Distinct factors are related to lower limb atherosclerosis in smokers and nonsmokers

Marques, Edmilson R.; Gemignani, Tiago; Azevedo, Renata Cruz Soares de; Higa, Celina M.; Coelho‐Filho, Otávio R.; Matos‐Souza, José R.; Spósito, Andrei C.; Nadruz, Wilson

doi:10.1097/hjh.0000000000001820

Cited by 3 publications

(4 citation statements)

References 26 publications

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“…Systematic measurement of calf BP measurement has been reported for more than a century [1,4,5,17] but few studies have compared arm and calf BP measures [3][4][5][6][7]18]. In our report, supine calf SBP and DBP measures were in average 23 strengthening the validity of our findings [6,7].…”

Section: Discussionsupporting

confidence: 71%

“…These data are in agreement with data reported in alternative populations [3] and suggest that such pro-atherogenic factors, which are acknowledged risk factors for peripheral artery disease [14], were associated with decreases in calf-arm DBP due to leg artery remodeling. In accordance with this assumption, previous studies showed that pro-atherogenic risk factors, such as smoking, are associated with higher prevalence of atherosclerotic plaques in popliteal arteries and decreased leg SBP, even in the absence of overt peripheral artery disease [18]. Conversely, it was noteworthy that age, a risk factor for peripheral artery disease [14], was associated with calf-arm DSBP in a direct rather than an inverse fashion.…”

Section: Discussionmentioning

confidence: 62%

“…This study has limitations. First, although the BP device used in our protocol was previously used to evaluate calf supine and standing BP in alternative populations [2][3][4]10,18], it has not undergone systematic validation for leg BP measurement. Second, individuals with leg/calf SBP ratio <0.90 or >1.40 were excluded from our analysis, and all the participants lived in Baependi, a small town with great rural activity located in the southeastern region of Brazil.…”

Section: Discussionmentioning

confidence: 99%

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Relationship of blood pressure measured in the calf with arm blood pressure and arterial stiffness: a general population study

Marques,

Bernardino,

Alvim

et al. 2023

Journal of Hypertension

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Aim: Leg blood pressure (BP) measurement is needed when arm BP evaluation is not feasible, and calf BP, especially when measured in standing position, may have greater association with cardiovascular remodeling than arm BP. This study evaluated the relationship between calf and arm BP, and investigated whether calf BP would be superior to arm BP in predicting increased arterial stiffness [pulse wave velocity (PWV) > 10 m/s]. Methods: We evaluated clinical and laboratory characteristics, BP measurements, and PWV in 1397 individuals resident in Baependi, Brazil, between 2017 and 2019. Arm BP was measured in the seated and supine positions while calf BP was measured in supine and standing positions using digital oscillometric devices. Carotid–femoral PWV was measured using a noninvasive mechanotransducer. Results: The sample had 62.7% females, age = 48.1 ± 15.4 years and 8.4% with PWV >10 m/s. Results of linear regression analysis showed that BP values of 140/90 mmHg measured in the arm in supine and seated position were equivalent to calf supine BP values of 164/81 mmHg and 166/78 mmHg and calf standing BP values of 217/137 mmHg and 221/137 mmHg, respectively. Calf-arm BP differences were associated with age, glomerular filtration rate, body mass index, smoking, low-density lipoprotein-cholesterol, diabetes and height. Furthermore, stepwise logistic regression analysis revealed that arm supine systolic BP, but not calf BP measurements, was independently associated with increased arterial stiffness. Conclusion: Thresholds of ≈165/80 mmHg and ≈220/135 mmHg could be used for diagnosing hypertension when only calf measurements in supine and standing positions, respectively, are available. Conversely, calf BP was not superior to arm BP in predicting increased arterial stiffness.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

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Relationship of blood pressure measured in the calf with arm blood pressure and arterial stiffness: a general population study

Marques,

Bernardino,

Alvim

et al. 2023

Journal of Hypertension

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“…54,55 Even though lower extremity arterial disease and carotid artery disease to some extent share similar risk factors, 56 these two arterial territories are quite different in several aspects, such as prevalence of atherosclerosis 57 and regarding hemodynamic properties. 58 In conclusion, levels of biomarkers such as NT pro-BNP and MR-proADM can be used as independent predictors for clinically detected carotid artery stenosis during longterm follow-up of subjects from the general population.…”

Section: Characteristicmentioning

confidence: 89%

Pro B-type Natriuretic Peptide and Midregional Proadrenomedullin are Associated with Incident Carotid Stenosis During Long Term Follow-up

Fatemi

Acosta

Zarrouk

et al. 2021

Journal of Stroke and Cerebrovascular Diseases

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Background: Plasma biomarkers may be useful to detect healthy individuals at increased risk for atherosclerotic manifestations, such as carotid artery stenosis. The aim of this longitudinal cohort study was to evaluate new biomarkers in relation to C-reactive protein and conventional risk factors for carotid artery stenosis during long term follow-up Methods: The following markers were measured in 5550 middle-aged subjects: C-reactive protein, lipoprotein-associated phospholipase A2, proneurotensin, midregional pro-adrenomedullin, midregional pro-atrial natriuretic peptide, N-terminal pro B-type natriuretic peptide, copeptin, and cystatin C. Subjects with prevalent carotid artery stenosis were excluded. Subjects were followed in national patient registers for 23.4 (interquartile range 19.5À24.3) years regarding incident carotid artery stenosis, both operated and non-operated. Results: When including conventional risk markers in Cox regression, N-terminal pro B-type natriuretic peptide (Hazard ratio 1.36; 95% confidence interval 1.12À1.65; p = 0.002) was independently associated with incident carotid artery stenosis, whereas there were trends for C-reactive protein (HR 1.20; 95% confidence interval 0.98À1.48; p = 0.071), and midregional pro-adrenomedullin (Hazard ratio 1.21; 95% confidence interval 0.99À1.47; p = 0.061). Midregional pro-adrenomedullin (Hazard ratio 1.30; 95% confidence interval 1.03À1.65; p = 0.029) was independently associated with incident surgery for carotid artery stenosis, whereas there was a trend for N-terminal pro B-type natriuretic peptide (Hazard ratio 1.31; 95% confidence interval 1.00À1.72; p = 0.052). Conclusions: N-terminal pro B-type natriuretic peptide and midregional pro-adrenomedullin can be used as predictors for clinically detected carotid artery stenosis during long-term follow-up of healthy subjects.

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Association of carotid wall layers with atherosclerotic plaques and cardiac hypertrophy in hypertensive subjects

et al. 2021

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Distinct factors are related to lower limb atherosclerosis in smokers and nonsmokers

Abstract: These findings indicate that risk factors for peripheral artery disease may differ between smokers and nonsmokers and further suggest that atherosclerosis in lower limb arteries is directly related to local hemodynamic forces among smokers.

Cited by 3 publications

References 26 publications

Relationship of blood pressure measured in the calf with arm blood pressure and arterial stiffness: a general population study

Relationship of blood pressure measured in the calf with arm blood pressure and arterial stiffness: a general population study

Pro B-type Natriuretic Peptide and Midregional Proadrenomedullin are Associated with Incident Carotid Stenosis During Long Term Follow-up

Association of carotid wall layers with atherosclerotic plaques and cardiac hypertrophy in hypertensive subjects

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