Aortic Pressure Augmentation Predicts Adverse Cardiovascular Events in Patients With Established Coronary Artery Disease

Chirinos, Julio A.; Zambrano, Juan P.; Chakko, Simon; Veerani, Anila; Schob, Alan; Willens, Howard J.; Pérez, Guido O.; Mendez, Armando J.

doi:10.1161/01.hyp.0000165025.16381.44

Cited by 331 publications

(220 citation statements)

References 43 publications

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“…16 An invasive study in male subjects undergoing cardiac catheterization for presumed coronary artery disease related intra-aortic AI to outcome. 32 It may be that in our cohort with a low prevalence (7%) of known vascular disease, other factors including hypertension become more relevant in determining outcome than vascular stiffness. Another possibility in those on hemodialysis is the presence of an arteriovenous fistula, which has been shown to alter arterial hemo- dynamics, and it could be possible that AI measures other factors in addition to central arterial wave reflection in participants with such a large arteriovenous fistula.…”

Section: Discussionmentioning

confidence: 89%

Brachial Blood Pressure But Not Carotid Arterial Waveforms Predict Cardiovascular Events in Elderly Female Hypertensives

Dart¹,

Gatzka²,

Kingwell³

et al. 2006

Hypertension

172

105

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Abstract-Central arterial waveforms and related indices of large artery properties can be determined with relative ease.This would make them an attractive adjunct in the risk stratification for cardiovascular disease. Although they have been associated with some classical risk factors and the presence of coronary disease, their prospective value in predicting cardiovascular outcomes is unknown. The present study determined the relative predictive value for cardiovascular disease-free survival of large artery properties as compared with noninvasive brachial blood pressure alone in a population of elderly female hypertensive subjects. We measured systemic arterial compliance, central systolic pressure, and carotid augmentation index in a subset of female participants in the Second Australian National Blood Pressure Study (untreated blood pressure 169/88Ϯ12/8 mm Hg). There were a total of 53 defined events during a median of 4.

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Section: Discussionmentioning

confidence: 89%

Brachial Blood Pressure But Not Carotid Arterial Waveforms Predict Cardiovascular Events in Elderly Female Hypertensives

Dart¹,

Gatzka²,

Kingwell³

et al. 2006

Hypertension

172

105

View full text Add to dashboard Cite

show abstract

“…In this study, the treatment was more effective with subjects who fulfilled the International Diabetes Federation criteria for MS. The result is important, because a 10% elevation in AIx increases the risk of major adverse cardiovascular events by 28% in patients with coronary artery disease and patients with MS are a high-risk group (Chirinos et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

Long-term intervention with Lactobacillus helveticus fermented milk reduces augmentation index in hypertensive subjects

et al. 2010

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Background: The milk casein-derived biologically active tripeptides, isoleucyl-prolyl-proline (Ile-Pro-Pro) and valyl-prolyl-proline (Val-Pro-Pro), have documented antihypertensive effect probably related to reduced angiotensin formation. It has been suggested that these tripeptides may reduce arterial stiffness and improve endothelial function. Our aim was to evaluate whether the milk-based drink containing Ile-Pro-Pro and Val-Pro-Pro influence arterial stiffness, measured as augmentation index (AIx), and endothelial function in man. Methods: In a double-blind parallel group intervention study, 89 hypertensive subjects received daily peptide milk containing a low dose of tripeptides (5 mg/day) for 12 weeks and a high dose (50 mg/day) for the following 12 weeks, or a placebo milk drink to titrate the dose-response effect. Arterial stiffness was assessed by pulse wave analysis at the beginning and end of each intervention period. Endothelial function was tested by examining pulse wave reflection response to sublingual nitroglycerin and salbutamol inhalation. Blood pressure was measured by using office and 24-h ambulatory blood pressure measurement. Results: At the end of the second intervention period, AIx decreased significantly in the peptide group compared with the placebo group (peptide group À1.53% (95% confidence interval (CI) À2.95 to À0.12), placebo group 1.20% (95% CI 0.09-2.32), P ¼ 0 Á 013). No change in endothelial function index was observed (peptide group 0.02 (95% CI À0.06 to 0.08), placebo group 0.04 (95% CI À0.04 to 0.12), P ¼ 0.85). There were no statistically significant differences between the effects of the peptide and placebo treatment on office and 24-h ambulatory blood pressure. Conclusions: Long-term treatment with Lactobacillus helveticus-fermented milk containing bioactive peptides reduces arterial stiffness expressed as AIx in hypertensive subjects.

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“…On the other hand, central blood pressure (CBP), reflecting ascending aortic blood pressure, has also been important because its elevation induces coronary atherosclerosis. 3,4 In addition, CBP is thought to reflect direct stress on the heart because it expresses the pressure-loading condition next to the heart compared with peripheral blood pressure. 5,6 The large-scale ASCOT-CAFÉ study 7 reported that CBP may be a determinant of clinical outcomes and that brachial blood pressure is not always a good indicator of a drug's blood pressure-lowering effect on arterial hemodynamics (CAFÉ trial).…”

Section: Introductionmentioning

confidence: 99%

Comparison of central blood pressure and cardio-ankle vascular index for association with cardiac function in treated hypertensive patients

et al. 2009

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Recent automated applanation tonometry can measure radial pulse wave-derived central blood pressure (CBP), which has shown a prognostic value independently of peripheral blood pressure. However, CBP's clinical significance has not been fully established. We examined the associations between CBP and cardiac structure and function by comparing them with those of arterial stiffness assessed by cardio-ankle vascular index (CAVI) in treated hypertensive patients. Enrolled in the study were 102 patients (71 ± 7 years) with treated hypertension. The transmitral early-to-atrial velocity ratio (E/A), peak systolic (S¢), early diastolic (E¢) mitral annular velocities and the Tei index were measured as indexes of cardiac function derived from conventional and tissue Doppler echocardiography. Left ventricular mass index (LVMI) was measured as an index of LV hypertrophy. CBP and CAVI were measured just after echocardiographic examination. CBP, but not CAVI, correlated with LVMI (r¼0.306, Po0.01). Although CBP correlated only with the Tei index (r¼0.201, Po0.05), CAVI correlated with E/A (r¼À0.387, Po0.001), S¢ (r¼À0.270, Po0.01), E¢ (r¼À0.362, Po0.01) and the Tei index (r¼0.339, Po0.01). Stepwise regression analysis revealed that neither CBP nor CAVI was independently associated with E/A, S¢ or E¢. However, CAVI, but not CBP, was independently associated with the Tei index (b coefficient¼0.311, Po0.001), reflecting both LV systolic and diastolic function. In conclusion, CBP may be suitable for detecting LV hypertrophy. In contrast, CAVI may be suitable for detecting LV dysfunction. This difference, suggesting the clinical value of each parameter, should be kept in mind when we use CBP and CAVI for assessing arteriosclerosis in treated hypertension.

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Aortic Pressure Augmentation Predicts Adverse Cardiovascular Events in Patients With Established Coronary Artery Disease

Cited by 331 publications

References 43 publications

Brachial Blood Pressure But Not Carotid Arterial Waveforms Predict Cardiovascular Events in Elderly Female Hypertensives

Brachial Blood Pressure But Not Carotid Arterial Waveforms Predict Cardiovascular Events in Elderly Female Hypertensives

Long-term intervention with Lactobacillus helveticus fermented milk reduces augmentation index in hypertensive subjects

Comparison of central blood pressure and cardio-ankle vascular index for association with cardiac function in treated hypertensive patients

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