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Journal of the American College of... Jun 2019
Topics: Blood Pressure; Blood Pressure Determination; Humans; Hypertension; Percutaneous Coronary Intervention
PubMed: 31171091
DOI: 10.1016/j.jacc.2019.03.494 -
Annals of Medicine Dec 2022Whether the association between pulse pressure (PP) and mortality varies with systolic blood pressure (SBP) in ischaemic heart failure (HF) with left ventricular...
BACKGROUND
Whether the association between pulse pressure (PP) and mortality varies with systolic blood pressure (SBP) in ischaemic heart failure (HF) with left ventricular systolic dysfunction (LVSD) is unknown.
OBJECTIVE
To evaluate the association between PP and all-cause mortality in ischaemic HF patients with SBP status at admission.
PATIENTS AND METHODS
This prospective cohort study included 1581 ischaemic HF patients with LVSD. A total of 23.3% ( = 368) and 22.2% ( = 351) of the participants had SBP <110 mmHg and SBP >140 mmHg, respectively, with more than 80% of participants being male. Restricted cubic spline was performed to determine whether a nonlinear relationship existed between PP and all-cause mortality risk. A multivariable Cox proportional hazards model was used to assess the association between PP and all-cause mortality.
RESULTS
After a median of follow-up of 3.0 years, 257 events (16.4%) were observed in the cohort. There was a J-shaped relationship between PP and all-cause mortality (P value for nonlinearity = 0.020), with a risk nadir of approximately 46-49 mmHg. All-cause mortality risk varied with SBP status. Higher PP was associated with worse prognosis when the SBP was ≥110 mmHg, whereas the relationship did not reach statistical significance when the SBP was <110 mmHg.
CONCLUSION
A J-shaped relationship between PP and all-cause mortality was observed in ischaemic HF patients with LVSD, and higher PP was associated with worse prognosis only in those with SBP ≥110 mmHg. Further studies are needed to corroborate these findings.KEY MESSAGESA J-shaped relationship between pulse pressure and all-cause mortality was observed in ischaemic heart failure patients with left ventricular systolic dysfunction, with a risk nadir of approximately 46-49 mmHg.All-cause mortality risk varied with systolic blood pressure status, and higher pulse pressure was associated with worse prognosis when systolic blood pressure was above 110 mmHg.
Topics: Blood Pressure; Cohort Studies; Female; Heart Failure; Humans; Hypertension; Male; Prognosis; Proportional Hazards Models; Prospective Studies; Ventricular Dysfunction, Left
PubMed: 36223284
DOI: 10.1080/07853890.2022.2128208 -
Journal of the American College of... Feb 2016
Topics: Atherosclerosis; Blood Pressure; Female; Humans; Male; Registries; Risk Assessment; Thrombosis
PubMed: 26821628
DOI: 10.1016/j.jacc.2015.11.022 -
American Journal of Hypertension May 2023There are six different formulae for estimating mean arterial pressure (MAP) from systolic and diastolic pressure readings. This study is to determine the optimum...
BACKGROUND
There are six different formulae for estimating mean arterial pressure (MAP) from systolic and diastolic pressure readings. This study is to determine the optimum formula for calculating MAP when compared to the gold standard approach, which is the area under the curve of an invasively measured pulse waveform divided by the cardiac cycle duration.
METHODS
Eight live pigs were used as the experimental model for the invasive measurement of femoral artery pressure (AP) by a fluid filled catheter connected with a pressure transducer. In addition, intraocular pressure (IOP) and jugular vein pressure (JVP) were also recorded. The mean pressure (MP) was calculated from digital waveforms sampled at 1,000 points per second with the six formulae and area method for AP, IOP and JVP.
RESULTS
The absolute mean difference between the area MAP and each formula's MAP ranged from 0.98 to 3.23 mm Hg. Our study also found that even under physiological conditions, area MAP can vary between successive pulses by up to 5 mm Hg. For mean IOP and JVP, the mean difference between a formula's MP and the area method's was less than 1 mm Hg for most formulae. With the pooled data, there was excellent agreement amongst all formulae for MAP with the intra-class correlation coefficient (ICC) ranging from 0.97 to 0.99, while the ICC of most formulae for IOP and JVP was 1.0.
CONCLUSIONS
Our study suggests that all current formulae are adequate for estimating MAP, though some formulae are not suitable for mean IOP and JVP.
Topics: Swine; Animals; Blood Pressure; Intraocular Pressure; Arterial Pressure; Heart; Heart Rate
PubMed: 36945835
DOI: 10.1093/ajh/hpad026 -
Internal Medicine Journal Jan 2021Despite multiple studies, it has not been possible to account for the normal changes of blood pressure that occur from infancy to old age. We sought a comprehensive... (Review)
Review
Despite multiple studies, it has not been possible to account for the normal changes of blood pressure that occur from infancy to old age. We sought a comprehensive explanation, by linking brachial pressure with the well documented changes in the arterial pulse waveform, whose peak and nadir determine systolic, diastolic and pulse pressure in brachial arteries. Changes in humans arterial pulse wave contour from birth to old age can be readily explained on (i) growth, with increasing length of the body from birth to adolescence, and adult height maintained thereafter, and (ii) degeneration and dilation of the aorta from elastic fibre fracture throughout life, causing progressive increase in aortic pressure wave amplitude from early return of wave reflection, and summation of incident with reflected waves in systole. These changes throughout life complement arterial pulse waveform analysis and explain brachial cuff pressure values, with optimal pulse wave pattern for cardiac interaction apparent in adolescence.
