Home About us Contact
|
Home About us Contact | ||
|
|
||
Arterial Stiffness (arterial + stiffness)
Kinds of Arterial Stiffness Selected AbstractsRELATIONSHIP BETWEEN ARTERIAL STIFFNESS AND GLUCOSE METABOLISM IN WOMEN WITH METABOLIC SYNDROMECLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 9 2006Paul Nestel SUMMARY 1Cardiovascular risk factors associated with the metabolic syndrome affect vascular functions adversely. The aim of the present study was to assess the relationship between parameters of glucose homeostasis and arterial stiffness in women with characteristics of the metabolic syndrome. 2Twenty post-menopausal women participated in a cross-sectional study in which systemic arterial compliance (SAC) and plasma glucose, lipids and glycosylated haemoglobin (HbA1c) were measured while subjects were maintained on a diet high in fibre, raised in protein and reduced in saturated fat. 3Regression analysis suggested that mean ( SD) fasting glucose of 5.9 ± 1.7 mmol/L, glucose levels 2 h after a 75 g glucose load of 6.8 ± 3.6 mmol/L, systolic blood pressure of 131 ± 12 mmHg and HbA1c of 5.3 ± 1.7% predicted SAC negatively. The following correlations were obtained between SAC and: (i) fasting glucose: R = -0.49, P = 0.028; (ii) 2 h glucose level post-glucose load: R = -0.42, P = 0.064; (iii) HbA1c: R = -0.42, P = 0.056; and (iv) systolic blood pressure: R = -0.55, P = 0.012. 4Relationships between SAC and fasting glucose and systolic blood pressure were significantly independent of each other. There was no evidence of relationships between SAC and any plasma lipid parameter (other than a trend in relation to plasma triglyceride), bodyweight or waist circumference. 5In conclusion, in post-menopausal women with metabolic syndrome, fasting plasma glucose and systolic blood pressure, and possibly HbA1c and the 2 h glucose post-glucose load, predicted increased arterial stiffness. [source] Impaired Fasting Glucose Is Associated with Increased Arterial Stiffness in Elderly People without Diabetes Mellitus: The Rotterdam StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2006Nicole M. Van Popele MD OBJECTIVES: To study the association between impaired fasting glucose (IFG) and arterial stiffness in older adults. DESIGN: Cross-sectional population-based study. SETTING: The Rotterdam Study, a Dutch population-based cohort study. PARTICIPANTS: Two thousand nine hundred eighty-seven subjects aged 60 and older. MEASUREMENTS: Arterial stiffness assessed by measuring common carotid arterial distensibility and glucose status classified into three categories: normal fasting glucose (NFG) (fasting glucose <6.1 mmol/L), IFG (fasting glucose 6.1,6.9 mmol/L), and diabetes mellitus (DM). RESULTS: In the total cohort, common carotid distensibility decreased with increasing impairment of glucose metabolism. Subjects younger than 75 with IFG were comparable with subjects with NFG with respect to arterial stiffness. Subjects aged 75 and older with IFG had stiffer arteries than subjects with NFG, reaching the same arterial stiffness as subjects with DM. For subjects younger than 75, mean difference in distensibility coefficient between subjects with NFG and with IFG was 0.1 (95% confidence interval (CI)=,0.04,0.05, P=.88) and between subjects with NFG and with DM was 1.2 (95% CI=0.7,1.7, P<.001). For subjects aged 75 and older, the mean difference between these groups was 0.7 (95% CI=0.2,1.2, P=.007) and 0.8 (0.3,1.4; P=.002), respectively. In the total cohort, fasting glucose was strongly associated with carotid distensibility (,-coefficient=,0.29, P<.001). CONCLUSION: IFG is related to arterial stiffness in elderly subjects. An advanced stage of arterial stiffness, comparable with that of subjects with DM, is only reached at the age of 75. [source] Late-Life Depression is Associated with Arterial Stiffness: A Population-Based StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2003Henning Tiemeier MD Objectives: To determine whether arterial stiffness is associated with depression in the elderly. Design: Population-based cross-sectional study. Setting: In Ommoord, a suburb of Rotterdam, the Netherlands. Participants: Three thousand seven hundred four subjects of the Rotterdam Study aged 60 and older. Measurements: Arterial stiffness was assessed using the distensibility of the carotid artery and the carotid-femoral pulse wave velocity. All participants were screened for depressive symptoms with the Center for Epidemiologic Studies,Depression scale. Those with depressive symptoms had a psychiatric evaluation to establish a diagnosis of depressive disorders according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Results: Participants with increased arterial stiffness were more likely to have depressive symptoms. Odds ratios (ORs) for depressive symptoms were 1.24 (95% confidence interval (CI) = 1.01,1.52) per standard deviation decrease in carotid distensibility and 1.17 (95% CI = 1.00,1.38) per standard deviation increase in aortic pulse wave velocity. The association was stronger for depressive disorders meeting DSM-IV criteria (OR = 1.44, 95% CI = 1.03,2.03; OR = 1.48, 95% CI = 1.16,1.90, respectively). Control for atherosclerosis, as measured by the ankle-to-brachial index or presence of plaques in the carotid artery, did not change the associations. Conclusion: This study shows an association between arterial stiffness and depression in the elderly. The findings are compatible with the vascular depression hypothesis. These data suggest that arterial stiffness may partly cause the proposed relationship between vascular factors and depression. [source] ORIGINAL RESEARCH,ENDOCRINOLOGY: Pulse Pressure, an Index of Arterial Stiffness, Is Associated with Androgen Deficiency and Impaired Penile Blood Flow in Men with EDTHE JOURNAL OF SEXUAL MEDICINE, Issue 1 2009Giovanni Corona MD ABSTRACT Introduction., Pulse pressure (PP; i.e., the arithmetic difference between systolic and diastolic blood pressure) reflects arterial stiffness and has been suggested to be an independent cardiovascular risk factor. Aim., The aim of the present study is to asses the possible contribution of PP to arteriogenic erectile dysfunction (ED) and ED-associated hypogonadism. Methods., A consecutive series of 1,093 (mean age 52.1 ± 13.0 years) male patients with ED and without a previous history of hypertension or not taking any antihypertensive drugs were investigated. Main Outcome Measures., Several hormonal and biochemical parameters were studied, along with structured interview on erectile dysfunction (SIEDY), ANDROTEST structured interviews, and penile Doppler ultrasound. Results., Subjects with higher PP quartiles showed worse erectile function and higher prevalence of arteriogenic ED even after adjustment for confounding factors. Furthermore, sex hormone binding globulin-unbound testosterone levels declined as a function of PP quartiles. Accordingly, the prevalence of overt hypogonadism (calculated free testosterone < 180 pmol/L or free testosterone < 37 pmol/L) increased as a function of PP quartiles (17.