Underestimation of Vasodilator Effects of Nitroglycerin by Upper Limb Blood Pressure

Takazawa, Kenji; Tanaka, Nobuhiro; Takeda, Kazuhiro; Kurosu, Fujio; Ibukiyama, Chiharu

doi:10.1161/01.hyp.26.3.520

Cited by 151 publications

(114 citation statements)

References 6 publications

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“…21 As Tr was not affected by WBV training, the decrease in AIx was attributed to a reduction in the magnitude of the reflected wave, which corresponds with aSBP in individuals with increased AIx. 37 Because our participants were normotensives, the improved arterial function may have influenced the decrease in aSBP rather than the reduction in aSBP caused a passive decrease in baPWV.…”

Section: Discussionmentioning

confidence: 94%

Whole-body vibration training reduces arterial stiffness, blood pressure and sympathovagal balance in young overweight/obese women

et al. 2012

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Obesity is associated with early cardiovascular dysfunction and reduced muscle strength. Whole-body vibration (WBV) training may improve arterial function and muscle strength. The effects of WBV training on arterial stiffness (brachial-ankle pulse wave velocity, baPWV), wave reflection (augmentation index, AIx), brachial systolic blood pressure (bSBP), aortic systolic blood pressure (aSBP), heart rate variability, and muscle strength (one-repetition maximum, 1RM) were examined in 10 young (21 ± 2 year) overweight/obese women (body mass index, BMI¼29.9 ± 0.8 kg m -2 ). Participants were randomized to a 6-week WBV training or non-exercising control (CON) period in a crossover design. WBV training (3 daysÂweek) consisted of static and dynamic squats and calf raises with vibration intensity at 25-30 Hz and 1-2 mm amplitude (2.83-4.86 G). There were significant (Po0.05) decreases in baPWV (À0.9±0.3 m s -1 ), AIx (À8.0±2.2 %), bSBP (À5.3±1.5 mm Hg), aSBP (À5.2 ± 2.1 mm Hg), low-frequency power (À0.13 ± 0.05 nu) and sympathovagal balance (LF/HF, À0.42 ± 0.16) after WBV training compared with CON. Significant (Po0.05) increases in high-frequency power (HF, 0.19 ± 0.04 nu) and leg extension 1RM (8.2±2.3 kg) occurred after WBV training compared with CON. Six weeks of WBV training decreased systemic arterial stiffness and aSBP via improvements in wave reflection and sympathovagal balance in young overweight/obese normotensive women. WBV training may benefit arterial function and muscle strength in deconditioned individuals who cannot perform conventional exercise.

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Section: Discussionmentioning

confidence: 94%

Whole-body vibration training reduces arterial stiffness, blood pressure and sympathovagal balance in young overweight/obese women

et al. 2012

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“…As the changes in P2 and AIx were correlated and Tr was unaffected after PV, our data suggest that the post-vibration AIx response could be mainly driven by a reduction in vascular smooth muscle tone in the legs. 30,31 The aortic pressure pulse wave is a composite of an early forward wave (P1) and a reflected wave traveling from the periphery back to the aorta (P2). 6 In cardiac patients with increased AIx, aortic SBP is determined by P2 whereas peripheral SBP is more dependent on P1.…”

Section: Discussionmentioning

confidence: 99%

“…6 In cardiac patients with increased AIx, aortic SBP is determined by P2 whereas peripheral SBP is more dependent on P1. 31 Thus, the reduction in aortic P2 after administration of a vasodilator drug causes a decrease in aortic SBP. 31 In the present study, although PV evoked significant decreases in AIx and AP (À2.3 mm Hg), both aortic and brachial SBP as well as P1 did not change.…”

Section: Discussionmentioning

confidence: 99%

“…31 Thus, the reduction in aortic P2 after administration of a vasodilator drug causes a decrease in aortic SBP. 31 In the present study, although PV evoked significant decreases in AIx and AP (À2.3 mm Hg), both aortic and brachial SBP as well as P1 did not change. As our subjects were healthy young adults and P1 was higher than P2 after PV, the aortic and brachial SBP were determined by P1.…”

