BACKGROUND AND OBJECTIVES : Pulse wave velocity (PWV) is an ideal indicator of arterial stiffness. This study investigated arterial stiffness of different vascular regions in patients suffering with Behcet's disease (BD), and we assessed whether arterial stiffness was affected by the clinical parameters of BD. Subjects and METHODS : This study included 53 BD patients (mean age: 38+/-8 years) and 65 healthy controls (mean age: 38+/-8 years) who were without any known cardiovascular diseases. After recording the clinical parameters of the BD patients, pulse wave velocity was measured with an automated device in the heart-femoral, heart-carotid, heart-brachial and femoral-ankle segments. RESULTS : Patients with BD had significantly higher PWV values than did the controls in all the regional arterial segments. The PWV values were not correlated with the duration of the disease, corticosteroid use or the presence of active disease at the time of examination. The clinical variables related to severe BD manifestations, which included severe disease, male gender, vascular lesions or immunosuppressant use, were partly associated with increased PWV on the univariate analysis, but any statistical significance for these clinical variables was lost in all the regional arterial segments on multivariate analysis. In addition, multivariate regression analysis revealed that age and the mean arterial pressure were independently associated with increased PWV in most regional arterial segments for BD patients. CONCLUSION : The patients with BD had significantly increased arterial stiffness in all the regional arterial segments when compared with the healthy controls. Longitudinal studies that employ a large population are required to determine the pathophysiologic and prognostic implications of increased arterial stiffness in BD.
Arterial Pressure ; Arteries ; Cardiovascular Diseases ; Humans ; Longitudinal Studies ; Male ; Multivariate Analysis ; Pulse Wave Analysis ; Vascular Stiffness*

OBJECTIVE: To explore the central aortic pressure in patients with Parkinson's disease (PD). METHODS: We investigated central arterial stiffness by measurement of the augmentation index (AIx) in PD patients. Patients were eligible for the study if they were de novo PD and 45 years of age or older. The patients’ demographics, vascular risk factors, and neurologic examinations were collected at baseline. The AIx was measured by applanation tonometry. RESULTS: A total of 147 subjects (77 in control and 70 in PD groups) were enrolled in the study. While there was no significant difference in peripheral systolic blood pressure (SBP), diastolic blood pressure (DBP), or mean arterial pressure between groups, peripheral pulse pressure (PP) was significantly lower in the PD group than in the control group (p = 0.012). Regarding central pressure, aortic DBP was significantly higher and PP was significantly lower in the PD group (p = 0.001, < 0.0001). Although there was no significant difference in the AIx between the groups, a trend toward a lower AIx was observed in the PD group (31.2% vs. 28.1%, p = 0.074). CONCLUSION: This study showed that peripheral and central PP was significantly lower in the PD group than in the control group. Our study suggests that PD patients may have a low risk of a cardiovascular event by reason of a lower PP.
Arterial Pressure ; Blood Pressure ; Demography ; Hemodynamics* ; Humans ; Manometry ; Neurologic Examination ; Parkinson Disease* ; Risk Factors ; Vascular Stiffness

OBJECTIVETo investigate the differences in central hemodynamic indices between hypertensive and normotensive subjects and identify the blood pressure index that the most strongly correlate with arterial stiffness and vascular damage markers.

METHODSA cohort of 820 hypertensive patients and 820 normotensive individuals matched for age and gender were enrolled in this study. We measured carotid-femoral and carotid-radial pulse wave velocity (PWV), aortic augmentation index (AIx) and central blood pressures using pulse wave analysis and applanation tonometry. Plasma homocysteine (HCY), high-sensitivity C-reactive protein (hsCRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were also tested in these subjects.

RESULTSIn both hypertensive and normotensive subjects, the central systolic blood pressure (SBP) and pulse pressure (PP) were significantly lower than brachial SBP and PP; this PP amplification was significantly lower in the normotensives (9.85∓6.55 mmHg) than in the hypertensives (12.64∓6.69 mmHg), but the amplification ratios were comparable between the two groups. Blood pressure and age were closely related with aortic arterial stiffness. Compared with normotensive subjects, hypertensive subjects had higher carotid-femoral PWV and AIx, and showed significantly lowered PP amplification ratio with age. Central PP was more strongly related to arterial stiffness and vascular damage markers than the other pressure indices. Multivariate analyses revealed that carotid-femoral PWV and aortic AIx were strongly influenced by central PP but not by the mean blood pressure or brachial PP.

CONCLUSIONThe central PP is a more direct indicator of central arterial stiffness and a better marker of vascular aging than other blood pressure variables. These findings support the use of central blood pressure as a treatment target in future trials.

