Journal of Hypertension最新文献

{"title":"Systemic immune-inflammation index and long-term mortality in patients with hypertension: a cohort study.","authors":"Yaling Zheng, Dongling Zhong, Juan Li, Yue Zhang, Huijing Li, Luoji Liu, Chi Ren, Shan Zhong, Xicen Liu, Xia He, Shiqi Jin, Lun Luo","doi":"10.1097/HJH.0000000000003927","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003927","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to examine the relationship between systemic inflammation and long-term mortality in patients with hypertension.</p><p><strong>Methods: </strong>The study employed a retrospective cohort design. The study population was derived from the National Health and Nutrition Examination Survey (NHANES), and the mortality data for this population was acquired from the National Death Index (NDI) database. Systemic inflammation was quantified by the Systemic Immune Inflammation Index (SII) and the Systemic Inflammatory Response Index (SIRI), which were then categorized into four groups (Q1-Q4, with Q4 representing the highest level of SII or SIRI). Weighted Cox regression models were constructed to investigate the association between mortality and SII and SIRI, with hazard ratios (HRs) subsequently calculated.</p><p><strong>Results: </strong>A total of 7431 participants were included in the analysis. The highest quantile (Q4) of SII was associated with a higher risk of all-cause mortality (hazard ratio 1.36, 95% CI 1.1-1.69, P < 0.001). After adjustment for important covariates, the association remained significant (hazard ratio 1.70, 95% CI 1.27-2.30, P < 0.001). The highest quantile (Q4) of SIRI was also associated with the highest risk of mortality (hazard ratio 2.11, 95% CI 1.64-2.70, P < 0.001), and this association remained significant after adjustment for important covariates (hazard ratio 1.64, 95% CI 0.61-1.22, P = 0.001).</p><p><strong>Conclusion: </strong>Both SII and SIRI scores were found to be associated with mortality rates in patients with hypertension. The findings suggest that these scores may serve as complementary biomarkers to the neutrophil-to-lymphocyte ratio (NLR) for assessing mortality risk in patients with hypertension. Further investigation is warranted to elucidate the underlying mechanisms that underpin this association.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts of hypertension and diabetes on the incidence of cardiovascular diseases and all-cause mortality: findings from the China Health and Retirement Longitudinal Study cohort.","authors":"Qiang Tu, Karice Hyun, Shuanglan Lin, Nashid Hafiz, Deborah Manandi, Emily Li, Xinzheng Wang, Haisheng Wu, Julie Redfern","doi":"10.1097/HJH.0000000000003946","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003946","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to examine the individual and joint effects of hypertension and diabetes on cardiovascular diseases and all-cause mortality among the middle-aged and older Chinese population.</p><p><strong>Methods: </strong>A total of 9681 individuals without preexisting CVD from the China Health and Retirement Longitudinal Study (CHARLS) were included. Participants were classified into four different groups: hypertension alone, diabetes alone, both conditions, neither condition. Multivariate Cox proportional hazards models were performed to estimate the risks of all-cause mortality and CVD.</p><p><strong>Results: </strong>During the 7-year follow-up, 967 deaths and 1535 CVD events were documented. Compared to individuals without hypertension and diabetes, hypertension alone [adjusted hazard ratio (aHR) 1.571, 95% confidence interval (CI) 1.316-1.875, P < 0.001], diabetes alone (aHR 1.618, 95% CI 1.187-2.205, P < 0.01) and comorbid hypertension and diabetes (aHR 2.041, 95% CI 1.557-2.677, P < 0.001) increased risks of all-cause mortality. The aHRs for CVD events in individuals with both conditions, hypertension alone and diabetes only were 2.011 (95% CI 1.651-2.449, P < 0.001), 1.408 (95% CI 1.233-1.608, P < 0.001) and 1.036 (95% CI 0.808-1.327, P > 0.05), respectively. The risk of CVD among those with comorbid hypertension and diabetes exceeded the sum of the risks due to hypertension and diabetes alone (relative excess risk ratio = 0.567, 95% CI 0.136-0.999).</p><p><strong>Conclusion: </strong>Individuals with comorbid hypertension and diabetes had greater risks of CVD and all-cause mortality, beyond those associated with either condition alone. The synergistic interaction between hypertension and diabetes aggravated the risk of CVD.