Temporal Relationship Between Arterial Stiffness and Systolic Blood Pressure Under Intensive or Standard Control: A Post Hoc Analysis of the STEP Trial

Ling, Qianhui; Song, Qirui; Bai, Jingjing; Wang, Anxin; Zhang, Weili; Chen, Mulei; Cai, Jun

doi:10.1161/hypertensionaha.122.20022

Cited by 7 publications

(5 citation statements)

References 39 publications

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“…High BP was another risk factor linked to a faster increase in baPWV [6] in the STEP trial (Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients) of a cross-lagged panel model in the 5369 participants. In both the intensive treatment groups (SBP target, 110-130 mm Hg) and standard treatment groups (SBP target, 130-150 mm Hg), arterial stiffness measured by baPWV was a consistent predictor of SBP and made it more difficult to achieve target SBP, especially in the intensive therapy group [23]. Chronic renal failure is also a risk factor for arterial stiffness [6,20].…”

Section: Discussionmentioning

confidence: 99%

Osteocalcin: A Potential Marker of Peripheral Arterial Stiffness in Hypertensive Patients

Wang,

Hsiao,

Wang

et al. 2024

Medicina

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Background and Objectives: Brachial–ankle pulse wave velocity (baPWV) is an established independent risk factor for cardiovascular events, cardiovascular mortality, and all-cause mortality. Osteocalcin (OC) is recognized to be associated with vascular function. The present study assessed the correlation between serum OC levels and peripheral arterial stiffness (PAS) measured through baPWV in hypertensive patients. Materials and Methods: Fasting blood samples were collected from 120 hypertensive participants. The serum total OC levels were measured using a commercial enzyme-linked immunosorbent assay kit, whereas the baPWV device was used to detect PAS. The PAS group had left or right baPWV > 18.0 m/s. Results: Among the hypertensive patients, 24 (20.0%) were classified into the PAS group. The PAS group exhibited a significantly older age (p = 0.011), higher prevalence of diabetes (p = 0.010), systolic blood pressure (p = 0.019), levels of serum fasting glucose (p = 0.003), blood urea nitrogen (p = 0.024), creatinine (p = 0.004), C-reactive protein (p = 0.007), OC (p = 0.002), and lower estimated glomerular filtration rate (p = 0.004) than the non-PAS group. Age (odds ratio [OR]: 1.076, 95% CI: 1.004–1.153, p = 0.037) and serum OC level (OR: 1.797, 95% confidence interval (CI): 1.077–3.000, p = 0.025) were independent factors linked to PAS in hypertensive patients in the multivariate logistic regression analysis. Conclusions: Serum OC levels and older age are positively associated with PAS in hypertensive patients.

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Section: Discussionmentioning

confidence: 99%

Osteocalcin: A Potential Marker of Peripheral Arterial Stiffness in Hypertensive Patients

Wang,

Hsiao,

Wang

et al. 2024

Medicina

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“…Nevertheless, when a pharmacological agent reduces mean blood pressure, it lowers arterial stiffness as well [ 32 ]. In this regard, a recent post hoc analysis of the STEP trial (Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients) confirmed that arterial stiffening precedes SBP in both the intensive and standard treatment groups, and it led to difficulty in reaching target SBP, particularly in the intensive treatment group [ 153 ]. In the same study, assignment to the intensive treatment group was associated with an attenuation of the age-related increase in arterial stiffness assessed with the baPWV at 3-year follow-up.…”

Section: Discussionmentioning

confidence: 99%

Aortic Stiffness: A Major Risk Factor for Multimorbidity in the Elderly

Triposkiadis

Xanthopoulos

Λαμπρόπουλος

et al. 2023

JCM

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Multimorbidity, the coexistence of multiple health conditions in an individual, has emerged as one of the greatest challenges facing health services, and this crisis is partly driven by the aging population. Aging is associated with increased aortic stiffness (AoStiff), which in turn is linked with several morbidities frequently affecting and having disastrous consequences for the elderly. These include hypertension, ischemic heart disease, heart failure, atrial fibrillation, chronic kidney disease, anemia, ischemic stroke, and dementia. Two or more of these disorders (multimorbidity) often coexist in the same elderly patient and the specific multimorbidity pattern depends on several factors including sex, ethnicity, common morbidity routes, morbidity interactions, and genomics. Regular exercise, salt restriction, statins in patients at high atherosclerotic risk, and stringent blood pressure control are interventions that delay progression of AoStiff and most likely decrease multimorbidity in the elderly.

