Central aortic pulse pressure, thrombogenicity and cardiovascular risk

Chen, Gailing; Bliden, Kevin P.; Chaudhary, Rahul; Liu, Fang; Kaza, Himabindu; Navarese, Eliano Pio; Tantry, Udaya S.; Gurbel, Paul A.

doi:10.1007/s11239-017-1524-y

Cited by 9 publications

(7 citation statements)

References 35 publications

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“…Pulse pressure (PP), defined as the difference between systolic and diastolic blood pressure (SBP and DBP), has also been declared to be associated with CAD. Increased PP was shown to be related to arterial stiffness [3][4][5] and adverse cardiovascular events [6][7][8][9]. Several studies have investigated the association between PP and the extent of CAD in patients undergoing invasive coronary angiography (CAG).…”

Section: Introductionmentioning

confidence: 99%

Brachial pulse pressure is associated with the presence and extent of coronary artery disease in stable angina patients: a cross-sectional study

Peng

2020

BMC Cardiovasc Disord

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Background: Previous epidemiological evidence has identified many risk factors for coronary artery disease (CAD). Pulse pressure (PP) was reported to be associated with CAD. However, more attention was paid to aortic PP than to brachial PP. This cross-sectional study aimed to investigate the direct relationship between brachial PP and the presence and extent of CAD in stable angina patients. Methods: We recruited a total of 1118 consecutive patients with stable chest pain suspected of CAD. After screening with exclusion criteria, 654 patients were finally included in our study. Every patient underwent both blood pressure measurement and selective coronary angiography. Univariate and multivariate analysis were performed to analyze the association between PP and the presence and extent of CAD. Results: This study revealed that brachial PP was an independent correlate of multivessel CAD. In multivariate generalized linear regression model, increasing brachial PP (per 1 mmHg) were associated with the increased number of diseased vessels (β = 0.01, SE = 0.00, P < 0.0001). Binary logistic regression analysis further confirmed this association. The risk of multivessel CAD increased significantly in patients with brachial PP ≥ 60 mmHg (OR = 1.69, 95% CI = 1.14-2.48, P = 0.0084) and as per 1 mmHg increased in brachial PP (OR = 1.02, 95% CI = 1.01-1.03, P = 0.0002), independent of age, gender, body mass index (BMI), smoking, diabetes, hypercholesterolemia and creatinine (Cr). This association was still of statistical significance in subgroup analysis of hypertension and diabetes. Conclusion: Increasing brachial PP was significantly and independently associated with increased risk of multivessel coronary disease in stable angina patients. The association of brachial PP with CAD was more pronounced in hypertension group than in non-hypertension one.

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Section: Introductionmentioning

confidence: 99%

Brachial pulse pressure is associated with the presence and extent of coronary artery disease in stable angina patients: a cross-sectional study

Peng

2020

BMC Cardiovasc Disord

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“…Прогрессирование НАЖБП тесно связано с активацией атерогенеза. На фоне стеатозной трансформации печени увеличивается концентрация проатерогенных компонентов крови (провоспалительных, протромботических и окислительно-стрессовых веществ), возрастает степень атерогенной дислипидемии и резистентность к инсулину [3]. В свою очередь, некоторые авторы связывают развитие резистентности к инсулину с повышением жесткости артерий [3,5].…”

Section: Introductionunclassified

“…На фоне стеатозной трансформации печени увеличивается концентрация проатерогенных компонентов крови (провоспалительных, протромботических и окислительно-стрессовых веществ), возрастает степень атерогенной дислипидемии и резистентность к инсулину [3]. В свою очередь, некоторые авторы связывают развитие резистентности к инсулину с повышением жесткости артерий [3,5]. На примере пациентов с хронической гипергликемией и гиперинсулинемией были продемонстрированы увеличение активности ренин-ангиотензинальдостероновой системы и экспрессия рецепторов к ангиотензину I, что приводило к гипертрофии сосудистой стенки и фиброзу.…”

Section: Introductionunclassified

“…На примере пациентов с хронической гипергликемией и гиперинсулинемией были продемонстрированы увеличение активности ренин-ангиотензинальдостероновой системы и экспрессия рецепторов к ангиотензину I, что приводило к гипертрофии сосудистой стенки и фиброзу. В этих работах для определения жесткости сосудов исследователи использовали показатели скорости пульсовой волны (СПВ) в сосудах мышечного (СПВм) и эластичного типа (СПВэ), которые тесно коррелировали с риском сердечно-сосудистых событий и смертностью [3,5]. Вместе с тем, изменение жесткости аорты напрямую влияет на показатели центрального аортального давления (ЦАД), которые, по мнению ряда авторов, являются более информативными, чем показатели артериального давления на плечевой артерии [6,8].…”

Section: Introductionunclassified

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The Influence of Non-Alc oholic Fatty Liver Disease on Indicators of Arterial Stiffness and Risk of Cardiovascular Complications in Patients with Arterial Hypertension

