Association between Fruit and Vegetable Intake and Arterial Stiffness: The China-PAR Project

Objective This study aimed to investigate the association between fruit and vegetable intake and arterial stiffness.Methods We conducted a cohort-based study comprising 6,628 participants with arterial stiffness information in the Prediction for Atherosclerotic Cardiovascular Disease Risk in China(China-PAR)project. A semi-quantitative food-frequency questionnaire was used to assess baseline(2007–2008) and recent(2018–2021) fruit and vegetable intake. We assessed changes in fruit and vegetable intake from2007–2008 to 2018–2021 in 6,481 participants. Arterial stiffness was measured using the arterial velocity–pulse index(AVI) and arterial pressure-volume index(API). Elevated AVI and API values were defined according to diverse age reference ranges.Results Multivariable-adjusted linear regression models revealed that every 100 g/d increment in fruit and vegetable intake was associated with a 0.11 decrease in AVI(B =-0.11;95% confidence interval [CI]:-0.20,-0.02) on average, rather than API(B = 0.02;95% CI:-0.09, 0.13). The risk of elevated AVI(odds ratio [OR] = 0.82;95% CI: 0.70, 0.97) is 18% lower in individuals with high intake(≥ 500 g/d) than in those with low intake(< 500 g/d). Furthermore, maintaining a high intake in the past median of 11.5years of follow-up was associated with an even lower risk of elevated AVI compared with a low intake at both baseline and follow-up(OR = 0.64;95% CI: 0.49, 0.83).Conclusion Fruit and vegetable intake was negatively associated with arterial stiffness, emphasizing recommendations for adherence to fruit and vegetable intake for the prevention of arterial stiffness.

Increased Risk of Arterial Stiffness in Rhumatoid Arthritis Patients in a Sub-Saharan African Setting

Background: Analysis of arterial stiffness (AS) is a good marker of early arterial disease and an important determinant of cardiovascular risk, independent of other traditional cardiovascular risk factors. Carotid-femoral pulse wave velocity (CfPWV) is the gold standard to evaluate arterial stiffness. There is evidence that patients with rheumatoid arthritis (RA) have a higher arterial stiffness than their age-matched healthy counterparts and thus have higher cardiovascular (CV) risk. However, data on arterial stiffness in African rheumatoid arthritis patients is scarce. Objectives: To determine the patterns of arterial stiffness in rheumatoid arthritis patients in a sub-Saharan African setting, using CfPWV and Augmentation index (AIx). Method: We conducted a case-control study, at the Douala general hospital over four months (February to May 2018) on 63 subjects among which 31 RA patients matched for age and sex with 32 healthy subjects. AIx and CfPWV were determined non-invasively by radial pulse wave analysis and carotid femoral wave analysis respectively, using a sphygmocor Atcor device (SphygmoCor, PWV Medical, Sydney, Australia). Results: The mean age of RA patients was 47 ± 14 years with most of them being females (n = 26, 83.9%). CfPWV was significantly higher in RA patients compared to the control group (mean: 8.85 ± 2.1 vs 7.45 ± 1.38;p ≤ 0.01) as well as was AIx (Median: 33 [26 - 43] vs 26 [20 - 31];p = 0.01). RA (OR: 6.105;95% CI: 1.52 - 24.54;p 1.34;95% CI: 1.14 - 5.17;p = 0.05), elevated CRP levels (OR: 4.01;95% CI: 1.16 - 13.68;p = 0.03) and Hypertension (OR: 5.75;95% CI: 1.24 -11.60;p Conclusion: Arterial stiffness, a well-recognized marker of cardiovascular risk is increased among patients suffering from rheumatoid arthritis when compared to a healthy control group.

Increased Arterial Stiffness in Subjects with Pre-diabetes among Middle Aged Population in Beijing,China