Aorta ; physiopathology ; Arterial Pressure ; Blood Pressure ; Case-Control Studies ; Hemodynamics ; Humans ; Hypertension ; Pulse Wave Analysis ; Vascular Stiffness

BACKGROUND/OBJECTIVES: We compared changes in heart-femoral pulse wave velocity (hfPWV) in response to low sodium and high sodium diet between individuals with sodium sensitivity (SS) and resistance (SR) to evaluate the influence of sodium intake on arterial stiffness. SUBJECTS/METHODS: Thirty-one hypertensive and 70 normotensive individuals were given 7 days of low sodium dietary approach to stop hypertension (DASH) diet (LSD, 100 mmol NaCl/day) followed by 7 days of high sodium DASH diet (HSD, 300 mmol NaCl/day) during 2 weeks of hospitalization. The hfPWV was measured and compared after the LSD and HSD. RESULTS: The hfPWV was significantly elevated from LSD to HSD in individuals with SS (P = 0.001) independently of changes in mean arterial pressure (P = 0.037). Conversely, there was no significant elevation of hfPWV from LSD to HSD in individuals with SR. The percent change in hfPWV from the LSD to the HSD in individuals with SS was higher than that in individuals with SR. Subgroup analysis revealed that individuals with both SS and hypertension showed significant elevation of hfPWV from LSD to HSD upon adjusted analysis using changes of the means arterial pressure (P = 0.040). However, there was no significant elevation of hfPWV in individuals with SS and normotension. CONCLUSION: High sodium intake elevated hfPWV in hypertensive individuals with SS, suggesting that high sodium intake increases aortic stiffness, and may contribute to enhanced cardiovascular risk in hypertensive individuals with SS.
Arterial Pressure ; Diet* ; Hospitalization ; Humans ; Hypertension ; Lysergic Acid Diethylamide ; Pulse Wave Analysis* ; Sodium* ; Sodium, Dietary ; Vascular Stiffness

BACKGROUND/OBJECTIVES: We compared changes in heart-femoral pulse wave velocity (hfPWV) in response to low sodium and high sodium diet between individuals with sodium sensitivity (SS) and resistance (SR) to evaluate the influence of sodium intake on arterial stiffness. SUBJECTS/METHODS: Thirty-one hypertensive and 70 normotensive individuals were given 7 days of low sodium dietary approach to stop hypertension (DASH) diet (LSD, 100 mmol NaCl/day) followed by 7 days of high sodium DASH diet (HSD, 300 mmol NaCl/day) during 2 weeks of hospitalization. The hfPWV was measured and compared after the LSD and HSD. RESULTS: The hfPWV was significantly elevated from LSD to HSD in individuals with SS (P = 0.001) independently of changes in mean arterial pressure (P = 0.037). Conversely, there was no significant elevation of hfPWV from LSD to HSD in individuals with SR. The percent change in hfPWV from the LSD to the HSD in individuals with SS was higher than that in individuals with SR. Subgroup analysis revealed that individuals with both SS and hypertension showed significant elevation of hfPWV from LSD to HSD upon adjusted analysis using changes of the means arterial pressure (P = 0.040). However, there was no significant elevation of hfPWV in individuals with SS and normotension. CONCLUSION: High sodium intake elevated hfPWV in hypertensive individuals with SS, suggesting that high sodium intake increases aortic stiffness, and may contribute to enhanced cardiovascular risk in hypertensive individuals with SS.
Arterial Pressure ; Diet* ; Hospitalization ; Humans ; Hypertension ; Lysergic Acid Diethylamide ; Pulse Wave Analysis* ; Sodium* ; Sodium, Dietary ; Vascular Stiffness

BACKGROUND AND OBJECTIVES: Large-artery stiffness is an independent predictor of cardiovascular disease (CVD), and carotid-femoral pulse wave velocity (cfPWV) is considered the gold standard measure of arterial stiffness. A resting heart rate is an easily measured vital sign that is also associated with CVD morbidity and mortality. Previous studies have reported the significant relationship of a resting heart rate with arterial stiffness as measured by cfPWV only in hypertensive subjects; their relationship in nonhypertensive subjects remains unknown. The present study, therefore, examined their relationship in normotensive subjects. SUBJECTS AND METHODS: In 102 healthy Korean Americans between ages 20 and 60 years, their resting heart rate was measured by an automated blood pressure measuring device after a 10 minute rest in the supine position. Arterial stiffness was measured by cfPWV using the SphygmoCor device. RESULTS: The mean resting heart rate of participants (mean age, 39.64 years; 59% women) was 61.91 bpm (standard deviation [SD], 9.62 bpm) and mean the cfPWV was 6.99 (SD, 1.14) m/s. A multiple regression analysis showed that a resting heart rate is a significant predictor of cfPWV after controlling for age, body mass index, and mean arterial pressure. For one bpm increase of resting heart rate, cfPWV increased approximately 0.02 m/s. CONCLUSION: Our results suggest that a higher resting heart rate is independently associated with increased arterial stiffness as measured by cfPWV in normotensive adults. Arterial stiffness may explain the prognostic role of an individual's heart rate in cardiovascular morbidity and mortality.
Adult* ; Arterial Pressure ; Asian Americans ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Mortality ; Pulse Wave Analysis ; Supine Position ; Vascular Stiffness* ; Vital Signs

