousoulis D.
Published: April 2021

Objective:

Activation of platelet angiotensin receptors could potentially contribute to further progression of thrombotic events in hypertension. The aim of our study was to investigate the effect of antihypertensive therapy with ARBs on platelet function and morphology in a population of untreated hypertensive patients.

Design and method:

120 untreated hypertensive patients(mean age 51 years; office blood pressure: 153/87 ± 7.3 mmHg, 55% males; 56% smokers)were divided into groups based on ARBs treatment (group 1) or no (group 2) and were prospectively followed up. Group 1 was further classified into 2 subgroups with subgroup 1 (n = 50) receiving Olmesartan and subgroup 2(n = 50)receiving Candesartan. Platelet function was assessed at baseline and at 40 days by means of a PFA-100 analyzer using epinephrine (EPI) and ADP. Time to aperture occlusion, closure time (CT),was recorded in seconds. Additionally, clotting times, mean platelet volume (MPV), vWf:Ag and fibrinogen levels were assessed.

Results:

At baseline, platelet activity was determined(PFA CTEPI, PFA CTADP)with no statistically significant differences between groups. At reassessment, changes in both CT- PFAEPI and CT-PFAADP were found between groups(group 1: CT-PFAEPI = 138.9 ± 22.3 sec, group 2: CT-PFAEPI = 104.9 ± 22.9 sec, group 1: CT-PFAADP = 85.5 ± 18.6 sec and group 2: CT-PFAADP = 81.5 ± 11.9 sec). However, after checking the significance of these changes (δ)it was found that only CT-PFAEPI change (δ) difference between treatment groups reached statistical significance(group 2 vs subgroup 1: δCT-PFAEPI21.8 [95% CI (2.17 – 41.4)],p = 0,025, group 2 vs subgroup 2: δCT-PFAEPI20.7 [95% CI (1.09 – 40.3)], p = 0.035, subgroup 1 vs subgroup 2: δCT-PFAEPI 1.08[95% CI (-15.3 – 17.4)], p = NS). During follow-up, treatment with ARBs was associated with significant lowering of fibrinogen (from 341.7 ± 62.2 to 316.3 ± 61.8 mg/dl, p < 0.001),MPV levels (from 10.4 ± 0.91 to 8.8 ± 0.9fL, p < 0.001) and vWf:Ag (from 103.2 ± 6.7 to 93.8 ± 7.1)with no corresponding reductions in group 2. After multivariate analysis,CT-PFAEPI changes(δ)were significantly correlated only with ARBs(p < 0.001),irrespectively of specific drug.

Conclusions:

The present study indicates that treatment with ARBs contributes to downregulation of platelet activity in hypertension, suggesting that it could offer additional cardiovascular benefit in hypertensive patients.
DEVELOPING A MOST EQUIVALENT ALDOSTERONE MEASUREMENT TO LC-MS/MS BY A NOVEL HIGH-QUANTITATIVE NONCOMPETITIVE CHEMILUMINESCENCE IMMUNOASSAY
Authors: Satoh Fumitoshi , Ono Yoshikiyo , Tezuka Yuta , Omata Kei , Yamanami Hiroaki , Morimoto Ryo , Ito Sadayoshi
Published: April 2021

Objective:

Measurement of plasma aldosterone and renin concentration, or activity, is useful for selecting antihypertensive agents and detecting hyperaldosteronism in hypertensive patients. However, it takes several days to get results even if measured by inaccurate radioimmunoassay, or we must accept high-cost LC/MS, and development of a more rapid and accurate substitute has been long hoped. We have developed a novel, fully-automated, high-quantitative noncompetitive chemiluminescence immunoassay (NC-CLEIA) for detecting aldosterone in serum and plasma, and its performance is evaluated as compared to LC/MS measurement.

Design and method:

Recently a unique anti-metatype antibody, which recognizes the immunocomplex of aldosterone and its monoclonal antibody, was established. Using this antibody for sensing permitted the construction of non-competitive assay for the detection of aldosterone. The reaction protocol of novel aldosterone assay is the following. In the 1st reaction, aldosterone in patient's sample is captured on anti-body coated magnetic particles. Alkaline phosphatase-conjugated anti-metatype antibody is added and incubated as 2nd reaction following a wash. Then substrate solution is added after washing immunocomplex. The resulting reaction signals are proportional to the amount of aldosterone in the sample allowing quantitative determination of in serum or plasma sample. The overall reaction is completed within 30 min.

Results:

Limit of blank (LoB), limit of detection (LoD) and limit of quantitation (LoQ) of our NC-CLEIA aldosterone assay were 0.09 ng/dL, 0.21 ng/dL and 0.57 ng/dL, respectively. NC-CLEIA aldosterone measurements were linearly well correlated with LC/MS aldosterone measurements (N = 130, y = 1.027x - 0.23 ng/dL, Spearman's p = 0.996, p < 0.0001). Bland-Altman plot analysis between NC-CLEIA and LC-MS/MS of aldosterone revealed a bias of 0.40 ng/dL with the limits of agreement of -4.60 and 5.41 ng/dL with 95% confidence interval.

Conclusions:

Our novel NC-CLEIA aldosterone assay was well-correlated and had only a very low bias with LC-MS/MS method and also was able to accurately quantify low level samples even in essential hypertension patients. This assay may be useful for the routine analysis of aldosterone and for the screening and diagnosis of PA from large number of hypertensive patients.