Objective To investigate the relationship between arterial stiffness and pre-diabetes when assessed by the new glycosylated hemoglobin Ale （HbAlc） 5.7%-6.4% criterion or by impaired fasting glucose in middle aged Chinese. Methods 1122 adults aged 55 years or younger in the health examination centers for physical check-ups were enrolled in the two large-sized Tertiary Comprehensive Hospitals in Beijing from June 2011 to June 2012 after excluding those who previously had been diagnosed or treated as diabetes or cardiovascular disease. Subjects with a diagnosis of pre-diabetes according to impaired fasting glucose （IFG） （fasting plasma glucose （FPG） levels at 5.6-6.9 mmol/L）, HbA^c levels at 5.7%-6.4%, or both, were classified into four groups for observation： （1） Normoglycaemia （HbA^c〈5.7% and FPG 〈5.6 mmol/L）; （2） IFG alone （FPG levels at 5.6-6.9 mmol/L and HbA1c〈5.7% ）; （3） HbAI~ 5.7%-6.4% alone （HbA^c levels at 5.7%-6.4% and FPG 〈5.6 mmol/L）; and （4） both HbA1c 5.7%-6.4% and IFG （l-lbA1~ levels at 5.7%-6.4% and FPG levels at 5.6-6.9 mmol/L）. All subjects were measured for weight, height, waist circumference, blood pressure, fasting plasma glucose, HbA1c, lipid profile and brachial-ankle pulse wave velocity （baPWV）. Results The mean values of baPWV were 1282±8, 1311±10, 1398±30, and 1418_±27 cm/s （Mean_±SE） in Normoglycaemia, HbA~ 5.7%-6.4% alone, IFG alone and the both HbAlc 5.7%-6.4% and IFG groups, respectively. After adjusting for age, gender, blood pressure, BMI and triglyceride, baPWV was significantly higher in subjects with both HbAlc5.7%-6.4% and iFG compared among the subjects with Normoglycaemia （1350±14 vs. 1301±6 cm/s, P=0.002） and HbA1c 5.7%-6.4% alone （1350±14 vs. 1309±8 cm/s, P=0.013）.Conclusion Subjects with pre-diabetes exhibited a greater arterial stiffness.

Radial Applanation Tonometry as an Adjuvant Tool in the Noninvasive Arterial Stiffness and Blood Pressure Assessment

Since antiquity, the human arterial pulse represents an important parameter in the clinical assessment. Besides being routinely assessed in the medical practice, such pulse is not observed in its completeness yet, once many of the data obtained through it cannot be evaluated using conventional methods. Taking into account such methods, the measurement of arterial blood pressure using sphygmomanometry, although broadly widespread in the assessment and follow-up of patients who require accompaniment of their cardiovascular status, is not able to properly guide about parameters related to the central hemodynamic status, the latter most strongly associated with cardiovascular risk. Such incapability is due to the centrifugal augmentation of the pressures taken at different points of the arterial bed, based on the properties of the closed arterial system through which the blood flow travels. In this context, methodologies capable of assessing central parameters estimated using the pulse wave analysis, such as applanation tonometry, represent a promising adjuvant for evaluating patients with cardiovascular diseases, by providing detailed information concerning hemodynamic parameters otherwise inaccessible. In this scenario, the present review focuses on the applanation tonometry and its assessment on the radial artery, highlighting the importance of this method in the cardiovascular assessment, as well as its relevance in the clinical practice, when determining parameters peripherally obtained capable of estimating the central hemodynamic status.

Composition and Functional Capacity of Gut Microbes are Associated with Arterial Stiffness:A Prospective Study

Objective:Arterial stiffness is an important predictor of cardiovascular disease.Microbial diversity in the gut has been shown to be associated inversely with arterial stiffness in Caucasian populations.However,due to the different profiles of the gut microbiota among ethnicities,the relationship between gut-microbiota dysbiosis and the progression of arterial stiffness merits further investigation.This study aimed to investigate the association between the composition and functional capacity of the gut microbiota and the progression of arterial stiffness.Methods:“Shotgun”metagenomics sequencing were undertaken in 96 individuals from a hypertension-associated gut-microbiota study in the Kailuan cohort,who measured brachial-ankle pulse wave velocity(baPWV)and provided fecal samples between September 2014 and February 2015 at Kailuan General Hospital and 11 affiliated hospitals.The different composition and functional capacity of the gut microbiota were compared between individuals without arterial stiffness(normal arterial stiffness group,baPWV<1,400 cm/s,n=27)and participants with arterial stiffness(increased arterial stiffness group,baPWV≥1,400 cm/s,n=69)at baseline.These participants were followed up prospectively for a mean duration of 2.6 years,and 50 underwent a repeat baPWV measurement.Associations between the gut microbiota and severity and progression of arterial stiffness were assessed using MaAsLin2 software after adjustment for age,sex,and mean arterial blood pressure and correction for multiple testing.Gene“catalogs”were aligned to the Kyoto Encyclopedia of Genes and Genomes(KEGG)database to obtain information for potential functional capacities of the gut microbiota.Results:In this study,14 genera and 50 species of bacteria were identified to be abundant in participants with normal arterial stiffness compared with those with increased arterial stiffness.Of 14 genera,the prevalence of beneficial bacteria of the genera Leadbetterella and Cytophaga was correlated inversely with baPWV(P<0.05).Analyses of functional capacity revealed gut-microbial dysfunctions in the synthetic processes of“threonine dehydratase”“hypothetical protein”“mannosyl transferase”and“type-IV secretion-system proteins”in individuals suffering from arterial stiffness.During follow-up,bacteria of the proinflammatory genera Escherichia,Shigella,and Ruegeria were enriched in individuals with increased baPWV.Functional analyses showed that 26 KEGG orthologs of gut microbes were associated with an increase in baPWV and involved in“carbohydrate metabolism”“amino acid metabolism”and“protein families related to genetic information processing.”Conclusions:The composition and functional capacity of the microbial community in the gut of people suffering from arterial stiffness differed from those in individuals not suffering from arterial stiffness.Our data provide a new direction for the causality of the host-gut microbiota in arterial stiffness.

