Ethnic Differences in Arterial Wave Reflection Are Mostly Explained by Differences in Body Height - Cross-Sectional Analysis of the HELIUS Study

Schattenkerk, Daan W. Eeftinck; Gorp, Jacqueline van; Snijder, Marieke B.; Zwinderman, Aeilko H.; Agyemang, Charles; Peters, Ron J.G.; Born, Bert‐Jan H. van den

doi:10.1371/journal.pone.0160243

Cited by 10 publications

(9 citation statements)

References 42 publications

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“…Furthermore, with increasing age, the radial AI linearly increases but plateaus at approximately 60-year-old. This result is similar to the age-related changes in central aortic stiffness reported in a group of South Asian individuals [31].…”

Section: Approximation Of Ppw For All Agessupporting

confidence: 90%

Development of a Mathematical Model for Age-Dependent Radial Artery Pulse Wave Analysis Based on Pulse Waveform Decomposition

Yang

Kim

et al. 2020

IEEE Access

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Radial artery pulse waveforms (RAPWs) have been actively studied for decades because they provide critical health information, particularly related to risk factors of cardiovascular disease. The primary goal of this study is to develop a novel mathematical model that can regenerate age-dependent RAPWs by decomposing a single pulse pressure waveform (PPW). This study proposes to decompose a PPW into three waveform components with one forward wave component and two reflected wave components based on the physiology of pulse waveforms. Treated as basis functions, the three components with associated control parameters are incorporated in the proposed mathematical model. The underlying idea of the model is to generate desired pulse waveforms by combining basis functions whose characteristics depend on selection of control parameter values. For the current study, after determining the nine control parameters of the basis functions by post-processing algorithms, the proposed model for the PPW is derived from a linear combination of the basis functions. Using the model along with in vivo RAPW data, this study evaluates the performance of the model in regenerating PPWs for a wide range of ages from 85 years old to 15 years old. The results show an error of less than 6% between the PPWs numerically derived from the model and the in vivo data for the two key matrixes used in this study (the least-square error norm and the radial augmentation index), validating the effectiveness of the model. The model is applicable for RAPW simulator analysis and development. INDEX TERMS Age-dependent, hemodynamic, radial artery pulse waveform, wave decomposition, wave reflection model.

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Section: Approximation Of Ppw For All Agessupporting

confidence: 90%

Development of a Mathematical Model for Age-Dependent Radial Artery Pulse Wave Analysis Based on Pulse Waveform Decomposition

Yang

Kim

et al. 2020

IEEE Access

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“…Substantial differences in central BP exist across different ethnic groups that cannot be explained by differences in conventional risk factors for cardiovascular disease. [ 37 ] Consequently, the CASP reading in our cohort ideally should be compared to a healthy, HIV-uninfected, age-matched black population. Unfortunately, no normative values in black Africans are available.…”

Section: Discussionmentioning

confidence: 99%

High prevalence of “non-dipping” blood pressure and vascular stiffness in HIV-infected South Africans on antiretrovirals

et al. 2017

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BackgroundHIV-infected individuals are at increased risk of tissue inflammation and accelerated vascular aging (‘inflamm-aging’). Abnormal diurnal blood pressure (BP) rhythms such as non-dipping may contribute to an increased risk of cardiovascular and cerebrovascular events in HIV infected individuals. However, little data exists on ambulatory blood pressure (ABP) and measures of vascular stiffness in the black African HIV infected population.MethodsThis is a cross-sectional analysis of otherwise well, HIV infected outpatients on ART for >5 years. Study assessments included: 24hr ABP monitoring, pulse wave velocity (PWV) and central aortic systolic pressure (CASP) using a AtCor Medical Sphygmocor device, fasting lipogram, oral glucose tolerance test, high-sensitivity C-reactive protein (hsCRP) and anthropometric data. Patients completed a questionnaire of autonomic symptoms. CD4+ counts and viral loads were obtained from the National Laboratory results system.ResultsSixty seven black participants were included in the analysis of whom 91% (n = 61) were female with a mean age of 42.2 ± 8.6 years. The median duration on ART was 7.5 years (IQR = 6–10), 84% were virally supressed and the median CD4 count was 529.5cells/mm3 (IQR = 372.0–686.5). The majority (67%) were classified as overweight and 76% had an increased waist circumference, yet only 88% of participants were normotensive. A hsCRP level in the high cardiovascular risk category was found in 68% of participants. The prevalence of non-dipping BP was 65%. Interestingly, there was no association on multivariable analysis between dipping status and traditional risk factors for non-dipping BP, such as: obesity, autonomic dysfunction and older age.ConclusionThis relatively young cross-sectional sample of predominantly normotensive, but overweight black women on effective ART >5 years showed: a high prevalence of non-dipping BP, inflammation and vascular stiffness. Causality cannot be inferred but cardiovascular risk reduction should be emphasized in these patients.

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“…We previously identified substantial ethnic differences in BP and central haemodynamics. 21 , 22 This may also affect the prevalence of hypertension and ISH of the young in particular.…”

Section: Introductionmentioning

confidence: 99%

Isolated systolic hypertension of the young and its association with central blood pressure in a large multi-ethnic population. The HELIUS study

Schattenkerk

Gorp

Vogt

et al. 2018

Eur J Prev Cardiolog

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BackgroundIsolated systolic hypertension (ISH) of the young has been associated with both normal and increased cardiovascular risk, which has been attributed to differences in central systolic blood pressure and arterial stiffness.MethodsWe assessed the prevalence of ISH of the young and compared differences in central systolic blood pressure and arterial stiffness between ISH and other hypertensive phenotypes in a multi-ethnic population of 3744 subjects (44% men), aged <40 years, participating in the HELIUS study.ResultsThe overall prevalence of ISH was 2.7% (5.2% in men and 1.0% in women) with the highest prevalence in individuals of African descent. Subjects with ISH had lower central systolic blood pressure and pulse wave velocity compared with those with isolated diastolic or systolic-diastolic hypertension, resembling central systolic blood pressure and pulse wave velocity values observed in subjects with high-normal blood pressure. In addition, they had a lower augmentation index and larger stroke volume compared with all other hypertensive phenotypes. In subjects with ISH, increased systolic blood pressure amplification was associated with male gender, Dutch origin, lower age, taller stature, lower augmentation index and larger stroke volume.ConclusionISH of the young is a heterogeneous condition with average central systolic blood pressure values comparable to individuals with high-normal blood pressure. On an individual level ISH was associated with both normal and raised central systolic blood pressure. In subjects with ISH of the young, measurement of central systolic blood pressure may aid in discriminating high from low cardiovascular risk.

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Ethnic Differences in Arterial Wave Reflection Are Mostly Explained by Differences in Body Height - Cross-Sectional Analysis of the HELIUS Study

Cited by 10 publications

References 42 publications

Development of a Mathematical Model for Age-Dependent Radial Artery Pulse Wave Analysis Based on Pulse Waveform Decomposition

Development of a Mathematical Model for Age-Dependent Radial Artery Pulse Wave Analysis Based on Pulse Waveform Decomposition

High prevalence of “non-dipping” blood pressure and vascular stiffness in HIV-infected South Africans on antiretrovirals

Isolated systolic hypertension of the young and its association with central blood pressure in a large multi-ethnic population. The HELIUS study

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