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Heart Rate as a Cardiovascular Risk Factor in Hypertension
Published in Giuseppe Mancia, Guido Grassi, Konstantinos P. Tsioufis, Anna F. Dominiczak, Enrico Agabiti Rosei, Manual of Hypertension of the European Society of Hypertension, 2019
However, several experimental data show that a low heart rate actually improves large artery distensibility. This was shown long ago by the Milan group in both rats and human beings (59). By increasing heart rate with pacing, these authors demonstrated that carotid distensibility as measured from echo Doppler progressively declined with increasing heart rate. Consistent results were obtained in human beings with measurement of pulse wave velocity. Using the same technique to increase heart rate, a French group (60) and an Australian group (61) found a progressive increase in large artery stiffness also when data were adjusted for changes in blood pressure. Recent data from the HARVEST study confirmed the negative relationship between heart rate and the augmentation index in acute studies (unpublished results). However, ambulatory heart rate showed a positive relationship with the augmentation index measured 7 years later.
Hyperglycemia Impairs Blood Vessel Function
Published in Robert Fried, Richard M. Carlton, Type 2 Diabetes, 2018
Robert Fried, Richard M. Carlton
Pulse wave velocity is the speed of the blood pressure wave traveling a given distance between two sites of the arterial system. It is a function of vessel wall elasticity, wall thickness, and blood density. Pulse wave velocity correlates with arterial distensibility and stiffness and is a useful noninvasive index to assess atherosclerosis.
Aortic and Arterial Mechanics
Published in Michel R. Labrosse, Cardiovascular Mechanics, 2018
The impact produced by the blood on the walls of the aorta during cardiac ejection generates a pressure wave called a pulse wave, which propagates along the arterial tree from the aorta to the peripheral arteries. It causes a radial deformation of the arterial wall, which enables diastolic relay of the cardiac contraction. The pulse wave velocity (PWV) is considered a parameter that represents arterial stiffness. Indeed, the Moens–Korteweg relationship relates the PWV to the geometrical and mechanical characteristics of the artery when it is considered a thin-walled isotropic tube of infinite length:
Relationship between ambulatory arterial stiffness index and the severity of angiographic atherosclerosis in patients with H-type hypertension and coronary artery disease
Published in Clinical and Experimental Hypertension, 2023
Li Dong, Jing Liu, Yan Qin, Wen-Juan Yang, Liang Nie, Hua-Ning Liu, Qing-Hua Hu, Yu Sun, Wen-Yan Cao
This study has some limitations. Firstly, the sample size was small. This study was a retrospective and cross-sectional study, and the causal relationship between independent variables and dependent variables is not strong. At the same time, the prevalence of h-type hypertension is relatively lower than other previous studies. This is because the research object of this study is mainly the elderly in our single institution. In subsequent studies, we will include hypertensive patients from multiple centers to expand our sample size and strengthen the universality of the results. Secondly, because the ambulatory blood pressure measurement of hypertensive patients may be affected by factors such as snoring and sleep disorders, this may have affected the reliability of our conclusions. In addition, there was a lack of discussion on daytime AASI, nighttime AASI, AASI variability, blood pressure variability and other indicators. Finally, because AASI cannot monitor the effect of medical intervention on hypertension, the slope of the curve between SBP and DBP may be similar at the same pulse pressure. Although it can be easily obtained from ambulatory blood pressure monitoring (ABPM) readings, it is also controversial as a true measure of arterial stiffness. Therefore, in subsequent studies, we will conduct a larger prospective clinical study to explore the consistency between pulse wave velocity and AASI.
Comparison of office, home and ambulatory blood pressure measurements in hypertensive and suspected hypertensive SWICOS participants
Published in Blood Pressure, 2023
D. Radovanovic, F. Muggli, M. Bianchetti, A. Gallino, G. Parati, P. M. Suter, R. Schoenenberger-Berzins, P. Erne, A. W. Schoenenberger
For the evaluation of HMOD, the following central hemodynamic parameters were measured. Pulse wave velocity (PWV) was assessed after the completion of OBP measurements at baseline: pulse wave velocity (PWV) and central aortic BP were measured by a validated operator-independent, non-invasive device (Arteriograph®; Tensiomed Ltd., Budapest, Hungary) based on a validated oscillometric occlusive technique (Arteriograph, TensioMed Ltd., Budapest, Hungary) [14]. After 5 min of rest, supine brachial systolic and diastolic BP, heart rate and central hemodynamics parameters were simultaneously obtained. The arteriograph software estimates PWV by considering the timing of wave reflections and specifically the time interval between the peaks of the ejected (first) and reflected (second) systolic wave in relation to the jug between both waves. To ensure the quality of measured pulse wave velocity, only measurements of aortic PWV with a standard deviation of beat-to-beat variation ≤1.0 m/sec were included.
A Randomized Double-Blind Placebo-Controlled Trial Evaluating the Efficacy of Oral Cholecalciferol in Improving Renal and Vascular Functions in Vitamin D-Deficient Patients With Type 2 Diabetes Mellitus
Published in Journal of Dietary Supplements, 2023
Saibal Das, Sandhiya Selvarajan, Sadishkumar Kamalanathan, Sreejith Parameswaran, Bobby Zachariah
At the end of 8 and 24 weeks, there was no significant improvement in any vascular parameters in both the groups. An increase in pulse wave velocity by around 2.7 m/s increases the cardiovascular risk by 35–45%. However, our study showed no effect on any parameters of vascular functions after cholecalciferol supplementation. In a recent meta-analysis, cholecalciferol supplementation was found to exert no significant effect on most of the markers of vascular function. Similar results were found following treatment with different vitamin D analogs as well (11). After six months of therapy with calcitriol or cholecalciferol, there was no improvement in vascular endothelial functions or inflammation in patients with CKD (12). However, few contradictory results are also reported in the literature. A randomized, double-blind, placebo-controlled trial was performed to evaluate the effects of cholecalciferol supplementation on vascular function in 120 patients with non-diabetic CKD (stages 3 and 4) and vitamin D deficiency. In these patients, cholecalciferol supplementation (1000 − 120,000 IU/month for 2 − 12 months) did not cause any significant improvement in various markers of arterial stiffness (13). Similarly, a meta-analysis performed including 16 studies reporting results of vascular functions from 1177 participants on cholecalciferol supplementation for 4 − 52 weeks did not found any beneficial effects on endothelial functions.