Relationships between use of statins and arterial stiffness in normotensive and hypertensive patients with coronary artery disease

Background Statins improve arterial stiffness in patients with coronary artery disease （CAD）.Hypertension is a predominant contributor of arterial stiffening.However,the influence of hypertension on the effect of statins for improving arterial stiffness in CAD patients has seldom been investigated.Therefore,in this study,we investigated the relationships between statin use and arterial stiffness in normotensive and hypertensive CAD patients.Methods Brachial-ankle pulse wave velocity （ba-PWV） was measured in 437 patients,including 220 hypertensive CAD patients （121 used statins,99 did not） and 217 normotensive CAD patients （105 used statins,112 did not）.The normotensive and hypertensive CAD patients were matched according to age,sex,and body mass index （BMI）.Results In the normotensive and hypertensive CAD patients,lipid profiles were significantly improved in the statin group compared with the non-statin group.No significant differences in the administered statins （i.e.,atorvastatin,simvastatin,rosuvastatin,and pravastatin） and statin therapy duration were found between normotensive and hypertensive CAD patients （all P＞0.05）.No significant correlation of ba-PWV and statin therapy duration was found in all CAD patients,normotensive CAD patients,or hypertensive CAD patients （all P＞0.05）.ba-PWV in the statin group was significantly lower than that in the non-statin group in normotensive CAD patients （（1331.68±167.52） cm/s vs.（1468.61±244.54） cm/s,P=0.002） but not in hypertensive CAD patients （P＞0.05）.In multiple linear regression analyses,statin therapy was significantly associated with ba-PWV after adjusting for confounding variables in normotensive CAD patients （P=0.018） but not in hypertensive CAD patients （P＞0.05）.Conclusions Statins may significantly improve arterial stiffness in CAD patients,and hypertension may probably influence the effectiveness of statin therapy in improving arterial stiffness in this population.Further studies are required to investigate the effect of statins on arterial stiffness in normotensive and hypertensive CAD patients.

Associations of plasma homocysteine and high-sensitivity C-reactive protein levels with arterial stiffness in Chinese population： a community-based study

Background Arterial stiffness increases with age and is also associated with traditional cardiovascular risk factors. Little is known about the relations of homocysteine and high-sensitivity C-reactive protein （hs-CRP） to arterial stiffness in the Chinese community. The aim of the present study was to investigate the association of plasma homocysteine and hs-CRP levels with arterial stiffness in a community-based cohort. Methods We related levels of homocysteine and hs-CRP to four measures of arterial stiffness （carotid-femoral pulse wave velocity （PWV）, carotid-radial PWV, carotid-ankle PWV and heart rate corrected augmentation index） in 1680 participants from two communities of Beijing, China. Arterial stiffness was measured within two days of the time of biomarker measurement. Results In univariate analysis, homocysteine was positively associated with the carotid-femoral PWV （r=0.211, P 〈0.0001）, carotid-radial PWV （r=0.120, P 〈0.0001） and carotid-ankle PWV （r=0.148, P 〈0.0001）, whereas it was inversely related to the augmentation index （r= -0.052, P=0.016）. Hs-CRP was positively associated with the carotid-femoral PWV （r=0.074, P=0.001） and carotid-ankle PWV （r=0.050, P=0.02）. In multiple-adjusted models （R2=0.57）, homocysteine levels remained a significant determinant of the carotid-femoral PWV （standardized 13=0.065, P=0.007）, whereas the association of hs-CRP with measurements of arterial stiffness was not present. Conclusions In the Chinese population, plasma homocysteine levels are associated with alterations of aortic stiffness, whereas plasma levels of hs-CRP are not independently related to artery stiffening.

