Brachial Pressure Control Fails to Account for Most Distending Pressure-Independent, Age-Related Aortic Hemodynamic Changes in Adults

Hodson, Bryan; Norton, Gavin R.; Booysen, Hendrik L.; Sibiya, Moekanyi J.; Raymond, Andrew; Maseko, Muzi J.; Majane, Olebogeng H.I.; Libhaber, Elena; Sareli, Pinhas; Woodiwiss, Angela J.

doi:10.1093/ajh/hpv140

Cited by 10 publications

(11 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this regard, it was previously described that early in life, there is a rapid increase in stroke volume, reaching a peak at ∼20 y, followed by a slow decline from the beginning of the third decade of life ( Cattermole et al, 2017 ; Zócalo et al, 2020 ). The (relative) Pf stability observed within the range of 30 and 60 y of age is in agreement with previous findings in subjects with controlled and uncontrolled blood pressure ( Hodson et al, 2016 ), in healthy and unhealthy subjects ( Li et al, 2019 ) and in subjects with cardiovascular disease ( Namasivayam et al, 2016 ). On the other hand, whereas in this work, the increase in Pf after 70 y of age was discrete, works that included subjects with cardiovascular disease and/or exposed to CRFs described a greater (steeper) increase ( Figure 3 ).…”

Section: Discussionsupporting

confidence: 92%

“…However, in our knowledge, there are no works assessing waveform-derived indexes’ variations (as a continuous) considering data from different age-stages and their transitions (childhood-adolescence-adulthood). It is to note that studies that aimed at analyzing age-related differences do not allow for their adequate and comprehensive characterization, as they (i) considered small numbers of subjects [e.g., n = 65 ( Hughes et al, 2013 ), n = 267 ( Yu et al, 2020 )], (ii) did not exclude subjects with cardiovascular disease or exposed to CRFs [e.g., cardiology outpatients ( Namasivayam et al, 2016 ), unhealthy or diseased subjects ( Torjesen et al, 2014 ; Hodson et al, 2016 ; Li et al, 2019 ), and subjects with CRFs ( Mitchell et al, 2004 ; Hughes et al, 2013 ; Hickson et al, 2016 ; Wilenius et al, 2016 ; Gómez-Sánchez et al, 2020 ; Yu et al, 2020 )]; (iii) compared “mean values” of groups comprising subjects of wide age ranges (e.g., 5–7 years (y) ( Segers et al, 2007 ; Janner et al, 2010 ; Hodson et al, 2016 ) or 10 y ( Kelly et al, 1989 ; Mitchell et al, 2004 ; McEniery et al, 2005 ; Torjesen et al, 2014 ; Hickson et al, 2016 ; Namasivayam et al, 2016 ; Solanki et al, 2018 ; Li et al, 2019 ; Yu et al, 2020 ) of difference in the age of subjects belonging to the same group); (iv) considered only adults within a limited age range (e.g., 40–70 y, grouped by decades) ( Li et al, 2019 ), and (v) in general, did not consider subjects under 18–20 years of age. In this context, it should be noted that the need for RIs for vascular parameters in children and adolescents is now well-recognized and is considered necessary to extend their use in clinical practice ( Climie et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Central Pressure Waveform-Derived Indexes Obtained From Carotid and Radial Tonometry and Brachial Oscillometry in Healthy Subjects (2–84 Y): Age-, Height-, and Sex-Related Profiles and Analysis of Indexes Agreement

Zócalo

2022

Front. Physiol.