% vs. 39.7%, and 30.8% vs. 58.6% for the first vs. fourth quartile, respectively, for calculated free testosterone and free testosterone; all P < 0.0001 for trend). This association was confirmed even after adjustment for confounders (Adjusted [Adj]) r = 0.090 and 0.095 for calculated free testosterone < 180 pmol/L and free testosterone < 37 pmol/L, respectively; all P < 0.05). Conclusions., PP is an easy method to estimate and quantify patient arterial stiffness. We demonstrated here for the first time that elevated PP is associated with arteriogenic ED and male hypogonadism. The calculation of PP should became more and more familiar in the clinical practice of health care professionals involved in sexual medicine. Corona G, Mannucci E, Lotti F, Fisher AD, Bandini E, Balercia G, Forti G, and Maggi M. Pulse pressure, an index of arterial stiffness, is associated with androgen deficiency and impaired penile blood flow in men with ED. J Sex Med 2009;6:285,293. [source] Association of Serum Pentosidine With Arterial Stiffness in Hemodialysis PatientsARTIFICIAL ORGANS, Issue 3 2010YiLun Zhou Abstract Pentosidine is an advanced glycation end product (AGE). The present study was undertaken to investigate the association of serum pentosidine with carotid distensibility as a measure of arterial stiffness in hemodialysis patients. One hundred and three patients on maintenance hemodialysis were recruited. The distensibility coefficient of the common carotid artery was evaluated by an ultrasonic phase-locked echo-tracking system. Serum pentosidine was measured by competitive enzyme-linked immunosorbent assay. Serum albumin, lipid profile, calcium, phosphorus, intact parathyroid hormone (iPTH), high-sensitivity C-reactive protein (hs-CRP), and oxidized low-density lipoprotein (ox-LDL) levels were also measured. Correlation was determined by linear and multiple stepwise regression analysis. Serum pentosidine level studied in hemodialysis patients was 0.54 ± 0.13 µg/mL. No significant difference in serum pentosidine level was noted between patients with and without diabetes (0.59 ± 0.10 µg/mL vs. 0.53 ± 0.13 µg/mL, P = 0.062) as well as between patients with and without prior cardiovascular disease (CVD) history (0.56 ± 0.14 µg/mL vs. 0.53 ± 0.12 µg/mL, P = 0.206). In multivariate regression analysis, only age (, = 0.363, P < 0.001) and ox-LDL (, = 0.262, P = 0.004) were identified as independent determinants for serum pentosidine. Serum pentosidine was significantly correlated with carotid distensibility (r = ,0.387, P < 0.001), as well as age, ox-LDL, and hs-CRP. After adjustment for age, blood pressure, history of diabetes, prior CVD history, lipid profile, calcium, phosphorus, iPTH, hs-CRP, and ox-LDL, serum pentosidine was still negatively correlated with distensibility (, = ,0.175, P = 0.044). Serum pentosidine was independently associated with carotid distensibility in hemodialysis patients. This finding suggested that the accumulation of AGE might be an important pathway in the development of arterial stiffness in end-stage renal disease. [source] Arterial stiffness in relation to subclinical atherosclerosisEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 1 2009A. Wykretowicz ABSTRACT Background, Increased arterial stiffness or arteriosclerosis, represents a physiological part of ageing. Atherosclerosis is a process that does not affect the arterial bed uniformly but has a variable local distribution and is frequently superimposed on stiffened vessels. We therefore addressed the question of whether any correlation exists between the general characteristics of arterial stiffness or wave reflection and subclinical atherosclerosis as assessed by carotid intima-media thickness (IMT) in a sample of healthy subjects. Methods, A total of 116 healthy subjects (mean age 55 years, 43 female) were evaluated. Arterial stiffness and wave reflection was assessed with the use of digital volume pulse analysis (DVP) and pulse wave analysis (PWA). Subclinical atherosclerosis was assessed by measurement of IMT. Results, Stiffness Index (SIDVP), the measure of general arterial stiffness correlated significantly with IMT (r = 0·37, P < 0·01). IMT correlated significantly with age (r = 0·5, P < 0·0001), waist to hip ratio (WHR) (r = 0·39, P < 0·0001) and mean blood pressure (BPmean) (r = 0·4, P < 0·0001). IMT did not correlate with measures of wave reflection. SIDVP correlated significantly with age (r = 0·32, P < 0·005), WHR (r = 0·36, P < 0·0001), BPmean (r = 0·36, P < 0·0001) and measurements of wave reflection. However analysis of a model which included variables that significantly influenced SIDVP and IMT, such as age, WHR and mean BP showed that arterial stiffness is not independently associated with subclinical atherosclerosis. Conclusions, The indices of subclinical atherosclerosis, arterial stiffness and wave reflection, indicate different aspects of vascular status in otherwise healthy subjects [source] Impaired Fasting Glucose Is Associated with Increased Arterial Stiffness in Elderly People without Diabetes Mellitus: The Rotterdam StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2006Nicole M. Van Popele MD OBJECTIVES: To study the association between impaired fasting glucose (IFG) and arterial stiffness in older adults. DESIGN: Cross-sectional population-based study. SETTING: The Rotterdam Study, a Dutch population-based cohort study. PARTICIPANTS: Two thousand nine hundred eighty-seven subjects aged 60 and older. MEASUREMENTS: Arterial stiffness assessed by measuring common carotid arterial distensibility and glucose status classified into three categories: normal fasting glucose (NFG) (fasting glucose <6.1 mmol/L), IFG (fasting glucose 6.1,6.9 mmol/L), and diabetes mellitus (DM). RESULTS: In the total cohort, common carotid distensibility decreased with increasing impairment of glucose metabolism. Subjects younger than 75 with IFG were comparable with subjects with NFG with respect to arterial stiffness. Subjects aged 75 and older with IFG had stiffer arteries than subjects with NFG, reaching the same arterial stiffness as subjects with DM. For subjects younger than 75, mean difference in distensibility coefficient between subjects with NFG and with IFG was 0.1 (95% confidence interval (CI)=,0.04,0.05, P=.88) and between subjects with NFG and with DM was 1.2 (95% CI=0.7,1.7, P<.001). For subjects aged 75 and older, the mean difference between these groups was 0.7 (95% CI=0.2,1.2, P=.007) and 0.8 (0.3,1.4; P=.002), respectively. In the total cohort, fasting glucose was strongly associated with carotid distensibility (,-coefficient=,0.29, P<.001). CONCLUSION: IFG is related to arterial stiffness in elderly subjects. An advanced stage of arterial stiffness, comparable with that of subjects with DM, is only reached at the age of 75. [source] Late-Life Depression is Associated with Arterial Stiffness: A Population-Based StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2003Henning Tiemeier MD Objectives: To determine whether arterial stiffness is associated with depression in the elderly. Design: Population-based cross-sectional study. Setting: In Ommoord, a suburb of Rotterdam, the Netherlands. Participants: Three thousand seven hundred four subjects of the Rotterdam Study aged 60 and older. Measurements: Arterial stiffness was assessed using the distensibility of the carotid artery and the carotid-femoral pulse wave velocity. All participants were screened