Aortic Stiffness is an Independent Predictor of Stroke in Hypertensive Patients

Pereira, Telmo; Maldonado, João; Pereira, Liliana; Conde, Jorge

doi:10.5935/abc.20130079

Cited by 26 publications

(28 citation statements)

References 16 publications

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“…More specifically, we show that this effect is associated with the consumption of 3 g KWG dose, and the effect appeared to not be dose dependent. These findings are of interest given the well-established predictive ability of AI in determining future CVD events [21,22]. Our results also indicate that KWG does not significantly reduce postprandial glycemia relative to control.…”

Section: Discussionsupporting

confidence: 63%

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Effects of Korean White Ginseng (Panax Ginseng C.A. Meyer) on Vascular and Glycemic Health in Type 2 Diabetes: Results of a Randomized, Double Blind, Placebo-controlled, Multiple-crossover, Acute Dose Escalation Trial

et al. 2014

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Korean red ginseng (steam treated Panax ginseng C.A. Meyer), among most prized traditional herbal remedies, has been clinically shown to improve cardiovascular disease (CVD) risk factors. Whether this holds true for the dried non-steamed variety, known as Korean white ginseng (KWG) is unclear. This study therefore, investigated the efficacy and safety of escalating doses of KWG on vascular and glycemic parameters in type 2 diabetes (T2DM). Using an acute, randomized, placebo-controlled, double-blind, crossover design, 25 participants with well-controlled T2DM (12-males: 13-females, age: 63 ± 9 years, A1c: 6.9 ± 0.7%, BMI: 29.3 ± 4.3 kg/m2) underwent five visits during which they received 1 g, 3 g, or 6 g KWG or 3 g wheat-bran control (twice) together with 50 g-glucose load. For the duration of 240 minutes, augmentation index (AI), and central blood pressure were measured at baseline and at 60 min-intervals, and ambulatory blood pressure was assessed at baseline and at 10 min-intervals. Additionally, capillary blood was collected at time zero and at 15, 30, 45, 60, 90, 120, and 180 minutes post-treatment. A symptoms questionnaire was used to assess safety and adverse events. Two-way ANOVA demonstrated a significant time-treatment interaction effect on AI (p = 0.01) with one-way ANOVA showing significant reductions in AI with 3 g KWG relative to control (p = 0.04). Compared to control, acute administration of KWG appeared to be safe, but did not affect any other postprandial, vascular or glycemic parameters. KWG might have a beneficial effect on AI, a cumulative indicator of arterial health. However, these results are preliminary and highlight the need for long-term investigation with a focus on its accountable components. Clinical Trial Registration: NCT01699074

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Section: Discussionsupporting

confidence: 63%

“…Arterial stiffness has emerged as a novel marker of CVD risk, displaying a clear independent predictive value [22,23]. As such, acute improvements in AI demonstrated with 3 g KWG may have a clinical potential, and could aid in broadening our understanding on the hemodynamic potential of ginseng.…”

Section: Discussionmentioning

confidence: 99%

Effects of Korean White Ginseng (Panax Ginseng C.A. Meyer) on Vascular and Glycemic Health in Type 2 Diabetes: Results of a Randomized, Double Blind, Placebo-controlled, Multiple-crossover, Acute Dose Escalation Trial

et al. 2014

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“…This substudy identified that wave reflection index, even when adjusted for age, sex, heart rate, brain natriuretic protein level, fasting glucose, antihypertensive regimen, and carotid intima-media thickness, remained a predictor of future cardiovascular events ( P =0.003) 24. A study by Pereira et al showed that, independent of hypertension and other risk factors for arteriosclerotic heart disease, individuals with aortic stiffness had a 1.39 (95% confidence interval 1.08–1.72; P =0.02) increase in relative risk of fatal stroke 25. Other studies have shown an association between increased aortic stiffness and microvascular cerebral disease, including lacunar infarcts, in individuals with hypertension 26.…”

Section: Clinical Importance Of Aortic Stiffnessmentioning

confidence: 99%

Aortic stiffness: pathophysiology, clinical implications, and approach to treatment