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synergistic effect of anemia and obstructive sleep apnea on hypertension: National Health and Nutrition Examination Survey 2015-2018.","authors":"Jiajia Yao, Xi He, Han Wang, Anzi Wang, Lin Zhen","doi":"10.1097/HJH.0000000000003939","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003939","url":null,"abstract":"<p><strong>Objective: </strong>Anemia, obstructive sleep apnea (OSA), and hypertension are common social health problems. They are interconnected. This study assessed the independent association of anemia and OSA with hypertension and the interaction between anemia and OSA on hypertension in the US population.</p><p><strong>Methods: </strong>Data used by this retrospective study were obtained from the National Health and Nutrition Examination Survey (NHANES) 2015-2018. The relative excess risk due to interaction (RERI), weighted logistic regression, and the attributable proportion due to interaction (AP) were used to investigate the interaction above. Its impact was also assessed via subgroup analysis by gender, age, race, diabetes, smoking, alcohol use, education, and marital status.</p><p><strong>Results: </strong>After covariate adjustment in 6949 eligible observers, it was found that compared with non-OSA patients, OSA patients were at higher risk of hypertension [odds ratio (OR) = 1.254, 95% confidence interval (CI) 1.099-1.432, P < 0.001). Meanwhile, OSA and anemia had a potential synergistic effect on the incidence of the disease (OR = 1.705, 95% CI: 1.390-2.091, P < 0.01): the RERI was 0.371, and the AP was 0.218. In addition, such effect was observed in the subgroup of other race (AP = 0.48), the nondrinking subgroup (AP = 2.50), the subgroup graduating from high school or above (AP = 0.28), the unmarried subgroup (AP = 0.4), the subgroup without diabetes (AP = 0.24), and the drinking subgroup (AP = 0.41).</p><p><strong>Conclusion: </strong>Anemia and OSA had a potential synergistic effect on hypertension. Their relationship needs to be further elucidated by a further study.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart failure with preserved ejection fraction: from echocardiographic characteristics to a cardiovascular damage score in a high-risk hypertensive population.","authors":"Dario Leone, Fabrizio Vallelonga, Matteo Botta, Marco Cesareo, Lorenzo Airale, Anna Colomba, Salvatore Fragapani, Giulia Bruno, Giulia Mingrone, Jacopo Ligato, Martina Sanapo, Franco Veglio, Alberto Milan","doi":"10.1097/HJH.0000000000003942","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003942","url":null,"abstract":"<p><strong>Background: </strong>Heart failure with preserved ejection fraction (HFpEF) is a high prevalence condition, with high rates of hospitalization and mortality. Arterial hypertension is the main risk factor for HFpEF. Among hypertensive patients, alterations in cardiac and vascular morphology identify hypertension-mediated organ damage (HMOD). Cardiac HMOD in terms of ventricular hypertrophy and diastolic dysfunction is a continuum between the preclinical condition (arterial hypertension) and HFpEF. In hypertensive patients, it is currently unknown what is the prevalence of individuals classifiable as being at high risk of developing HFpEF and whether aortic morphofunctional vascular changes are present.</p><p><strong>Aim: </strong>This study seeks to retrospectively assess the prevalence of echocardiographic alterations consistent with the diagnosis of HFpEF in a cohort of patients with essential arterial hypertension, and the prevalence of vascular HMOD (V-HMOD) in different risk categories of patients.</p><p><strong>Methods: </strong>Hypertensive outpatients referred at the Hypertension Center of Turin from 2003 to 2021 were retrospectively evaluated. Patients with a previous diagnosis of heart failure and known cardiovascular events were excluded. A predictive model associated with the risk of HFpEF development was calculated using echocardiographic variables. V-HMOD morphological and functional parameters were assessed by ascending aorta diameter and arterial stiffness (carotid-femoral pulse wave velocity, cfPWV).