RESUMEN
BACKGROUND: Studies concerning ideal cardiovascular (CV) health and its relationship with arterial stiffness are lacking. This study examined the association between arterial stiffness with ideal CV health as defined by the American Heart Association, across age groups and gender. METHODS: The cross-sectional study included 1365 adults. Ideal CV health was defined as meeting ideal levels of the following components: 4 behaviors (smoking, body mass index, physical activity, and Mediterranean diet adherence) and 3 factors (total cholesterol, blood pressure, and glycated hemoglobin). Patients were grouped into 3 categories according to their number of ideal CV health metrics: ideal (5-7 metrics), intermediate (3-4 metrics), and poor (0-2 metrics). We analyzed the pulse wave velocity (PWV), the central and radial augmentation indexes, and the ambulatory arterial stiffness index (AASI). RESULTS: The ideal CV health profile was inversely associated with lower arterial radial augmentation index and AASI in both genders, particularly in middle-aged (45-65 years) and in elderly subjects (>65 years). Also in elderly subjects, adjusted models showed that adults with at least 3 health metrics at ideal levels had significantly lower PWV than those with 2 or fewer ideal health metrics. CONCLUSIONS: An association was found between a favorable level of ideal CV health metrics and lower arterial stiffness across age groups.
Asunto(s)
Enfermedades Cardiovasculares/diagnóstico , Estado de Salud , Estilo de Vida Saludable , Análisis de la Onda del Pulso , Rigidez Vascular , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Presión Sanguínea , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/fisiopatología , Enfermedades Cardiovasculares/psicología , Colesterol/sangre , Comorbilidad , Estudios Transversales , Diabetes Mellitus/sangre , Diabetes Mellitus/diagnóstico , Dieta Saludable , Dieta Mediterránea , Dislipidemias/sangre , Dislipidemias/diagnóstico , Ejercicio Físico , Femenino , Hemoglobina Glucada/metabolismo , Humanos , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Peso Corporal Ideal , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Factores Protectores , Factores de Riesgo , Conducta de Reducción del Riesgo , Factores Sexuales , Fumar/efectos adversos , Fumar/psicología , EspañaRESUMEN
Analizar los cambios del Índice de rigidez arterial ambulatorio y el Péptido Natriurético cerebral tipo B, ( IRAA y BNP) en 52 pacientes hipertensos que asistieron a la consulta Cardio-metabólica del Hospital Militar Dr. Carlos Arvelo, Caracas, Venezuela, entre enero y junio del 2015, antes y después del tratamiento antihipertensivo. Métodos: se realizó un ensayo clínico pareado, abierto, aleatorizado, donde los pacientes hipertensos de novo que cumplieron con los criterios de inclusión fueron asignados de forma aleatoria al grupo de trabajo. Se realizó seguimiento por tres meses posterior al inicio del tratamiento antihipertensivo. Se comparó la presión arterial media según el MAPA, IRAA y BNP en el primer y tercer mes en el grupo para evaluar éxito en alcanzar el control, así como también, se analizó la frecuencia de complicaciones cardiovasculares y muerte durante el estudio. Resultados: se encontró diferencia significativa entre los valores de AASI y BNP antes y después de 3 meses de tratamiento antihipertensivo (p= < 0,01) independientemente del tratamiento antihipertensivo utilizado en el grupo de estudio. Conclusión: El AASI y BNP mostraron ser modificables con el tratamiento antihipertensivo, y que ésta modificación se relaciona positivamente con los cambios de algunos de los parámetros del MAPA, como la Carga, la Presión de Pulso y la Presión Arterial Sistólica(AU)
to analyze the changes of AASI and BNP in hypertensive patients attending the Cardiometabolic consultation of Hospital Dr. Carlos Arvelo Military (Caracas, Venezuela) between January and June 2015, before and after antihypertensive treatment. Methods: this is a paired trial, open, clinical, randomized trial, where hypertensive patients recently diagnosed were randomly assigned to the study group. Monitoring was done three months after initiation of antihypertensive treatment. The mean blood pressure was compared according to ABPM, AASI and BNP from the first to the third month in the group to evaluate success in achieving control, and the frequency of cardiovascular complications and death during the study were also analyzed. Results: A significant difference was found between the values of AASI and BNP before and after 3 months of antihypertensive treatment ( p = <0,01) regardless of which antihypertensive treatment was used in the study group. Conclusion: The AASI and BNP were modified with antihypertensive treatment, and this change was positively related to changes in some parameters of the ABP Monitoring, such as Load, Pulse Pressure and Systolic. Blood Pressure(AU)
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Rigidez Vascular/fisiología , Hipertensión/fisiopatología , Antihipertensivos/administración & dosificación , Enfermedades Cardiovasculares , Medicina InternaRESUMEN
OBJECTIVE: Arterial stiffness is a contributor to the development of atherosclerosis and cardiovascular disease. The aim of the study was to analyse the relationship between sedentary behaviour and arterial stiffness in a Spanish adult population. METHODS: This cross-sectional study included 1365 subjects belonging to the EVIDENT project. Physical activity and sedentary behaviour were measured objectively over 7 days using ActiGraph accelerometers. Thresholds of 10 consecutive minutes were used to estimate the daily sedentary time in bouts ≥10 min. Each interruption in sedentary time (counts/min ≥100) was considered a break. Arterial stiffness was evaluated using the B-pro device through the following indicators: radial Augmentation Index (rAIx), Ambulatory Arterial Stiffness Index (AASI), and central and peripheral pulse pressure (PP). RESULTS: We found a positive relationship between central and peripheral pulse pressure (office, 24 h, awake and sleep PP) and total sedentary time. These arterial stiffness parameters were also associated with sedentary time in bouts ≥10 min. Significance disappeared in both cases, however, after adjusting for MVPA and breaks per sedentary hour. Adults who reported fewer breaks per sedentary hour (25th percentile < 2 n/day) had higher levels of AASI, awake and sleep PP. CONCLUSIONS: In a medium-sized sample of adult attenders of community clinics our data showed that it seems to be important to avoid prolonged uninterrupted periods of sedentary time.
