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 populati...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.展开更多
AIM:To access the association between albuminuria levels and arterial stiffness in non-diabetic patients with hypertension and chronic kidney disease(CKD) stages 1-2,treated with renin angiotensin blockade agents plus...AIM:To access the association between albuminuria levels and arterial stiffness in non-diabetic patients with hypertension and chronic kidney disease(CKD) stages 1-2,treated with renin angiotensin blockade agents plus other hypertensive drugs when needed.METHODS:One hundred fifteen patients [median age 52 years(68% males)] were consequently enrolled in the study.For each patient,we recorded gender,age,body mass index(BMI),peripheral systolic blood pressure(p SBP),peripheral diastolic blood pressure,peripheral pulse pressure,central systolic blood pressure(c SBP),central diastolic blood pressure(c DBP),central pulse pressure(c PP),hematocrit,hemoglobin,hs CRP,total cholesterol triglycerides,high-density lipoprotein-C,low-density lipoprotein-C,calcium,phosphorus,parathormone,and albumin,as well as 24 h urine albumin excretion.According to 24-h urine albumin collection,patients were then classified as those with moderately increased albuminuria(formerly called macroalbuminuria)(≤ 300 mg/d) and those with severely increased albuminuria(formerly called macroaluminuria(> 300 mg/d).We considered aortic stiffness(AS) indices [carotid femoral pulse wave velocity(PWVc-f) and augmentation index(AIx)] as primary outcomes ofthe study.We explored potential correlations between severely increased albuminuria and AS indices using a multiple linear regression model.RESULTS:Fifty-eight patients were included in the moderately increased albuminuria group and 57 in the severely increased albuminuria.Blood pressure measurements of the study population were 138 ± 14/82 ± 1.3 mm Hg(systolic/diastolic).There were no significant differences in age,sex,and BP measurements between the two groups.Patients with severely increased albuminuria had higher PWV and AIx than patients with moderately increased albuminuria(P < 0.02,P < 0.004,respectively).In addition these patients exhibited higher BMI(P < 0.03),hs CRP(P < 0.001),and fibrinogen levels(P < 0.02) compared to patients with moderately increased albuminuria.In multivariate linear regression analysis,severely increased albuminuria(β = 1.038,P < 0.010) p SBP(β = 0.028,P < 0.034) and Ht(β = 0.171,P = 0.001) remained independent determinants of the increased PWVc-f.Similarly,severely increased albuminuria(β = 4.385,P < 0.012),c SBP(β = 0.242,P < 0.001),c PP(β = 0.147,P < 0.01) and Ht levels(β = 0.591,P < 0.013) remained independent determinants of increased AIx.CONCLUSION:These findings demonstrate an independent association between AS indices and severely increased albuminuria in non-diabetic,hypertensive patients with CKD stages 1-2 treated with renin angiotensin aldosterone system blockers.展开更多
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...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.展开更多
Background: Coronary artery disease (CAD) is a paramount cause of death. Global and regional left ventricular (LV) systolic function is an important non-invasive marker of CAD. We can use tissue Doppler imaging (TDI) ...Background: Coronary artery disease (CAD) is a paramount cause of death. Global and regional left ventricular (LV) systolic function is an important non-invasive marker of CAD. We can use tissue Doppler imaging (TDI) to measure the low velocities generated by myocardium which are: S'-wave, E'-wave, and A'-wave. We aimed to examine the value of the S'-wave dispersion of TDI across mitral valve annular velocities to predict angiographically significant coronary artery obstruction. Patients and Methods: We included 100 patients with symptoms suggesting CAD. All patients had undergone full history taken and clinical examination;ECG, echocardiographic with assessment of LV function, and Doppler derived mitral valve velocities;TDI with measuring of S'-wave and coronary angiography. Lesions with ≥70% or more stenosis in major epicardial artery or ≥50% stenosis in the left main coronary artery were considered significant. Patients were classified into two groups according to the presence or absence of significant coronary stenosis. Results: Clinical and conventional echocardiographic and Tissue Doppler measures were comparable between the two groups;there was statisticallysignificant difference between Group I and Group II (P value;patients with significant coronary arteries lesions have higher S' wave dispersion as compared with patients with normal or mild significant coronary lesions. Conclusion: S'-wave dispersion may consider a good predictor of angiographically significant coronary artery disease.展开更多
