5.4 Pulse Wave Velocity Distribution in a Cohort Study–from Arterial Stiffness to Early Vascular Ageing (Eva)

Cunha, Pedro; Cotter, Jorge; Oliveira, Pedro; Vila, Isabel; Boutouyrie, P.; Laurent, Stéphane; Nilsson, Peter M.; Scuteri, Angelo; Sousa, Nuno

doi:10.1016/j.artres.2014.09.078

Cited by 34 publications

(53 citation statements)

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“…Also, we should not overlook the differences in the methodology for measuring PWV, even though good correlations of the oscillometric method have been previously reported, either with tonometric devices or with invasive catheter measurements . Such arguments could also support the explanation for the differences in large artery damage seen in our cohort (26.7%) as compared with the Cunha et al report (18.7%), even though mean PWV was similar in both studies, was higher in males and increased non‐linearly with aging. The recorded PWV across age strata was similar to those previously reported in the sub‐analysis of the EDIVA study by Pereira et al…”

Section: Discussionsupporting

confidence: 89%

“…This overall cardiovascular risk pattern explains the high prevalence of increased AS in the cohort, reaching 19.8%, being most common in males and increasing with aging. A higher prevalence of increased AS was therefore reported as compared with previous results, in which a prevalence of 12.5% was estimated in a cohort of 2542 Portuguese adults in the north region of Portugal . This difference may result either from dissimilarities in cohort size, and/or the cohort composition, considering that the ASINPHAR cohort enrolled participants in a different setting (pharmacies) from different regions of the country.…”

Section: Discussioncontrasting

confidence: 51%

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Measurement of arterial stiffness and vascular aging in community pharmacies—The ASINPHAR@2action project

Pereira

Paulino²,

Maximiano³

et al. 2019

J of Clinical Hypertension

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The ASINPHAR@2action project aims at raising awareness to arterial stiffness (AS) and early vascular aging (EVA) through a community pharmacy–based intervention. This preliminary analysis is focused on the analysis of the proportion of participants with increased AS and the identification of its main determinants. We performed an observational cross‐sectional study of participants enrolled in 11 community pharmacies in Portugal, between April and November 2017. Blood pressure (BP) and arterial function parameters were measured with a validated device. Clinical and demographic information was gathered, as well as the estimation of global cardiovascular risk, health‐related quality of life, and dietary profile. Cholesterol and glycaemia were taken from a recent laboratory bulletin. The cohort includes 658 participants with a mean age of 57.3 ± 16.3 years, 66% women. Brachial BP was 126.6 ± 16.4 mm Hg and 79.9 ± 11.5 mm Hg, and central BP was 115.8 ± 15.4 mm Hg and 81.2 ± 11.6 mm Hg, respectively, for systolic and diastolic BP. Mean pulse wave velocity (PWV) was 8.5 ± 2.3 m/s, and the augmentation index was 23.6 ± 15.6%. The proportion of participants with increased AS was 19.8%. The overall best‐fitting model for AS included age, gender, aortic PP, visceral fat, HDL cholesterol, AIx@75, total vascular resistance, hypertension, and diabetes, corresponding to an AUC of 0.910 (CI: 0.883, 0.937; P < 0.001) in the ROC curve analysis. The preliminary results of this pioneering large‐scale study measuring arterial function in community pharmacies provide the grounds for the operationalization of subclinical target organ damage screening in pharmacies, as a strategy to improve cardiovascular risk monitoring and to promote adherence to treatment.

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Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 51%

Measurement of arterial stiffness and vascular aging in community pharmacies—The ASINPHAR@2action project

Pereira

Paulino²,

Maximiano³

et al. 2019

J of Clinical Hypertension

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“…Interestingly, large artery stiffening shows a broadly similar behavior with aging, supporting the hypothesis of a cause-effect relationship between the 2 alterations. 30 In the peripheral muscular arteries, hypertrophy and remodeling serve to offset the excessive pressure pulsatility associated with aortic stiffness to protect capillaries in the parenchymal organs from barotrauma. However, these structural changes potentially result in impaired matching between metabolic demand and local perfusion, leading to chronic kidney disease and cognitive decline.…”

