Arterial stiffness and pressure wave reflection in the development of isolated diastolic hypertension

Abstract

Objectives: This prospective study was conducted to clarify the significance of augmented pressure wave reflection without accompanying increased arterial stiffness in the development of isolated diastolic hypertension (IDHT). Methods: A total of 3022 Japanese men without hypertension at the start of this study were included in the analyses. The blood pressure, brachial--ankle pulse wave velocity (brachial-ankle PWV), and radial augmentation index (rAI) were measured annually from year 2007 through year 2015. Results: At the end of the study period, 129 participants were diagnosed as having systolic/diastolic hypertension (SDHT), 112 as having isolated systolic hypertension (ISHT), and 74 as having IDHT. Both the brachial--ankle PWV and rAI showed significant individual odds ratios for new onset of SDHT and new onset of ISHT. However, only rAI, but not the brachial--ankle PWV, showed a significant odds ratio (1.44, P < 0.01) for new onset of IDHT. This association was significant in participants without elevated brachial--ankle PWV values at the start of the study, but not in those with elevated brachial--ankle PWV at the start of the study. Generalized estimating equation analyses demonstrated a significant longitudinal association of the rAI, but not brachial--ankle PWV, with the development of IDHT. Conclusion: Although increased arterial stiffness and augmented pressure wave reflection present concomitantly may be associated with the development of SDHT and ISHT, augmented pressure wave reflection alone, which may be related to isolated peripheral vascular damage, in the absence of accompanying increase of the arterial stiffness, may be a significant factor in the development of IDHT.

Differential biomechanics in resistance arteries of male compared with female Dahl hypertensive rats

“…Nonetheless, there is evidence in the current literature that suggests increased stiffness and augmented pressure wave (e.g. abnormal wave reflection) could additively contribute to the onset of hypertension [ 23 , 24 ]. It is possible that the crosstalk between micro-circulation and macro-circulation and the inter-connection between them leads to additive detrimental effects on the circulation due to increased global vascular stiffness [ 25 , 26 ].…”

A Nature-inspired Hierarchical Branching Structure Pressure Sensor for Medical Wearables

“…Notably, the value of AIr is slightly higher than the normal health values for people in their mid-20s, 40 which correlates with the slightly higher diastolic blood pressure of the volunteer (130/90 mmHg). 41 In addition, the corresponding fast Fourier transformation (FFT) results shown in Figure 6c indicated that the harmonic components of the collected pulse wave were mainly distributed in the range of 0-10 Hz, corresponding to that of healthy adults, 42 which proved that the response time of the HB sensor meets the requirement of pulse measurement. The calculated heart rate was 78 beats per minute (bpm) according to the first main peak in the FFT spectrum, indicating the health state of the volunteer.…”

Diabetic nephropathy ameliorated in patients with normal home blood pressure compared to those with isolated high home systolic blood pressure: A 5-year prospective cohort study among patients with type 2 diabetes mellitus

“…14 The pathogenesis of ISH is enrolled increased arterial stiffness. 30 Furthermore, arterial aging might result in an additional progression in IH-home SBP, which is a risk factor for target-organ damage 31 and diabetic nephropathy. 32 In type 2 diabetes, an association between proteinuria and high BP is strictly related to a higher risk of cardiovascular disease.…”