To investigate the effect of aerobic exercise combined with whole-body vibration (WBV) training on metabolic syndrome risk, and inflammatory markers, and to compare its effects on arterial stiffness and several blood ...To investigate the effect of aerobic exercise combined with whole-body vibration (WBV) training on metabolic syndrome risk, and inflammatory markers, and to compare its effects on arterial stiffness and several blood parameters related to metabolic syndrome with those of aerobic training alone. Thirty healthy participants were divided into 2 groups matched for age and body mass index (BMI). Fifteen subjects were assigned to the WBV group (WBV + aerobic training) and the other 15 to the control group (aerobic training only). All participants performed a treadmill exercise 3 days/week for 4 weeks, for 50 min after 30 min rest period. Exercise was performed at a heart rate (HR) corresponding to 60% of the HR at each individual’s maximum oxygen uptake (VO2max). Body weight and BMI after training were significantly lower than those before training in the WBV group (P < 0.01). Concerning arterial stiffness, the pulse-wave velocity after training was significantly lower than that before training in the WBV group (1048.7 ± 105.6 vs. 1008.4 ± 101.1 cm/s, P < 0.05). Meanwhile, the VO2max after training was significantly higher than that before training in the WBV group (47.7 ± 12.8 vs. 51.4 ± 14.1 mL·min-1·kg-1, P < 0.01). However, no significant differences were observed in any parameters before and after training in the control group. Our results suggest that aerobic exercise combined with WBV training may be effective in reducing arterial stiffness and improving cardiorespiratory fitness than aerobic training alone.展开更多
Objective: To test the hypothesis that Human Immunodeficiency Virus (HIV) infection in Black patients is associated with increased cardiometabolic risk factors that may increase aortic stiffness assessed by pulse wave...Objective: To test the hypothesis that Human Immunodeficiency Virus (HIV) infection in Black patients is associated with increased cardiometabolic risk factors that may increase aortic stiffness assessed by pulse wave velocity (PWV). Methods: We matched 96 Cameroonian Controls to 238 (Un) treated HIV-positive patients [HIV] for age. In each participant, aortic PWV (ComplioR), blood pressures (BP), lipid profile and fasting blood glucose (FPG) were measured. Results: Waist circumference was lower in HIV than in Controls (both p g·dl-1), and of diabetes (FPG > 125 mg·dl-1) were higher in HIV than in the Controls (50% vs 27%, and 23% vs 1%, respectively;both p < 0.0001). HDL-C was lower in HIV as compared to the Control (p = 0.02). Fasting triglycerides (TG) and the atherogenic dyslipidemia ratio [log(TG)/HDL-C] were higher in HIV than in the Controls (both p < 0.05). Hypertension prevalence was high but comparable in the two groups (48% vs 44% respectively, p > 0.05). HIV patients exhibited a twice-higher prevalence of MetS (AHA/NHLBI score 33/5) than that of the Controls (41% vs 21%;p 0.01). Similarly, severity of MetS phenotype was higher in HIV as compared to the Controls (2.14% vs 1.59%;p < 0.0001). PWV adjusted for age, mean BP and gender was faster in HIV in comparison to the controls (7.33 m/s vs 6.86 m/s, respectively;p = 0.036). Conclusions: HIV infection is associated with higher prevalence of MetS and its phenotype in Black African patients that may induce increased aortic stiffness.展开更多
Traditional risk factors for cardiovascular disease can only assess risks for groups of people. New parameters of arterial stiffness are more reliable for predicting cardiovascular outcomes for individuals with and wi...Traditional risk factors for cardiovascular disease can only assess risks for groups of people. New parameters of arterial stiffness are more reliable for predicting cardiovascular outcomes for individuals with and without a cardiovascular history. The objective of this study was to assess the effects of Magnesium-EDTA chelation therapy using new methods and parameters such as pulse wave velocity (PWV), central blood pressure (SBPao) and endothelial function (Aix). We followed 43 patients with an abnormal PWV and SBPao, setting them up in two groups. The 21 patients in Group A had already been diagnosed with cardiovascular disease. The other 22 patients in Group B also showed abnormal PWV, SBPao and Aix, but showed no cardiovascular symptoms. Each patient in Groups A and B received one Mg-EDTA treatment per week. The total treatment plan consisted of 25 Mg-EDTA chelation treatments according to the standard protocol of IBCMT. After 25 Mg-EDTA chelation sessions, PWV and SBPao improved significantly in all patients of Groups A and B. In addition, Aix improved significantly in these patients, but remained abnormal. Group C included 18 asymptomatic patients with normal PWV or SBPao. Aix was abnormal in this group, but to a much lesser extent than Groups A and B. The 18 asymptomatic patients of Group C did not receive Mg-EDTA treatment. Observation showed no significant changes in all three parameters of arterial stiffness. The results of this study indicate that a course of treatment with Magnesium-EDTA chelation therapy significantly lowers cardiovascular risks. We conclude that Mg-EDTA chelation therapy improves PWV as an indicator of arterial stiffness, SBPao (central blood pressure) as an indicator of aortic elasticity and Aix (augmented aortic index) as an indicator of endothelial functioning. These improvements in PWV, SBPao and Aix demonstrate that atherosclerosis is a dynamic and (partially) reversible process.展开更多