View full text Add to dashboard Cite

Aortic blood pressure (aoBP) waveform-derived indexes could provide valuable (prognostic) information over and above cardiovascular risk factors (CRFs). To obtain aoBP waveform-characteristics, several (i) techniques, (ii) recording sites, (iii) pressure-only waveform analysis mathematical approaches [e.g., pulse wave analysis (PWA), wave separation analysis (WSA)], and (iv) indexes [augmentation pressure and index (AP and AIx), forward (Pf) and backward (Pb) components of aoBP, reflection magnitude (RM), and reflection index (Rix)], were proposed. An accurate clinical use of these indexes requires knowing their physiological age-related profiles and the expected values for a specific subject. There are no works that have characterized waveform-derived indexes profiles in large populations considering: (i) as a continuous, data from different age stages (childhood, adolescence, and adulthood), (ii) complementary indexes, (iii) data obtained from different techniques and approaches, and (iv) analyzing potential sex- and body height (BH)-related differences. In addition, (v) there is a lack of normative data (reference intervals, RIs) for waveform-derived indexes.Aims(1) to evaluate the association and agreement between PWA- and/or WSA-derived indexes obtained with different techniques and approaches; (2) to determine the need for sex-, BH-, and/or age-specific RIs; (3) to define RIs for PWA- and WSA-derived indexes in a large cohort of healthy children, adolescents, and adults.Methods3619 subjects (3–90 y) were included; 1688 healthy (2–84 y). AP, AIx, AIx@75, Pf, Pb, RM, and RIx were obtained (carotid and radial tonometry, brachial oscillometry/plethysmography). The association and agreement between indexes were analyzed (Concordance correlation coefficients, Bland–Altman analysis). Mean and SD equations and sex-specific BH- and age-related profiles were obtained (regression methods; fractional polynomials).ResultsWaveform-derived indexes were not equivalent; for a specific index, there were systematic and proportional differences associated with the recording site (e.g., carotid vs. radial) and technique (e.g., tonometry vs. oscillometry). The need for sex-, BH-, or age-specific RIs was dependent on the index and/or age considered. RIs were defined for each index considering differences between recording sites and techniques. Equations for waveform-derived indexes age-related profiles were included, enabling to determine for a specific subject, the expected values and potential data deviations.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Central Pressure Waveform-Derived Indexes Obtained From Carotid and Radial Tonometry and Brachial Oscillometry in Healthy Subjects (2–84 Y): Age-, Height-, and Sex-Related Profiles and Analysis of Indexes Agreement

Zócalo

2022

Front. Physiol.

View full text Add to dashboard Cite

show abstract

“…It is known that elasticity of the arteries is impaired with advanced age. 22 , 23 Similarly, it has been reported that increased resting heart rate is associated with aortic stiffness and atherosclerosis. 24 , 25 Our study supports these results.…”

Section: Discussionmentioning

confidence: 95%

High aortic pulse-wave velocity may be responsible for elevated red blood cell distribution width in overweight and obese people: a community-based, cross-sectional study

Altıparmak¹,

Erkuş²,

Koçarslan³

et al. 2016

CVJA

View full text Add to dashboard Cite

SummaryBackground:Obesity and overweight are risk factors for atherosclerosis. Red blood cell distribution width (RDW) is associated with subclinical cardiac diseases. The aim of this study was to investigate the association between RDW and aortic stiffness in overweight or obese subjects.Methods:A total of 101 overweight or obese subjects without overt cardiovascular disorders, and 48 healthy controls were enrolled. RDW, aortic pulse-wave velocity (PWV) and augmentation index 75 (Aix75) were evaluated. The case subjects were divided into two sub-groups according to PWV values; ≥ 10 m/s in group I, and < 10 m/s in group II. Bivariate correlation and multiple regression analyses (stepwise) were performed.ResultsRDW and PWV were considerably increased in the case groups compared with the controls. RDW was significantly increased in group I compared with group II and the controls [median 12.0 m/s, interquartile range (IQR): 10.5–17.5; median 11.7 m/s, IQR: 10.2–14.2, and median 11.4 m/s, IQR: 9.6–15.5, p < 0.05, respectively]. Resting heart rate and age were higher in group I than group II (81 ± 11 vs 74 ± 12 beats/min and 41 ± 120 vs 36 ± 9 years, respectively, p < 0.05). Regression analyses revealed that while log-RDW, age and resting heart rate were independent predictors for aortic PWV, log-RDW was the most important predictor in the final model.Conclusions:RDW, resting heart rate and age independently predicted arterial stiffness, and RDW may be useful to provide an early recognition of subclinical atherosclerosis in overweight and obese individuals.