Стаценко

Streltsova

Turovets

2020

Arhivʺ vnutrennej mediciny

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Aim. To determine the value of concomitant non-alcoholic fatty liver disease in patients with arterial hypertension in the progression of rigidity of the main arteries and in increase of risk of cardiovascular complications. Material and methods. A cross-sectional comparative study was conducted. Group 1 (n=50, 35(70%) women, average age 57,4±6,9 years) included patients with arterial hypertension and non-alcoholic fatty liver disease, group 2 (n=50, 40(80%) women, average age 56,5±7,0 years) included patients with arterial hypertension only. The groups were comparable in the main clinical and demographic indicators (p>0,05). A comparative analysis of pulse wave velocity, central aortic pressure, vascular age and a 10-year risk of developing cardiovascular complications in both groups was performed.Results. There is a statistically larger number of patients with metabolic index>7,0 (58,0% vs 28,0%, p=0,0019). It was also established that systolic (121,9±10,9 mm Hg vs 115,9±8,9 mm Hg) and diastolic (82,5±9,3 mm Hg vs 77,4±8,9 mm Hg) aortic pressure, as well as the augmentation index (26,5±8,5% vs 18,6±4,2%), were significantly higher in patients with arterial hypertension and non-alcoholic fatty liver disease than in patients with isolated arterial hypertension. In the 1st group, a statistically significant increased pulse wave velocity was found both in muscular (12,0±3,1 m/s vs 10,6±1,8 m/s) and elastic (10,4±2,8 m/s vs 9,1±1,7 m/s) vessels, which indicates an increase in arterial stiffness. In addition, there was an increase in post-occlusal pulse wave velocity in this category of patients (11,0±3,3 m/s vs 9,4±1,9 m/s, p=0,0037). A significant increase in vascular age in relation to the passport age (60,4 [56,0:68,0] years vs 58,0 [53,0:60,0] years) and an increase in the 10-year fatal risk was detected (2,15 [1,42: 4,63] and 1,05 [0,52: 2,82] %, p = 0,0043 ) were also revealed in patients with arterial hypertension and non-alcoholic fatty liver disease compared to patients with isolated arterial hypertension. Significantly more patients with a high (13 (26,0%) vs 5 (10,0%), p = 0,0332) total cardiovascular risk were observed in group 1 than in group 2.Conclusions. Arterial stiffness was significantly higher in patients with arterial hypertension and non-alcoholic fatty liver disease than in patients with isolated arterial hypertension, which is confirmed by a statistically significant increase in pulse wave velocity and central aortic pressure. Comorbid patients have pronounced endothelial dysfunction, which is confirmed by a significant increase in the post-occlusion rate of the pulse wave. An increase in vascular age in relation to the passport age indicates earlier aging of blood vessels in the 1st group compared with the 2nd group. Patients in the main group have a higher incidence of a high 10-year risk of developing cardiovascular events compared with patients in the control group.

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“…A relation between PP elevation and morbidity and mortality due to cardiovascular events has been suggested in previous research and would be a potential physiopathological explanation for coronary artery disease (CAD). [2][3][4][5][6] However, although cross-sectional analyses have supported the hypothesis that wide PP is an independent risk factor for cardiovascular diseases, in general, and particularly for CAD, the prospective analyses failed to confirm this assumption. 7 This study aimed to investigate the potential value of PP as a marker of cardiovascular mortality.…”

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confidence: 98%

Pulse pressure as a risk factor for cardiovascular events: myth or reality?

Braite¹,

Santos²,

Neto³

et al. 2019

J Transcat Intervent

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Background: Elevated systolic blood pressure and decreased diastolic blood pressure increase systolic load, with concurrent decrease in coronary perfusion pressure. Researches suggested a relation between elevated pulse pressure and morbidity and mortality due to cardiovascular events. This study set out to investigate whether pulse pressure is a predisposing risk factor for coronary heart disease or an aggravating risk factor in patients with coronary artery disease. Methods: A total of 5,027 pressure registers were evaluated. Pulse pressure was determined invasively in the ascending aorta. Coronary artery disease was diagnosed in the presence of obstructive lesion with luminal diameter reduction of 50% or more in at least one major epicardial vessel. Intergroup comparisons were performed using the unpaired Student's t test or Mann-Whitney test, as indicated. Categorical variables were compared using the Chi-squared test. Long-term survival was assessed using Kaplan-Meier curves. The p values ≤0.05 were considered significant. Results: Pulse pressure ranged from 20.0 to 160.0mmHg (mean ± standard deviation: 68.4±22.3; median: 66.0mmHg; 75th percentile: 82.0mmHg). Pulse pressure was associated with risk factors for coronary artery disease when patients with and without obstructive coronary artery disease were compared. However, pulse pressure was not an independent predictor of mortality. Conclusion: Pulse pressure is not an independent predictor of mortality in patients with coronary artery disease undergoing angiography.

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Central aortic pulse pressure, thrombogenicity and cardiovascular risk

Cited by 9 publications

References 35 publications

Brachial pulse pressure is associated with the presence and extent of coronary artery disease in stable angina patients: a cross-sectional study

Brachial pulse pressure is associated with the presence and extent of coronary artery disease in stable angina patients: a cross-sectional study

The Influence of Non-Alc oholic Fatty Liver Disease on Indicators of Arterial Stiffness and Risk of Cardiovascular Complications in Patients with Arterial Hypertension

Pulse pressure as a risk factor for cardiovascular events: myth or reality?

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