Prevalent diabetes is at high risk for cardiovascular diseases and has a high familial inheritance. However, little is known whether a non-diabetic subject with a family history of diabetes is at high risk for vascula...Prevalent diabetes is at high risk for cardiovascular diseases and has a high familial inheritance. However, little is known whether a non-diabetic subject with a family history of diabetes is at high risk for vascular damage or not. The purpose of this study was to evaluate the association between a family history of diabetes and arterial stiffness in adult non-diabetic Japanese population. We analyzed eligible 787 non-diabetic subjects (502 men and 285 women) aged 35-69 years who enrolled in the baseline survey of a cohort study in Tokushima Prefecture, Japan and who underwent a brachial-ankle pulse wave velocity (ba-PWV) measurement. Information on individual life-style characteristics including medical history and treatment for diseases and a first-degree family history of diabetes was obtained through a structured self-administered questionnaire. Analysis of covariance and logistic regression analyses were used to evaluate the association between a family history of diabetes and ba-PWV. We found no differences in age-and-systolic blood pressure-adjusted and multivariate-adjusted means of ba-PWVs between subjects of both sexes with and without a family history of diabetes. Logistic regression analyses including both sexes also revealed that subjects with a family history of diabetes showed no differences in age-and-systolic blood pressure-adjusted and multivariate-adjusted odds ratios for high ba-PWV compared to those without that trait. Our results suggest that a family history of diabetes itself is not associated with arterial stiffness in adult non-diabetic Japanese population.展开更多
Objectives: To assess the arterial stiffness index (ASI) and pulse wave velocity (PWV) in patients with hypertension and to compare with age matched healthy controls;to assess and compare the ASI and PWV in relation t...Objectives: To assess the arterial stiffness index (ASI) and pulse wave velocity (PWV) in patients with hypertension and to compare with age matched healthy controls;to assess and compare the ASI and PWV in relation to the treatment status. Methods: The study was observational-cross sectional. Group one included chronic hypertensive patients on regular treatment for more than 2 months;group two included newly diagnosed hypertensive patients and group three had age matched healthy controls with normal blood pressure. The hypertensives subjects with other comormid conditions such as renal disease, diabetes were excluded from the study. The study was approved by the Institute Ethics Committee. The subjects were interviewed and explained the purpose of the study. All subjects gave written informed consent. The noninvasive periscope device was used to measure PWV, ASI and pulse pressure. Results: PWV, ASI and pulse pressure were statistically higher in hypertensive patients when compared to controls. Further, carotid-femoral PWV was correlated with mean arterial pressure in hypertensive subjects and was found to be statistically significant. Conclusion: PWV, ASI and pulse pressure are significantly higher in chronic and newly diagnosed non-diabetic hypertensives as compared to controls irrespective of their treatment status.展开更多
Background and objectives: Increased arterial stiffness is an accepted cardiovascular risk factor. Several studies have shown that regular exercise is associated with reduced arterial stiffness. However, the acute eff...Background and objectives: Increased arterial stiffness is an accepted cardiovascular risk factor. Several studies have shown that regular exercise is associated with reduced arterial stiffness. However, the acute effect is not well known. The aim of this study was to evaluate the immediate impact of exercise on arterial stiffness measured by pulse wave velocity (PWV). Subjects and Methods: Data from 100 consecutive patients who underwent graded maximal aerobic exercise test and pulse wave velocity study due to chest pain were analyzed. Results: With respect to brachial-ankle pulse wave velocity (baPWV), it decreased after the exercise test (before vs. after;1420 ± 260 vs. 1358 ± 245, 1428 ± 255, vs. 1360 ±239 cm/sec;left and right, respectively). Upper extremity systolic blood pressure did not change from baseline. However, upper extremity diastolic blood pressure increased slightly. In addition, lower extremity blood pressure decreased in both systolic and diastolic phases. In both normotensives and hypertensives, baPWV decreased after exercise test. Conclusion: Exercise immediately decreases arterial stiffness.展开更多