for depressive symptoms with the Center for Epidemiologic Studies,Depression scale. Those with depressive symptoms had a psychiatric evaluation to establish a diagnosis of depressive disorders according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Results: Participants with increased arterial stiffness were more likely to have depressive symptoms. Odds ratios (ORs) for depressive symptoms were 1.24 (95% confidence interval (CI) = 1.01,1.52) per standard deviation decrease in carotid distensibility and 1.17 (95% CI = 1.00,1.38) per standard deviation increase in aortic pulse wave velocity. The association was stronger for depressive disorders meeting DSM-IV criteria (OR = 1.44, 95% CI = 1.03,2.03; OR = 1.48, 95% CI = 1.16,1.90, respectively). Control for atherosclerosis, as measured by the ankle-to-brachial index or presence of plaques in the carotid artery, did not change the associations. Conclusion: This study shows an association between arterial stiffness and depression in the elderly. The findings are compatible with the vascular depression hypothesis. These data suggest that arterial stiffness may partly cause the proposed relationship between vascular factors and depression. [source] Increased arterial stiffness in children and adolescents with type 1 diabetes: no association between arterial stiffness and serum levels of adiponectinPEDIATRIC DIABETES, Issue 1 2010Angela Galler Galler A, Heitmann A, Siekmeyer W, Gelbrich G, Kapellen T, Kratzsch J, Kiess W. Increased arterial stiffness in children and adolescents with type 1 diabetes: no association between arterial stiffness and serum levels of adiponectin. Objective: Type 1 diabetes is associated with an increased risk of atherosclerosis. Adiponectin serum levels correlate inversely with cardiovascular disease in adults. The aim of this study was to examine associations between arterial stiffness indices and serum adiponectin concentrations in children and adolescents with type 1 diabetes and to study the impact of metabolic control. Subjects and methods: We evaluated arterial stiffness, distensibility, and compliance in 93 children and adolescents with type 1 diabetes and correlated the data with clinical parameters and HbA1c levels. The control group comprised 85 matched healthy children. Serum levels of adiponectin in children with diabetes were measured by enzyme-linked immunoassay and correlated with arterial stiffness indices. Results: Arterial stiffness was significantly increased in children and adolescents with type 1 diabetes (aged 13.0 ± 3.8 yr) compared with matched healthy children (p = 0.03). Arterial stiffness was elevated in males with type 1 diabetes compared with females (p = 0.023). Arterial distensibility was significantly lower in children with diabetes compared with healthy controls (p = 0.025). Arterial stiffness, distensibility, and compliance did not correlate with diabetes duration, level of HbA1c, or serum cholesterol. Adiponectin concentrations in children and adolescents with diabetes were significantly elevated compared with normal values based on gender, age, and body mass index. We found no significant associations between arterial stiffness indices and adiponectin levels in children with type 1 diabetes. Conclusions: Children and adolescents with type 1 diabetes had increased arterial stiffness and reduced arterial distensibility and arterial compliance. However, no associations between arterial functional alterations and adiponectin concentrations were seen. [source] Large Artery Stiffness: Implications For Exercise Capacity And Cardiovascular RiskCLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 3 2002Bronwyn A Kingwell SUMMARY 1. Large artery stiffness, or its inverse, compliance, determines pulse pressure, which, in turn, influences myocardial work capacity and coronary perfusion, both of which impact on exercise capacity and cardiovascular risk. 2. In support of a role for arterial properties in exercise performance, aerobically trained athletes (aged 30,59 years) have lower arterial stiffness than their sedentary counterparts. Furthermore, in healthy older subjects (aged 57,80 years), time to exhaustion on treadmill testing correlated positively with arterial compliance. 3. Arterial stiffness is more closely linked to exercise capacity and myocardial risk in patients with coronary disease where, independently of degree of coronary disease, those with stiffer proximal arteries have a lower exercise-induced ischaemic threshold. 4. Moderate aerobic training elevates resting arterial compliance by approximately 30%, independently of mean pressure reduction, in young healthy individuals but not in isolated systolic hypertensive patients. Rat training studies support a role for exercise training in structural remodelling of the large arteries. 5. High-resistance strength training is associated with stiffer large arteries and higher pulse pressure than matched controls. 6. Large artery stiffness is an important modulator of the myocardial blood supply and demand equation, with significant ramifications for athletic performance and ischaemic threshold in coronary disease patients. Moderate aerobic training, but not high-resistance strength training, reduces large artery stiffness in young individuals whereas older subjects with established isolated systolic hypertension are resistant to such adaptation. [source] Treatment of isolated systolic hypertension in diabetes mellitus type 2DIABETES OBESITY & METABOLISM, Issue 4 2006Ingrid Os Age-related arterial stiffness is more pronounced in diabetics compared to non-diabetics, which could explain the prevalence of isolated systolic hypertension (ISH, systolic blood pressure ,140 mmHg and diastolic blood pressure <90 mmHg) being approximately twice that of the general population without diabetes. Large-scale interventional outcome trials have also shown that diabetics usually have higher pulse pressure and higher systolic blood pressure than non-diabetics. Advanced glycation end-product formation has been implicated in vascular and cardiac complications of diabetes including loss of arterial elasticity, suggesting possibilities for new therapeutic options. With increasing age, there is a shift to from diastolic to systolic blood pressure and pulse pressure as predictors of cardiovascular disease. This may affect drug treatment as different antihypertensive drugs may have differential effects on arterial stiffness that can be dissociated from their effects on blood pressure. While thiazide diuretics are associated with little or no change in arterial stiffness despite a robust antihypertensive effect, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers and calcium-channel blockers have been shown to reduce arterial stiffness. However, combination therapy is nearly always necessary to obtain adequate blood pressure control in diabetics. There are no randomized controlled trials looking specifically at treatment of ISH in diabetics. Recommendations regarding treatment of ISH in diabetes mellitus type 2 are based on extrapolation from studies in non-diabetics, post-hoc analyses and prespecified subgroup analysis in large-scale studies, and metaanalysis. These analyses have clearly demonstrated that blood pressure lowering