| Objective: This study aimed to explore whether blood pressure circadian rhythm is associated with brachial-ankle pulse wave velocity(ba PWV)and brachial artery flow-mediated dilation(FMD)in patients with essential hypertension.Method: This cross-sectional study included 4,217 patients with essential hypertension who completed 24-hour ambulatory blood pressure monitoring,ba PWV,and FMD.Ba PWV and FMD were measured to evaluate arterial stiffness and endothelial dysfunction.Participants were divided into dipper,non-dipper and reverse dipping groups according to the percentage of nocturnal systolic blood pressure dipping.Results: In this study,ba PWV was highest in reverse dipping groups followed by non-dipper and dipper groups(1667.11 ± 327.90 vs.1613.88 ± 325.11 vs.1577.45 ±306.15 cm/s,P < 0.001)and FMD gradually increased(4.41 ± 2.87 vs.4.70 ± 2.84 vs.4.92 ± 2.79 %,P = 0.001).Multiple linear regression models showed that the ba PWV and FMD were significantly associated with nocturnal systolic blood pressure(SBP)decline.Interestingly,FMD(β = 0.040,P = 0.022)was only positively associated with drop in nocturnal SBP decline in patients <65 years of age.Whereas ba PWV was consistently negatively associated with nocturnal SBP decline regardless of age(β =-0.109,P < 0.001,age <65 years;β =-0.150,P = 0.002,age ≥ 65).Conclusion: Impairment of ba PWV and FMD were correlated with abnormal blood pressure circadian rhythms in essential hypertension,suggesting a decrease in the percentage of nighttime SBP may associate with endothelial function and arterial stiffness.Objective: This study aimed to explore whether brachial-ankle pulse wave velocity(ba PWV)and brachial artery flow-mediated dilation(FMD)or the interaction of both parameters are associated with subclinical target organ damage(STOD)indices in patients with essential hypertension.Method: A total of 4,618 patients registered from January 2015 to October 2020 were included.ba PWV and FMD were measured to evaluate arterial stiffness and endothelial dysfunction.Whereas left ventricular hypertrophy(LVH),urine albumin-creatinine ratio(UACR),and carotid intima-media thickness(CIMT)were obtained as STOD indicators.Results: On multivariable logistic regression analysis with potential confounders,higher quartiles of ba PWV and FMD were significantly associated with an increased risk of STOD.In patients <65 years of age,the odds ratio(OR)of LVH,UACR,and CIMT≥0.9 mm for the fourth versus the first quartile of ba PWV were 1.765(1.390-2.240),2.832(2.014-3.813),and 3.075(2.315-4.084),respectively.In interaction analysis,an increase in ba PWV shows a progressively higher risk of STOD across the quartiles of FMD.Also,the estimated absolute risks of LVH,UACR,and CIMT ≥ 0.9mm for the first to fourth quartile of ba PWV increased from 1.88 to 2.75,2.35 to 4.44,and 3.10 to6.10,respectively in patients grouped by FMD quartiles.The addition of ba PWV to FMD slightly improved risk prediction for STOD.Conclusion: Ba PWV and FMD were independently associated with an increased risk ofSTOD in patients with essential hypertension especially among patients <65 years of age.Patients with elevated ba PWV and decreased FMD parameters are at increased risk of STOD.Aim: This study aimed to investigate the causal effects between arterial stiffness and cardiovascular disease.Methods and results: We performed bidirectional Mendelian randomization(MR)analysis implementing the results from a large-scale genome-wide association study for arterial stiffness index by the MRC-IEU(N=151053),hypertension by the UK Biobank(N = 462933),coronary heart disease by CARDIo GRAMplus C4D(N = 141217),atrial fibrillation by the UKB、the AFGen Consortium(N = 1030836),heart failure by the HERMES(N = 977323)to identify genetic instruments.The inverse variance weighted method was the primary MR method used.A genetic predisposition to ASI significantly increased the risk of hypertension(OR,1.036,95%CI,1.015-1.058)and a positive potential causal relationship between hypertension and ASI(IVW : β = 0.335,P =1.56E-30).The significance remained consistent in MR sensitivity analyses.Genetically ASI did not show a significant association with the risk of ASI and coronary heart disease,atrial fibrillation or heart failure,and coronary heart disease,atrial fibrillation or heart failure also did not associate with ASI(all P >0.05).Conclusions: Our study supports ASI as a causal risk factor for hypertension and hypertension is also a potential causal risk factor for ASI.However,this study did not identify the effect of ASI and other cardiovascular diseases,including coronary heart disease,atrial fibrillation and heart failure.Similar results in reverse MR analysis. |
PDF Full Text Request