
DOI: 10.1055/s-0040-1703991
Arterial Stiffness as a Measure of Vascular Dysfunction in Hypertensive Women

Abstract
Hypertension, affecting a third of the world’s population is associated with many vascular changes in blood vessels, which include rise of peripheral resistance and arterial stiffness. As there are very few studies done on Indian hypertensive women, this project was taken up to determine the prevalence of arterial stiffness in them. In this study, arterial stiffness is determined by assessing the carotid–femoral pulse wave velocity (C-F PWV). Fifty hypertensive female subjects between the ages 25 and 75 years were selected as subjects after informing the procedure and taking their consent. PWV was obtained from blood (BP) and electrocardiogram (ECG) recordings. They showed that subjects belonged to 3 categories depending on the level of their blood pressure—normal, grade I, and grade II hypertensives. PWV increased progressively with level of hypertension (p values = 0.0171 and <0.0001, which are significant for hypertensives having current BP equal to grade I and II hypertension, respectively). Vascular remodeling leading to loss of elasticity and impaired relaxation is believed to play a key role in development of arterial stiffness and subsequent rise of PWV in hypertensives. Arterial stiffness causes vascular dysfunction and is known to be an independent risk factor for many cardiovascular diseases like ventricular remodeling, diastolic dysfunction, myocardial infarction, and so forth. Control of Blood Pressure and its sequelae by dietary interventions and regular exercise is advisable.
Publication History
Publication Date:
24 March 2020 (online)
© 2020. Women in Cardiology and Related Sciences. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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References
- 1 O. Rourke MF, Staessen JA, Vlachopoulos C, Duprez D, Plante GE. Clinical applications of arterial stiffness; definitions and reference values. Am J Hypertens 2002; 15 (05) 426-444
- 2 Taddei S, Virdis A, Ghiadoni L. et al. Age-related reduction of NO availability and oxidative stress in humans. Hypertension 2001; 38 (02) 274-279
- 3 Hadi HA, Carr CS, Al Suwaidi J. Endothelial dysfunction: cardiovascular risk factors, therapy, and outcome. Vasc Health Risk Manag 2005; 1 (03) 183-198
- 4 Seeland U, Brecht A, Nauman AT. et al. Prevalence of arterial stiffness and the risk of myocardial diastolic dysfunction in women. Biosci Rep 2016; 36 (05) e00400
- 5 Horváth IG, Németh A, Lenkey Z. et al. Invasive validation of a new oscillometric device (arteriograph) for measuring augmentation index, central blood pressure and aortic pulse wave velocity. J Hypertens 2010; 28 (10) 2068-2075
- 6 Gurovich AN, Beck DT, Braith RW. Aortic pulse wave analysis is not a surrogate for central arterial Pulse Wave Velocity. Exp Biol Med (Maywood) 2009; 234 (11) 1339-1344
- 7 Laurent S, Cockcroft J, Van Bortel L. et al. European Network for Non-invasive Investigation of Large Arteries. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006; 27 (21) 2588-2605
- 8 AlGhatrif M, Strait JB, Morrell CH. et al. Longitudinal trajectories of arterial stiffness and the role of blood pressure: the Baltimore Longitudinal Study of Aging. Hypertension 2013; 62 (05) 934-941
- 9 Whelton PK, Carey RM, Aronow WS, Casey Jr DE, Collins KJ, Dennison Himmelfarb C. et al. ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults—a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018; 71 (19) •••
- 10 Chopra HK, Ram CVS, Ram S. Recent guidelines for hypertension. Circ Res 2019; 124 (07) 984-986