in ISH confers improved prognosis and reduced cardiovascular and renal outcomes in both diabetics and non-diabetics. [source] Brachial-ankle pulse wave velocity and cardiovascular risk factors in the non-diabetic and newly diagnosed diabetic Chinese: Guangzhou Biobank Cohort Study-CVDDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 2 2010Lin Xu Abstract Background Increased arterial stiffness is an important cause of cardiovascular disease (CVD). We examined determinants of arterial stiffness in subjects across strata of glycaemic status. Methods A total of 1249 subjects from a sub-study of the Guangzhou Biobank Cohort Study (GBCS-CVD) had brachial-ankle pulse wave velocity (baPWV) measured by automatic oscillometric method. Major cardiovascular risk factors including glycosylated haemoglobin A1c (HbA1c), high sensitivity C-reactive protein (hsCRP), fasting triglyceride, low- and high-density lipoprotein cholesterol and both fasting and post 2-h oral glucose-load glucose, systolic and diastolic blood pressure were assessed. Results In all, 649, 479 and 121 subjects were classified into normoglycaemia, impaired glucose metabolism (IGM) and newly diagnosed diabetes groups, respectively. Both age and systolic blood pressure were significantly associated with increased baPWV in all three groups (all p < 0.001). In both normoglycaemic and IGM groups, hsCRP and HbA1c were positively associated with baPWV (p from 0.04 to < 0.001), whereas current smoking and triglyceride were associated with baPWV in the normoglycaemic and IGM group, respectively (p = 0.04 and 0.001). No gender difference in baPWV was observed in the normoglycaemic or IGM groups. However, in the newly diagnosed diabetes group, men had higher baPWV than women (p = 0.01). Conclusions In the normoglycaemic and IGM subjects, after adjusting for age, blood pressure and other confounders, increasing HbA1c was associated with increased baPWV, suggesting a pathophysiological role of chronic glycaemia that can contribute to vascular disease risk in persons without diabetes. Copyright © 2010 John Wiley & Sons, Ltd. [source] Higher arterial stiffness, greater peripheral vascular resistance and lower blood flow in lower-leg arteries are associated with long-term hyperglycaemia in type 2 diabetic patients with normal ankle-brachial indexDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 4 2009Eiji Suzuki Abstract Background Higher arterial stiffness and greater peripheral vascular resistance reduce blood flow in lower-leg arteries and contribute to the development of ischaemic limb in diabetic patients even without peripheral artery occlusive disease. The aim of this study was to clarify whether these vascular parameters are associated with long-term hyperglycaemia in diabetic patients. Methods We examined 45 type 2 diabetic patients and 38 age-matched nondiabetic subjects without peripheral artery occlusive disease assessed by ankle-brachial index consecutively admitted to our hospital, and followed them over a 3-year period (3.7 ± 0.7 years) with no vasodilative medication. Blood flow and resistive index, a measure of peripheral vascular resistance, at the popliteal artery were evaluated using gated two-dimensional cine-mode phase-contrast magnetic resonance imaging. Brachial-ankle pulse wave velocity was measured to assess arterial stiffness. Results At baseline, consistent with our previous report, diabetic patients showed higher brachial-ankle pulse wave velocity (p < 0.0001) and resistive index (p < 0.0001) and lower flow volume (p = 0.0044) than those of nondiabetic subjects. Stepwise multiple regression analysis revealed that duration of diabetes, mean HbA1c during the study, use of renin-angiotensin system inhibitors and change per year in resistive index were identified as significant independent variables predicting change per year in blood flow (r2 = 0.733, p < 0.0001) in diabetic patients. Mean HbA1c during the study was positively correlated with changes per year in brachial-ankle pulse wave velocity (p = 0.00007) and resistive index (p = 0.0014) and was negatively correlated with that in blood flow (p < 0.0001) in diabetic patients. Conclusions Long-term hyperglycaemia is a major cause of impaired peripheral circulation in lower-leg arteries in diabetic patients without peripheral artery occlusive disease. Copyright © 2009 John Wiley & Sons, Ltd. [source] "Supranormal" Cardiac Function in Athletes Related to Better Arterial and Endothelial FunctionECHOCARDIOGRAPHY, Issue 6 2010Maria Florescu M.D. Objective: Athlete's heart is associated with left ventricular (LV) hypertrophy (LVH), and "supranormal" cardiac function, suggesting that this is a physiological process. Hypertrophy alone cannot explain increase in cardiac function, therefore, other mechanisms, such as better ventriculo-arterial coupling might be involved. Methods: We studied 60 male (21 ± 3 years) subjects: 27 endurance athletes, and a control group of 33 age-matched sedentary subjects. We assessed global systolic and diastolic LV function, short- and long-axis myocardial velocities, arterial structure and function and ventriculo-arterial coupling, endothelial function by flow-mediated dilatation, and amino-terminal pro-brain natriuretic peptide (NT-proBNP) and biological markers of myocardial fibrosis and of oxidative stress. Results: Athletes had "supranormal" LV longitudinal function (12.4 ± 1.0 vs 10.1 ± 1.4 cm/s for longitudinal systolic velocity, and 17.4 ± 2.6 vs 15.1 ± 2.4 cm/s for longitudinal early diastolic velocity, both P < 0.01), whereas ejection fraction and short-axis function were similar to controls. Meanwhile, they had better endothelial function (16.7 ± 7.0 vs 13.3 ± 5.3%, P < 0.05) and lower arterial stiffness (pulse wave velocity 7.1 ± 0.6 vs 8.8 ± 1.1 m/s, P = 0.0001), related to lower oxidative stress (0.259 ± 0.71 vs 0.428 ± 0.88 nmol/mL, P = 0.0001), with improved ventriculo-arterial coupling (37.1 ± 21.5 vs 15.5 ± 13.4 mmHg.m/s3× 103, P = 0.0001). NT-proBNP and markers of myocardial fibrosis were not different from controls. LV longitudinal function was directly related to ventriculo-arterial coupling, and inversely related to arterial stiffness and to oxidative stress. Conclusions: "Supranormal" cardiac function in athletes is due to better endothelial and arterial function, related to lower oxidative stress, with optimized ventriculo-arterial coupling; athlete's heart is purely a physiological phenomenon, associated with "supranormal" cardiac function, and there are no markers of myocardial fibrosis. (Echocardiography 2010;27:659-667) [source] C-Reactive Protein and Aortic Stiffness in Patients with Idiopathic Dilated CardiomyopathyECHOCARDIOGRAPHY, Issue 1 2007Feridun Kosar M.D. Background: Previous studies have shown an association between C-reactive protein (CRP)and arterial stiffness in most cardiovascular diseases. Increased CRP levels and arterial stiffness have been considered independent predictors of cardiovascular mortality in cardiovascular disease and even in the general population. Objective: The aim of this study was to investigate the relationship between CRP, a marker of systemic inflammation and aortic stiffness in patients with idiopathic dilated cardiomyopathy (DCMP). Methods: Serum