show abstract

“…cBP is determined by the complex interaction between aortic compliance, elasticity and the resistance arteries' ability to channel blood flow in accordance with tissue needs (Stephen Hedley and Phelan 2017). Hence, cBP is superior to brachial blood pressure in identifying changes in vascular functional parameters (Hodson et al 2016) and cardiovascular risk (Williams et al 2006;Roman et al 2007;Cheng et al 2013;Fan et al 2016;Herbert et al 2014). Particularly in young men, central diastolic BP, but not peripheral systolic pressure, is a predictor of cardiovascular risk (Wilkinson et al 2001).…”

Section: Discussionmentioning

confidence: 99%

Association of 25-hydroxy vitamin D level with the blood pressure response to a maximum exercise test among professional indoor athletes

Bauer

Kraushaar²,

Dörr

et al. 2020

Eur J Appl Physiol

View full text Add to dashboard Cite

Purpose Low vitamin D levels have been associated with elevated blood pressure (BP) in the general population. However, whether there is an association of vitamin D insufficiency with BP changes during maximum exercise in athletes is currently unclear. Methods A total of 120 male professional indoor athletes (age 26 ± 5 years) were examined. BP was measured at rest and during a graded cycling test. We assessed the BP response (BPR) during maximum exercise and the respective load. BP and BPR (peak-baseline BP) were analysed with respect to 25-OH vitamin D levels, with levels < 30 ng/mL defining vitamin D insufficiency. Results 35 athletes were classified as being vitamin D insufficient. BP was not different between sufficient and insufficient vitamin D groups (122 ± 10/75 ± 7 vs. 120 ± 12/77 ± 9 mmHg). At maximum exercise, however, systolic BP (198 ± 17 vs. 189 ± 19, p = 0.026) and the pulse pressure (118 ± 18 vs. 109 ± 21 mmHg, p = 0.021) were higher in the sufficient group; the BPR was not different between groups (76 ± 20/5 ± 6 vs. 69 ± 22/3 ± 6 mmHg, p = 0.103). Athletes with sufficient levels had a higher maximum power output (3.99 ± 0.82 vs. 3.58 ± 0.78 W/kg, p = 0.015) and achieved higher workloads (367 ± 78 vs. 333 ± 80 W, p = 0.003). The workload-adjusted BPR (maximum systolic BP/MPO) was not different between athletes with sufficient and insufficient vitamin D levels (51 ± 10 vs. 56 ± 14 mmHg × kg/W, p = 0.079). Conclusion Athletes with sufficient vitamin D achieved a higher maximum systolic BP and a higher maximum power output. The workload-adjusted BPR was not different between groups, which suggests that this finding reflects a better performance of athletes with sufficient vitamin D.

show abstract

Brachial Pressure Control Fails to Account for Most Distending Pressure-Independent, Age-Related Aortic Hemodynamic Changes in Adults

Abstract: Brachial BP control in the general population fails to account for most distending pressure-independent, age-related changes in aortic hemodynamics across the adult lifespan.

Cited by 10 publications

References 29 publications

Central Pressure Waveform-Derived Indexes Obtained From Carotid and Radial Tonometry and Brachial Oscillometry in Healthy Subjects (2–84 Y): Age-, Height-, and Sex-Related Profiles and Analysis of Indexes Agreement

Central Pressure Waveform-Derived Indexes Obtained From Carotid and Radial Tonometry and Brachial Oscillometry in Healthy Subjects (2–84 Y): Age-, Height-, and Sex-Related Profiles and Analysis of Indexes Agreement

High aortic pulse-wave velocity may be responsible for elevated red blood cell distribution width in overweight and obese people: a community-based, cross-sectional study

Association of 25-hydroxy vitamin D level with the blood pressure response to a maximum exercise test among professional indoor athletes

Contact Info

Product

Resources

About