Effect of aliskiren on arterial stiffness, compared with ramipril in patients with mild to moderate essential hypertension

Background Aliskiren is a novel blood pressure-lowering agent acting as an oral direct renin inhibitor. The aim of this study was to assess the effect of aliskiren on arterial stiffness, compared with that of ramipril in mild to moderate essential hypertensive patients. Methods Following a two week placebo run-in period, patients with a mean sitting diastolic blood pressure （ms-DBP） 〉95 and 〈110 mmHg （1 mmHg=0.133 kPa）, and a mean sitting systolic blood pressure （ms-SBP） 〈180 mmHg were randomly allocated to treatment with aliskiren （150 mg/d, n=20） or ramipril （5 mg/d, n=20） for eight weeks. Blood pressure, plasma renin activity, and the brachial-ankle pulse wave velocity （ba-PWV） were measured before and after eight weeks of treatment. Results Eight weeks of treatment significantly decreased systolic blood pressure and diastolic blood pressure in both the aliskiren group and ramipril group. The hypotensJve effect did not differ between the two groups. Plasma renin activity decreased after aliskiren treatment and increased after ramipril treatment. There was no significant difference in baseline ba-PWV between the aliskiren and ramipril groups （P=-0.892）. The ba-PWV was significantly reduced in both the aliskiren group （1535 （1405-1666） vs. 1464 （1360-1506） cm/s） （P 〈0.01） and the ramipril group （1544 （1433-1673） vs. 1447 （1327-1549） cm/s） （P 〈0.01）. No statistically significant difference was found in the decline of ba-PWV between the two groups （P=0.766）. Conclusions The current study revealed that aliskiren （150 mg/d） could ameliorate arterial stiffness and its effect was similar to ramipril （5 mg/d） in mild to moderate hypertensive patients, indicating that in addition to lowering blood pressure, aliskiren had beneficial effect on vascular protection.

Association between arterial stiffness and risk of coronary artery disease in a community-based population

Background Arterial stiffness is well known as an important risk factor for coronary artery disease.In this study,we aimed to investigate the association between carotid-ankle pulse wave velocity （caPWV） and risk of coronary artery disease （CAD）,and the interaction between pulse wave velocity （PWV） and other potential risk factors of CAD.Methods A community-based cross-sectional study was conducted for subjects living in Beijing,China.We collected 213 subjects with coronary artery disease and 1 266 subjects without CAD between September 2007 and January 2009 in a community center of Beijing.A multivariate Logistic regression analysis was carried out to assess the odds ratios of factors related to CAD.Results We found CAD subjects were more likely to have a higher body massindex （BMI）,fasting glucose,uric acid,low-density lipoprotein （LDL） cholesterol,high-sensitivity Creactive protein （hs-CRP）,carotic-femoral pulse wave velocity （cfPWV） and caPWV （P ＜0.05）,and CAD subjects had a significantly lower HDL cholesterol levels （P ＜0.05）.Moreover,the proportion of hypertension in CAD subjects was significantly higher than non-CAD subjects.The multiple Logistic regression analysis showed that hypertension,higher uric acid,hs-CRP,cfPWV and caPWV levels significantly increased the risk of CAD,with ORs （Cl） of 1.47 （1.25-1.74）,1.17 （1.01-1.26）,1.35 （1.10-1.67）,1.15 （1.09-1.19） and 1.07 （1.01-1.15）,respectively.Higher HDL cholesterol was significantly associated with reduced risk of CAD,with ORs （CI） of 0.58 （0.40-0.83）.In addition,cfPWV had significant association with age,hypertension,LDL cholesterol,with Pearson＇s coefficients of 0.166,0.074,and 0.030,respectively.Conclusions cfPWV and caPWV are independently associated with significant CAD,and cfPWV has significant correlation with age and hypertension.cfPWV and caPWV may be used as a practical tool for predicting the risk of CAD.

Effect of n-3 PUFAs on arterial stiffness in patients with cardiovascular disease

Background Fish oil, rich in long-chain n-3 PUFAs, EPA and DHA, are known to reduce various risk factors for CAD1-3. However, conclusive regarding the benefits of n-3 PUFAs on arterial stiffness, a risk factor for CAD, has not yet been established. Methods In the placebo-controlled, single-blind, prospective study, 60 subjects were randomly allocated to consume daily nutritional supplement of 3 gram capsules containing either placebo （soybean oil） or fish oil, EPA （540 mg） ＋ DHA （360 mg） for 12 weeks. Anthropometry, pulse wave velocity （PWV） and polyunsaturated fatty acid were measured and compared before and after study therapy. Results After study therapy, PWV reduced significantly in the fish oil group compared with the placebo group （-8 ± 18 cm/s vs 39 ± 19 cm/s, P 〈 0.05）. Conclusions Fish oil shows beneficial effect on improving arterial stiffness in patients with coronary disease.