- 11 Cleland JG, Swedberg K, Follath F. et al. Study Group on Diagnosis of the Working Group on Heart Failure of the European Society of Cardiology. The EuroHeart Failure survey programme—a survey on the quality of care among patients with heart failure in Europe. Part 1: patient characteristics and diagnosis. Eur Heart J 2003; 24 (05) 442-463
- 12 Rabkin SW, Chan SH. Correlation of pulse wave velocity with left ventricular mass in patients with hypertension once blood pressure has been normalized. Heart Int 2012; 7 (01) e5
- 13 Kola S, George M, Srinivasamurthy S. et al. Assessment of arterial stiffness index in hypertensive patients in relation to their treatment status attending a tertiary care center in South India. Pharmacol Pharm 2014; 5: 413-418
- 14 Harvey A, Montezano AC, Touyz RM. Vascular biology of ageing—implications in hypertension. J Mol Cell Cardiol 2015; 83: 112-121
- 15 Wang M, Lakatta EG. Altered regulation of matrix metalloproteinase-2 in aortic remodeling during aging. Hypertension 2002; 39 (04) 865-873
- 16 Vlassara H, Uribarri J. Advanced glycation end products (AGE) and diabetes: cause, effect, or both?. Curr Diab Rep 2014; 14 (01) 453
- 17 McNulty M, Mahmud A, Feely J. Advanced glycation end-products and arterial stiffness in hypertension. Am J Hypertens 2007; 20 (03) 242-247
- 18 Corman B, Duriez M, Poitevin P. et al. Aminoguanidine prevents age-related arterial stiffening and cardiac hypertrophy. Proc Natl Acad Sci U S A 1998; 95 (03) 1301-1306
- 19 Kass DA, Shapiro EP, Kawaguchi M. et al. Improved arterial compliance by a novel advanced glycation end-product crosslink breaker. Circulation 2001; 104 (13) 1464-1470
- 20 Stewart AD, Millasseau SC, Kearney MT, Ritter JM, Chowienczyk PJ. Effects of inhibition of basal nitric oxide synthesis on carotid-femoral pulse wave velocity and augmentation index in humans. Hypertension 2003; 42 (05) 915-918
- 21 Benetos A, Adamopoulos C, Bureau JM. et al. Determinants of accelerated progression of arterial stiffness in normotensive subjects and in treated hypertensive subjects over a 6-year period. Circulation 2002; 105 (10) 1202-1207
- 22 Guerin AP, Blacher J, Pannier B, Marchais SJ, Safar ME, London GM. Impact of aortic stiffness attenuation on survival of patients in end-stage renal failure. Circulation 2001; 103 (07) 987-992
- 23 Townsend RR, Wimmer NJ, Chirinos JA. et al. Aortic PWV in chronic kidney disease: a CRIC ancillary study. Am J Hypertens 2010; 23 (03) 282-289
- 24 Wu C-F, Liu P-Y, Wu T-J, Hung Y, Yang SP, Lin GM. Therapeutic modification of arterial stiffness: an update and comprehensive review. World J Cardiol 2015; 7 (11) 742-753
- 25 Teede HJ, Dalais FS, Kotsopoulos D, Liang YL, Davis S, McGrath BP. Dietary soy has both beneficial and potentially adverse cardiovascular effects: a placebo-controlled study in men and postmenopausal women. J Clin Endocrinol Metab 2001; 86 (07) 3053-3060
- 26 Teede HJ, McGrath BP, DeSilva L, Cehun M, Fassoulakis A, Nestel PJ. Isoflavones reduce arterial stiffness: a placebo-controlled study in men and postmenopausal women. Arterioscler Thromb Vasc Biol 2003; 23 (06) 1066-1071
- 27 Nestel P, Fujii A, Zhang L. An isoflavone metabolite reduces arterial stiffness and blood pressure in overweight men and postmenopausal women. Atherosclerosis 2007; 192 (01) 184-189
- 28 Pase MP, Grima NA, Sarris J. The effects of dietary and nutrient interventions on arterial stiffness: a systematic review. Am J Clin Nutr 2011; 93 (02) 446-454
- 29 Nocon M, Hiemann T, Müller-Riemenschneider F, Thalau F, Roll S, Willich SN. Association of physical activity with all-cause and cardiovascular mortality: a systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil 2008; 15 (03) 239-246
- 30 Mora S, Cook N, Buring JE, Ridker PM, Lee IM. Physical activity and reduced risk of cardiovascular events: potential mediating mechanisms. Circulation 2007; 116 (19) 2110-2118