</p><p><strong>Results: </strong>Eight hundred and four patients (34.8% women) were analyzed, age 53.1 ± 14 years; left ventricular mass index (LVMi) and E/e' ratio were impaired in 15.9 and 29.1% of cases, respectively. Dividing them into tertiles according to score: score 1 or less (30.2%); score 2-3 (47.4%); score at least 3 (22.7%). Patients identified at high risk of HFpEF (score ≥3) had higher age, BMI and blood pressure than the other two groups (P < 0.05); they showed a significantly higher prevalence of female patients (42.3%), treatment with at least two antihypertensive drugs (40.1%), diabetes (7.1%), and dyslipidemia (28%; P < 0.05), with a larger ascending aorta diameter (35.5 ± 5.5 mm, P < 0.05) and higher cfPWV (8.8 ± 2.4 m/s, P < 0.05).</p><p><strong>Conclusion: </strong>At least one in five hypertensive patients, referred to an outpatient echocardiographic examination, has C-HMOD compatible with a high-risk category of HFpEF and have a significant increase in V-HMOD. This reinforces the notion that arterial hypertension and HFpEF are not two distinctly separate conditions but a continuum of pathophysiologic alterations.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural and load-dependent arterial stiffness across the adult life span.","authors":"Changyang Xing, Lei Xu, Fan Li, Xiujing Xie, Xiangping Guan, Xiaojun Zhan, Wu Chen, Hengli Yang, Xiangzhu Wang, Yingli Wang, Jinsong Li, Qi Zhou, Yuming Mu, Qing Zhou, Yunchuan Ding, Yu Zheng, Yu Wu, Xiaofeng Sun, Hua Li, Chaoxue Zhang, Cheng Zhao, Shaodong Qiu, Guozhen Yan, Hong Yang, Yinjuan Mao, Weiwei Zhan, Chunyan Ma, Ying Gu, Mingxing Xie, Tianan Jiang, Lijun Yuan","doi":"10.1097/HJH.0000000000003943","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003943","url":null,"abstract":"<p><strong>Background: </strong>The arterial stiffening is attributed to the intrinsic structural stiffening and/or load-dependent stiffening by increased blood pressure (BP). The respective lifetime alterations and major determinants of the two components with normal aging are not clear.</p><p><strong>Methods: </strong>A total of 3053 healthy adults (1922 women) aged 18-79 years were enrolled. The carotid intima-media thickness, diameter, and local BPs were automatically determined by the radio frequency ultrasound system. The Peterson and Young elastic moduli were then calculated to represent total arterial stiffness. Structural stiffness was recalculated at a reference BP of 120/80 mmHg with established models. Load-dependent stiffness was the difference between total and structural stiffness.</p><p><strong>Results: </strong>Both structural and load-dependent stiffness increased with aging, with much larger changes in the structural components. The age-related increasing rates were higher in women for the structural stiffness than men (P < 0.05), but similar for the load-dependent stiffness. The clinical characteristics and arterial stiffness were widely correlated, but most correlations were quite weak (r < 0.3) other than BPs. Multiple regression analyses adjusted for sex, age and other clinical correlates showed that structural stiffness increased with pulse pressure (PP) and load-dependent stiffness increased with mean arterial pressure (MAP), respectively.</p><p><strong>Conclusion: </strong>The age-related arterial stiffening is mainly caused by the intrinsic structural stiffening, which demonstrated significant age-sex interaction. BPs were the major clinical determinants of arterial stiffness, with PP and MAP associated with different arterial stiffness components. The differentiation of the structural and load-dependent arterial stiffness should be highlighted for the optimal vascular health management.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remission of persistent hypertension and hypokalaemia following redo adrenalectomy for primary aldosteronism - case report.","authors":"Diluka Pinto, Ada Teo, Sujith Wijerethne, Chin Meng Khoo, Troy Puar, Rajeev Parameswaran","doi":"10.1097/HJH.0000000000003944","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003944","url":null,"abstract":"<p><p>We report on a case of a 67-year-old male who was referred to our care with persistent aldosteronism post adrenalectomy. Biochemical failure after surgery is rare after surgery for primary aldosteronism (PA). Persistent hypokalaemia and raised aldosteronism is an indication of treatment failure after surgery. Causes of failure may be multiple aldosterone producing nodules or diffuse hyperplasia, inappropriate or incomplete lateralization studies, presence of CACNA1D -mutated aldosterone producing adenomas (APAs) and incomplete or partial adrenalectomy. In our case the persistent disease was imaged with METOMIDATE PET as the patient had a previous history of adrenal vein clipping during index surgery. The patient underwent reoperative adrenalectomy and was cured of hypokalaemia and hypertension, despite a long duration of his disease. This case highlights some of the reasons for biochemical failure and work up of the patient for reoperative surgery.