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...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.展开更多
Objective: Increased hemoglobin (Hb) levels are known to be associated with increased cardiovascular events and mortalities. Therefore, we assumed that high Hb levels were associated with arterial stiffness. Pulse wav...Objective: Increased hemoglobin (Hb) levels are known to be associated with increased cardiovascular events and mortalities. Therefore, we assumed that high Hb levels were associated with arterial stiffness. Pulse wave velocity (PWV) is a simple and noninvasive method for measuring arterial stiffness to assess cardiovascular disease in general populations. Accordingly, we conducted a cross-sectional study to explore the association of Hb with PWV. Methods: A total of 6642 adults aged 54.5 ± 11.2 years undergoing physical examinations were enrolled, 71.7% of whom were males. Arterial stiffness was evaluated by carotid-femoral PWV (cfPWV). Multivariable regression analyses were performed to determine the relationship between Hb and increased cfPWV. Results: In this study, the mean Hb (per 10 g/L increase) was 144.7 ± 13.9 g/L, and the mean cfPWV was 15.1 ± 3.1 m/s. cfPWV was significantly higher in high hemoglobin groups >15.4 g/L (Quartile 4) than in the lowest hemoglobin group (Quartile 1 < 13.6 g/L;P < 0.001). Multiple linear regression analysis revealed that Hb positively correlated with cfPWV (β= 0.16, P < 0.01). Univariate Logistic regression analysis revealed that Hb was associated with increased cfPWV, with an odd ratio (OR) of 1.46 (95% confidence interval [CI], 1.39-1.54). After adjusting for potential confounders, Hb and the highest Hb quartile group were also independently associated with increased cfPWV, with a fully adjusted OR of 1.11 (95% CI, 1.02-1.20) and 1.45 (95% CI, 1.01-2.08), respectively. Conclusion: This study demonstrated that Hb levels significantly correlate with increased cfPWV.展开更多
Background:Arterial stiffening increases with age and blood pressure and is associated with cardiovascular disease(CVD),but the relationship between blood pressure lowering and arterial stiffening is still uncertain,e...Background:Arterial stiffening increases with age and blood pressure and is associated with cardiovascular disease(CVD),but the relationship between blood pressure lowering and arterial stiffening is still uncertain,especially in older people.This study aimed to evaluate the effect of intensive blood pressure treatment on the progression of arterial stiffness and risk of CVD in older patients with hypertension.Methods:The Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients(STEP)trial was a multicenter,randomized,controlled trial performed at 42 clinical centers throughout China,and 8511 patients aged 60-80 years with essential hypertension were enrolled and randomly assigned to systolic blood pressure(SBP)target of 110 mmHg to<130 mmHg(intensive treatment)or 130 mmHg to<150 mmHg(standard treatment).Patients underwent repeated examinations of the brachial-ankle pulse wave velocity(baPWV)and ankle-brachial index(ABI)at baseline,and the arterial stiffness was evaluated at the 3-year follow-up.A total of 5339 patients who had twice repeated measurements were included in this study.Changes in arterial stiffness between the intensive and standard treatment groups were analyzed using a multivariate linear regression model.The Cox proportional hazard regression model was used to evaluate the effect of intensive treatment on primary CVD outcomes.Results:The changes in baPWV were 61.5 cm/s(95%confidence interval[CI]:49.8-73.2 cm/s)in the intensive treatment group and 98.4 cm/s(95%CI:86.7-110.1 cm/s)in the standard treatment group(P<0.001).Intensive treatment significantly delayed the progression of arterial stiffness,with an annual change of 23.1 cm·s^(-1)·year-1 vs.36.7 cm·s^(-1)·year^(-1)of baPWV in the intensive and standard treatment groups,respectively.During a median follow-up period of 3.36 years,primary CVD outcomes occurred in 77(2.9%)patients in the intensive treatment group compared with 93(3.5%)in the standard treatment group.Intensive treatment resulted in a significantly lower CVD risk in patients aged 70-80 years or with SBP<140 mmHg.Conclusion:Intensive blood pressure control with an SBP target of 110 mmHg to<130 mmHg could delay the progression of arterial stiffness and reduce the risk of CVD in older patients with hypertension.Clinical trial registration:http://www.clinicaltrials.gov;No.NCT03015311.展开更多
基金support by grants from the National Key TechnologiesR&D Program of China during the 11th Five-Year Plan Period(2007BAI07A10)the Jiangsu Province Science and TechnologySupport Program(BE2009613)the 9th Six Talents Peak Project ofJiangsu Province(WS-022),and the Qing Lan Project
文摘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.