CRP levels and aortic stiffness parameters were measured in DCMP patients (n= 37) and age- and gender-matched control subjects (n= 30). High-sensitivity CRP levels were determined by an immunonephelometry assay. Aortic strain (AS) and aortic distensibility (AD) were calculated from the aortic diameters measured using M-mode echocardiography and blood pressure obtained by sphygmomanometry. Results: Serum levels of CRP in DCMP patients were higher than in the control subjects (5.47 ± 2.06 mg/L and 2.35 ± 0.47 mg/L, P < 0.001, respectively). AS and AD were significantly decreased in DCMP patients compared to the controls (P < 0.001 and P < 0.001, respectively). There were positive correlations between CRP, and (r = 0.3.64, P = 0.027) smoking (r = 0.3.56, P = 0.024), and increasing age (r = 0.587, P < 0.001), and negative correlations between CRP, and DBP (r =,0.485, P < 0.001), diameter change (DC; r =,0.493, P < 0.001), AS (r =,0.526, P < 0.001), and AD (r =,0.626, P < 0.001). Conclusion: We have shown that there is a significant relation between high serum CRP levels and impaired aortic stiffness in patients with idiopathic DCMP. These findings may indicate an important role of CRP in the pathogenesis of impaired aortic stiffness in idiopathic DCMP. [source] Arterial stiffness in relation to subclinical atherosclerosisEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 1 2009A. Wykretowicz ABSTRACT Background, Increased arterial stiffness or arteriosclerosis, represents a physiological part of ageing. Atherosclerosis is a process that does not affect the arterial bed uniformly but has a variable local distribution and is frequently superimposed on stiffened vessels. We therefore addressed the question of whether any correlation exists between the general characteristics of arterial stiffness or wave reflection and subclinical atherosclerosis as assessed by carotid intima-media thickness (IMT) in a sample of healthy subjects. Methods, A total of 116 healthy subjects (mean age 55 years, 43 female) were evaluated. Arterial stiffness and wave reflection was assessed with the use of digital volume pulse analysis (DVP) and pulse wave analysis (PWA). Subclinical atherosclerosis was assessed by measurement of IMT. Results, Stiffness Index (SIDVP), the measure of general arterial stiffness correlated significantly with IMT (r = 0·37, P < 0·01). IMT correlated significantly with age (r = 0·5, P < 0·0001), waist to hip ratio (WHR) (r = 0·39, P < 0·0001) and mean blood pressure (BPmean) (r = 0·4, P < 0·0001). IMT did not correlate with measures of wave reflection. SIDVP correlated significantly with age (r = 0·32, P < 0·005), WHR (r = 0·36, P < 0·0001), BPmean (r = 0·36, P < 0·0001) and measurements of wave reflection. However analysis of a model which included variables that significantly influenced SIDVP and IMT, such as age, WHR and mean BP showed that arterial stiffness is not independently associated with subclinical atherosclerosis. Conclusions, The indices of subclinical atherosclerosis, arterial stiffness and wave reflection, indicate different aspects of vascular status in otherwise healthy subjects [source] Acute effects of caffeine and tobacco on arterial function and wave travelEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 12 2006J. Swampillai Abstract Background, Caffeine and tobacco consumption are risk factors for heart failure, but their effects remain controversial. It has been hypothesized that they cause alterations in arterial stiffness and arterial wave travel which may increase ventricular loading. In this study the authors examined the influence of these widely used stimulants on wave intensity and arterial stiffness parameters using carotid wave intensity analysis. Materials and methods, A new Doppler-based ultrasound method was used to measure the acute effects of caffeine and tobacco on wave intensity in the right common carotid artery. The measurements enabled changes in arterial stiffness parameters to be recorded. Results, In 17 subjects compared with 10 controls, caffeine increased blood pressure, early systolic wave intensity and wave speed, but late-systolic wave intensity and mid-systolic reflections were unchanged. In 11 smokers studied before and after smoking one cigarette, blood pressure and arterial stiffness increased but wave intensity was unchanged. No changes were observed in the controls. Conclusions, Increased wave intensity during ejection after caffeine suggested sympathomimetic effects on the left ventricular function. Increased wave speed in the common carotid artery implied augmented central loading after caffeine, but the absence of measurable changes in local arterial stiffness in the carotid artery suggested more complex and regional effects. Cigarette smoking acutely increased local arterial stiffness in the common carotid artery. These changes can be detected using wave intensity analysis. [source] Variations in carotid arterial compliance during the menstrual cycle in young womenEXPERIMENTAL PHYSIOLOGY, Issue 2 2006Koichiro Hayashi The effect of menstrual cycle phase on arterial elasticity is controversial. In 10 healthy women (20.6 ± 1.5 years old, mean ±s.d.), we investigated the variations in central and peripheral arterial elasticity, blood pressure (carotid and brachial), carotid intima,media thickness (IMT), and serum oestradiol and progesterone concentrations at five points in the menstrual cycle (menstrual, M; follicular, F; ovulatory, O; early luteal, EL; and late luteal, LL). Carotid arterial compliance (simultaneous ultrasound and applanation tonometry) varied cyclically, with significant increases from the values seen in M (0.164 ± 0.036 mm2 mmHg,1) and F (0.171 ± 0.029 mm2 mmHg,1) to that seen in the O phase (0.184 ± 0.029 mm2 mmHg,1). Sharp declines were observed in the EL (0.150 ± 0.033 mm2 mmHg,1) and LL phases (0.147 ± 0.026 mm2 mmHg,1; F= 8.51, P < 0.05). Pulse wave velocity in the leg (i.e. peripheral arterial stiffness) did not exhibit any significant changes. Fluctuations in carotid arterial elasticity correlated with the balance between oestradiol and progesterone concentrations. No significant changes were found in carotid and brachial blood pressures, carotid artery lumen diameter, or IMT throughout the menstrual cycle. These data provide evidence that the elastic properties of central, but not peripheral, arteries fluctuate significantly with the phases of the menstrual cycle. [source] Importance of arterial stiffness as cardiovascular risk factor for future development of new type of drugsFUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 3 2008Pierre Boutouyrie Abstract Cardiovascular risk prediction relies on classical risk factors such as age, gender, lipids, hypertension, smoking and diabetes. Although the value of such scales of risk is high for populations, its value for individual is reduced and too much influenced by non-modifiable risk factors (age and gender). Biomarkers of risk have been deceiving and genome wide scan approach is too recent. Target organ damage may help in selecting patients at high risk and in determining intervention. Aortic pulse wave velocity, an index of aortic stiffness, has been widely validated as providing additional risk predictions beyond and