Large artery stiffness and microalbuminuria: a causal relationship?

Older age is associated with elevated large elastic artery stiffness, a strong predictor of cardiovascular (CVD) risk in middle-age/older (MA/O) adults independent of blood pressure (BP). Greater 24-hour systolic BP variability (BPV) is also an independent risk factor for CVD and is linked to large artery stiffness in MA/O adults with hypertension and diabetes. However, its relation to age-related arterial stiffness in adults with low risk factor burden is unclear. We hypothesized that higher systolic BPV would be: 1) associated with advancing age, and 2) related to elevated aortic and carotid artery stiffness among healthy MA/O adults. To determine this, 98 healthy adults (ages 19-70 yrs) with measurements of systolic BPV (standard deviation of 24 hr systolic BP) via ambulatory BP monitoring, aortic stiffness (carotid-femoral pulse wave velocity, cfPWV), carotid artery stiffness (β-stiffness via carotid tonometry/B mode ultrasound) and circulating metabolic factors were included. In the entire cohort, greater systolic BPV was not associated with age, cfPWV, carotid β stiffness or circulating lipids/glucose (all P>0.05), but was correlated (age-adjusted) with 24 hr systolic BP (r= 0.41, P<0.001) and BMI (r= 0.21, P<0.05). In stepwise linear regression analyses that included age, sex, BMI, only 24 hr systolic BP was associated with systolic BPV (β= 0.14 ± 0.03, Model R 2 = 0.20, P< 0.001). Interestingly, there was no difference in 24 hr systolic BPV (11.4 ± 0.4 vs 11.4 ± 0.5 SD mmHg, P=0.99) in young (n=55; 29.0 ± 0.7 yrs) vs. MA/O (n= 43; 53.0 ± 1.2 yrs) adults despite higher cfPWV (594 ± 12 vs 913 ± 39 cm/sec, P<0.001), carotid β-stiffness (6.8 ± 0.6 vs 9.3 ±0.9 U, P=0.001) and 24 hr systolic BP (121 ± 1 vs 125 ± 2 mmHg, P<0.05). Systolic BPV was associated with BMI (r= 0.42, p< 0.01) and fasting blood glucose (r= 0.54, P= 0.001) in MA/O but not young adults. In a stepwise linear regression model among MA/O, 24 hr systolic BP (β= 0.18 ± 0.04, R 2 = 0.36, P<0.001) and fasting glucose (β= 0.10 ± 0.05, R 2 change= 0.07, P<0.001) were the only significant correlates of systolic BPV (Model R 2 = 0.43, P<0.001). In conclusion, 24 hr systolic BP and fasting blood glucose, but not age or large elastic artery stiffness, were the strongest determinants of higher systolic BPV in normotensive MA/O adults.

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Abstract P253: Relation Between Microvascular Function and Large Artery Stiffness in African American Diabetic Patients

Hypertension ◽

10.1161/hyp.70.suppl_1.p253 ◽

2017 ◽

Vol 70 (suppl_1) ◽

Author(s):

Ajibola M Adedayo ◽

Ayobami Eluwole ◽

Fasika Tedla ◽

Arye Kremer ◽

Nicole Mastrogiovanni ◽

...

Keyword(s):

African Americans ◽

Glycemic Control ◽

Vascular Complications ◽

Microvascular Dysfunction ◽

Microvascular Function ◽

Reactivity Index ◽

Entire Group ◽

Diabetic Patients ◽

Large Artery ◽

Artery Stiffness

Rationale: Diabetes is highly prevalent among African Americans and poses a higher risk for vascular complications in this population. Although socioeconomic factors are well known to influence outcomes, true biologic differences in risk factor vulnerability have been suggested. Vascular complications have been traditionally viewed as either macrovascular (myocardial infarction and stroke) or microvascular (retinopathy, nephropathy, and neuropathy). Better glycemic control is known to improve microvascular but not macrovascular complications. In recent years, there has been a growing appreciation that microvascular dysfunction may promote large artery disease and vice versa. Given this notion of vascular “cross-talk” and since subclinical dysfunction is known to precede target organ damage, the objective of this study was to determine whether subclinical microvascular dysfunction is related to large artery stiffness. Methods: A total of 141 patients with type II diabetes were recruited from our outpatient clinics over a 6 month period. Medical information was obtained via patient interview and electronic medical record review including laboratory results. Microvascular function was assessed by the vascular reactivity index (VRI), which assesses changes in digital temperature before and after release of arterial cuff occlusion (VENDYS 5000BC DTM system Endothelix, Inc.). Large artery stiffness was assessed by carotid-femoral pulse wave velocity (PWV) using applanation tonometry (Sphygmocor, Atcor Inc.). Results: Mean age was 60 + 8 years, 64% were female. 80% had hypertension and 90% had dyslipidemia. 15% had chronic kidney disease. Mean HbA1C levels were 8.1 + 2.2%. For the entire group, VRI was significantly correlated with PWV (r=.27, p=.002). On multivariate analysis, VRI was independently associated with PWV (β=-1.0, p=.001) and a trend towards an association with HbA1c (β =.07, p=.09) after adjusting for traditional cardiovascular risk factors. Conclusions: Among African Americans with diabetes, subclinical microvascular dysfunction is significantly correlated to large artery stiffness and possibly to glycemic control. Further study is needed to clarify mediating factors of these relationships.

