Carotid intima–media thickness, but not chronic kidney disease independently associates with noncardiac arterial vascular events in South Africa

Kolkenbeck‐Ruh, Andrea; Woodiwiss, Angela J.; Naran, Ravi; Sadiq, Eitzaz; Robinson, Chanel; Motau, Tshegofatso H; Monareng, Taalib; Mabena, Philanathi; Manyatsi, Nomvuyo; Gazwa, Pitchou Z.; Abdool-Carrim, Talib; Majane, Olebogeng H.I.; Veller, Martin; Modi, Girish; Norton, Gavin R.

doi:10.1097/hjh.0000000000001921

Cited by 5 publications

(5 citation statements)

References 26 publications

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“…An increased IMT was considered as either >0.80 mm or >age-related thresholds for IMT derived from age-specific 95th percentiles of normotensive, nondiabetic participants from the community sample as previously described. 21 Multiple logistic regression analysis was performed to determine the independent relations between carotid IMT or plaque and vascular events. Adjustments included in multivariate models were those associated with vascular events.…”

Section: Methodsmentioning

confidence: 99%

“…Indeed, strong independent associations between IMT and arterial events are noted across the adult life span, including at a chronologically premature age. 21 However, whether the presence of plaque is equally as closely associated with arterial events over the younger adult age range, or where events may be attributed to more thrombotic than atherosclerotic occlusion, is unknown.…”

Section: Introductionmentioning

confidence: 99%

“…As longitudinal studies cannot be readily conducted to assess events over a young adult age range, to further evaluate the role of carotid IMT versus plaque in the development of arterial events over this age range, we compared IMT and plaque in cases versus controls at different ages across the full adult life span in a country where these events commonly occur over a young adult age. 21 We assessed relationships with noncardiac arterial vascular events (stroke and critical limb ischemia [CLI]) as coronary artery disease is infrequent at a young age in the ethnic group in the country where the study was performed. 21 To evaluate whether age determines the extent to which lower limb thrombotic as opposed to atherosclerotic occlusion occurs, histological examination of amputated lower limb arteries was evaluated in those with CLI.…”

Section: Introductionmentioning

confidence: 99%

“…21 We assessed relationships with noncardiac arterial vascular events (stroke and critical limb ischemia [CLI]) as coronary artery disease is infrequent at a young age in the ethnic group in the country where the study was performed. 21 To evaluate whether age determines the extent to which lower limb thrombotic as opposed to atherosclerotic occlusion occurs, histological examination of amputated lower limb arteries was evaluated in those with CLI.…”

Section: Introductionmentioning

confidence: 99%

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Complementary Impact of Carotid Intima–Media Thickness With Plaque in Associations With Noncardiac Arterial Vascular Events

et al. 2019

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The ability of carotid intima–media thickness (IMT) to predict risk beyond plaque is controversial. In 952 participants (critical limb ischemia [CLI] or stroke, n = 473; community, n = 479), we assessed whether relationships with events for IMT complement the impact of plaque in young patients depending on the extent of thrombotic versus atherosclerotic disease. The extent of atherosclerotic versus thrombotic occlusion was determined in 54 patients with CLI requiring amputations. Thrombotic occlusion in CLI was associated with younger age ( P < .0001) and less plaque ( P = .02). Independent relations between plaque and CLI were noted in older (>50 years; P < .005 to <.0001) but not younger ( P > .38) participants, while independent relations between plaque and stroke ( P < .005 to <.0001) and between IMT and CLI ( P < .0001) were noted in younger participants. Although in performance (area under the receiver operating curve) for event detection, IMT thresholds failed to add to plaque alone in older patients (0.680 ± 0.020 vs 0.664 ± 0.017, P = .27), IMT improved performance for combined stroke and CLI detection when added to plaque in younger patients (0.719 ± 0.023 vs 0.631 ± 0.026, P < .0001). Because in younger participants the high prevalence of thrombotic occlusion in CLI is associated with less plaque, IMT adds information in associations with arterial vascular events.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Complementary Impact of Carotid Intima–Media Thickness With Plaque in Associations With Noncardiac Arterial Vascular Events

et al. 2019

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“…Serum creatinine concentrations were measured using the Advia Chemistry systems (Siemens) with calibration traceable to isotope dilution mass spectrometry (IDMS). The 4-varible CKD-EPI equation was employed to estimate glomerular filtration rate (GFR) [25]. Blood samples for the measurement of insulin and resistin concentrations were centrifuged and immediately stored at -80°C.…”