Topics: Adult; Aorta; Arterial Pressure; Blood Pressure; Brachial Artery; Humans; Longevity; Systole
PubMed: 32175664
DOI: 10.1111/imj.14815 -
European Heart Journal Jul 2019
Topics: Blood Pressure; Brachial Artery; Heart Failure; Humans; Prognosis
PubMed: 25694463
DOI: 10.1093/eurheartj/ehv005 -
Current Opinion in Nephrology and... Mar 2001For many years systolic and diastolic blood pressure were the exclusive mechanical factors predicting cardiovascular risk in populations of normotensive and hypertensive... (Review)
Review
For many years systolic and diastolic blood pressure were the exclusive mechanical factors predicting cardiovascular risk in populations of normotensive and hypertensive individuals. However, if hypertension acts as a mechanical factor with deleterious consequences on the arterial wall, the totality of the blood pressure curve should be considered to evaluate the risk. The purpose of this review is to show that, in addition to systolic and diastolic blood pressure, other haemodynamic indexes with particular relevance for cardiac complications and that originate from pulsatile pressure should be taken into account, namely brachial pulse pressure and aortic pulse wave velocity. The main recent findings in normotensive and hypertensive populations are: (i) increased pulse pressure is an independent predictor of myocardial infarction, congestive heart failure and cardiovascular death, even in hypertensive patients undergoing successful antihypertensive drug therapy; (ii) increased aortic pulse wave velocity and increased carotid incremental elastic modulus are also both independent predictors of cardiovascular mortality, mainly in patients with end-stage renal disease and, to a lesser extent, in individuals with essential hypertension. Currently, increased pulse pressure and increased pulse wave velocity may be considered either as simple markers of an underlying vascular disease or as strong cardiovascular risk factors. The solution of this important question requires the development of specific intervention trials.
Topics: Arteries; Blood Pressure; Cardiovascular Diseases; Diastole; Elasticity; Female; Humans; Hypertension; Male; Risk Factors; Systole
PubMed: 11224702
DOI: 10.1097/00041552-200103000-00015 -
Annual International Conference of the... Jul 2019Many individuals suffer from ailments such hypertension that require frequent health monitoring. Unfortunately, current technology does not possess the ability for...
Many individuals suffer from ailments such hypertension that require frequent health monitoring. Unfortunately, current technology does not possess the ability for unobtrusive, continuous monitoring. This paper proposes estimation of pulse pressure based on pulse transient time determined from one non-contact, and one contact sensor: Doppler radar for non-contact detection of heart beat, and piezoelectric finger pulse sensor. The time delay between heart beat and finger pulse was determined using MATLAB software, and pulse wave velocity (PWV) was calculated. Finally, subjects' pulse pressure estimated using PWV was found to be in good agreement with pulse pressure measured using an off the shelf sphygmomanometer by reading and taking difference of systolic and diastolic blood pressure.
Topics: Blood Pressure; Blood Pressure Determination; Heart Rate; Humans; Pulse; Pulse Wave Analysis
PubMed: 31947348
DOI: 10.1109/EMBC.2019.8857439 -
European Heart Journal Feb 2022
Topics: Blood Pressure; Humans; Hypertension; Systole
PubMed: 34508628
DOI: 10.1093/eurheartj/ehab553 -
American Journal of Physiology.... Oct 2023Peripheral artery disease (PAD) refers to obstructed blood flow in peripheral arteries typically due to atherosclerotic plaques. How PAD alters aortic blood pressure and...
Peripheral artery disease (PAD) refers to obstructed blood flow in peripheral arteries typically due to atherosclerotic plaques. How PAD alters aortic blood pressure and pressure wave propagation during exercise is unclear. Thus, this study examined central blood pressure responses to plantar flexion exercise by investigating aortic pulse wave properties in PAD. Thirteen subjects with PAD and 13 healthy [age-, sex-, body mass index (BMI) matched] subjects performed rhythmic plantar flexion for 14 min or until fatigue (20 contractions/min; started at 2 kg with 1 kg/min increment up to 12 kg). Brachial (oscillometric cuff) and radial (SphygmoCor) blood pressure and derived-aortic waveforms were analyzed during supine rest and plantar flexion exercise. At rest, baseline augmentation index ( = 0.0263) and cardiac wasted energy ( = 0.0321) were greater in PAD due to earlier arrival of the reflected wave ( = 0.0289). During exercise, aortic blood pressure (aMAP) and aortic pulse pressure showed significant interaction effects ( = 0.0041 and = 0.0109, respectively). In particular, PAD had a greater aMAP increase at peak exercise ( = 0.0147). Moreover, the tension time index was greater during exercise in PAD ( = 0.0173), especially at peak exercise ( = 0.0173), whereas the diastolic time index ( = 0.0685) was not different between the two groups. Hence, during exercise, the subendocardial viability ratio was lower in PAD ( = 0.0164), especially at peak exercise ( = 0.0164). The results suggest that in PAD, the aortic blood pressure responses and myocardial oxygen demand during exercise are increased compared with healthy controls.
Topics: Humans; Arterial Pressure; Blood Pressure; Peripheral Arterial Disease; Heart Rate; Exercise; Pulse Wave Analysis
PubMed: 37486070
DOI: 10.1152/ajpregu.00303.2022