Arterial Stiffness as a Cardiovascular Risk Factor in Prostate Cancer Survivors:A Case-Control Study

Purpose In New Zealand,prostate cancer (PCa) is the most commonly diagnosed cancer in men and the third most common cause of male cancer deaths.Among these patients,the most common non-cancer related cause of death is cardiovascular disease (CVD).Aortic arterial stiffness may be clinically viable solution for detecting and tracking CVD risk factor in PCa survivors.The aim of the study was to determine whether aortic arterial stiffness is increased in PCa survivors compared to age-matched controls.Methods Participants recruited for this prospective comparative study were PCa survivors who had completed treatment(other than endocrine therapy) or were on active surveillance compared,or were age-matched non-cancer controls.During a single 1-h appointment,all participants had measures of aortic arterial stiffness,arterial wave reflection,central blood pressure and body composition taken.Results Ninety-eight men were recruited,51 PCa survivors and 47 controls.There was no significant between group dif-ference for aortic arterial stiffness[12.0 m/s (SD:1.7) vs.12.0 m/s (SD:1.9),P=0.953,d=0.0].Fat free mass[60.7 kg(SD:4.9) vs.65.1 kg (SD:8.3),P=0.007,d=0.6]and skeletal muscle index[8.6 kg/m2 (SD:0.6) vs.9.0 kg/m2 (SD:0.9),P=0.050,d=0.5]were lower in the PCa group.Conclusions Aortic arterial stiffness is not increased (worse) in men with PCa who receive various treatments,compared to age-matched controls.These findings may indicate that factors other than increased aortic arterial stiffness contribute to heightened risk of cardiovascular events in this population.

Association of microalbuminuria with ambulatory arterial stiffness index in patients with type 2 diabets mellitus

Background Microalbuminuria （MAU） and ambulatory arterial stiffness index （AASI） may predict cardiovascular events and death. However, there is little information about the correlation between the two parameters in patients with type 2 diabetes mellitus （T2DM）. Therefore, we examined the association of MAU with 24-hour AASI in patients with T2DM. Methods A total of 189 patients with 24-hour ambulatory blood pressure monitoring （24h-ABPM） who were hospitalized from January 2011 to January 2017 were selected. 136 patients without hypertension were screened. The subjects were divided into two groups according to urinary albumin-to-creatinine ratio （uACR）. MAU group was defined as uACR of 30-299 mg/g （n=69）, NMAU group was defined as uACR 〈30 mg/g （n=67）. AASI was calculated as 1 minus the regression slope of diastolic blood pressure （DBP） value vs. systolic blood pressure （SBP） value according to ABPM. The differences of clinical and bio- chemical indicators between the two groups were determined. The correlation between AASI and MAU was analyzed by unconditional forward stepwise logistic regression. Results Patients with MAU had significantly higher level of diabetic duration, TC, LDL-C, Scr, AASI and lower eGFR than NMAU group （P〈0.05）. Using MAU as the dependent variable （ 1 with MAU and 0 without MAU）, LDL-C, decreased eGFR, AASI were independent risk factors of MAU in patients with T2DM. The ROC curve of AASI in predicting the risk of MAU showed when AASI was 0.48, the area under the curve was the largest 0.659（95 % CI 0.568-0.750, P=0.001）. The sensitivity was 71.0% and the specificity was 56.7%. Conclusions Patients with MAU have higher AASI than patients without MAU. As a new index of arterial stiffness, AASI is associated with MAU, and could inde- pendently predict MAU in patients with T2DM.