BACKGROUND AND OBJECTIVES: Microalbuminuria (MAU) and decreased estimated glomerular filtration rate (eGFR) are risk factors for cardiovascular disease (CVD) in patients with hypertension. However, in hypertensive patients with normal or minimally reduced eGFR (> or =60 mL/min/1.73 m2) and with normo- or MAU, the value of combined estimation of eGFR and urine microalbumin for the risk assessment has not been widely reported. We evaluated the association between arterial stiffness and the combined estimation of eGFR and urine microalbumin. SUBJECTS AND METHODS: Subjects with never treated hypertension and normal or minimally reduced eGFR were evaluated (n=491, 50.1+/-10.4 years). eGFR was calculated by the simplified Modification of Diet in Renal Disease formula. Urinary albumin-to-creatinine ratio (UACR) was assessed with spot urine. Arterial stiffness was assessed with heart-femoral pulse wave velocity (hfPWV). All subjects were divided into four groups; group 1, eGFR > or =90 mL/min/1.73 m2 (normal eGFR) and normo-albuminuria (NAU); group 2, eGFR 89.9-60 mL/min/1.73 m2 (minimally reduced eGFR) and NAU; group 3, normal eGFR and MAU; group 4, minimally reduced eGFR and MAU. RESULTS: Group 1 had the lowest hfPWV (964.6+/-145.4; group 2, 1013.5+/-168.9; group 3, 1058.2+/-238.0; group 4, 1065.8+/-162.9 cm/sec). Analysis adjusting age, sex, body mass index, heart rate and mean arterial pressure showed significantly lower hfPWV of group 1 compared to group 2 (p=0.032) and 3 (p=0.007). Multiple regression analysis showed a significant association of hfPWV with logUACR {beta=0.096, 95% confidence interval (CI) 8.974-60.610, p=0.008} and eGFR (beta=-0.069, 95% CI -1.194 - -0.005, p=0.048). CONCLUSION: Minimally reduced eGFR or MAU is independently associated with increased arterial stiffness, indicating greater CVD risk.
Arterial Pressure ; Body Mass Index ; Cardiovascular Diseases ; Diet ; Glomerular Filtration Rate ; Heart Rate ; Humans ; Hypertension ; Pulse Wave Analysis ; Renal Insufficiency ; Risk Assessment ; Risk Factors ; Vascular Stiffness

Cardiovascular disease is the leading cause of morbidity and mortality worldwide. Early detection of subclinical atherosclerosis is important for reduction of cardiovascular risk. However, the current diagnostic strategy, which focuses on traditional risk factors or the use of risk scoring, is unsatisfactory. Arterial walls thicken and stiffen with age, a process known as arteriosclerosis. There is a close interaction between arterial stiffness and atherosclerosis. Increased luminal pressure and shear stress caused by arterial stiffening result in endothelial dysfunction, accelerate the formation of atheromas, and stimulate excessive collagen production and deposition in the arterial wall. Carotid intima-media thickness (CIMT) has been shown to predict cardiovascular risk in many large studies. However, there is controversy regarding the value of CIMT for prediction of cardiovascular risk because of differences in study design, specifically with respect to CIMT measurements. Pulse wave velocity (PWV) is the most widely used measure of arterial stiffness; measurement of PWV is simple, non-invasive, and reproducible. Many clinical studies and meta-analyses have shown that PWV has predictive value in cardiovascular disease beyond traditional risk factors, both in the general population and in patients with various diseases. Brachial pressure has been a poor surrogate for aortic pressure for more than 50 years. However, recent studies have shown a closer relationship between central blood pressure and intermediate cardiovascular phenotypes or cardiovascular target organ damage, compared to the respective relationships with brachial blood pressure. Considering the non-invasiveness and ability to collect multiple types of clinical data, measurement of CIMT, PWV, and central blood pressure may be useful to identify patients at high risk for development of cardiovascular disease.
Arterial Pressure ; Arteriosclerosis ; Atherosclerosis ; Blood Pressure ; Cardiovascular Diseases ; Carotid Intima-Media Thickness ; Collagen ; Humans ; Mortality ; Phenobarbital ; Phenotype ; Plaque, Atherosclerotic ; Pulse Wave Analysis ; Risk Factors ; Vascular Stiffness

