Aortic blood pressure (BP) and 24-h ambulatory BP are both better associated with target organ damage than office brachial BP. However, it remains unclear whether a combination of these two techniques would be the optimal methodology to evaluate patients' BP in terms of left ventricular diastolic dysfunction (LVDD) prevention. In 230 participants, office brachial and aortic BPs were measured by a validated BP monitor and a tonometry-based device, respectively. 24-h ambulatory brachial and aortic BPs were measured by a validated ambulatory BP monitor (Mobil-O-Graph, Germany). Systematic assessment of patients' LVDD was performed. After adjustment for age, gender, hypertension and antihypertensive treatment, septum and lateral E/Ea were significantly associated with office aortic systolic BP (SBP) and pulse pressure (PP) and 24-h brachial and aortic SBP and PP (P ⩽ 0.04), but not with office brachial BP (P ⩾ 0.09). Similarly, 1 standard deviation in SBP was significantly associated with 97.8 ± 20.9, 86.4 ± 22.9, 74.1 ± 23.3 and 51.3 ± 22.6 in septum E/Ea and 68.6 ± 2 0.1, 54.2 ± 21.9, 37.9 ± 22.4 and 23.1 ± 21.4 in lateral E/Ea, for office and 24-h aortic and brachial SBP, respectively. In qualitative analysis, except for office brachial BP, office aortic and 24-h brachial and aortic BPs were all significantly associated with LVDD (P ⩽ 0.03), with the highest odds ratio in 24-h aortic SBP. Furthermore, aortic BP, no matter in the office or 24-h ambulatory setting, showed the largest area under receiver operating characteristic curves (P ⩽ 0.02). In conclusion, 24-h aortic BP is superior to other BPs in the association with LVDD.
Diabetes complications increase with disease duration. No study was performed on the relationship between aortic stiffness and diabetes duration, taking into account the respective influence of such factors on macro- and microcirculation. In total, 618 subjects with type 2 diabetes (259 men) attending the Department of Internal Medicine of Tizi Ouzou Hospital (Algeria) were studied in collaboration with Hotel-Dieu Hospital (Paris, France). Brachial blood pressure (BP), anthropometric, clinical and biological data were evaluated. Aortic stiffness was estimated by carotid-femoral pulse wave velocity (PWV). From lower to higher tertile of diabetes duration, age, BP and PWV (10.1±2.7 to 12.3±2.8 m s) increased, while diabetes control and renal function worsened (all P<0.01). Diabetes duration was independently associated with PWV (R=0.035, P<0.0001), even after adjustment for age, BP, heart rate, cardiovascular events and metabolic syndrome. Diabetes duration was significantly correlated to the prevalence of microalbuminuria (OR (95% CL) 1.3 (1.06-1.63), P=0.01), independently of age, sex, BP and renal function. Increased aortic stiffness was independently associated with the prevalence of cardiovascular events (P<0.001), reaching its maximal value above the first 2 years of diabetes duration. In conclusion, diabetes duration is an independent determinant of aortic stiffness in subjects with type 2 diabetes, representing about 4% of PWV variability. Diabetes duration is associated with microvascular complications independently of renal function, and with macrovascular complications through the presence of increased aortic stiffness.
Specific cerebral responses to CBT instructions could be detected with continuous electroencephalograms and related to orthodontic pain processing, which may provide a new insight in exploring CBT for orthodontic pain control.
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