Major impact of body position on arterial stiffness indices derived from radial applanation tonometry in pregnant and nonpregnant women

Jaccoud, Letitia; Rotaru, Corina; Heim, Abigael; Liaudet, Lucas; Waeber, Bernard; Hohlfeld, P.; Feihl, François

doi:10.1097/hjh.0b013e328352abf9

Cited by 16 publications

(18 citation statements)

References 29 publications

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“…The prognostic significance of waveform-related parameters, including rAIx, aAIx, and PP amplification, is strongly influenced by arm position during measurement. Currently, both seated (with the wrist often below the heart level) and supine postures are accepted for radial waveform assessment, often providing different results [22,23], and especially when associated systemic hemodynamic changes are detected [24,25]. Our data are in keeping with the findings by Vrachatis et al [26], who reported that changes in distending pressure were responsible for the differences in HR-adjusted AIx and PP amplification between the seated and the supine position.…”

Section: Discussionsupporting

confidence: 88%

Effects of gravity-induced upper-limb blood pressure changes on wave transmission and arterial radial waveform

Pucci

Battista

Anastasio

et al. 2016

Journal of Hypertension

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Section: Discussionsupporting

confidence: 88%

Effects of gravity-induced upper-limb blood pressure changes on wave transmission and arterial radial waveform

Pucci

Battista

Anastasio

et al. 2016

Journal of Hypertension

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“…Out of the three studies that evaluated AIx, two support that it is elevated in the supine position (vs head-up tilt 601; 37 vs standing posture 38 ), whereas in one (supine vs sitting) the reverse finding was reported for AIx75 (with nonsignificant difference for AIx). 36 The present study showed that the earlier arrival of the reflected pressure wave (as assessed by arrival time of reflected waves at central aorta), as well as its timing (due to the longer systolic duration) with the forward ejected pressure wave at the aorta, may favor the augmentation of the aortic SBP. This may in part explain the lower PP amplification observed in the supine position, as aPP but not bPP is affected by the early reflection of the backward pressure wave.…”

Section: Discussionmentioning

confidence: 56%

“…On the contrary, very limited data, derived exclusively from non-randomized studies, exist so far regarding the postural effects on the noninvasively assessed aortic hemodynamic parameters. [35][36][37][38] It is expected that as the noninvasive assessment of aBP is based on the calibration of the pressure waveform with the bBP, body posture will affect aBP as well. Moreover, it might be argued that aBP might be further influenced from changes in body posture due to alteration in heart rate, pressure wave reflections or arterial stiffness.…”

Section: Introductionmentioning

confidence: 99%

Effect of supine versus sitting position on noninvasive assessment of aortic pressure waveform: a randomized cross-over study

et al. 2013

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Biomarkers derived noninvasively from the aortic blood pressure (BP) waveform provide information regarding cardiovascular (CV) risk independently of brachial BP (bBP). Although body position has significant impact on the assessment of bBP, its effect on aortic hemodynamics remains unknown. This study investigated the changes in both brachial and aortic hemodynamics, between the supine and sitting position. In this randomized cross-over study, the bBP and the aortic pressure waveform were assessed after a 5 min rest (sitting and supine in randomized order); aortic BP, pulse pressure (PP) amplification, augmentation index (AIx) and subendocardial viability index (SEVR) were assessed. Sixty-one subjects were examined (36 males, mean age 50±12 years). Mean BP did not differ between the sitting and supine position (110.8±13.7 vs 110.9±14.9, respectively, P=0.945). However, significant difference between the sitting and supine position in brachial PP (45.9±16.0 vs 52.6±15.6, respectively, P<0.001), aortic PP (36.7±15.2 vs 43.1±13.9, P<0.001), PP amplification (1.28±0.1 vs 1.23±0.1, P<0.001), AIx (26.9±11.9 vs 31.1±10.2, P<0.001) and SEVR (179.6±25.7 vs 161.2±25.8, P<0.001) were found. Review of the literature identified underestimation of the role of body position on aortic hemodynamics. In conclusion, increased PP in both the aorta and brachial artery were found in the supine compared to the sitting position. Reduced PP amplification and SEVR were further observed in the supine position, due to increased pressure wave reflections (AIx).

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“…Another possibility is that supine posture during sleep reduces pressure wave amplification. 24,25 Whilst this needs further study, the fact that PPA began to decline gradually, hours before the nadir of BP was reached, which we assume was during sleep, implies that this phenomenon is unlikely to be explained by posture alone.…”

Section: Discussionmentioning

confidence: 86%

Novel Description of the 24-Hour Circadian Rhythms of Brachial Versus Central Aortic Blood Pressure and the Impact of Blood Pressure Treatment in a Randomized Controlled Clinical Trial

et al. 2013

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Abstract-Elevated brachial blood pressure (BP) is associated with increased cardiovascular risk and predicts morbidity and mortality in humans. Recently, 24-hour ambulatory BP monitoring and assessment of central aortic BP have been introduced to improve BP phenotyping. The Ambulatory Central Aortic Pressure (AmCAP) study combines these approaches and describes, for the first time, the diurnal patterns of simultaneously measured 24-hour ambulatory brachial and central pressures in a prespecified substudy embedded within a clinical trial of BP lowering in patients with hypertension. Twenty-four-hour ambulatory brachial and central pressure measurements were acquired using a tonometer mounted into the articulating strap of a wristwatch-like device (BPro) in 171 participants with hypertension recruited into the ASSERTIVE (AliSkiren Study of profound antihypERtensive efficacy in hyperTensIVE patients) trial. Participants were randomly assigned to BP lowering with either aliskiren 300 mg QD or telmisartan 80 mg QD for 12 weeks. Ambulatory brachial and central BP was measured in all participants both at baseline and at study end. Brachial and central BP both demonstrated typical diurnal patterns with lower pressures at night. However, night time was associated with smaller reductions in central relative to brachial pressure and decreased pulse pressure amplification (P<0.0001 for both). These effects were not modulated after BP lowering and were maintained after adjustment for day and night-time BP and heart rate (P=0.02

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Major impact of body position on arterial stiffness indices derived from radial applanation tonometry in pregnant and nonpregnant women

Abstract: Body position has a major impact on the pattern of central aortic pressure augmentation by reflected waves in healthy young women examined either during third trimester pregnancy or in the nonpregnant state.

Cited by 16 publications

References 29 publications

Effects of gravity-induced upper-limb blood pressure changes on wave transmission and arterial radial waveform

Effects of gravity-induced upper-limb blood pressure changes on wave transmission and arterial radial waveform

Effect of supine versus sitting position on noninvasive assessment of aortic pressure waveform: a randomized cross-over study

Novel Description of the 24-Hour Circadian Rhythms of Brachial Versus Central Aortic Blood Pressure and the Impact of Blood Pressure Treatment in a Randomized Controlled Clinical Trial

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