Asunto(s)
Enfermedades Cardiovasculares/fisiopatología , Conducta Sedentaria , Rigidez Vascular , Actigrafía/instrumentación , Adulto , Anciano , Anciano de 80 o más Años , Presión Sanguínea , Monitoreo Ambulatorio de la Presión Arterial , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Actividad Motora , Medición de Riesgo , Factores de Riesgo , España/epidemiología , Factores de Tiempo , Adulto JovenRESUMEN
Objetivo. Correlacionar o índice de rigidez com os resultados das densitometrias ósseas da coluna lombar, do fêmur proximal e do antebraço distal. Métodos. Foram avaliados 171 homens idosos moradores da comunidade sem diagnóstico de doenças osteometabólicas. A avaliação clínica buscou os fatores de risco de baixa massa óssea e fratura por trauma mínimo. A densitometria óssea considerou para a análise densitométrica as regiões de L1-L4, colo femoral, trocânter, quadril total, rádio 33%. O índice de rigidez foi o parâmetro considerado na ultrassonometria. Os resultados da densitometria e da ultrassonometria ósseas foram avaliados quanto ao T-Score ≤ -2,0 ou > -2,0. Resultados. A idade variou de 60 a 88 anos, com média de 69 ± 6,1. A média do índice de massa corporal foi 25,8 ± 3,6. Verificou-se tabagismo atual em 31,6% e 5,1% referiram etilismo. Receberam diagnóstico de osteoporose 39,2%, e 18,1% tiveram densitometria normal. Houve diferença quanto ao peso, índice de massa corporal, índice de rigidez e o T-Score do índice de rigidez entre os grupos quanto ao T-Score ≤ -2,0. Houve correlações fracas entre o índice de rigidez e as densidades minerais ósseas. Conclusão. As fracas correlações entre o índice de rigidez e as densidades minerais ósseas limitam o uso do método no diagnóstico de osteoporose nessa população. Os achados indicam que o índice de rigidez não é bom preditor da densidade mineral óssea avaliada pela densitometria. Entretanto, os homens com diagnóstico de osteoporose foram mais magros, com menor índice de massa corporal e tiveram menor índice de rigidez.
Objective. To correlate the stiffness index with results of bone densitometry of the lumbar spine, proximal fêmur and distal forearm. Methods. We evaluated 171 community-dwelling elderly men without diagnosed bone diseases. Clinical evaluation assessed risk factors for low bone mass and fracture by minor trauma. Densitometry evaluation considered the boné density measures at the regions of L1-L4, femoral neck, trochanter, total hip, radio 33%. Quantitative ultrasound considered stiffness index in the analysis. The results of bone densitometry and quantitative ultrasound were assessed for T-score ≤ -2.0 or > -2.0. Results. The age ranged from 60 to 88 years, averaging 69 ± 6.1. The mean body mass index was 25.8 ± 3.6. Patients reported smoking in 31.6% and alcohol abuse in 5.1% of times. Osteoporosis was diagnosed in 39.2% and 18.1% had normal density. There was difference as to weight, body mass index, stiffness index and the index T-score of stiffness index between the groups in the T-Score ≤ -2.0. There were weak correlations between the stiffness index and bone mineral density. Conclusion. The poor correlation between stiffness index and bone mineral density limit the use of the method in the diagnosis of osteoporosis in this population. These findings indicate that stiffness index does not predict bone density as effectively as bone densitometry by the current standard methodology. However, men diagnosed with osteoporosis were thinner, with lower body mass index and had lower stiffness index.