Benidipine has effects similar to losartan on the central blood pressure and arterial stiffness in mild to moderate essential hypertension

Background Central blood pressure （BP） is pathophysiologically more important than peripheral BP for the pathogenesis of cardiovascular disease. Arterial stiffness is also a good predictor of cardiovascular morbidity and mortality. The effects of benidipine, a unique dual L-IT-type calcium channel blocker, on central BP have not been reported. This study aimed to compare the effect of benidipine and Iosartan on the central BP and arterial stiffness in mild to moderate essential hypertensives. Methods This 24 weeks, multi-center, open label, randomized, active drug comparative, parallel group study was designed as a non-inferiority study. The eligible patients （n=200） were randomly assigned to receive benidipine （n=101） or Iosartan （n=99）. Radial artery applanation tonometry and pulse wave analysis were used to measure the central BP, pulse wave velocity （PWV） and augmentation index （AIx）. We also measured the metabolic and inflammatory markers. Results After 24 weeks, the central BP decreased significantly from baseline by （16.8±14.0/10.5±9.2） mmHg （1 mmHg =0.133 kPa） （systolic/diastolic BP; P 〈0.001） in benidipine group and （18.9±14.7/12.1±10.2） mmHg （P 〈0.001） in Iosartan group respectively. Both benidipine and Iosartan groups significantly lowered peripheral BP （P 〈0.001） and AIx （P 〈0.05）, but there were no significant differences between the two groups. The mean aortic, brachial and femoral PWV did not change in both groups after 24-week treatment. There were no significant changes of the blood metabolic and inflammatory biomarkers in each group. Conclusion Benidipine is as effective as Iosartan in lowering the central and peripheral BP, and improving arterial stiffness.

Evaluation of carotid intima-media thickness and carotid arterial stiffness in children with adenotonsillar hypertrophy

Background:Adenotonsillar hypertrophy can produce cardiopulmonary disease in children.However,it is unclear whether adenotonsillar hypertrophy causes atherosclerosis.This study evaluated carotid intimamedia thickness and carotid arterial stiffness in children with adenotonsillar hypertrophy.Methods:The study included 40 children with adenotonsillar hypertrophy(age:5-10 years)and 36 healthy children with similar age and body mass index.Systolic blood pressure,diastolic blood pressure,and pulse pressure were measured in all subjects.Carotid intima-media thickness,carotid arterial systolic diameter,and carotid arterial diastolic diameter were measured using a high-resolution ultrasound device.Based on these measurements,carotid arterial strain,carotid artery distensibility,beta stiffness index,and elasticity modulus were calculated.Results:Carotid intima-media thickness was greater in children with adenotonsillar hypertrophy(0.36±0.05 mm vs.0.34±0.04 mm,P=0.02)compared to healthy controls.Beta stiffness index(3.01±1.22 vs.2.98±0.98,P=0.85),elasticity modulus(231.39±99.23 vs.226.46±83.20,P=0.88),carotid arterial strain(0.17±0.06 vs.0.17±0.04,P=0.95),and carotid artery distensibility(13.14±3.88 vs.12.92±3.84,P=0.75)were similar between children with adenotonsillar hypertrophy and the healthy controls.Conclusions:The present study revealed increased carotid intima-media thickness in children with adenotonsillar hypertrophy.The risk of subclinical atherosclerosis may be higher in children with adenotonsillar hypertrophy.

Limb Muscle Hemodynamics and Arterial Distensibility Depend on Atmospheric Pressure in Hypertensive Men

Objective To verify whether peripheral blood circulation and arterial wall distensibility are influenced by atmospheric pressure （AtPr） and to examine if their association is dependent on age and/or sex. Methods Associations among natural AtPr levels （on the examination day as well as 1 and 2 days prior）, limb muscle hemodynamics, and distensibility of conduit arteries were retrospectively examined in an observational study of 276 untreated patients with primary moderate hypertension （mean age 56.4 years, 194 men）. Forearm and calf circulations at rest and 3 min after ischemia were measured by venous occlusion plethysmography. Compliance of the brachial and shank arteries was assessed by oscillometry. Results After adjustment for age, degree of hypertension, and season, correlation and multiple resression analyses revealed a season-independent but age-dependent direct correlation between the stiffness of limb arteries and AtPr levels on the examination day in men, but not women. The association weakened with the degree of hypertension, disappeared with age, and was more evident in the arms than in the legs. Conclusion Parameters of arterial wall distensibility in adult hypertensive men are susceptible to AtPr changes within the usually observed limits （730-770 mmHg）. It is proposed that reduction of arterial wall barometric responsiveness in women and aging men is a likely mechanism underlying their meteosensitivity.