Section: Discussionmentioning

confidence: 99%

Different Impact of Essential Hypertension on Structural and Functional Age-Related Vascular Changes

et al. 2017

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T he endothelium plays a crucial role in acute regulation of vascular tone and in long-term vascular remodeling. In healthy conditions, nitric oxide (NO) is the most important endothelium-derived vasodilator molecule able to inhibit the major key mechanisms promoting the development of atherosclerosis, thus, promoting vascular health.1 NO breakdown by reactive oxygen species (ROS) is the main cause of reduced NO availability and endothelial dysfunction, both in physiological aging and in many pathological conditions, including arterial hypertension.1,2 Hypertension is supposed to induce early vascular aging in different arterial districts. However, vascular features of physiological aging and hypertension are not necessarily similar. With respect to endothelial function, essential hypertensive patients (HT) show a reduced response to acetylcholine (Ach) as compared with normotensive individuals (NT) in each age range. However, with increasing age, vascular response to Ach is similarly reduced among HT and NT. 3,4 Vascular structure changes in the microcirculation represent another hallmark of essential hypertension. 5,6 Increased media to lumen ratio (M/L), which characterizes vascular remodeling, can result from a reduced outer diameter that narrows the lumen without net growth (eutrophic remodeling) or from a thicker media encroaching on the lumen (hypertrophic remodeling). Eutrophic remodeling is most often found in essential hypertension. 7-9 M/L is considered the most reproducible index of small resistance artery structure, 10,11 with a relevant prognostic value, being associated with increased prevalence of cardiovascular events in a high-risk population. 12 Vascular fibrosis is critically important in determining vascular remodeling in hypertension, and it involves, among others, changes in collagen deposition. 13,14 The impact of physiological aging on microvascular structure and the role of vascular fibrosis are still unknown. Therefore, in the present study, we evaluated whether vascular remodeling is physiologically present with advancing age at the level of peripheral small resistance arteries. We also assessed whether the hypertensive disease causes an acceleration of the aging process for vascular function and structure. Collagen deposition as a Abstract-We evaluated whether vascular remodeling is present in physiological aging and whether hypertension accelerates the aging process for vascular function and structure. Small arteries from 42 essential hypertensive patients (HT) and 41 normotensive individuals (NT) were dissected after subcutaneous biopsy. Endothelium-dependent vasodilation (pressurized myograph) was assessed by acetylcholine, repeated under the nitric oxide synthase inhibitor N-nitro-larginine methylester or the antioxidant tempol. Structure was evaluated by media-lumen ratio (M/L). Intravascular oxidative generation and collagen deposition were assessed. Inhibition by N-nitro-l-arginine methylester on ACh was inversely related to age in both groups (P<0.0001) and blunted in HT vers...

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“…Existing studies show controversial results with respect to sex‐related differences in cfPWV. Moreover, the influence of sex on AS remains to be defined . Considering the above‐mentioned discrepancies, the need for sex‐specific cfPWV percentiles and RIs obtained in a large healthy Argentinean cohort is evident.…”

Section: Introductionmentioning

confidence: 99%

Reference intervals and percentiles for carotid‐femoral pulse wave velocity in a healthy population aged between 9 and 87 years

Díaz¹,

Zócalo

Bia

et al. 2018

J of Clinical Hypertension

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There is little information regarding age‐related reference intervals (RIs) of carotid‐femoral pulse wave velocity (cfPWV) for large healthy populations in South America. The aims of this study were to determine cfPWV RIs and percentiles in a cohort of healthy children, adolescents, and adults and to generate year‐to‐year percentile curves and body‐height percentile curves for children and adolescents. cfPWV was measured in 1722 healthy participants with no cardiovascular risk factors (9–87 years, 60% men). First, RIs were evaluated for males and females through correlation and covariate analysis. Then, mean and standard deviation age‐related equations were obtained for cfPWV using parametric regression methods based on fractional polynomials and age‐specific (year‐to‐year) percentile curves that were defined using the standard normal distribution. Age‐specific first, 2.5th, 5th, 10th, 25th, 50th, 75th, 90th, 95th, 97.5th, and 99th percentile curves were calculated. Finally, height‐related cfPWV percentile curves for children and adolescents (<21 years) were established. After adjusting for age and blood pressure differences with respect to females, males showed higher cfPWV levels (6.60 vs 6.45 m/s; P < .01). Thus, specific RIs for males and females were reported. The study provides the largest database to date concerning cfPWV in healthy people from Argentina. Specific RIs and percentiles of cfPWV are now available according to age and sex. Specific percentiles of cfPWV according to body height were reported for people younger than 21 years.

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5.4 Pulse Wave Velocity Distribution in a Cohort Study–from Arterial Stiffness to Early Vascular Ageing (Eva)

Cited by 34 publications

References 0 publications

Measurement of arterial stiffness and vascular aging in community pharmacies—The ASINPHAR@2action project

Measurement of arterial stiffness and vascular aging in community pharmacies—The ASINPHAR@2action project

Different Impact of Essential Hypertension on Structural and Functional Age-Related Vascular Changes

Reference intervals and percentiles for carotid‐femoral pulse wave velocity in a healthy population aged between 9 and 87 years

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