Pressure-Corrected Carotid Stiffness and Young's Modulus: Evaluation in an Outpatient Clinic Setting.

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  • Additional Information
    • Source:
      Publisher: Oxford University Press Country of Publication: United States NLM ID: 8803676 Publication Model: Print Cited Medium: Internet ISSN: 1941-7225 (Electronic) Linking ISSN: 08957061 NLM ISO Abbreviation: Am J Hypertens Subsets: MEDLINE
    • Publication Information:
      Publication: 2013- : Oxford : Oxford University Press
      Original Publication: [New York, NY] : Elsevier, [c1988-
    • Subject Terms:
      Blood Pressure Determination*/methods ; Carotid Arteries*/physiopathology ; Elastic Modulus* ; Vascular Stiffness*/physiology; Ambulatory Care Facilities ; Blood Pressure/physiology ; Humans ; Pulse Wave Analysis ; Reproducibility of Results
    • Abstract:
      Background: Conventional measures for assessing arterial stiffness are inherently pressure dependent. Whereas statistical pressure adjustment is feasible in (larger) populations, it is unsuited for the evaluation of an individual patient. Moreover, statistical "correction" for blood pressure may actually correct for: (i) the acute dependence of arterial stiffness on blood pressure at the time of measurement; and/or (ii) the remodeling effect that blood pressure (hypertension) may have on arterial stiffness, but it cannot distinguish between these processes.
      Methods: We derived-assuming a single-exponential pressure-diameter relationship-3 theoretically pressure-independent carotid stiffness measures suited for individual patient evaluation: (i) stiffness index β0, (ii) pressure-corrected carotid pulse wave velocity (cPWVcorr), and (iii) pressure-corrected Young's modulus (Ecorr). Using linear regression analysis, we evaluated in a sample of the CATOD study cohort changes in mean arterial pressure (ΔMAP) and comparatively the changes in the novel (Δβ0, ΔcPWVcorr, and ΔEcorr) as well as conventional (ΔcPWV and ΔE) stiffness measures after a 2.9 ± 1.0-year follow-up.
      Results: We found no association between ΔMAP and Δβ0, ΔcPWVcorr, or ΔEcorr. In contrast, we did find a significant association between ΔMAP and conventional measures ΔcPWV and ΔE. Additional adjustments for biomechanical confounders and traditional risk factors did neither materially change these associations nor the lack thereof.
      Conclusions: Our newly proposed pressure-independent carotid stiffness measures avoid the need for statistical correction. Hence, these measures (β0, cPWVcorr, and Ecorr) can be used in a clinical setting for (i) patient-specific risk assessment and (ii) investigation of potential remodeling effects of (changes in) blood pressure on intrinsic arterial stiffness.
      (© The Author(s) 2021. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd.)
    • Comments:
      Erratum in: Am J Hypertens. 2024 Apr 12;:. (PMID: 38607700)
    • Grant Information:
      ZONMW_452172006 Netherlands ZONMW_ ZonMw
    • Contributed Indexing:
      Keywords: arterial remodeling; arterial stiffness; blood pressure; hypertension; pressure dependence
    • Publication Date:
      Date Created: 20210210 Date Completed: 20211209 Latest Revision: 20240412
    • Publication Date:
      20240412
    • Accession Number:
      PMC8351507
    • Accession Number:
      10.1093/ajh/hpab028
    • Accession Number:
      33564865