Arterial stiffness, hypertension and diabetes mellitus

Cockcroft, JR; Webb, DJ; Wilkinson, Ian B.

doi:10.1038/sj.jhh.1001023

Cited by 55 publications

(37 citation statements)

References 27 publications

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“…Ascorbic acid has been shown to reverse impaired endothelium-dependent NO-mediated vasodilatation in a number of conditions, including acute hyperglycemia induced locally in the brachial artery (3). Endothelium-derived NO is thought to have an important role in the functional regulation of arterial stiffness (9,10,25,48,53). The preservation of endothelial NO bioactivity, by ascorbic acid, may explain our observed findings.…”

Section: Discussionsupporting

confidence: 71%

“…Extremely high insulin levels would have developed otherwise. Supraphysiological concentrations of insulin can directly stimulate the sympathetic system but may also cause NO-mediated vasodilatation (9,45). Hyperinsulinemia would therefore have confounded the hemodyamic effects of hyperglycemia.…”

Section: Discussionmentioning

confidence: 99%

“…Several in vivo experiments have reported impaired nitric oxide (NO)-mediated endothelial function during acute hyperglycemia (1,3,18,40,54). Endothelium-derived NO may play an important role in the functional regulation of arterial stiffness (9,10,25,48,53). Stiffening of the arterial tree increases the velocity and amplitude of pulse waves reflected from the periphery back to the heart (31).…”

mentioning

confidence: 99%

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Protective effects of ascorbic acid on arterial hemodynamics during acute hyperglycemia

Mullan¹,

Ennis²,

Fee³

et al. 2004

American Journal of Physiology-Heart and Circulatory Physiology

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Mortality increases when acute coronary syndromes are complicated by stress-induced hyperglycemia. Early pulse wave reflection can augment central aortic systolic blood pressure and increase left ventricular strain. Altered pulse wave reflection may contribute to the increase in cardiac risk during acute hyperglycemia. Chronic ascorbic acid (AA) supplementation has recently been shown to reduce pulse wave reflection in diabetes. We investigated the in vivo effects of acute hyperglycemia, with and without AA pretreatment, on pulse wave reflection and arterial hemodynamics. Healthy male volunteers were studied. Peripheral blood pressure (BP) was measured at the brachial artery, and the SphygmoCor pulse wave analysis system was used to derive central BP, the aortic augmentation index (AIx; measure of systemic arterial stiffness), and the time to pulse wave refection ( Tr; measure of aortic distensibility) from noninvasively obtained radial artery pulse pressure (PP) waveforms. Hemodynamics were recorded at baseline and then every 30 min during a 120-min systemic hyperglycemic clamp (14 mmol/l). The subjects, studied on two separate occasions, were randomized in a double-blind, crossover manner to placebo or 2 g intravenous AA before the initiation of hyperglycemia. During hyperglycemia, AIx increased and Tr decreased. Hyperglycemia did not change peripheral PP but did magnify central aortic PP and diminished the normal physiological amplification of PP from the aorta to the periphery. Pulse wave reflection, as assessed from peripheral pulse wave analysis, is enhanced during acute hyperglycemia. Pretreatment with AA prevented the hyperglycemia-induced hemodynamic changes. By protecting hemodynamics during acute hyperglycemia, AA may have therapeutic use.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Protective effects of ascorbic acid on arterial hemodynamics during acute hyperglycemia

Mullan¹,

Ennis²,

Fee³

et al. 2004

American Journal of Physiology-Heart and Circulatory Physiology

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“…10 Little is known about the effect of both high blood pressure (BP) and DM on aortic stiffness. [11][12][13] The aim of our study was to evaluate the influence of BP and type II DM on aortic stiffness in patients with one disease or the other compared to those with both HT and type II DM.…”

Section: Introductionmentioning

confidence: 99%

Effects of coexisting hypertension and type II diabetes mellitus on arterial stiffness

et al. 2004

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“…[1][2][3] It is the major cause of reduced total arterial compliance (C A ) and increased central pulse-wave velocity, changes that both widen the pulse and disproportionately increase systolic pressure. A growing recognition that vascular stiffening and increased pulse pressure (PP) are dominant risk factors for cardiovascular disease, 4 -8 particularly among the elderly, 9 -12 is driving the search for novel agents that can specifically enhance C A and reduce pressure pulsatility.…”

mentioning

confidence: 99%

Improved Arterial Compliance by a Novel Advanced Glycation End-Product Crosslink Breaker

et al. 2001

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Background-Arterial stiffening with increased pulse pressure is a leading risk factor for cardiovascular disease in the elderly. We tested whether ALT-711, a novel nonenzymatic breaker of advanced glycation end-product crosslinks, selectively improves arterial compliance and lowers pulse pressure in older individuals with vascular stiffening. Methods and Results-Nine US centers recruited and randomly assigned subjects with resting arterial pulse pressures Ͼ60 mm Hg and systolic pressures Ͼ140 mm Hg to once-daily ALT-711 (210 mg; nϭ62) or placebo (nϭ31) for 56 days. Preexisting antihypertensive treatment (90% of subjects) was continued during the study. Morning upright blood pressure, stroke volume, cardiac output, systemic vascular resistance, total arterial compliance, carotid-femoral pulse wave velocity, and drug tolerability were assessed. ALT-711 netted a greater decline in pulse pressures than placebo (Ϫ5.3 versus Ϫ0.6 mm Hg at day 56; Pϭ0.034 for treatment effect by repeated-measures ANOVA). Systolic pressure declined in both groups, but diastolic pressure fell less with ALT-711 (Pϭ0.056). Mean pressure declined similarly in both groups (Ϫ4 mm Hg; PϽ0.01 for each group, Pϭ0.34 for treatment effect). Total arterial compliance rose 15% in ALT-711-treated subjects versus no change with placebo (Pϭ0.015 versus ALT-711), an effect that did not depend on reduced mean pressure. Pulse wave velocity declined 8% with ALT-711 (PϽ0.05 at day 56, Pϭ0.08 for treatment effect). Systemic arterial resistance, cardiac output, and heart rate did not significantly change in either group. Conclusions-ALT-711 improves total arterial compliance in aged humans with vascular stiffening, and it may provide a novel therapeutic approach for this abnormality, which occurs with aging, diabetes, and isolated systolic hypertension.

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Arterial stiffness, hypertension and diabetes mellitus

Cited by 55 publications

References 27 publications

Protective effects of ascorbic acid on arterial hemodynamics during acute hyperglycemia

Protective effects of ascorbic acid on arterial hemodynamics during acute hyperglycemia

Effects of coexisting hypertension and type II diabetes mellitus on arterial stiffness

Improved Arterial Compliance by a Novel Advanced Glycation End-Product Crosslink Breaker

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