Beat-to-beat blood pressure variability: an early predictor of disease and cardiovascular risk

Bakkar, Nour-Mounira Z.; El‐Yazbi, Ahmed F.; Zouein, Fouad A.; Fares, Souha

doi:10.1097/hjh.0000000000002733

Cited by 24 publications

(28 citation statements)

References 94 publications

(149 reference statements)

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“… 47 , 48 The measurement of BP variability could provide additional insight into the differences in hemodynamic and autonomic control between men and women. 49 , 50 However, the present methods are not well suited to the study of BP variability, as only 1 supine and 2 seated and 2 standing BP values were recorded, which is a limitation of our study.…”

Section: Discussionmentioning

confidence: 92%

Posture‐Related Differences in Cardiovascular Function Between Young Men and Women: Study of Noninvasive Hemodynamics in Rural Malawi

Choudhary

Penninkangas

Eräranta

et al. 2022

JAHA

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Background Cardiovascular risk is higher in men than in women, but little information exists about sex‐related differences in cardiovascular function from low‐income countries. We compared hemodynamics between sexes in rural Malawi in a cohort followed up since their birth. Methods and Results Supine, seated, and standing hemodynamics were recorded from 251 women and 168 men (mean age, 21 years; body mass index, 21 kg/m 2 ) using oscillometric brachial waveform analyses (Mobil‐O‐Graph). The results were adjusted for estimated glomerular filtration rate, and plasma potassium, lipids, and glucose. Men had higher brachial and aortic systolic blood pressure and stroke index regardless of posture ( P <0.001), and higher upright but similar supine diastolic blood pressure than women. Regardless of posture, heart rate was lower in men ( P <0.001), whereas cardiac index did not differ between sexes. Women presented with lower supine and standing systemic vascular resistance index ( P <0.001), whereas supine‐to‐standing increase in vascular resistance ( P =0.012) and decrease in cardiac index ( P =0.010) were higher in women. Supine left cardiac work index was similar in both sexes, whereas standing and seated left cardiac work index was higher in men than in women ( P <0.001). Conclusions In young Malawian adults, men had higher systolic blood pressure, systemic vascular resistance, and upright cardiac workload, whereas women presented with higher posture‐related changes in systemic vascular resistance and cardiac output. These findings show systematic sex‐related differences in cardiovascular function in a cohort from a low‐income country with high exposure to prenatal and postnatal malnutrition and infectious diseases.

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Section: Discussionmentioning

confidence: 92%

Posture‐Related Differences in Cardiovascular Function Between Young Men and Women: Study of Noninvasive Hemodynamics in Rural Malawi

Choudhary

Penninkangas

Eräranta

et al. 2022

JAHA

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“…Table 3 was primarily used to examine the variability of the continuous blood pressure signal. It has been demonstrated that two people with similar blood pressure can have different blood pressure volatility, and that continuously monitoring blood pressure to obtain blood pressure variability sequences can be used as a hidden indicator independent of other cardiovascular risk factors 22,40 . The standard deviation, coe cient of variation, and continuous variation of continuous blood pressure in experimental and control rats did not show signi cant differences in this study, but non-linear algorithms like sample entropy and detrended uctuation analysis were used to sensitively identify changes in blood pressure uctuations in the two groups of rats.…”

Section: Discussionmentioning

confidence: 99%

“…The autonomic nervous system and stress re exes can be evaluated by converting recorded blood pressure and ECG data into HRV and BPV. The use of variable parameters allows for a quantitative assessment of the cardiovascular autonomic nervous system's functioning 22 .…”

Section: Introductionmentioning

confidence: 99%

Based on variability parameters analysis of autonomic function in rats with Parkinson's disease induced by rotenone

