Influence of beat-to-beat blood pressure variability on vascular elasticity in hypertensive population

Xia, Yufa; Liu, Xin; Wu, Dan; Xiong, Hongyan; Ren, Lijie; Xu, Lin; Wu, Wanqing

doi:10.1038/s41598-017-08640-4

Cited by 30 publications

(31 citation statements)

References 33 publications

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“…[27–28] Furthermore, a strong association between arterial stiffness, estimated with a beat-to-beat analyzer in a hypertensive population, and Systolic BPV was shown. [29]…”

Section: Discussionmentioning

confidence: 99%

Blood pressure variability with different measurement methods

et al. 2019

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Blood pressure variability (BPV) is an independent cardiovascular risk factor in hypertensive patients. The best method for quantifying BPV is still an object of debate. The existence of different BPV patterns, particularly age and arterial stiffness related, is postulated. Our aims were: to compare BPV using different blood pressure (BP) measurement methods to compare different calculation approaches to analyze the predictors of BPV. Cross-sectional study in 108 elderly hypertensive hospitalized patients. Each patient underwent blood pressure measurements with 5 different modalities: 24 hour BP and pulse wave velocity (PWV) monitoring (24hBPM), measurement by nurses or physicians, self-measurement and beat-to-beat monitoring. Differences between maximum and minimum values (ΔBP), averages of the absolute differences between consecutive values (ARV) and coefficients of variation (CV) were calculated. ΔBP showed the wider values’ dispersion (Δ systolic blood pressure (SBP): 66.4 ± 22.9 and Δ diastolic blood pressure [DBP]: 45.0 ± 13.5 mmHg). ARV and CV were highest with nurses’ measurements (SBP-ARV 9.2 ± 6.2; DBP-ARV 6.9 ± 5.2; SBP-CV 7.6 ± 5.3; DBP-CV 9.6 ± 5.5). The strongest correlation was found comparing physicians’ SBP measurements and 24hBPM ARVs (R2 0.23, P <.05). 24hBPM ΔSBP in a multivariate analysis was significantly associated with age (β −3.85, SE 0.83; P <.001) and PWV (β 20.29, SE 3.70; P <.001). Calcium antagonists were associated with a lower ΔSBP (β −14.6, SE 6.1, P <.05) while diuretics and alpha-blockers with a significant increase (β 14.4 SE 5.4, P <.01; β 26.9 SE 11.7, P <.05). Age, PWV, diuretics, alpha-blockers, but also measurements obtained by nurses, increase BP variability while calcium antagonists reduce it. BP profiles in elderly in-hospital patients potentially provide important information; they should, however, be interpreted cautiously.

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“…[27–28] Furthermore, a strong association between arterial stiffness, estimated with a beat-to-beat analyzer in a hypertensive population, and Systolic BPV was shown. [29]…”

Section: Discussionmentioning

confidence: 99%

Blood pressure variability with different measurement methods

et al. 2019

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“…However, increased heart-feet PWV was observed in patients with hypertension, suggesting that PAD and hypertension apply opposing effects on PWV [ 160 ]. Even beat to beat blood pressure variability have shown to be correlated with an increase in PWV in the hypertensive population [ 162 ]. Additionally, in a study of 101 healthy subjects and 102 patients with diabetes with/without PAD, reduced brachial-ankle PWV (baPWV) was found in people with diabetes and PAD (1221 cm/s) compared to non-PAD diabetic subjects (1607 cm/s) [ 163 ].…”

Section: Emerging Techniquesmentioning

confidence: 99%

Peripheral vascular disease assessment in the lower limb: a review of current and emerging non-invasive diagnostic methods

et al. 2018

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BackgroundWorldwide, at least 200 million people are affected by peripheral vascular diseases (PVDs), including peripheral arterial disease (PAD), chronic venous insufficiency (CVI) and deep vein thrombosis (DVT). The high prevalence and serious consequences of PVDs have led to the development of several diagnostic tools and clinical guidelines to assist timely diagnosis and patient management. Given the increasing number of diagnostic methods available, a comprehensive review of available technologies is timely in order to understand their limitations and direct future development effort.Main bodyThis paper reviews the available diagnostic methods for PAD, CVI, and DVT with a focus on non-invasive modalities. Each method is critically evaluated in terms of sensitivity, specificity, accuracy, ease of use, procedure time duration, and training requirements where applicable.ConclusionThis review emphasizes the limitations of existing methods, highlighting a latent need for the development of new non-invasive, efficient diagnostic methods. Some newly emerging technologies are identified, in particular wearable sensors, which demonstrate considerable potential to address the need for simple, cost-effective, accurate and timely diagnosis of PVDs.Electronic supplementary materialThe online version of this article (10.1186/s12938-018-0494-4) contains supplementary material, which is available to authorized users.

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“…Impaired brain perfusion has been linked to increased WMHs and reduced cortical volumes (Alosco et al, 2013;Jefferson et al, 2009). The impaired altered beat-to-beat variability may stress the autoregulatory mechanisms of the vascular system, inducing endothelial dysfunction and vascular remodelling processes (Xia et al, 2017). These processes commonly lead to the thickening of the arterioles and occlusion of capillaries which increase the peripheral resistance, R p , and subsequently triggers the stiffening, τ, of large arteries (Dabrowska et al, 2020;Laurent and Boutouyrie, 2015).…”

Section: Af Subgroup Analysismentioning

confidence: 99%

Biophysics-based statistical learning: Application to heart and brain interactions

Banus

Lorenzi

Cámara

et al. 2021

Medical Image Analysis

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Initiatives such as the UK Biobank provide joint cardiac and brain imaging information for thousands of individuals, representing a unique opportunity to study the relationship between heart and brain. Most of research on large multimodal databases has been focusing on studying the associations among the available measurements by means of univariate and multivariate association models. However, these approaches do not provide insights about the underlying mechanisms and are often hampered by the lack of prior knowledge on the physiological relationships between measurements. For instance, important indices of the cardiovascular function, such as cardiac contractility, cannot be measured in-vivo. While these non-observable parameters can be estimated by means of biophysical models, their personalisation is generally an ill-posed problem, often lacking critical data and only applied to small datasets. Therefore, to jointly study brain and heart, we propose an approach in which the parameter personalisation of a lumped cardiovascular model is constrained by the statistical relationships observed between model parameters and brain-volumetric indices extracted from imaging, i.e. ventricles or white matter hyperintensities volumes, and clinical information such as age or body surface area. We explored the plausibility of the learnt relationships by inferring the model parameters conditioned on the absence of part of the target clinical features, applying this framework in a cohort of more than 3 000 subjects and in a pathological subgroup of 59 subjects diagnosed with atrial fibrillation. Our

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Influence of beat-to-beat blood pressure variability on vascular elasticity in hypertensive population

Cited by 30 publications

References 33 publications

Blood pressure variability with different measurement methods

Blood pressure variability with different measurement methods

Peripheral vascular disease assessment in the lower limb: a review of current and emerging non-invasive diagnostic methods

Biophysics-based statistical learning: Application to heart and brain interactions

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