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Pulse transit time (PTT) represents a potential approach for cuff-less blood pressure (BP) monitoring. Conventionally, PTT is determined by (1) measuring (a) ECG and ear, finger, or toe PPG waveforms or (b) two of these PPG waveforms and (2) detecting the time delay between the waveforms. The conventional PTTs (cPTTs) were compared in terms of correlation with BP in humans. Thirty-two volunteers [50% female; 52 (17) (mean (SD)) years; 25% hypertensive] were studied. The four waveforms and manual cuff BP were recorded before and after slow breathing, mental arithmetic, cold pressor, and sublingual nitroglycerin. Six cPTTs were detected as the time delays between the ECG R-wave and ear PPG foot, R-wave and finger PPG foot [finger pulse arrival time (PAT)], R-wave and toe PPG foot (toe PAT), ear and finger PPG feet, ear and toe PPG feet, and finger and toe PPG feet. These time delays were also detected via PPG peaks. The best correlation by a substantial extent was between toe PAT via the PPG foot and systolic BP [− 0.63 ± 0.05 (mean ± SE); p < 0.001 via one-way ANOVA]. Toe PAT is superior to other cPTTs including the popular finger PAT as a marker of changes in BP and systolic BP in particular.

We should pay more attention to the long-term monitoring and early warning of type 2 diabetes and its complications. The traditional blood glucose tests are traumatic and cannot effectively monitor the development of diabetic complications. The development of mobile health is changing rapidly. Therefore, we are interested in developing a new noninvasive, economical, and instant-result method to accurately diagnose and monitor type 2 diabetes and its complications. We aimed to determine whether type 2 diabetes and its complications, including hypertension and hyperlipidemia, could be diagnosed and monitored by using pulse wave. We collected the pulse wave parameters from 50 healthy people, 139 diabetic patients without hypertension and hyperlipidemia, 133 diabetic patients with hypertension, 70 diabetic patients with hyperlipidemia, and 75 diabetic patients with hypertension and hyperlipidemia. The pulse wave parameters showing significant differences among these groups were identified. Various machine learning models such as linear discriminant analysis, support vector machines (SVMs), and random forests were applied to classify the control group, diabetic patients, and diabetic patients with complications. There were significant differences in several pulse wave parameters among the 5 groups. The parameters height of tidal wave (h ), time distance between the start point of pulse wave and dominant wave (t ), and width of percussion wave in its one-third height position (W) increase and the height of dicrotic wave (h ) decreases when people develop diabetes. The parameters height of dominant wave (h ), h , and height of dicrotic notch (h ) are found to be higher in diabetic patients with hypertension, whereas h is lower in diabetic patients with hyperlipidemia. For detecting diabetes, the method with the highest out-of-sample prediction accuracy is SVM with polynomial kernel. The algorithm can detect diabetes with 96.35% accuracy. However, all the algorithms have a low accuracy when predicting diabetic patients with hypertension and hyperlipidemia (below 70%). The results demonstrated that the noninvasive and convenient pulse-taking diagnosis described in this paper has the potential to become a low-cost and accurate method to monitor the development of diabetes. We are collecting more data to improve the accuracy for detecting hypertension and hyperlipidemia among diabetic patients. Mobile devices such as sport bands, smart watches, and other diagnostic tools are being developed based on the pulse wave method to improve the diagnosis and monitoring of diabetes, hypertension, and hyperlipidemia.

This study compared the acute effects of resistance training (RT) between a moderate (ML) and a high loading (HL) intensity (12RM vs. 4RM, respectively), with the same intensity of effort on arterial stiffness and wave reflection in young healthy adults. Eleven healthy adults (age 36.4 ± 6.8 years) performed two RT protocols, ML and HL, in a randomized order. Both RT sessions consisted of three sets of deadlifts and three sets of bench presses, with 2 min rest between sets and exercises. Loading intensity was 12RM and 4RM for the ML and HL conditions, respectively. Measurements of pulse wave velocity (PWV) and pulse wave analysis (PWA; e.g., augmentation index) were collected at baseline, immediately post, and 15 min post‐training. ML elicited significantly greater increases in carotid‐femoral PWV (from 6.4 ± 0.3 to 7.3 ± 0.5), and augmentation index normalized to 75 bpm (from −5.1 ± 1.1) than HL (all p < 0.05). These findings demonstrate that an acute bout of RT performed to volitional failure using lower loads and higher repetitions impose a greater workload on the arterial and cardiovascular system in comparison to a RT scheme with heavier loads and lower repetitions.

