Artery Research

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Volume 20, Issue C, December 2017, Pages 71 - 72

P62 BLOOD PRESSURE LOWERING HALTS CAROTID ARTERY STIFFENING IN HYPERTENSIVE PATIENTS: THE CATOD STUDY

Authors
Siske Bos1, Rosa Maria Bruno2, Bart Spronck3, Maarten Heusinkveld1, Stefano Taddei4, Lorenzo Ghiadoni2, Koen Reesink1
1Maastricht University, Netherlands
2University of Pisa, Italy
3Yale University, USA
4University of Florence, Italy
Available Online 6 December 2017.
DOI
10.1016/j.artres.2017.10.084How to use a DOI?
Abstract

Background: We anticipate that in vascular outpatients followed over time, measured changes in arterial stiffness will be the multifactorial result of pressure-dependence, ageing- related degeneration, wall stress homeostasis, and medical treatment. Carotid ultrasound enables assessment of carotid pulse wave velocity (cPWV, via Bramwell- Hill), geometry (relative wall thickness, RWT = 2*IMT/diameter), and intrinsic material stiffness (Young’s-modulus, via Moens-Korteweg). We investigated changes in these carotid properties over time, and their interrelationship. To check whether the change in measured cPWV could be merely due to pressure-dependence, we calculated based on the stiffness index β0 [2] the theoretical pressure-dependent change in cPWV [3].

Methods: Hypertensive outpatients (n = 147) were assessed at baseline and 3.5±1.1 year follow- up, and were stratified according to baseline-to-follow-up change in diastolic blood pressure (ΔDBP) into three groups: decreasedDBP (ΔDBP < −7 mmHg), constantDBP (−7 mmHg ≤ ΔDBP≤7 mmHg) and increasedDBP (ΔDBP > 7 mmHg), with the cut-off being twice the typical DBP measurement error [1].

Results: The theoretical pressure-dependent change in cPWV was 0.4±1.3 m/s lower (p < 0.001, n = 147), corroborating the anticipated multifactorial conditions. Table 1 shows no changes in cPWV, RWT and Young’s-modulus for decreasedDBP. For constantDBP, both cPWV and Young’s-modulus were increased at follow-up.

IncreasedDBP showed increases in cPWV and Young’s-modulus and a decreased RWT. The latter implies a 9.2±10.7 kPa increase in circumferential wall stress (p < 0.001), in contrast to a 5.3±6.9 kPa decrease (p < 0.001) in decreasedDBP (p < 0.05 for between groups).

n = 147 ΔcPWV [m/s] ΔRWT [−] ΔYoung’s-modulus [MPa]
Mean±sd p Mean±sd p Mean±sd p
DecreasedDBP (n = 53) −0.1±1.4 0.72 0.00±0.04 0.38 −0.01±0.32 0.87
ConstantDBP (n = 67) +0.6*±1.4 <0.001 0.00±0.04 0.18 +0.10*±0.26 <0.001
IncreasedDBP (n = 27) +0.5*±1.5 0.029 −0.02*,**±0.04 0.002 +0.19*±0.35 <0.001

Δs calculated as follow-up – baseline.

*:

p < 0.05 compared to decreasedDBP.

**:

p < 0.05 compared to constantDBP.

The bold indicates that there is a statistically significant difference between follow-up and baseline.

Table 1.

Changes in measure carotid properties with 3.5-year follow-up.

Conclusions: In this outpatient cohort, with clear DBP reduction, there is a discontinuation of carotid stiffening, but no reversal. In patients with increased DBP, progressive carotid stiffening appears driven by impaired wall stress homeostasis.

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This is an open access article distributed under the CC BY-NC license.

References

[1]Spronck et al., Pressure-dependence of arterial stiffness: potential clinical implications, J Hypertens, Vol. 33, No. 2, 2015, pp. 330-8.
[2]Spronck et al., Arterial stiffness index beta and cardio-ankle vascular index inherently depend on blood pressure but can be readily corrected, J Hypertens, Vol. 35, No. 1, 2017, pp. 98-104.
[3]Spronck et al., Patient-specific blood pressure correction technique for arterial stiffness: evaluation in a cohort on anti-angiogenic medication, Hypertens Res, 2017, pp. 2017.
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Journal
Artery Research
Volume-Issue
20 - C
Pages
71 - 72
Publication Date
2017/12/06
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2017.10.084How 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  - Siske Bos
AU  - Rosa Maria Bruno
AU  - Bart Spronck
AU  - Maarten Heusinkveld
AU  - Stefano Taddei
AU  - Lorenzo Ghiadoni
AU  - Koen Reesink
PY  - 2017
DA  - 2017/12/06
TI  - P62 BLOOD PRESSURE LOWERING HALTS CAROTID ARTERY STIFFENING IN HYPERTENSIVE PATIENTS: THE CATOD STUDY
JO  - Artery Research
SP  - 71
EP  - 72
VL  - 20
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2017.10.084
DO  - 10.1016/j.artres.2017.10.084
ID  - Bos2017
ER  -