The Impact of Finerenone on Changes in Pulse Wave Velocity, Arterial Pressure and Heart Related Deaths in Hemodialysis Patients—Study Perspective

The description in the abstract lacks clear logic and a comprehensive summary of this study, so please revise and improve it according to the design theme and main content of this study, and describe it in the order of (research background), purpose/aim, method, results and conclusions. The introduction of the abstract and preface is rather lengthy, but the summary of the whole study and the presentation of the research background are not perfect (mainly because the logic of the context is not clear and orderly), so it will appear a bit messy. Hope to be able to modify (this has been mentioned in the preliminary opinion). Cardiovascular events (CVE) pose a significant threat to individuals with end-stage renal disease (ESRD), yet these patients are often excluded from cardiovascular clinical trials, leaving prognostic factors associated with CVE in ESRD patients largely unexplored. Recent human studies have demonstrated elevated circulating aldosterone levels in ESRD patients, correlating with left ventricular hypertrophy. Additionally, animal models have shown improvements in uremic cardiomyopathy with spironolactone therapy, prompting interest in assessing the efficacy of spironolactone or eplerenone in reducing mortality and improving cardiovascular function in dialysis patients. Clinicians have historically been cautious about prescribing mineralocorticoid receptor antagonists (MRAs) to congestive heart failure patients with chronic kidney disease (CKD) due to hyperkalemia risk. However, the emergence of finerenone, a novel MR antagonist with a favorable safety profile and lower hyperkalemia risk, has renewed interest in MRA therapy in this population. Heart disease, including coronary artery disease, hypertension, and left ventricular failure, is alarmingly prevalent in dialysis patients, contributing significantly to elevated mortality rates compared to the general population. Arterial stiffness, as indicated by pulse wave velocity (PWV), progressively worsens with advancing CKD stages, peaking in severity among ESRD patients undergoing dialysis. High PWV serves as a crucial risk stratification tool in ESRD. Elevated NT-proBNP and BNP levels in ESRD patients are well-documented, with significant associations observed between baseline peptide concentrations and cardiovascular morbidity and mortality. By incorporating finerenone into our study, we aim to investigate its potential benefits in reducing arterial stiffness, lowering blood pressure, and ultimately mitigating heart-related mortality among hemodialysis patients. This study holds substantial implications for hypertension and cardiovascular risk management in this vulnerable patient population. Eligible participants must have been on chronic hemodialysis for at least three months, with ACE inhibitors or angiotensin receptor blockers included in their therapy at maximum tolerable doses. Serum potassium levels 5.7 mmol/L, left ventricular ejection fraction 50%, and PWV higher than age-estimated values are also prerequisites for study entry. Randomized allocation will be conducted using a permuted block design, stratified by center, with allocation communicated via signed study forms during initial examinations. All steps of this research will be conducted in accordance with the principles of the Helsinki Declaration.

Relationship between brachial-ankle pulse wave velocity and metabolic syndrome components in a Chinese population

The purpose of this study was to assess the relationship between arterial stiffness, as measured by brachial-ankle pulse wave velocity （baPWV）, and the presence of the metabolic syndrome （MS） in a Chinese population. A total of 4,445 subjects were enrolled. The prevalence of MS in for the general population, males and females, respectively. our study population was 21.7%, 17.2% and 25.6% With adjustments for age, gender, cigarette smoking, heart rate, total cholesterol, low-density lipoprotein （LDL） cholesterol, and the use of anti-hypertensive drug, the stepwise regression analysis showed that baPWV had a significant relationship with components of MS, including systolic blood pressure （P 〈 0.001）, diastolic blood pressure （P 〈 0.001）, glucose （P 〈 0.001）, highdensity lipoprotein （HDL） cholesterol （P = 0.04）, and triglycerides （P 〈 0.001）, but no relationship with waist circumference （P = 0.25）. With an increase in the number of the MS components, baPWV increased significantly both in women and men. This study indicated that the MS is indeed a risk factor for arterial stiffness. Monitoring of baPWV in patients with MS may help in identifying persons at high risk for cardiovascular disease.

Association of Estimated Pulse Wave Velocity and the Dynamic Changes in Estimated Pulse Wave Velocity with All-Cause Mortality among Middle-Aged and Elderly Chinese

Objective We aimed to clarify the association between estimated pulse wave velocity(ePWV)and the changes in ePWV with all-cause mortality among middle-aged and elderly Chinese.Methods Data were obtained from the China Health and Retirement Longitudinal Study(CHARLS)from 2011-2018.The ePWV was calculated using an equation that included age and mean blood pressure(MBP).The ΔePWV was assessed as the difference in ePWV between the first two waves.Cox proportional hazard models were used to determine the association between ePWV and ΔePWV with all-cause mortality after adjustment for potential confounders.Results Of 13,116 participants during a median follow-up of 7.0 years,1,356 deaths occurred.An increased ePWV was independently associated with all-cause mortality.The hazard ratio[95% confidence interval(CI)]for participants from the 1^(st)-4^(th) quartile groups was 1.00,1.69(1.31-2.18),3.09(2.44-3.91),and 8.54(6.78-10.75),respectively.Each standard deviation(SD)increment of ePWV increased the risk of all-cause mortality by 132%.Furthermore,theΔePWV was significantly associated with a 1.28-fold(95%CI,1.18-1.38)risk of all-cause mortality per SD increment.Conclusion This cohort study provided novel evidence from a Chinese population that an increased ePWV or progression of the ePWV was independently associated with all-cause mortality,which highlighted the importance of mitigating ePWV progression in clinical practice.

