Effects of weight loss and insulin reduction on arterial stiffness in the SAVE trial

Hughes, Timothy M.; Althouse, Andrew D.; Niemczyk, Nancy A.; Hawkins, Marquis; Kuipers, Allison L.; Sutton-Tyrrell, Kim

doi:10.1186/1475-2840-11-114

Cited by 57 publications

(52 citation statements)

References 31 publications

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“…26 Accordingly, baPWV and cfPWV are correlated similarly with cardiovascular disease risk factors and clinical events. 27 We have reported stronger associations of coronary artery calcification 28 and weight loss/insulin reductions 20 with baPWV than cfPWV. In the present study and others, 20 cfPWV had twice the variance of baPWV, which could explain the lack of association between cfPWV and Ab status; however, it does not explain why cfPWV was more strongly related with WMHv.…”

Section: Resultsmentioning

confidence: 83%

“…27 We have reported stronger associations of coronary artery calcification 28 and weight loss/insulin reductions 20 with baPWV than cfPWV. In the present study and others, 20 cfPWV had twice the variance of baPWV, which could explain the lack of association between cfPWV and Ab status; however, it does not explain why cfPWV was more strongly related with WMHv. Measures of central stiffness may simply be associated more strongly with cardiovascular disease risk and cerebrovascular disease, while baPWV may represent another phenomenon linking systemic vascular stiffness with Ab deposition in the brain.…”

Section: Resultsmentioning

confidence: 83%

“…19 All measures were performed under standardized conditions as previously described. 20 PWV was measured in the central (carotidfemoral [cfPWV] and heart-femoral [hfPWV]), peripheral (femoral-ankle [faPWV]), and mixed (brachial-ankle [baPWV]) vascular beds. PWV was calculated as the distance in centimeters between arterial sites of interest over time (in seconds) that the pressure waveforms traveled from the heart to the respective arterial sites.…”

mentioning

confidence: 99%

“…Site-specific measurements were detailed previously. 20 The average of 2 runs was calculated to determine average PWV. For baPWV, the average PWV of the left and right sides was utilized in the analysis.…”

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confidence: 99%

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Pulse wave velocity is associated with β-amyloid deposition in the brains of very elderly adults

et al. 2013

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Objective: To determine arterial stiffness and b-amyloid (Ab) deposition in the brain of dementiafree older adults. Methods:We studied a cohort of 91 dementia-free participants aged 83-96 years. In 2009, participants completed brain MRI and PET imaging using Pittsburgh compound B (PiB; a marker of amyloid plaques in human brain). In 2011, we measured resting blood pressure (BP), mean arterial pressure (MAP), and arterial stiffness by pulse wave velocity (PWV) in the central, peripheral, and mixed (e.g., brachial ankle PWV [baPWV]) vascular beds, using a noninvasive and automated waveform analyzer.Results: A total of 44/91 subjects were Ab-positive on PET scan. Ab deposition was associated with mixed PWV, systolic BP, and MAP. One SD increase in baPWV resulted in a 2-fold increase in the odds of being Ab-positive (p 5 0.007). High white matter hyperintensity (WMH) burden was associated with increased central PWV, systolic BP, and MAP. Compared to Ab-negative individuals with low WMH burden, each SD increase in PWV was associated with a 2-fold to 4-fold increase in the odds of being Ab-positive and having high WMH.Conclusions: Arterial stiffness was associated with Ab plaque deposition in the brain, independent of BP and APOE e4 allele. The associations differed by type of brain abnormality and vascular bed measured (e.g., WMH with central stiffness and Ab deposition and mixed stiffness). Arterial stiffness was highest in individuals with both high Ab deposition and WMH, which has been suggested to be a "double hit" contributing to the development of symptomatic dementia. Neurology ® 2013;81:1711-1718 GLOSSARY Ab 5 b-amyloid; AD 5 Alzheimer disease; baPWV 5 brachial-ankle pulse wave velocity; BMI 5 body mass index; BP 5 blood pressure; cfPWV 5 carotid-femoral pulse wave velocity; CI 5 confidence interval; DBP 5 diastolic blood pressure; faPWV 5 femoral-ankle pulse wave velocity; GEMS 5 Ginkgo Evaluation of Memory Study; hfPWV 5 heart-femoral pulse wave velocity; ICC 5 intraclass correlation coefficients; MAP 5 mean arterial pressure; MCI 5 mild cognitive impairment; OR 5 odds ratio; PiB 5 Pittsburgh compound B; PWV 5 pulse wave velocity; SBP 5 systolic blood pressure; WMH 5 white matter hyperintensities; WMHv 5 white matter hyperintensities volume.Hypertension is linked to cognitive impairment and the pathologic features of Alzheimer disease (AD), including neurofibrillary tangles and b-amyloid (Ab) plaques, 1 as well as small-vessel disease and white matter hyperintensities (WMH) in the brain.2 Arterial stiffness appears to play a major role in the relationship between hypertension and its consequences in the brain; mounting evidence implicates arterial stiffness in the pathogenesis of impaired cognitive function and dementia in the elderly. 4 Except for APOE e4 genotype and aging, the risk factors and determinants of Ab deposition in brain are poorly understood.Recent studies show that blood pressure (BP) is associated with brain Ab deposition as measured by PiB-PET 5,6 ; thus, arterial stiffness may pla...

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Section: Resultsmentioning

confidence: 83%

Section: Resultsmentioning

confidence: 83%

mentioning

confidence: 99%

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confidence: 99%

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Pulse wave velocity is associated with β-amyloid deposition in the brains of very elderly adults

et al. 2013

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“…Dengo et al in a recent randomized, placebo-controlled study proved that weight loss through a hypocaloric diet can reduce arterial stiffness in major arteries in older patients [16]. Hughes et al demonstrated that young overweight and obese adults who lower their insulin levels and lose weight over 6 months experience decreased vascular stiffness measured by pulse wave velocity (PWV) [17].…”

Section: Discussionmentioning

confidence: 99%