Gao

Wang

et al. 2022

Preprint

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Background: Parkinson's disease is a common neurodegenerative disease, and while early detection of cardiovascular symptoms may aid in early diagnosis, there are no definitive markers to assess cardiovascular autonomic damage in Parkinson's disease. Methods: Twenty Sprague Dawley rats were randomly assigned to the experimental (n=12) and control (n=8) groups, and a model of Parkinson's disease was created in the experimental group by stereotaxic injection of rotenone into the substantia nigra compacta and ventral tegmental area. Telemetry implantation was carried out after successful modeling. Equal dosages of saline were injected into control animals at the same places. In both groups of rats, ECG, blood pressure, core temperature, and activity were recorded using a Data Science International implantable physiological signal telemetry device. The time domain, frequency domain, and non-linear analysis were used to examine the blood pressure and heart rate variability of the two groups of rats. Results: The experimental group had higher Detrended Fluctuation Analysis (DFA) of blood pressure signals (systolic, diastolic, and mean arterial pressure), mean arterial pressure, normalized high frequency power (nHF) than the control rats (p<0.05). The experimental group had lower sample entropy (SampEn) of blood pressure signals (diastolic and mean arterial pressure), root mean squared successive differences (RMSSD), normalized lower frequency power (nLF) and total power than the control group (p<0.05). However, the standard deviation, coefficient of variation, and continuous variation in the linear analysis of continuous blood pressure signal between the two groups were not statistically significant (p>0.05). Conclusion: The rats in the rotenone model had significant autonomic dysfunction, and non-linear analysis approaches such as detrended fluctuation analysis and sample entropy were able to discern the diseased condition of the rats more sensitively while processing the continuous blood pressure data.

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“…Indeed, aberrant beat-to-beat BPV is associated with end-organ damage related to excursions in perfusion (Wei et al, 2014). Alternatively, nonlinear parameters quantify complexity and regularity that decreases and increases in disease states, respectively (Bakkar et al, 2021). Despite the value of linear parameters of variability, fluctuations of the cardiovascular system are described as nonhomogeneous, that is, different parts of the signal exhibit distinctive scaling properties, and are thus believed to be better quantified using nonlinear parameters (Ivanov et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

“…Despite the value of linear parameters of variability, fluctuations of the cardiovascular system are described as nonhomogeneous, that is, different parts of the signal exhibit distinctive scaling properties, and are thus believed to be better quantified using nonlinear parameters (Ivanov et al, 2001). Indeed, entropy and detrended fluctuation analysis of the beat-to-beat BP time series are shown to possess superior power of discriminating among patient groups compared to conventional parameters of variability and average BP (Bakkar et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Predictive Capacity of Beat-to-Beat Blood Pressure Variability for Cardioautonomic and Vascular Dysfunction in Early Metabolic Challenge

Fares

Bakkar²,

El‐Yazbi³

2022

Front. Pharmacol.

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Diabetic patients present established cardiovascular disease at the onset of diagnostic metabolic symptoms. While premature autonomic and vascular deterioration considered risk factors for major cardiovascular complications of diabetes, present in initial stages of metabolic impairment, their early detection remains a significant challenge impeding timely intervention. In the present study, we examine the utility of beat-to-beat blood pressure variability (BPV) parameters in capturing subtle changes in cardiac autonomic and vascular control distinguishing between various risk categories, independent of the average BP. A rat model of mild hypercaloric (HC) intake was used to represent the insidious cardiovascular changes associated with early metabolic impairment. Invasive hemodynamics were used to collect beat-to-beat BP time series in rats of either sex with different durations of exposure to the HC diet. Linear (standard deviation and coefficient of variation) and nonlinear (approximate entropy, ApEn, and self-correlation of detrended fluctuation analysis, α) BPV parameters were calculated to assess the impact of early metabolic impairment across sexes and feeding durations. HC-fed male, but not female, rats developed increased fat:lean ratio as well as hyperinsulinemia. Unlike linear parameters, multivariate analysis showed that HC-fed rats possessed lower ApEn and higher α, consistent with early changes in heart rate variability and blunting of parasympathetic baroreceptor sensitivity, particularly in males. Moreover, logistic regression demonstrated the superiority of nonlinear parameters of diastolic BPV in predicting a prediabetic disease state. Our findings support the use of nonlinear beat-to-beat BPV for early detection of cardiovascular derangements in the initial stages of metabolic impairment.

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Beat-to-beat blood pressure variability: an early predictor of disease and cardiovascular risk

Cited by 24 publications

References 94 publications

Posture‐Related Differences in Cardiovascular Function Between Young Men and Women: Study of Noninvasive Hemodynamics in Rural Malawi

Posture‐Related Differences in Cardiovascular Function Between Young Men and Women: Study of Noninvasive Hemodynamics in Rural Malawi

Based on variability parameters analysis of autonomic function in rats with Parkinson's disease induced by rotenone

Predictive Capacity of Beat-to-Beat Blood Pressure Variability for Cardioautonomic and Vascular Dysfunction in Early Metabolic Challenge

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