文摘AIM:To access the association between albuminuria levels and arterial stiffness in non-diabetic patients with hypertension and chronic kidney disease(CKD) stages 1-2,treated with renin angiotensin blockade agents plus other hypertensive drugs when needed.METHODS:One hundred fifteen patients [median age 52 years(68% males)] were consequently enrolled in the study.For each patient,we recorded gender,age,body mass index(BMI),peripheral systolic blood pressure(p SBP),peripheral diastolic blood pressure,peripheral pulse pressure,central systolic blood pressure(c SBP),central diastolic blood pressure(c DBP),central pulse pressure(c PP),hematocrit,hemoglobin,hs CRP,total cholesterol triglycerides,high-density lipoprotein-C,low-density lipoprotein-C,calcium,phosphorus,parathormone,and albumin,as well as 24 h urine albumin excretion.According to 24-h urine albumin collection,patients were then classified as those with moderately increased albuminuria(formerly called macroalbuminuria)(≤ 300 mg/d) and those with severely increased albuminuria(formerly called macroaluminuria(> 300 mg/d).We considered aortic stiffness(AS) indices [carotid femoral pulse wave velocity(PWVc-f) and augmentation index(AIx)] as primary outcomes ofthe study.We explored potential correlations between severely increased albuminuria and AS indices using a multiple linear regression model.RESULTS:Fifty-eight patients were included in the moderately increased albuminuria group and 57 in the severely increased albuminuria.Blood pressure measurements of the study population were 138 ± 14/82 ± 1.3 mm Hg(systolic/diastolic).There were no significant differences in age,sex,and BP measurements between the two groups.Patients with severely increased albuminuria had higher PWV and AIx than patients with moderately increased albuminuria(P < 0.02,P < 0.004,respectively).In addition these patients exhibited higher BMI(P < 0.03),hs CRP(P < 0.001),and fibrinogen levels(P < 0.02) compared to patients with moderately increased albuminuria.In multivariate linear regression analysis,severely increased albuminuria(β = 1.038,P < 0.010) p SBP(β = 0.028,P < 0.034) and Ht(β = 0.171,P = 0.001) remained independent determinants of the increased PWVc-f.Similarly,severely increased albuminuria(β = 4.385,P < 0.012),c SBP(β = 0.242,P < 0.001),c PP(β = 0.147,P < 0.01) and Ht levels(β = 0.591,P < 0.013) remained independent determinants of increased AIx.CONCLUSION:These findings demonstrate an independent association between AS indices and severely increased albuminuria in non-diabetic,hypertensive patients with CKD stages 1-2 treated with renin angiotensin aldosterone system blockers.
基金supported by the National Key R&D Program of China[2021YFC2500500]Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences[2021-I2M-1-010]+2 种基金the National Natural Science Foundation of China[82073658]the Taikang Yicai Public Health and Epidemic Control Fund[TKYC-GW-2020]the Research Unit of Prospective Cohort of Cardiovascular Diseases and Cancers of the Chinese Academy of Medical Sciences[2019RU038]。
文摘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.
文摘Background: Coronary artery disease (CAD) is a paramount cause of death. Global and regional left ventricular (LV) systolic function is an important non-invasive marker of CAD. We can use tissue Doppler imaging (TDI) to measure the low velocities generated by myocardium which are: S'-wave, E'-wave, and A'-wave. We aimed to examine the value of the S'-wave dispersion of TDI across mitral valve annular velocities to predict angiographically significant coronary artery obstruction. Patients and Methods: We included 100 patients with symptoms suggesting CAD. All patients had undergone full history taken and clinical examination;ECG, echocardiographic with assessment of LV function, and Doppler derived mitral valve velocities;TDI with measuring of S'-wave and coronary angiography. Lesions with ≥70% or more stenosis in major epicardial artery or ≥50% stenosis in the left main coronary artery were considered significant. Patients were classified into two groups according to the presence or absence of significant coronary stenosis. Results: Clinical and conventional echocardiographic and Tissue Doppler measures were comparable between the two groups;there was statisticallysignificant difference between Group I and Group II (P value;patients with significant coronary arteries lesions have higher S' wave dispersion as compared with patients with normal or mild significant coronary lesions. Conclusion: S'-wave dispersion may consider a good predictor of angiographically significant coronary artery disease.