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“…At least, no clear relationships of those changes with urate-lowering were found in this study (Additional file 6 : Table S5), and the beneficial vascular effects might have been partly caused by selective and direct URAT1 inhibition by dotinurad at the urate-entry site on vascular walls and resultant attenuation of ROS production [ 8 , 9 ]. In particular, arterial stiffening is a key driver of hypertension and could be a therapeutic target in its care [ 38 , 39 ]. Considering the pathophysiological roles of those markers in the development and progression of cardiometabolic diseases, dotinurad may have the potential to cause off-target effects, which favorably influence vascular properties and cardiovascular and metabolic health status.…”

Section: Discussionmentioning

confidence: 99%

Clinical effects of a selective urate reabsorption inhibitor dotinurad in patients with hyperuricemia and treated hypertension: a multicenter, prospective, exploratory study (DIANA)

Tanaka

Hisauchi

et al. 2023

Eur J Med Res

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Introduction Dotinurad is a newer urate-lowering agent that selectively inhibits urate transporter 1 in the renal proximal tubule and increases urinary urate excretion. Currently, little is known about the clinical efficacies of dotinurad in patients with hyperuricemia and hypertension. The aim of this study was to assess the clinical effects of a selective urate reabsorption inhibitor dotinurad on serum uric acid (SUA) levels and relevant vascular markers in patients with hyperuricemia and treated hypertension. Methods This investigator-initiated, multicenter, prospective, single-arm, open-label, exploratory clinical trial in Japan enrolled patients with hyperuricemia and treated hypertension who received a 24-week dotinurad therapy (a starting dose at 0.5 mg once daily and up-titrated to 2 mg once daily). The primary endpoint was a percentage change in the SUA level from baseline to week 24. The secondary endpoints were cardiovascular and metabolic measurements, including changes in the cardio-ankle vascular index (CAVI) and derivatives of reactive oxygen metabolites (d-ROMs) concentration at week 24. Results Fifty patients (mean age 70.5 ± 11.0 years, with 76.0% being men, and mean SUA level 8.5 ± 1.2 mg/dL) were included in the analysis. The percentage change from baseline in the SUA level at week 24 was − 35.8% (95% confidence interval [CI] − 39.7% to − 32.0%, P < 0.001), with approximately three quarters of patients achieving an SUA level of ≤ 6.0 mg/dL at week 24. The proportional changes from baseline in the geometric mean of CAVI and d-ROMs at week 24 were 0.96 (95% CI 0.92 to 1.00, P = 0.044) and 0.96 (95% CI 0.92 to 1.00, P = 0.044), respectively. Conclusion In addition to meaningful SUA-lowering effects, 24 weeks of dotinurad therapy may favorably affect arterial stiffness and oxidative stress markers, suggesting off-target vascular protection of dotinurad. Further research is expected to verify our findings and elucidate the entire off-target effects of dotinurad. Trial registration jRCTs021210013, registration date June 24, 2021

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Temporal Relationship Between Arterial Stiffness and Systolic Blood Pressure Under Intensive or Standard Control: A Post Hoc Analysis of the STEP Trial

Cited by 7 publications

References 39 publications

Osteocalcin: A Potential Marker of Peripheral Arterial Stiffness in Hypertensive Patients

Osteocalcin: A Potential Marker of Peripheral Arterial Stiffness in Hypertensive Patients

Aortic Stiffness: A Major Risk Factor for Multimorbidity in the Elderly

Clinical effects of a selective urate reabsorption inhibitor dotinurad in patients with hyperuricemia and treated hypertension: a multicenter, prospective, exploratory study (DIANA)

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