Section: Clinical Demographic Anthropometric and Blood Measurementsmentioning

confidence: 99%

Associations between circulating resistin concentrations and left ventricular mass are not accounted for by effects on aortic stiffness or renal dysfunction

Norman

Norton

Peterson

et al. 2020

BMC Cardiovasc Disord

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Background: Although, in-part through an impact on left ventricular mass (LVM), resistin (an adipokine) may contribute to heart failure, whether this is explained by the adverse effects of resistin on aortic stiffness and renal function is unknown. Methods: Relationships between circulating resistin concentrations and LVM index (LVMI), and LVM beyond that predicted by stroke work (inappropriate LVM [LVM inappr ]) (echocardiography) were determined in 647 randomly selected community participants, and in regression analysis, the extent to which these relations could be explained by aortic pulse wave velocity (PWV) or estimated glomerular filtration rate (eGFR) was evaluated. Results: Independent of confounders, resistin concentrations were independently associated with LVMI, LVM inappr , LV hypertrophy (LVH), PWV and eGFR. Furthermore, independent of confounders, LVMI, LVM inappr and LVH were independently associated with PWV and eGFR. However, adjustments for either PWV or eGFR failed to modify the relationships between resistin concentrations and LVMI, LVM inappr or LVH. Moreover, in multivariate regression analysis neither PWV nor eGFR significantly modified the contribution of resistin to LVM inappr or LVMI. Conclusions: Independent relationships between circulating concentrations of the adipocytokine resistin and LVM are not explained by the impact of resistin on ventricular-vascular coupling or renal dysfunction. Resistin's effects on LVM are therefore likely to be through direct actions on the myocardium.

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Contribution of systemic blood flow to untreated or inadequately controlled systolic--diastolic or isolated systolic hypertension in a community sample of African ancestry

Mmopi¹,

Norton²,

Bello³

et al. 2020

Journal of Hypertension

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Aims: Age-related increases in systemic blood flow [stroke volume (SV), cardiac output (CO), and aortic flow (Q)] contribute substantially to untreated or inadequately controlled (uncontrolled) blood pressure (BP) in Africa. We aimed to identify the haemodynamic determinants of uncontrolled systolic--diastolic (Syst--diast HT) versus uncontrolled isolated systolic (ISH) or diastolic (IDH) hypertension. Methods: Using central arterial pressure and aortic outflow tract velocity and diameter measurements (echocardiography), the haemodynamic correlates of BP were determined in 725 community participants of African ancestry (19.6% uncontrolled Syst--diast HT, 9.2% uncontrolled ISH, 11.3% uncontrolled IDH). Results: Independent of confounders, compared with those with a normotensive BP, those with uncontrolled Syst--diast HT had increases in SV, CO, Q, systemic vascular resistance (SVR) and aortic characteristic impedance (Z c ) and decreases in total arterial compliance (TAC) (P < 0.05--P < 0.0001). In multivariate regression models, uncontrolled Syst--diast HT was as strongly associated with Q, SV or CO as with SVR (P = 0.04--P = 0.20), Z c (P = 0.74--P < 0.0005) and TAC (P = 0.43--P < 0.005). Independent of confounders, compared with normotensive individuals those with uncontrolled ISH had increases in SV, CO, Q and Z c but not SVR, and decreases in TAC (P < 0.05-P < 0.0001), and those with IDH only had increases in SVR (P < 0.0001). Uncontrolled ISH was more strongly associated with Q, SV and CO than with SVR (P < 0.0005), but less than with TAC (P < 0.05--P < 0.0005). Conclusion: In groups of African ancestry living in Africa, hypertension because of increases in either SBP or DBP is as strongly associated with increases in systemic flow (SV, Q) as with arterial and arteriolar effects (Z c, TAC, SVR).

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Carotid intima–media thickness, but not chronic kidney disease independently associates with noncardiac arterial vascular events in South Africa

Cited by 5 publications

References 26 publications

Complementary Impact of Carotid Intima–Media Thickness With Plaque in Associations With Noncardiac Arterial Vascular Events

Complementary Impact of Carotid Intima–Media Thickness With Plaque in Associations With Noncardiac Arterial Vascular Events

Associations between circulating resistin concentrations and left ventricular mass are not accounted for by effects on aortic stiffness or renal dysfunction

Contribution of systemic blood flow to untreated or inadequately controlled systolic--diastolic or isolated systolic hypertension in a community sample of African ancestry

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