基金grants from the Key National Basic Research Program of China,Nature Science Foundation of China (81270941) to Ye P,and the Nature Science Foundation of China,the Beijing Nova Program (Z121107002513124) to Bai Y
基金This work was supported by grants from the Key National Basic Research Program of China (2012CB517503, 2013CB530804) and Nature Science Foundation of China (81270941) to Ye P, and the Nature Science Foundation of China (81100878) and the Beijing Nova Program (Z121107002513124) to Bai Y. The authors have no conflict of interest to declare.
文摘To investigate the effect of aerobic exercise combined with whole-body vibration (WBV) training on metabolic syndrome risk, and inflammatory markers, and to compare its effects on arterial stiffness and several blood parameters related to metabolic syndrome with those of aerobic training alone. Thirty healthy participants were divided into 2 groups matched for age and body mass index (BMI). Fifteen subjects were assigned to the WBV group (WBV + aerobic training) and the other 15 to the control group (aerobic training only). All participants performed a treadmill exercise 3 days/week for 4 weeks, for 50 min after 30 min rest period. Exercise was performed at a heart rate (HR) corresponding to 60% of the HR at each individual’s maximum oxygen uptake (VO2max). Body weight and BMI after training were significantly lower than those before training in the WBV group (P < 0.01). Concerning arterial stiffness, the pulse-wave velocity after training was significantly lower than that before training in the WBV group (1048.7 ± 105.6 vs. 1008.4 ± 101.1 cm/s, P < 0.05). Meanwhile, the VO2max after training was significantly higher than that before training in the WBV group (47.7 ± 12.8 vs. 51.4 ± 14.1 mL·min-1·kg-1, P < 0.01). However, no significant differences were observed in any parameters before and after training in the control group. Our results suggest that aerobic exercise combined with WBV training may be effective in reducing arterial stiffness and improving cardiorespiratory fitness than aerobic training alone.
文摘Objective: To test the hypothesis that Human Immunodeficiency Virus (HIV) infection in Black patients is associated with increased cardiometabolic risk factors that may increase aortic stiffness assessed by pulse wave velocity (PWV). Methods: We matched 96 Cameroonian Controls to 238 (Un) treated HIV-positive patients [HIV] for age. In each participant, aortic PWV (ComplioR), blood pressures (BP), lipid profile and fasting blood glucose (FPG) were measured. Results: Waist circumference was lower in HIV than in Controls (both p g·dl-1), and of diabetes (FPG > 125 mg·dl-1) were higher in HIV than in the Controls (50% vs 27%, and 23% vs 1%, respectively;both p < 0.0001). HDL-C was lower in HIV as compared to the Control (p = 0.02). Fasting triglycerides (TG) and the atherogenic dyslipidemia ratio [log(TG)/HDL-C] were higher in HIV than in the Controls (both p < 0.05). Hypertension prevalence was high but comparable in the two groups (48% vs 44% respectively, p > 0.05). HIV patients exhibited a twice-higher prevalence of MetS (AHA/NHLBI score 33/5) than that of the Controls (41% vs 21%;p 0.01). Similarly, severity of MetS phenotype was higher in HIV as compared to the Controls (2.14% vs 1.59%;p < 0.0001). PWV adjusted for age, mean BP and gender was faster in HIV in comparison to the controls (7.33 m/s vs 6.86 m/s, respectively;p = 0.036). Conclusions: HIV infection is associated with higher prevalence of MetS and its phenotype in Black African patients that may induce increased aortic stiffness.