OBJECTIVES: The purpose of this study was to investigate the association of the average volume of alcohol consumption and binge drinking with arterial stiffness. METHODS: The study population consisted of 5944 community-dwelling healthy adults aged 50 years and older. Average volume of alcohol consumption was calculated and frequency of binge drinking defined as the consumption of 7 or more drinks for men and 5 or more for women on a single occasion, was assessed using a structured interview. High brachial-ankle pulse wave velocity (baPWV), a marker of arterial stiffness, was defined as the highest gender-specific quartile of maximal baPWV distribution in the study population. RESULTS: Compared to never drinkers, the multivariate-adjusted odds ratio (OR) of men who consumed 0.1-10.0, 10.1-20.0, 20.1-40.0, and >40.0 g/day was 0.93, 1.18, 1.38, and 2.36, respectively. The OR was 0.90, 0.97, 1.45, and 1.82 in women consuming 0.1-5.0, 5.1-10.0, 10.1-20.0, and >20.0 g/day, respectively. Binge drinking of <1 day/week (OR=1.66, 95% confidence interval [CI]=1.13-2.42) and > or =1 day/week (OR=1.61, 95% CI=1.04-2.50) were associated with increased risk for high baPWV in men, and binge drinking of > or =1 day/week (OR=3.12, 95% CI=1.16-8.34) was associated with increased risk for high baPWV in women. CONCLUSIONS: A J-shaped relationship between the average volume of alcohol consumption and high baPWV was observed, suggesting the detrimental effects of heavy alcohol drinking on arterial stiffness. Binge drinking was also significant risk factors for increased arterial stiffness, independently of the average volume of alcohol consumption.
Adult ; Aged ; Alcohol Drinking ; Atherosclerosis ; Binge Drinking ; Female ; Humans ; Male ; Odds Ratio ; Peripheral Arterial Disease ; Pulse Wave Analysis ; Risk Factors ; Vascular Stiffness

BACKGROUND AND OBJECTIVES: Even short-term treatment with angiotensin converting enzyme inhibitor in essential hypertension has been known to improve left ventricular (LV) diastolic function, LV hypertrophy (LVH), and aortic stiffness. The purpose of this study was to examine the effects of angiotensin II receptor antagonist (Losartan) on LV diastolic function, LVH, and aortic stiffness in essential hypertension. MATERIALS AND METHODS: Twenty-three hypertensive patients who were aged over 50 years, previously untreated, and without cardiac, renal, neurologic disease, or diabetes, were studied. Before and 12 weeks after monotherapy with Losartan 50 mg q.d., (1) supine arterial blood pressure by sphygmomanometry, (2) interventricular septum and LV posterior wall thickness, and LV end-diastolic dimension by M-mode echocardiography, (3) mitral peak E and A wave velocity by doppler echocardiography, (4) pulse wave velocity (PWV) in the descending aorta from aortic arch to the bifurcation by doppler echocardiography, were done. RESULTS: Twelve weeks after treatment, systolic blood pressure was lowered from 168.2+/-3.5 mmHg to 142.9+/-2.9 mmHg (p<0.05), diastolic blood pressure from 98.52.4 mmHg to 87.51.3 mmHg (p<0.05). Peak E/A ratio was increased from 0.75+/-0.04 to 0.82+/-0.04 (p<0.05). LV mass was decreased from 267.5+/-15.8 g to 235.6+/-12.6 g (p<0.05), and LV mass index from 166.8+/-8.0 g/m2 to 146.9+/-6.0 g/m2 (p<0.05). However, there were no significant change in PWV (from 7.18+/-0.10 m/sec to 7.23+/-0.30 m/sec, p>0.05), compliance (from 1.31+/-0.04 to 1.34+/-0.12, p>0.05), and compliance index (from 0.16+/-0.01 to 0.15+/-0.01, p>0.05). CONCLUSION: Short-term treatment with Losartan decreases blood pressure, improves LV diastolic function and LVH, but not aortic stiffness.
Angiotensin II* ; Angiotensins* ; Aorta, Thoracic ; Arterial Pressure ; Blood Pressure ; Compliance ; Echocardiography ; Echocardiography, Doppler ; Humans ; Hypertension ; Hypertrophy ; Losartan* ; Peptidyl-Dipeptidase A ; Pulse Wave Analysis ; Receptors, Angiotensin ; Vascular Stiffness* ; Ventricular Function, Left*