above classical risk factors, and has now entered into official guidelines. Many interventions (dietary, behaviour, drug treatment) were shown to influence arterial stiffness positively, but little evidence of a direct effect of intervention on arterial stiffness independent of blood pressure is available. New pharmacological targets and new drugs need to be identified. To become a surrogate endpoint for drug development, there is a need to demonstrate that regression arterial stiffness is associated with improved outcome. In parallel to this demonstration, points to be improved are the homogenization and spreading of the technique of measurement, the establishment of a reference value database. [source] Optimal treatment of hypertension in the elderly: A Korean perspectiveGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 1 2008Kwang-Il Kim With the progression of the aging population, common diseases of the elderly have become the center of attention in most developed countries. Hypertension is one of the most common morbid conditions in the elderly and has a great impact on their health status because it is the main risk factor of cardiovascular and cerebrovascular diseases. However, a considerable amount of uncertainty remains regarding hypertension in the elderly, such as the benefits of hypertension control in oldest-old populations, the optimal level of blood pressure control, and the efficacy of antihypertensive drugs for the prevention of cognitive dysfunction. While there are many controversial issues concerning the optimal management of hypertension in the elderly, the number of elderly hypertensive patients that require treatment is expected to increase due to the aging population. As a result, knowledge regarding the mechanisms of hypertension in the elderly and specific consideration in managing hypertensive elderly patients are needed to improve the clinical outcome. Furthermore, new therapeutic interventions that are aimed at attenuating age-related vascular changes should be investigated, because hypertension in the elderly, especially isolated systolic hypertension has specific characteristics of increased arterial stiffness in most cases. [source] Differential effects of sevoflurane and propofol anesthesia on left ventricular,arterial coupling in dogsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 8 2010Y. L. J. M. DERYCK Background: General anesthetics interfere with arterial and ventricular mechanical properties, often altering left ventricular,arterial (LVA) coupling. We hypothesized that sevoflurane and propofol alter LVA coupling by different effects on arterial and ventricular properties. Methods: Experiments were conducted in six anesthetized open-chest dogs for the measurement of left ventricular pressure and aortic pressure and flow. Measurements were performed during anesthesia with 0.5, 1.0 and 1.5 minimum alveolar concentration sevoflurane and 12, 24 and 36 mg/kg/h propofol. LVA coupling was assessed as the ratio of ventricular end-systolic elastance (Ees, measuring ventricular contractility) to effective arterial elastance (Ea, measuring ventricular afterload). The steady component of afterload, arterial tone, was assessed by systemic vascular resistance and arterial pressure,flow curves. The pulsatile component of afterload was assessed by aortic impedance and compliance. Results: Sevoflurane decreased aortic pressure and cardiac output more than propofol. Sevoflurane reduced arterial tone, increased arterial stiffness and did not affect wave reflections. It increased Ea, decreased Ees and reduced LVA coupling. Propofol reduced arterial tone, did not affect arterial stiffness and decreased wave reflections. It did not affect Ea, Ees or LVA coupling. Conclusions: Sevoflurane increased ventricular afterload and decreased ventricular performance, thereby altering LVA coupling. Propofol did not affect ventricular afterload or ventricular performance, thereby preserving LVA coupling. Thus, propofol preserves LVA coupling in dogs better, and might be a better choice for patients with compromised left ventricular function. [source] Impaired Fasting Glucose Is Associated with Increased Arterial Stiffness in Elderly People without Diabetes Mellitus: The Rotterdam StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2006Nicole M. Van Popele MD OBJECTIVES: To study the association between impaired fasting glucose (IFG) and arterial stiffness in older adults. DESIGN: Cross-sectional population-based study. SETTING: The Rotterdam Study, a Dutch population-based cohort study. PARTICIPANTS: Two thousand nine hundred eighty-seven subjects aged 60 and older. MEASUREMENTS: Arterial stiffness assessed by measuring common carotid arterial distensibility and glucose status classified into three categories: normal fasting glucose (NFG) (fasting glucose <6.1 mmol/L), IFG (fasting glucose 6.1,6.9 mmol/L), and diabetes mellitus (DM). RESULTS: In the total cohort, common carotid distensibility decreased with increasing impairment of glucose metabolism. Subjects younger than 75 with IFG were comparable with subjects with NFG with respect to arterial stiffness. Subjects aged 75 and older with IFG had stiffer arteries than subjects with NFG, reaching the same arterial stiffness as subjects with DM. For subjects younger than 75, mean difference in distensibility coefficient between subjects with NFG and with IFG was 0.1 (95% confidence interval (CI)=,0.04,0.05, P=.88) and between subjects with NFG and with DM was 1.2 (95% CI=0.7,1.7, P<.001). For subjects aged 75 and older, the mean difference between these groups was 0.7 (95% CI=0.2,1.2, P=.007) and 0.8 (0.3,1.4; P=.002), respectively. In the total cohort, fasting glucose was strongly associated with carotid distensibility (,-coefficient=,0.29, P<.001). CONCLUSION: IFG is related to arterial stiffness in elderly subjects. An advanced stage of arterial stiffness, comparable with that of subjects with DM, is only reached at the age of 75. [source] Late-Life Depression is Associated with Arterial Stiffness: A Population-Based StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2003Henning Tiemeier MD Objectives: To determine whether arterial stiffness is associated with depression in the elderly. Design: Population-based cross-sectional study. Setting: In Ommoord, a suburb of Rotterdam, the Netherlands. Participants: Three thousand seven hundred four subjects of the Rotterdam Study aged 60 and older. Measurements: Arterial stiffness was assessed using the distensibility of the carotid artery and the carotid-femoral pulse wave velocity. All participants were screened for depressive symptoms with the Center for Epidemiologic Studies,Depression scale. Those with depressive symptoms had a psychiatric evaluation to establish a diagnosis of depressive disorders according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Results: Participants with increased arterial stiffness were more likely to have depressive symptoms. Odds ratios (ORs) for depressive symptoms were 1.24 (95% confidence interval (CI) = 1.01,1.52) per standard deviation decrease in carotid distensibility and 1.17 (95% CI = 1.00,1.38) per standard deviation increase in aortic pulse wave velocity. The association was stronger for depressive