文摘Traditional risk factors for cardiovascular disease can only assess risks for groups of people. New parameters of arterial stiffness are more reliable for predicting cardiovascular outcomes for individuals with and without a cardiovascular history. The objective of this study was to assess the effects of Magnesium-EDTA chelation therapy using new methods and parameters such as pulse wave velocity (PWV), central blood pressure (SBPao) and endothelial function (Aix). We followed 43 patients with an abnormal PWV and SBPao, setting them up in two groups. The 21 patients in Group A had already been diagnosed with cardiovascular disease. The other 22 patients in Group B also showed abnormal PWV, SBPao and Aix, but showed no cardiovascular symptoms. Each patient in Groups A and B received one Mg-EDTA treatment per week. The total treatment plan consisted of 25 Mg-EDTA chelation treatments according to the standard protocol of IBCMT. After 25 Mg-EDTA chelation sessions, PWV and SBPao improved significantly in all patients of Groups A and B. In addition, Aix improved significantly in these patients, but remained abnormal. Group C included 18 asymptomatic patients with normal PWV or SBPao. Aix was abnormal in this group, but to a much lesser extent than Groups A and B. The 18 asymptomatic patients of Group C did not receive Mg-EDTA treatment. Observation showed no significant changes in all three parameters of arterial stiffness. The results of this study indicate that a course of treatment with Magnesium-EDTA chelation therapy significantly lowers cardiovascular risks. We conclude that Mg-EDTA chelation therapy improves PWV as an indicator of arterial stiffness, SBPao (central blood pressure) as an indicator of aortic elasticity and Aix (augmented aortic index) as an indicator of endothelial functioning. These improvements in PWV, SBPao and Aix demonstrate that atherosclerosis is a dynamic and (partially) reversible process.
文摘Prevalent diabetes is at high risk for cardiovascular diseases and has a high familial inheritance. However, little is known whether a non-diabetic subject with a family history of diabetes is at high risk for vascular damage or not. The purpose of this study was to evaluate the association between a family history of diabetes and arterial stiffness in adult non-diabetic Japanese population. We analyzed eligible 787 non-diabetic subjects (502 men and 285 women) aged 35-69 years who enrolled in the baseline survey of a cohort study in Tokushima Prefecture, Japan and who underwent a brachial-ankle pulse wave velocity (ba-PWV) measurement. Information on individual life-style characteristics including medical history and treatment for diseases and a first-degree family history of diabetes was obtained through a structured self-administered questionnaire. Analysis of covariance and logistic regression analyses were used to evaluate the association between a family history of diabetes and ba-PWV. We found no differences in age-and-systolic blood pressure-adjusted and multivariate-adjusted means of ba-PWVs between subjects of both sexes with and without a family history of diabetes. Logistic regression analyses including both sexes also revealed that subjects with a family history of diabetes showed no differences in age-and-systolic blood pressure-adjusted and multivariate-adjusted odds ratios for high ba-PWV compared to those without that trait. Our results suggest that a family history of diabetes itself is not associated with arterial stiffness in adult non-diabetic Japanese population.
文摘Objectives: To assess the arterial stiffness index (ASI) and pulse wave velocity (PWV) in patients with hypertension and to compare with age matched healthy controls;to assess and compare the ASI and PWV in relation to the treatment status. Methods: The study was observational-cross sectional. Group one included chronic hypertensive patients on regular treatment for more than 2 months;group two included newly diagnosed hypertensive patients and group three had age matched healthy controls with normal blood pressure. The hypertensives subjects with other comormid conditions such as renal disease, diabetes were excluded from the study. The study was approved by the Institute Ethics Committee. The subjects were interviewed and explained the purpose of the study. All subjects gave written informed consent. The noninvasive periscope device was used to measure PWV, ASI and pulse pressure. Results: PWV, ASI and pulse pressure were statistically higher in hypertensive patients when compared to controls. Further, carotid-femoral PWV was correlated with mean arterial pressure in hypertensive subjects and was found to be statistically significant. Conclusion: PWV, ASI and pulse pressure are significantly higher in chronic and newly diagnosed non-diabetic hypertensives as compared to controls irrespective of their treatment status.
文摘Background and objectives: Increased arterial stiffness is an accepted cardiovascular risk factor. Several studies have shown that regular exercise is associated with reduced arterial stiffness. However, the acute effect is not well known. The aim of this study was to evaluate the immediate impact of exercise on arterial stiffness measured by pulse wave velocity (PWV). Subjects and Methods: Data from 100 consecutive patients who underwent graded maximal aerobic exercise test and pulse wave velocity study due to chest pain were analyzed. Results: With respect to brachial-ankle pulse wave velocity (baPWV), it decreased after the exercise test (before vs. after;1420 ± 260 vs. 1358 ± 245, 1428 ± 255, vs. 1360 ±239 cm/sec;left and right, respectively). Upper extremity systolic blood pressure did not change from baseline. However, upper extremity diastolic blood pressure increased slightly. In addition, lower extremity blood pressure decreased in both systolic and diastolic phases. In both normotensives and hypertensives, baPWV decreased after exercise test. Conclusion: Exercise immediately decreases arterial stiffness.
