Artery Research

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Volume 6, Issue 4, December 2012, Pages 143 - 144

2.3 CLINICALLY APPLICABLE APPROACH TO DISCRIMINATE BLOOD PRESSURE DEPENDENT AND INDEPENDENT CHANGES IN ARTERIAL STIFFNESS

Authors
K.D. Reesink, F. Vanmolkot, J. Op’t Roodt, B. Spronck, E. Hermeling, A.A. Kroon
Maastricht University Medical Centre, Maastricht, Netherlands
Available Online 17 November 2012.
DOI
10.1016/j.artres.2012.09.015How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Background: Monitoring of changes in arterial stiffness in hypertensive patients requires consideration of blood pressure (BP) dependent effects. Based on non-invasive measurements of carotid artery BP and cross-sectional area waveforms, we assessed the BP-dependent change in stiffness in 24 patients referred to our outpatient hypertension clinic, irrespective of antihypertensive treatment.

Methods and Results: In 13 women and 11 men (mean±SD; SBP/DBP: 157±26/92±10 mmHg, age: 53±15 yrs, BMI: 29±6 kg/m2) tonometric foot-to-foot carotid-femoral pulse wave velocity (cfPWVf-f) and common carotid artery cross-sectional area (wall-track) and local pressure waveforms were measured at baseline and at 3-month follow-up. Carotid stiffness was expressed as pulse wave velocity based on the distensibility coefficient (cPWVDC). Per individual, a mono-exponential curve was fitted through baseline carotid diastolic (d), dicrotic notch and systolic (s) pressure-area points to enable prediction of the BP-dependent change in stiffness (expressed as ΔcPWVDC*), based on BP values measured at follow-up. In patients in whom diastolic blood pressure (DBP) was significantly reduced, cfPWVf-f and (measured) cPWVDC were reduced by 1 m/s, similar to the predicted BP-dependent change in stiffness (Table). Patients showing no change in BP showed no change in stiffness. Correlations were: ΔcPWVDC* versus ΔcfPWVf-f: r=0.49 (p=0.020) and ΔcPWVDC* versus ΔcPWVDC: r=0.45 (p=0.037), while ΔcfPWVf-f versus ΔcPWVDC: r=0.26 (p=0.22).

Conclusion: Quantitative assessment of carotid stiffness as function of pressure enables prediction of BP-dependent changes in stiffness. Our clinically applicable approach could help to discriminate pressure dependent and independent effects of antihypertensive treatment on arterial stiffness.

All subjects p ΔDBP < −7mmHg p ΔDBP > −7mmHg p
Δ DBP mmHg −6 ± 9 0.002 −12 ± 6 <0.001 1 ± 5 0.40
n 24 14 10
Δmeds ddd 1 ± 1 <0.001 2 ± 1 <0.001 0 ± 1 0.18
Δ SBP mmHg −14 ± 17 0.001 −24 ± 10 <0.001 1 ± 14 0.83
ΔPP mmHg −7 ± 12 0.007 −12 ± 9 <0.001 0 ± 13 0.92
Δ cfPWVf-f m/s −0.4 ± 1.6 0.29 −1.0 ± 1.5 0.026 0.5 ± 1.4 0.25
Δ cPWVDC m/s −0.6 ± 1.1 0.021 −1.0 ± 0.8 <0.001 0.1 ± 1.2 0.80
Δ cPWVDC* m/s −0.6 ± 1.1 0.013 −1.2 ± 0.9 <0.001 0.1 ± 0.8 0.58

Mean±SD. Δmeds denotes antihypertensive medication change, in daily defined dose (ddd). DBP threshold is twice the intrameasurement standard deviation of 3.5 mmHg for DBP.

Table

Changes in predicted* and measured arterial stiffness at 3-month follow up

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Journal
Artery Research
Volume-Issue
6 - 4
Pages
143 - 144
Publication Date
2012/11/17
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2012.09.015How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

risenwbib
TY  - JOUR
AU  - K.D. Reesink
AU  - F. Vanmolkot
AU  - J. Op’t Roodt
AU  - B. Spronck
AU  - E. Hermeling
AU  - A.A. Kroon
PY  - 2012
DA  - 2012/11/17
TI  - 2.3 CLINICALLY APPLICABLE APPROACH TO DISCRIMINATE BLOOD PRESSURE DEPENDENT AND INDEPENDENT CHANGES IN ARTERIAL STIFFNESS
JO  - Artery Research
SP  - 143
EP  - 144
VL  - 6
IS  - 4
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2012.09.015
DO  - 10.1016/j.artres.2012.09.015
ID  - Reesink2012
ER  -