disorders meeting DSM-IV criteria (OR = 1.44, 95% CI = 1.03,2.03; OR = 1.48, 95% CI = 1.16,1.90, respectively). Control for atherosclerosis, as measured by the ankle-to-brachial index or presence of plaques in the carotid artery, did not change the associations. Conclusion: This study shows an association between arterial stiffness and depression in the elderly. The findings are compatible with the vascular depression hypothesis. These data suggest that arterial stiffness may partly cause the proposed relationship between vascular factors and depression. [source] Blood Pressure Components in Clinical HypertensionJOURNAL OF CLINICAL HYPERTENSION, Issue 9 2006Michel E. Safar MD This review offers a critical evaluation of the remarkable progress in antihypertensive therapy since its inception. Despite the introduction of newer, more sophisticated drugs, treatment results have remained stable. Problems impeding further improvement include limited patient compliance, clinical inertia, incomplete adherence to guidelines, and dependence on brachial artery cuff pressures for diagnosis, risk assessment, and treatment response. Brachial artery systolic and pulse pressures do not reliably represent aortic or carotid artery pressures, which are better risk predictors for the heart and brain. Mean pressure, which is the same throughout the arterial tree, is directly measurable by cuff oscillometry, and might become the best single risk predictor. Available drugs have limited ability to decrease the aortic stiffness that is responsible for the elevated systolic blood pressure of aging. Therefore, to improve risk assessment and therapeutic benefit, we might include mean blood pressure and pulse pressure into blood pressure measurements, pursue efforts to measure central blood pressure, and search for new drugs to reduce arterial stiffness. [source] Relationship between vascular calcification, arterial stiffness and bone mineral density in a cross-sectional study of prevalent Australian haemodialysis patientsNEPHROLOGY, Issue 1 2009NIGEL D TOUSSAINT SUMMARY Background: Cardiovascular disease in dialysis patients is associated with increased vascular calcification (VC) and arterial stiffness, both inversely correlated with bone mineral density (BMD). Few studies have correlated VC in the dialysis population with measurements of BMD and arterial compliance. Methods: We report cross-sectional data on 45 haemodialysis (HD) patients assessing the prevalence of VC and its associations. Patients had computed tomography scans through abdominal aorta and superficial femoral arteries (SFA) to determine VC, pulse wave velocity (PWV) using SphygmoCor device measuring arterial stiffness, and dual-energy X-ray absorptiometry (DXA) to determine BMD. Results: Patients, 64% male, 38% diabetic, had median age 58 years. Mean PWV was 8.7 ± 3.5 m/s and median aortic VC score 488.1 ± 298 Hounsfield units, with 91% having aortic VC present. In univariate linear regression analysis, aortic VC correlated positively with length of HD (P = 0.03) and diabetes (P = 0.06). Increasing PWV was positively associated with age (P = 0.001), diabetes (P = 0.05) and VC (aortic P = 0.08, SFA P = 0.01). In multivariate regression analysis, length of HD and diabetes were significantly associated with aortic VC, whereas age and diabetes were associated with SFA VC and PWV. Mean lumbar spine and femoral neck T-scores on DXA were 0.14 and ,1.66 respectively. Conclusion: Increased VC and reduced arterial compliance, both closely related, are common in Australian HD patients. Both are associated with diabetes and increasing age, and greater aortic VC is seen with longer duration of dialysis. [source] Increased arterial stiffness in children and adolescents with type 1 diabetes: no association between arterial stiffness and serum levels of adiponectinPEDIATRIC DIABETES, Issue 1 2010Angela Galler Galler A, Heitmann A, Siekmeyer W, Gelbrich G, Kapellen T, Kratzsch J, Kiess W. Increased arterial stiffness in children and adolescents with type 1 diabetes: no association between arterial stiffness and serum levels of adiponectin. Objective: Type 1 diabetes is associated with an increased risk of atherosclerosis. Adiponectin serum levels correlate inversely with cardiovascular disease in adults. The aim of this study was to examine associations between arterial stiffness indices and serum adiponectin concentrations in children and adolescents with type 1 diabetes and to study the impact of metabolic control. Subjects and methods: We evaluated arterial stiffness, distensibility, and compliance in 93 children and adolescents with type 1 diabetes and correlated the data with clinical parameters and HbA1c levels. The control group comprised 85 matched healthy children. Serum levels of adiponectin in children with diabetes were measured by enzyme-linked immunoassay and correlated with arterial stiffness indices. Results: Arterial stiffness was significantly increased in children and adolescents with type 1 diabetes (aged 13.0 ± 3.8 yr) compared with matched healthy children (p = 0.03). Arterial stiffness was elevated in males with type 1 diabetes compared with females (p = 0.023). Arterial distensibility was significantly lower in children with diabetes compared with healthy controls (p = 0.025). Arterial stiffness, distensibility, and compliance did not correlate with diabetes duration, level of HbA1c, or serum cholesterol. Adiponectin concentrations in children and adolescents with diabetes were significantly elevated compared with normal values based on gender, age, and body mass index. We found no significant associations between arterial stiffness indices and adiponectin levels in children with type 1 diabetes. Conclusions: Children and adolescents with type 1 diabetes had increased arterial stiffness and reduced arterial distensibility and arterial compliance. However, no associations between arterial functional alterations and adiponectin concentrations were seen. [source] ,Dynamic' Starling mechanism: effects of ageing and physical fitness on ventricular,arterial couplingTHE JOURNAL OF PHYSIOLOGY, Issue 7 2008Shigeki Shibata Cardiovascular diseases increase with advancing age, associated with left ventricular and arterial stiffening in humans. In contrast, daily exercise training prevents and/or improves both ventricular and arterial stiffening with ageing. We propose a new approach to quantify the dynamics of the Starling mechanism, namely the beat-to-beat modulation of stroke volume (SV) caused by beat-to-beat alterations in left ventricular filling, which we propose reflects the complex interaction between ventricular and arterial stiffness. We hypothesized that the dynamic Starling mechanism would be impaired with ageing, and that this impairment would be prevented and restored by daily exercise training. Two different approaches were employed: (1) a cross-sectional study to assess the effects of ageing and life-long exercise training; and (2) a longitudinal study to assess the effects of one-year endurance training in the elderly. Spectral transfer function gain between beat-to-beat changes in left ventricular end-diastolic pressure and SV was used as an index of the dynamic Starling mechanism. Gain was significantly lower