Section: Discussionmentioning

confidence: 99%

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Impact of passive vibration on pressure pulse wave characteristics

et al. 2011

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The augmentation index (AIx), a marker of wave reflection, decreases following acute leg exercise. Passive vibration (PV) causes local vasodilation that may reduce AIx. This study investigated the effects of acute PV on wave reflection and aortic hemodynamics. In a crossover fashion 20 (M ¼ 9, F ¼ 11) healthy young (22±3 year) participants were randomized to 10 min PV or no vibration control (CON) trials. Subjects rested in the supine position with their legs over a vibration platform for the entire session. Radial waveforms were obtained by applanation tonometry before and after 3 min (Post-3) and 30 min (Post-30) of PV (B5.37 G) or CON. No change in parameters was found at Post-3. We found significant time-by-trial interactions (Po0.01) at Post-30 for augmented pressure, AIx and second systolic peak pressure (P2), such that these parameters significantly (Po0.05) decreased (À2.3 ± 3.0 mm Hg, À7.2 ± 6.9% and À1.5±3.5 mm Hg, respectively) after PV but not after CON. These findings suggest that acute PV applied to the legs decreases AIx owing to a decrease in wave reflection magnitude (P2). Further research is warranted to evaluate the potential clinical application of PV in populations at an increased cardiovascular risk who are unable to perform conventional exercise.

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“…Further studies have shown that reduction in left ventricular and aortic systolic pressure is not associated with equivalent decrease in brachial or radial systolic pressure, so that the beneficial effect of GTN is underestimated from conventional measurement of arterial pressure by sphygmomanometer. 11,16,17 Inability of the sphygmomanometer to determine the full effect of nitrate action stimulated introduction of new methods which are based on Murrell's original findings with GTN. One such method, namely pulse wave analysis, was used in the present study.…”

Section: Discussionmentioning

confidence: 99%

Potential for use of pulse wave analysis in determining the interaction between sildenafil and glyceryl trinitrate

O’Rourke

Nichols

2002

Clinical Cardiology

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Background: The early part of the central aortic pressure pulse, with amplitude (PI – Pd), is generated by left ventricular ejection, while the latter part (or augmented pressure), with amplitude (Ps – Pi), is generated by the reflected wave arriving during systole. The effects of arterial vasodilator agents, especially nitrates, on central aortic systolic blood pressure are grossly underestimated by sphygmomanometric measurements of brachial artery pressure. Hypothesis: The objective of this study was to investigate the potential for use of central arterial pulse wave analysis, obtained noninvasively from the radial pulse, in determining the interaction between sildenafil and the nitric oxide donor drug glyceryl trinitrate (GTN). Methods: Central aortic pressure waveforms were generated from noninvasively measured radial artery pressure waveforms and subjected to pulse wave analysis to determine the interactionbetween sildenafil and transdermally applied GTN. Results: Transdermal GTN (2.5, 5.0, and 15 mg per 24‐h patches) alone caused no consistent change in sphygmomanometer‐determined systolic or diastolic pressures, but there was a consistent, dose‐related fall in amplitude of the augmented systolic pressure, (Ps – Pi), of 4.0,7.0, and 11 mmHg, respectively, with little change in diastolic pressure. The 2.5 mg patch caused a fall of 4.0 mmHg in aortic systolic pressure, while augmentation index (AIx) fell from 20 to 11% and pulse pressure fell 18%. When oral sildenafil (50 mg) was administered after GTN (2.5 mg), aortic systolic pressure fell another 4.0 mmHg. This decrease in systolic pressure caused a fall in AIx to almost 0.0%; pulse pressure fell another 9.0%. Conclusion: These modifications in aortic systolic and pulse pressure are due primarily to reduction in wave‐reflection amplitude and are not detected by sphygmomanometer‐measured brachial artery pressure.

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Underestimation of Vasodilator Effects of Nitroglycerin by Upper Limb Blood Pressure

Cited by 151 publications

References 6 publications

Whole-body vibration training reduces arterial stiffness, blood pressure and sympathovagal balance in young overweight/obese women

Whole-body vibration training reduces arterial stiffness, blood pressure and sympathovagal balance in young overweight/obese women

Impact of passive vibration on pressure pulse wave characteristics

Potential for use of pulse wave analysis in determining the interaction between sildenafil and glyceryl trinitrate

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