Arterial stiffness: using simple surrogate measures to make sense of a biologically complex phenomenon

Lewandowski, Adam J.; Pitcher, Alex; Banerjee, Rajarshi; Leeson, Paul

doi:10.1038/hr.2011.197

Cited by 6 publications

(6 citation statements)

References 8 publications

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“…Nevertheless, reassuringly, preterm-born individuals exposed to the perinatal interventions showed no signs of increased blood pressure. However, to understand the true impact, interactions with age and disease development may need to be considered [64], and further investigations to understand how these changes might modify cardiovascular risk will need to be considered.…”

Section: Clinical Relevancementioning

confidence: 99%

Preeclampsia, prematurity and cardiovascular health in adult life

Lewandowski

Leeson

2014

Early Human Development

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Section: Clinical Relevancementioning

confidence: 99%

Preeclampsia, prematurity and cardiovascular health in adult life

Lewandowski

Leeson

2014

Early Human Development

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“…Peripheral measures of arterial stiffness such as pulse wave velocity (PWV) are associated with BP variability in older cohorts with hypertension and diabetes [ 18 – 20 ] but studies in young healthy individuals have been less consistent [ 6 , 21 ]. This may be because of heterogeneity in arterial stiffness between peripheral and central circulations earlier in life [ 22 , 23 ]. Comprehensive multimodality approaches to quantify both central and peripheral vascular measures in the same individual have allowed in-depth analysis of associations between clinical measures and arterial pathophysiology [ 24 – 27 ].…”

Section: Introductionmentioning

confidence: 99%

Aortic stiffness and blood pressure variability in young people

Boardman

Lewandowski

Lazdam

et al. 2017

Journal of Hypertension

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Introduction:Increased blood pressure (BP) variability is a cardiovascular risk marker for young individuals and may relate to the ability of their aorta to buffer cardiac output. We used a multimodality approach to determine relations between central and peripheral arterial stiffness and BP variability.Methods:We studied 152 adults (mean age of 31 years) who had BP variability measures based on SD of awake ambulatory BPs, 24-h weighted SD and average real variability (ARV). Global and regional aortic distensibility was measured by cardiovascular magnetic resonance, arterial stiffness by cardio-ankle vascular index (CAVI) and pulse wave velocity (PWV) by SphygmoCor (carotid–femoral) and Vicorder (brachial–femoral).Results:In young people, free from overt cardiovascular disease, all indices of SBP and DBP variability correlated with aortic distensibility (global aortic distensibility versus awake SBP SD: r = −0.39, P < 0.001; SBP ARV: r = −0.34, P < 0.001; weighted 24-h SBP SD: r = −0.42, P < 0.001). CAVI, which closely associated with aortic distensibility, also related to DBP variability, as well as awake SBP SD (r = 0.19, P < 0.05) and weighted 24-h SBP SD (r = 0.24, P < 0.01), with a trend for SBP ARV (r = 0.17, P = 0.06). In contrast, associations with PWV were only between carotid–femoral PWV and weighted SD of SBP (r = 0.20, P = 0.03) as well as weighted and ARV of DBP.Conclusion:Greater BP variability in young people relates to increases in central aortic stiffness, strategies to measure and protect aortic function from a young age may be important to reduce cardiovascular risk.

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“…Resting measures of brachial-femoral pulse wave velocity will be measured using sphygmomanometer-derived indices (Vicorder, Skidmore Medical, Taunton, UK) with cuffs placed around brachial and femoral arteries to identify pulse arrival times [ 24 ]. In addition, sphygmomanometer-derived indices of aortic blood pressure will be derived from brachial blood pressure measurements (Vicorder, Skidmore Medical, Taunton, UK) [ 25 ].…”

Section: Methodsmentioning

confidence: 99%

Trial of Exercise to Prevent HypeRtension in young Adults (TEPHRA) a randomized controlled trial: study protocol

Williamson

Huckstep

Frangou

et al. 2018

BMC Cardiovasc Disord

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BackgroundHypertension prevalence in young adults has increased and is associated with increased incidence of cerebrovascular and cardiovascular events in middle age. However, there is significant debate regards how to effectively manage young adult hypertension with recommendation to target lifestyle intervention. Surprisingly, no trials have investigated whether lifestyle advice developed for blood pressure control in older adults is effective in these younger populations.Methods/DesignTEPHRA is an open label, parallel arm, randomised controlled trial in young adults with high normal and elevated blood pressure. The study will compare a supervised physical activity intervention consisting of 16 weeks structured exercise, physical activity self-monitoring and motivational coaching with a control group receiving usual care/minimal intervention. Two hundred young adults aged 18–35 years, including a subgroup of preterm born participants will be recruited through open recruitment and direct invitation. Participants will be randomised in a ratio of 1:1 to either the exercise intervention group or control group. Primary outcome will be ambulatory blood pressure monitoring at 16 weeks with measure of sustained effect at 12 months. Study measures include multimodal cardiovascular assessments; peripheral vascular measures, blood sampling, microvascular assessment, echocardiography, objective physical activity monitoring and a subgroup will complete multi-organ magnetic resonance imaging.DiscussionThe results of this trial will deliver a novel, randomised control trial that reports the effect of physical activity intervention on blood pressure integrated with detailed cardiovascular phenotyping in young adults. The results will support the development of future research and expand the evidence-based management of blood pressure in young adult populations.Trial RegistrationClinicaltrials.gov registration number NCT02723552, registered on 30 March, 2016.

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Arterial stiffness: using simple surrogate measures to make sense of a biologically complex phenomenon

Cited by 6 publications

References 8 publications

Preeclampsia, prematurity and cardiovascular health in adult life

Preeclampsia, prematurity and cardiovascular health in adult life

Aortic stiffness and blood pressure variability in young people

Trial of Exercise to Prevent HypeRtension in young Adults (TEPHRA) a randomized controlled trial: study protocol

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