Subclinical Indication of Linkage Between Markers of Skeletal and Cardiovascular Properties

Little is known about early coincidental changes in bone and vascular properties, particularly in the context of skeletal anabolism （puberty） versus relative equilibrium （young adulthood）. We aimed to determine if subclinical markers of vascular function were associated with bone mineral content （BMC） and to evaluate the contribution of systemic factors in healthy females ages 14-42 years. Endothelial function was assessed by flow mediated dilatation （FMD）, arterial stiffness by pulse wave velocity （PWV） and augmentation index （AIx）, blood pressure （BP） by sphygmomanometer, BMC by DXA, and systemic factors by fasting blood draw. General linear models controlled for age, race and height indicated a positive association between systolic BP （SBP） and BMC independent of systemic factors. When stratified by age using 19 years as a cut-point, there was an inverse relationship between AIx75 in adolescents with insulin （P〈0.10） or inflammatory markers （P〈0.10） in statistical models. Conversely, there was a positive relationship between BMC and both PWV and AIx75 in young adults （P〈0.05）. The link between bone and the vasculature may be life stage-dependent. In the context of a less dynamic microenvironment in young adult females, metabolic factors appear to moderate less of an effect of hemodynamic properties on the skeleton relative to adolescents.

Effects of antihypertensives on arterial responses associated with obstructive sleep apneas

Background Many patients with obstructive sleep apnea syndrome (OSAS) have complicated with hypertension and may be prescribed with antihypertension medications to control their blood pressure But whether antihypertension medications can also decrease arterial stiffness or control the blood pressure increasing following obstructive events is not well described This study aimed to investigate whether antihypertensive medications can ameliorate the changes in arterial stiffness and blood pressure associated with OSA Methods Sixtyone OSAS patients [13 women, 48 men, mean age (534±123) years], 26 normotensive patients (N), 7 hypertensive patients on no antihypertension medications (H), and 28 hypertensive patients on various combination antihypertension therapy (HM), were prospectively diagnosed with standard nocturnal polysomnography Beattobeat blood pressure was continuously recorded from the radial artery by applanation tonometry during baseline sleep As a measure of arterial stiffness, arterial augmentation index (AAI) was calculated as the ratio of augmented systolic blood pressure (SBP) to pulse pressure and expressed as a percentage for the following conditions: awakening, the first 10 ('early apnea') and last 10 ('late apnea') cardiac cycles of obstructive events (apnea or hypopnea), and the first 15 cardiac cycles following event termination ('post apnea') for all events with nadir O2 saturation ≤89% Results Systolic blood pressure (SBP) postapnea [(14274±1306) mmHg (N), (13706±2656) mmHg (H), (13694±141) mmHg (HM)] was significantly increased from awakening [(13576±1476) mmHg (N), (13558±2317) mmHg (H), (12977±1400) mmHg (HM)], early apnea [(13053±1265) mmHg (N), (12447±2497) mmHg (H), (12604±1312) mmHg (HM)], and late apnea [(1298±1268) mmHg(N), (12478±2515) mmHg (H), (12448±1382) mmHg (HM)] respectively (P<0001, repeated measures ANOVA) AAI was significantly increased for the N group (P<0001) from awakening to late apnea [(1045±262)% vs (1443±321)%] and from early apnea to late apnea [(1061±234)% vs (1443±321)%], and also for H group (P<005) from awakening to late apnea [(1123±387)% vs (1632±802)%] and from early apnea to late apnea [(1175±379)% vs (1632±802)%] Meanwhile, no significant differences in AAI among awakening, early apnea, late apnea, and postapnea conditions were found in HM group Conclusions The current data demonstrate that systemic blood pressure increases significantly during the postapneic phase of OSAS, compared with that during awakening and intraapnea phases even with the use of combined antihypertensive therapy which could normalize BP during awakening in the hypertensive patients However, increases in arterial stiffness during obstructive events could be ameliorated by combined antihypertension medications