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Association of HIV-infection, antiretroviral treatment and metabolic syndrome with large artery stiffness: a cross-sectional study

BMC Infectious Diseases ◽

10.1186/s12879-018-3637-0 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 4

Author(s):

Titus F. Msoka ◽

Gary P. Van Guilder ◽

Yvo M. Smulders ◽

Marceline van Furth ◽

John A. Bartlett ◽

...

Keyword(s):

Metabolic Syndrome ◽

Hiv Infection ◽

Antiretroviral Treatment ◽

Cross Sectional Study ◽

Large Artery ◽

Sectional Study ◽

Cross Sectional ◽

Artery Stiffness

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Large artery stiffness is associated with marinobufagenin in young adults

Journal of Hypertension ◽

10.1097/hjh.0000000000001866 ◽

2018 ◽

Vol 36 (12) ◽

pp. 2333-2339 ◽

Cited By ~ 8

Author(s):

Michél Strauss ◽

Wayne Smith ◽

Wen Wei ◽

Alexei Y. Bagrov ◽

Olga V. Fedorova ◽

...

Keyword(s):

Young Adults ◽

Large Artery ◽

Artery Stiffness

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The estrogen-induced alterations in large artery stiffness are not attenuated by the non-dipping status in untreated hypertensive postmenopausal women

American Journal of Hypertension ◽

10.1016/s0895-7061(03)00151-1 ◽

2003 ◽

Vol 16 (5) ◽

pp. A31

Author(s):

K TZIOUMIS

Keyword(s):

Postmenopausal Women ◽

Large Artery ◽

Artery Stiffness

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Greater impairments in cerebral artery compared with skeletal muscle feed artery endothelial function in a mouse model of increased large artery stiffness

The Journal of Physiology ◽

10.1113/jphysiol.2014.285338 ◽

2015 ◽

Vol 593 (8) ◽

pp. 1931-1943 ◽

Cited By ~ 13

Author(s):

Ashley E. Walker ◽

Grant D. Henson ◽

Kelly D. Reihl ◽

R. Garrett Morgan ◽

Parker S. Dobson ◽

...

Keyword(s):

Skeletal Muscle ◽

Mouse Model ◽

Endothelial Function ◽

Cerebral Artery ◽

Large Artery ◽

Artery Stiffness

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Gender Differences in Large Artery Stiffness Pre- and Post Puberty

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2003-030722 ◽

2003 ◽

Vol 88 (11) ◽

pp. 5375-5380 ◽

Cited By ~ 105

Author(s):

Anna A. Ahimastos ◽

Melissa Formosa ◽

Anthony M. Dart ◽

Bronwyn A. Kingwell

Keyword(s):

Gender Differences ◽

Heart Rate ◽

Cardiac Output ◽

Arterial Compliance ◽

Large Artery ◽

Healthy Children ◽

Large Arteries ◽

Age Related ◽

Artery Stiffness ◽

Males And Females

Abstract Age-related large artery stiffening is more pronounced in women compared with men and is an important cause of isolated systolic hypertension. This study aimed to investigate whether such gender differences are inherent or the result of sex steroid influences. Healthy children prepuberty [26 female (10.3 ± 0.1 yr), 32 male (10.3 ± 0.1 yr), mean age ± sd] and post puberty [30 female (15.9 ± 0.2 yr), 22 male (15.9 ± 0.4 yr)] were studied. Large artery stiffness was assessed globally via systemic arterial compliance and regionally via pulse wave velocity. Prepubertal males and females did not differ in body size, cardiac output, or heart rate. Prepubertal females had stiffer large arteries and higher pulse pressure than age-matched males (P < 0.05). Postpubertal males were taller and heavier and had a greater cardiac output and lower heart rate compared with similarly aged females. In relation to pubertal status, females developed more distensible large arteries post puberty whereas males developed stiffer large vessels (P < 0.05). These changes where such that central large artery stiffness was similar between genders in the postpubertal group. Together these data suggest that large artery stiffness varies intrinsically between genders but is also modulated by both male and female sex steroids.

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