基金This work was supported by grants from the Key National Basic Research Program of China (No. 2013CB530804) and from National Natural Science Foundation of China (No. 81270941).
文摘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.
文摘Objective: Increased hemoglobin (Hb) levels are known to be associated with increased cardiovascular events and mortalities. Therefore, we assumed that high Hb levels were associated with arterial stiffness. Pulse wave velocity (PWV) is a simple and noninvasive method for measuring arterial stiffness to assess cardiovascular disease in general populations. Accordingly, we conducted a cross-sectional study to explore the association of Hb with PWV. Methods: A total of 6642 adults aged 54.5 ± 11.2 years undergoing physical examinations were enrolled, 71.7% of whom were males. Arterial stiffness was evaluated by carotid-femoral PWV (cfPWV). Multivariable regression analyses were performed to determine the relationship between Hb and increased cfPWV. Results: In this study, the mean Hb (per 10 g/L increase) was 144.7 ± 13.9 g/L, and the mean cfPWV was 15.1 ± 3.1 m/s. cfPWV was significantly higher in high hemoglobin groups >15.4 g/L (Quartile 4) than in the lowest hemoglobin group (Quartile 1 < 13.6 g/L;P < 0.001). Multiple linear regression analysis revealed that Hb positively correlated with cfPWV (β= 0.16, P < 0.01). Univariate Logistic regression analysis revealed that Hb was associated with increased cfPWV, with an odd ratio (OR) of 1.46 (95% confidence interval [CI], 1.39-1.54). After adjusting for potential confounders, Hb and the highest Hb quartile group were also independently associated with increased cfPWV, with a fully adjusted OR of 1.11 (95% CI, 1.02-1.20) and 1.45 (95% CI, 1.01-2.08), respectively. Conclusion: This study demonstrated that Hb levels significantly correlate with increased cfPWV.
基金supported by grants from the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(Nos.2016-I2M-1-006 and 2021-I2M-1-011)
文摘Background:Arterial stiffening increases with age and blood pressure and is associated with cardiovascular disease(CVD),but the relationship between blood pressure lowering and arterial stiffening is still uncertain,especially in older people.This study aimed to evaluate the effect of intensive blood pressure treatment on the progression of arterial stiffness and risk of CVD in older patients with hypertension.Methods:The Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients(STEP)trial was a multicenter,randomized,controlled trial performed at 42 clinical centers throughout China,and 8511 patients aged 60-80 years with essential hypertension were enrolled and randomly assigned to systolic blood pressure(SBP)target of 110 mmHg to<130 mmHg(intensive treatment)or 130 mmHg to<150 mmHg(standard treatment).Patients underwent repeated examinations of the brachial-ankle pulse wave velocity(baPWV)and ankle-brachial index(ABI)at baseline,and the arterial stiffness was evaluated at the 3-year follow-up.A total of 5339 patients who had twice repeated measurements were included in this study.Changes in arterial stiffness between the intensive and standard treatment groups were analyzed using a multivariate linear regression model.The Cox proportional hazard regression model was used to evaluate the effect of intensive treatment on primary CVD outcomes.Results:The changes in baPWV were 61.5 cm/s(95%confidence interval[CI]:49.8-73.2 cm/s)in the intensive treatment group and 98.4 cm/s(95%CI:86.7-110.1 cm/s)in the standard treatment group(P<0.001).Intensive treatment significantly delayed the progression of arterial stiffness,with an annual change of 23.1 cm·s^(-1)·year-1 vs.36.7 cm·s^(-1)·year^(-1)of baPWV in the intensive and standard treatment groups,respectively.During a median follow-up period of 3.36 years,primary CVD outcomes occurred in 77(2.9%)patients in the intensive treatment group compared with 93(3.5%)in the standard treatment group.Intensive treatment resulted in a significantly lower CVD risk in patients aged 70-80 years or with SBP<140 mmHg.Conclusion:Intensive blood pressure control with an SBP target of 110 mmHg to<130 mmHg could delay the progression of arterial stiffness and reduce the risk of CVD in older patients with hypertension.Clinical trial registration:http://www.clinicaltrials.gov;No.NCT03015311.