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resolution of hypertension after kidney transplantation is associated with improved kidney transplant outcomes: a nationwide cohort study.","authors":"Kyungho Lee, Bong-Sung Kim, Junseok Jeon, Dong Wook Shin, Jung Eun Lee, Wooseong Huh, Kyung-Do Han, Hye Ryoun Jang","doi":"10.1097/HJH.0000000000003938","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003938","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with advanced chronic kidney disease suffer from hypertension, and kidney transplantation (KT) has potential to induce hypertension resolution. We hypothesized that hypertension resolution after KT is associated with better KT outcomes.</p><p><strong>Methods: </strong>We identified KT recipients (2006-2015) who had pretransplant hypertension. They were categorized into two groups based on their hypertension status after KT: persistent vs. resolved hypertension, using data from the Korea National Health Insurance System. Cox proportional hazard analyses were performed to assess the risk of graft failure and mortality, adjusting for various clinical factors.</p><p><strong>Results: </strong>Among 11 317 KT recipients with pretransplant hypertension, 7269 (64%) remained hypertensive, while 4048 (36%) experienced hypertension resolution. Recipients with resolved hypertension exhibited a lower prevalence of delayed graft function and major comorbidities, including diabetes, ischemic heart disease, and stroke. Graft failure and mortality rates were significantly lower in resolved hypertension group. After adjusting for multiple covariates, hazard ratios of resolved hypertension were 0.61 (95% confidence interval 0.52-0.72) for graft failure and 0.68 (0.56-0.81) for all-cause mortality.</p><p><strong>Conclusions: </strong>A significant proportion of patients experienced hypertension resolution after KT, which is associated with improved graft and overall survival. The post-KT hypertension resolution can be used as a prognostic indicator for predicting better KT outcomes.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of single-pill versus free equivalent combinations on persistence and major adverse cardiovascular events in hypertension: a real-world analysis.","authors":"Gábor Simonyi, Michel Burnier, Krzysztof Narkiewicz, György Rokszin, Zsolt Abonyi-Tóth, Gábor Kovács, Praveen Kumar Potukuchi, Mohamed Abdel-Moneim, Csaba Farsang","doi":"10.1097/HJH.0000000000003916","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003916","url":null,"abstract":"<p><strong>Objectives: </strong>Hypertension guidelines recommend the use of single-pill combinations (SPCs) of antihypertensive drugs to improve treatment persistence and blood pressure control. This study aimed to investigate the long-term effects of ramipril/amlodipine (R/A) SPC versus free equivalent dose combinations (FEC) on cardiovascular outcomes and treatment persistence.</p><p><strong>Methods: </strong>This retrospective, observational study analysed the database of the Hungarian National Health Insurance Fund. The study included patients with hypertension aged at least 18 years who were initiated on R/A SPC or FEC of different dose combinations (R/A 5/5, 5/10, 10/5 and 10/10 mg) between 2012 and 2018, with follow-up for up to 60 months. Imbalances in baseline characteristics were reduced with propensity score-based sub-classification. All analyses were performed with Cox proportional hazard model and propensity score sub-classification to adjust the imbalances in baseline characteristics. Drug persistence and MACEs were the primary and secondary endpoints, respectively.</p><p><strong>Results: </strong>Overall, 104 882 patients with SPC and 68 324 patients with FEC-treated hypertension were included. The R/A 5/5 mg combination represented the largest proportion (62%). The nonpersistence rate was significantly lower with SPC than with FEC from month 1 to month 24 in the R/A 5/5 mg combination (P < 0.001) and during the entire observation period in the remaining combinations. The MACE rate was significantly reduced with all R/A SPCs versus FECs. No effects on age and sex on both endpoints were noted.</p><p><strong>Conclusion: </strong>This study further supports the beneficial effects of the use of SPC on 60-month persistence and MACEs in hypertension.