A Review of Vascular Traits and Assessment Techniques, and Their Heritability

Craig, Antonia; Delles, Christian; Murray, Eleanor

doi:10.1007/s44200-022-00016-y

Cited by 2 publications

(3 citation statements)

References 148 publications

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“…Risk of cardiovascular events also rises with increasing arterial stiffness; [ 3 , 5 ] meta-analysis of 17 longitudinal studies suggesting that this risk is amplified by other evidence of hypertension-mediated organ damage (HMOD) [ 21 ]. However, the sequential nature of arterial stiffening and hypertension remains debated [ 22 , 23 ]. This debate may arise from data sampling periods, with the relationship between arterial stiffness and BP evolving over time.…”

Section: Discussionmentioning

confidence: 99%

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Vascular phenotypes in early hypertension

et al. 2022

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The study characterises vascular phenotypes of hypertensive patients utilising machine learning approaches. Newly diagnosed and treatment-naïve primary hypertensive patients without co-morbidities (aged 18–55, n = 73), and matched normotensive controls (n = 79) were recruited (NCT04015635). Blood pressure (BP) and BP variability were determined using 24 h ambulatory monitoring. Vascular phenotyping included SphygmoCor® measurement of pulse wave velocity (PWV), pulse wave analysis-derived augmentation index (PWA-AIx), and central BP; EndoPAT™-2000® provided reactive hyperaemia index (LnRHI) and augmentation index adjusted to heart rate of 75bpm. Ultrasound was used to analyse flow mediated dilatation and carotid intima-media thickness (CIMT). In addition to standard statistical methods to compare normotensive and hypertensive groups, machine learning techniques including biclustering explored hypertensive phenotypic subgroups. We report that arterial stiffness (PWV, PWA-AIx, EndoPAT-2000-derived AI@75) and central pressures were greater in incident hypertension than normotension. Endothelial function, percent nocturnal dip, and CIMT did not differ between groups. The vascular phenotype of white-coat hypertension imitated sustained hypertension with elevated arterial stiffness and central pressure; masked hypertension demonstrating values similar to normotension. Machine learning revealed three distinct hypertension clusters, representing ‘arterially stiffened’, ‘vaso-protected’, and ‘non-dipper’ patients. Key clustering features were nocturnal- and central-BP, percent dipping, and arterial stiffness measures. We conclude that untreated patients with primary hypertension demonstrate early arterial stiffening rather than endothelial dysfunction or CIMT alterations. Phenotypic heterogeneity in nocturnal and central BP, percent dipping, and arterial stiffness observed early in the course of disease may have implications for risk stratification.

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Section: Discussionmentioning

confidence: 99%

“…However, the sequential nature of arterial stiffening and hypertension remains debated [22,23]. This debate may arise from data sampling periods, with the relationship between arterial stiffness and BP evolving over time.…”

Section: Discussionmentioning

confidence: 99%

Vascular phenotypes in early hypertension

et al. 2022

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“…Changes in the structure of the type 1 AT-II receptor gene can lead to alterations in the regulation of vascular tone and proliferation of the vascular wall, and hence, this gene is considered one of the candidate genes associated with cardiovascular pathology. [ 40 ]…”

Section: R Esultsmentioning

confidence: 99%

Clinical Pharmacogenetics of Angiotensin II Receptor Blockers in Iraq

Al-Hussaniy

Hassan

Oraibi³

et al. 2023

Journal of Pharmacy and Bioallied Sciences

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Background: Clinical pharmacogenetics is a rapidly growing field that focuses on the study of genetic variations and their impact on drug metabolism, efficacy, and safety. Angiotensin II receptor blockers (ARBs) are commonly used to treat hypertension in Iraq but not all patients respond equally to these drugs. Aim: This article aims to review the current evidence on the clinical pharmacogenetics of ARBs in Iraq and its implications for personalized medicine. Materials and Methods: We conducted a literature review of studies on the genetic variations that affect the response to ARBs in Iraq. We also reviewed the prevalence of these genetic variants in the Iraqi population and discussed the potential clinical implications for personalized medicine. Results: The most studied genetic variations associated with ARB response in Iraq are the angiotensin-converting enzyme gene insertion/deletion polymorphism and the angiotensin II type 1 receptor gene A1166C polymorphism. The angiotensin-converting enzyme gene insertion/deletion polymorphism is associated with variability in response to ARBs, while the angiotensin II type 1 receptor A1166C polymorphism is associated with an increased risk of cardiovascular events in patients treated with ARBs. The prevalence of these genetic variants in the Iraqi population varies widely depending on the region and ethnic group. Conclusion: The clinical pharmacogenetics of ARBs in Iraq suggests that pharmacogenetic testing could improve the selection and dosing of ARBs in Iraqi patients, leading to better patient outcomes and cost-effective healthcare.

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A Review of Vascular Traits and Assessment Techniques, and Their Heritability

Cited by 2 publications

References 148 publications

Vascular phenotypes in early hypertension

Vascular phenotypes in early hypertension

Clinical Pharmacogenetics of Angiotensin II Receptor Blockers in Iraq

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