Sethi¹,

Rivera²,

Oliveros³

et al. 2014

IBPC

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Aortic stiffness is a hallmark of aging, and classic cardiovascular risk factors play a role in accelerating this process. Current changes in medicine, which focus on preventive care, have led to a growing interest in noninvasive evaluation of aortic stiffness. Aortic stiffness has emerged as a good tool for further risk stratification because it has been linked to increased risk of atherosclerotic heart disease, myocardial infarction, heart failure, and stroke. This has led to the invention and validation of multiple methods to measure aortic stiffness. Pulse wave velocity is emerging as the gold standard for evaluation of aortic stiffness. This review focuses on the pathophysiology involved in aortic stiffness, methods available for evaluation of aortic stiffness, the importance of central pressure as a predictor of future cardiovascular events, and therapies that affect aortic stiffness.

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“…Arterial stiffness is an important indicator of cardio-/ cerebrovascular comorbidities (e.g., hypertension, diabetes, and atherosclerosis) (1)(2)(3)(4) and risks (e.g., stroke) (5). It also aids in tracking the progression of other common cardiovascular diseases, such as Marfan syndrome and abdominal aortic aneurysm (AAA) (6,7).…”

Section: Introductionmentioning

confidence: 99%

Quantification of aortic stiffness using magnetic resonance elastography: Measurement reproducibility, pulse wave velocity comparison, changes over cardiac cycle, and relationship with age

et al. 2015

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Purpose To assess MRE-derived aortic shear stiffness (μMRE) measurements for: 1. Reproducibility 2. changes over the cardiac cycle; and 3. relationship with age. Methods Cardiac-gated aortic MRE was performed on 20 healthy volunteers (ages 20–73yrs). For assessing reproducibility of stiffness measurements, scans were repeated per volunteer. MRE wave images were analyzed to obtain stiffness of the abdominal aorta across the cardiac cycle, and comparisons were made with subject age. Results Analysis of concordance correlation coefficient between scans 1 and 2 showed that rc=0.86 (95% confidence interval (CI):0.77,0.94) with P<0.0001. Significantly higher μMRE was observed for all volunteers during end-systole when compared to end-diastole (P<0.0001). μMRE increased with age; end-systolic stiffness demonstrated a relatively stronger correlation with age (r=0.62,P=0.003) when compared to end-diastolic stiffness (r=0.51,P=0.023); the slopes of end-systole and end-diastole were found to be significantly different (P=0.011). normalμMRE at end-systole and end-diastole correlated linearly with PWV with an r=0.54(P=0.013) and r=0.58(P=0.008), respectively. Conclusion The results of this study indicate that MRE-derived aortic shear stiffness measurements are robust (reproducible and comparable to similar techniques). Mean μMRE was higher during end-systole when compared to end-diastole. μMRE was found to increase with age and showed a stronger correlation with end-systolic stiffness than with end-diastolic stiffness.

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Aortic Stiffness is an Independent Predictor of Stroke in Hypertensive Patients

Abstract: Aortic PWV is a risk factor for stroke in hypertensive patients, and its integration into clinical follow-up programs in patients whose cardiovascular risk is manifest is strongly recommended.

Cited by 26 publications

References 16 publications

Effects of Korean White Ginseng (Panax Ginseng C.A. Meyer) on Vascular and Glycemic Health in Type 2 Diabetes: Results of a Randomized, Double Blind, Placebo-controlled, Multiple-crossover, Acute Dose Escalation Trial

Effects of Korean White Ginseng (Panax Ginseng C.A. Meyer) on Vascular and Glycemic Health in Type 2 Diabetes: Results of a Randomized, Double Blind, Placebo-controlled, Multiple-crossover, Acute Dose Escalation Trial

Aortic stiffness: pathophysiology, clinical implications, and approach to treatment

Quantification of aortic stiffness using magnetic resonance elastography: Measurement reproducibility, pulse wave velocity comparison, changes over cardiac cycle, and relationship with age

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