in the sedentary elderly (70 ± 3 years) than in both young individuals (27 ± 6 years) and Masters athletes (68 ± 3 years), and it was significantly lower in Masters athletes than in young controls (elderly: 0.37 ± 0.11; Masters athletes: 0.96 ± 0.55; young: 1.52 ± 0.42 ml m,2 mmHg,1, mean ±s.d.). Gain increased by 65% after one-year exercise training in the elderly, although the response was quite variable (P= 0.108). These findings suggest that the dynamic Starling mechanism is impaired with human ageing possibly due to ventricular,arterial stiffening. Life-long daily exercise training may minimize this impairment, although the effect may be limited particularly when started later in life. [source] Body Mass Index But Not Pulse Pressure Is Associated with Lesser Penile,Vaginal Intercourse Frequency in Healthy Young MenTHE JOURNAL OF SEXUAL MEDICINE, Issue 5 2010Stuart Brody PhD ABSTRACT Introduction., A growing literature links aspects of sexual and cardiovascular function. Recent research revealed that pulse pressure (systolic minus diastolic) was associated with poorer erectile function (and hypogonadism) in male patients with erectile dysfunction. It is unclear to what degree pulse pressure (and body mass index) would be associated with aspects of sexual function in a younger, healthy sample (controlling for possible confounders). Aims., To examine the associations of frequency of specific sexual behaviors with both resting pulse pressure and body mass index. Methods., Sixty-five healthy young men (mean age 25.2 ± 4.6 years) had their resting blood pressure, weight, and height recorded, and reported the frequency of their various sexual activities. Main Outcome Measures., Correlations of pulse pressure with different sexual behaviors (univariate and adjusted for possible confounding variables including age, mean blood pressure, body mass index, social desirability responding score, and cohabitation status). Results., For these healthy young men, on univariate and adjusted analyses, pulse pressure was not significantly associated with frequencies of penile,vaginal intercourse, other partnered sexual activity, or masturbation. In contrast, body mass index was associated with lesser frequency of penile,vaginal intercourse but not other sexual behaviors. Conclusions., The association of pulse pressure with sexual function previously observed in older men was not observed in this younger healthy sample. Other measures of arterial stiffness might be indicated in a healthy young population. Even within the normal range and adjusted for possible confounders, increasing body mass index (a rough proxy for body fat) is associated with reduced frequency of specifically penile,vaginal intercourse, which might be a result of some combination of characterological and hormonal factors. Brody S. Body mass index but not pulse pressure is associated with lesser penile,vaginal intercourse frequency in healthy young men. J Sex Med 2010;7:1853,1857. [source] ORIGINAL RESEARCH,ENDOCRINOLOGY: Pulse Pressure, an Index of Arterial Stiffness, Is Associated with Androgen Deficiency and Impaired Penile Blood Flow in Men with EDTHE JOURNAL OF SEXUAL MEDICINE, Issue 1 2009Giovanni Corona MD ABSTRACT Introduction., Pulse pressure (PP; i.e., the arithmetic difference between systolic and diastolic blood pressure) reflects arterial stiffness and has been suggested to be an independent cardiovascular risk factor. Aim., The aim of the present study is to asses the possible contribution of PP to arteriogenic erectile dysfunction (ED) and ED-associated hypogonadism. Methods., A consecutive series of 1,093 (mean age 52.1 ± 13.0 years) male patients with ED and without a previous history of hypertension or not taking any antihypertensive drugs were investigated. Main Outcome Measures., Several hormonal and biochemical parameters were studied, along with structured interview on erectile dysfunction (SIEDY), ANDROTEST structured interviews, and penile Doppler ultrasound. Results., Subjects with higher PP quartiles showed worse erectile function and higher prevalence of arteriogenic ED even after adjustment for confounding factors. Furthermore, sex hormone binding globulin-unbound testosterone levels declined as a function of PP quartiles. Accordingly, the prevalence of overt hypogonadism (calculated free testosterone < 180 pmol/L or free testosterone < 37 pmol/L) increased as a function of PP quartiles (17.% vs. 39.7%, and 30.8% vs. 58.6% for the first vs. fourth quartile, respectively, for calculated free testosterone and free testosterone; all P < 0.0001 for trend). This association was confirmed even after adjustment for confounders (Adjusted [Adj]) r = 0.090 and 0.095 for calculated free testosterone < 180 pmol/L and free testosterone < 37 pmol/L, respectively; all P < 0.05). Conclusions., PP is an easy method to estimate and quantify patient arterial stiffness. We demonstrated here for the first time that elevated PP is associated with arteriogenic ED and male hypogonadism. The calculation of PP should became more and more familiar in the clinical practice of health care professionals involved in sexual medicine. Corona G, Mannucci E, Lotti F, Fisher AD, Bandini E, Balercia G, Forti G, and Maggi M. Pulse pressure, an index of arterial stiffness, is associated with androgen deficiency and impaired penile blood flow in men with ED. J Sex Med 2009;6:285,293. [source] Relationship of asymmetric dimethylarginine and homocysteine to vascular aging in systemic lupus erythematosus patientsARTHRITIS & RHEUMATISM, Issue 6 2010Michelle Perna Objective Systemic lupus erythematosus (SLE) is independently associated with accelerated atherosclerosis and premature arterial stiffening. Asymmetric dimethylarginine (ADMA) and homocysteine are mechanistically interrelated mediators of endothelial dysfunction and correlates of atherosclerosis in the general population. The aim of this study was to assess the relationship of ADMA and homocysteine to subclinical vascular disease in patients with SLE. Methods One hundred twenty-five patients with SLE who were participating in a study of cardiovascular disease underwent clinical and laboratory assessment, carotid artery ultrasonography to detect atherosclerosis, and radial artery applanation tonometry to measure arterial stiffness. Results Neither ADMA nor homocysteine correlated with the presence or extent of carotid atherosclerosis. In contrast, ADMA was significantly related to the arterial stiffness index. Independent correlates of arterial stiffening included the ADMA concentration, the presence of diabetes mellitus, older age at the time of diagnosis, longer disease duration, and the absence of anti-Sm or anti-RNP antibodies. A secondary multivariable analysis substituting homocysteine for ADMA demonstrated comparable relationships with arterial stiffness (r2 = 0.616 for homocysteine and r2 = 0.595 for ADMA). Conclusion ADMA and homocysteine are biomarkers for and may be mediators of premature arterial stiffening in patients with SLE. Because arterial stiffness has independent prognostic value for cardiovascular morbidity and mortality, its predictors may identify patients who are at increased risk of cardiovascular disease. [source] | |||||||||||||||||||||||||||||||