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of diastolic blood pressure and coronary artery calcium in South Asian American adults.","authors":"Meena Moorthy, Namratha R Kandula, Nicola Lancki, Juned Siddique, Neela Thangada, Daichi Shimbo, Havisha Pedamallu, Alka M Kanaya, Nilay S Shah","doi":"10.1097/HJH.0000000000003940","DOIUrl":"10.1097/HJH.0000000000003940","url":null,"abstract":"<p><strong>Objective: </strong>DBP is associated with atherosclerosis and cardiovascular disease, independent of SBP. However, prior evaluation of the association of DBP with coronary artery calcium (CAC) has not included South Asian adults, a population that is at excess risk of atherosclerotic cardiovascular disease.</p><p><strong>Methods: </strong>In the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study, we evaluated the association of sex-specific DBP tertiles and CAC score at least 100 with robust Poisson regression adjusted for age, sex, SBP, BP medication use, and other cardiovascular risk factors. We examined these associations stratified by antihypertensive medication use, and secondarily the association of baseline DBP tertile with incident CAC at least 100 over median 4.7 years of follow-up.</p><p><strong>Results: </strong>Among 1155 participants (48% women, mean age 57 years), mean (standard deviation) DBP was 74 (10) mmHg, 33% were on antihypertensive medications, and 22% had CAC at least 100. Relative to DBP in tertile 1, DBP in tertiles 2 and 3 was associated with a significantly higher prevalence of CAC at least 100 [adjusted prevalence ratio 1.30 [95% confidence interval (CI) 1.03-1.65] and 1.47 (1.12-1.93), respectively]. These significant associations were primarily observed in participants who were not on antihypertensive medications. Baseline DBP tertile was not associated with incident CAC at least 100.</p><p><strong>Conclusion: </strong>Among South Asian adults in MASALA, DBP in the second or third tertiles vs. tertile 1 were associated with a higher prevalence of CAC at least 100 after adjustment for covariates including SBP. DBP may be an important clinical ASCVD risk factor among South Asian adults.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beat-to-beat variability of aortic pulse wave velocity: implications for aortic stiffness measurements.","authors":"Alessandro Giudici, Andrea Grillo, Filippo Scalise, Koen D Reesink, Tammo Delhaas, Paolo Salvi, Bart Spronck, Gianfranco Parati","doi":"10.1097/HJH.0000000000003935","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003935","url":null,"abstract":"<p><strong>Objectives: </strong>Aortic pulse wave velocity (aPWV) predicts cardiovascular risk. Being the reference method for aortic stiffness evaluation, invasive aPWV is also recommended for validation of noninvasive devices. Because of intrinsic haemodynamic variability and processing issues, aPWV shows beat-to-beat variability. We aimed to quantify this variability and evaluate its implications for the reliability and use of aPWV as reference in validation and clinical application studies.</p><p><strong>Methods: </strong>The study included n = 84 patients, in whom two datasets of invasive data were recorded: 1) simultaneous ascending aorta and iliac pressure acquisitions using a dual-tip intra-aortic catheter, and 2) an additional ascending aorta pressure acquisition. By combining the iliac and ascending aorta pressure recordings from the first and second acquisitions, respectively, we evaluated how a sequential acquisition protocol affects variability. We compared three pressure waveform foot identification methods to investigate the effect of data processing on variability. Furthermore, we estimated how averaging over nbeats consecutive heartbeats affects the standard deviation (SD) of such nbeats-averaged estimate of aPWV.</p><p><strong>Results: </strong>The simultaneously acquired invasive aPWV showed a 5% beat-to-beat SD (variability), with small but significant differences between foot identification methods. The sequential acquisition protocol doubled aPWV variability compared to simultaneous acquisition. However, because averaging had a much stronger effect on sequentially measured aPWV, the two acquisition protocols yielded comparable variabilities at nbeats = 10 (2% vs. 3%).</p><p><strong>Conclusions: </strong>Our study suggests that, independently from the acquisition protocol and data processing, the intrinsic beat-to-beat variability of aPWV becomes manageable when aPWV values of at least ten heartbeats are averaged.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}