Pulse characteristics are well-established biomarkers of physical health; however, their relevance to psychological well-being remains insufficiently explored. A key barrier is the difficulty of acquiring pulse recordings and blood pressure measurements of adequate quality outside clinical or laboratory settings by using accessible measurement approaches. This study aimed to examine the feasibility of using smartphone photoplethysmography to extract fingertip pulse-waveform features and to evaluate their associations with psychological measures. It further aimed to systematically compare time-, curvature-, and frequency-domain pulse-waveform features in relation to psychological variables. A total of 127 students and university employees in Shenzhen, China, were recruited. Participants recorded repeated 4-minute fingertip videos by using a custom smartphone app while a fingertip oximeter simultaneously acquired reference pulse signals. Smartphone videos were converted into photoplethysmography signals, segmented into beat-to-beat intervals, and summarized into time-, curvature-, and frequency-domain features, with normalization for heart rate and stature. Psychological well-being and mental health were assessed using the Satisfaction With Life Scale, Subjective Vitality Scale, Positive and Negative Affect Schedule, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and the Self-Assessment Manikin. Associations between pulse-waveform features and psychological measures were examined using univariate regression with participant-level aggregation and cluster-robust standard errors. Random forest models evaluated multivariate predictive performance by using participant-level cross-validation. Agreement between smartphone-derived and oximeter-derived waveform features was assessed using Bland-Altman analysis. Correlation analyses revealed strong within-domain associations among time-, curvature-, and frequency-domain pulse-waveform features, with comparatively weaker cross-domain correlations. A correlation-based feature-selection procedure reduced multicollinearity and yielded a final set of 7 features: estimated reflection index, crest time (CT), the third curvature minimum (F/A), the fourth curvature minimum (H/A), the first power spectrum density component, the baseline of Fourier decomposition (V0), and systolic blood pressure. Univariate regression analyses indicated that negative psychological states were primarily associated with time- and curvature-domain features. Depressive symptoms were significantly related to F/A, V0, and the estimated reflection index. Anxiety showed an association with F/A, and negative affect was associated with CT and F/A. In contrast, positive affect measures showed fewer and weaker associations. Valence was related to F/A and H/A, whereas arousal was associated with CT and H/A. Random forest models demonstrated statistically significant but modest predictive performance for negative mental health outcomes, with weaker performance for positive affect. Bland-Altman analyses indicated minimal systematic bias for outcomes with significant predictive correlations. Comparisons with an oximeter showed significant correlations and acceptable agreement, with time-domain features demonstrating greater robustness than reflection-based metrics. Smartphone-based photoplethysmography can capture pulse-waveform features associated with psychological measures, particularly negative psychological states. However, predictive performance remains limited, and variability in signal quality from user-operated recordings poses a practical challenge.

Purpose The dietary egg-protein hydrolysate Newtricious (NWT)-03 has previously demonstrated improvements in blood pressure and metabolic profiles. However, the long-term effects on vascular function and cardiometabolic risk markers are unknown. Methods Forty-four older (aged 60–75) adults with overweight/obesity experiencing elevated Subjective Cognitive Failures (SCF) were randomized into a 36-week, double-blind, placebo-controlled trial. Participants either consumed 5.7 g of an egg-protein hydrolysate (NWT-03) or maltodextrin placebo. Endothelial function (brachial artery flow-mediated vasodilation [FMD] and carotid artery reactivity [CAR] responses after a cold pressor test), arterial stiffness (carotid-to-femoral pulse wave velocity [PWV c-f ]), retinal microvascular calibers, and cardiometabolic risk markers (insulin sensitivity using a 7-point oral glucose tolerance test, serum lipid profiles, and blood pressure) were evaluated. Results FMD observed a non-significant trend towards a 0.3 percentage point (pp) increase in the intervention compared to the placebo group (95% CI: [0.0, 0.7]; p = 0.08), and a significant intervention effect was observed on CAR responses based on a 0.7 pp improvement after a cold pressor test (95% CI: [0.1, 1.3]; p = 0.03). No significant overall changes were observed for arterial stiffness as measured by PWV c-f . Retinal microvascular calibers and cardiometabolic parameters also did not change. Conclusion Long-term supplementation with 5.7 g of the egg-protein hydrolysate NWT-03 for 36 weeks improved vascular endothelial function in older adults with overweight/obesity experiencing elevated SCF, which may benefit cardiovascular disease risk. No overall changes in other vascular function markers, retinal microvascular calibers or cardiometabolic risk markers were observed. Clinical Trial Registration The study was registered at ClinicalTrials.gov in January 2021 as NCT04831203: https://clinicaltrials.gov/study/NCT04831203

Purpose The aim of this study was to investigate the long-term effects of almond consumption on peripheral vascular function, ambulant blood pressure profiles (ABP), and serum/plasma markers reflecting endothelial dysfunction and inflammation in participants with overweight/obesity and prediabetes. Methods Thirty-four participants completed this single-blinded, randomized, cross-over trial with 5-month intervention and control periods, separated by a 2-month wash-out. During the intervention period, participants consumed 50 g of whole almonds daily. At the end of each intervention period, peripheral vascular function was assessed by measuring the carotid-to-femoral and carotid-to-radial pulse wave velocities (PWV c-f and PWV c-r , respectively) and retinal microvascular calibers. Serum/plasma concentrations of soluble intracellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), interleukin-6 (IL-6), IL-8, tumor necrosis factor-alpha (TNFα), serum amyloid A protein (SAA) and high-sensitivity C-reactive protein (hs-CRP) and 24-hour ABP were also analyzed. Results Almond consumption did not significantly affect arterial stiffness (PWV c−f and PWV c−r ), while central retinal venular equivalent (CRVE) was minimally increased by 2 μm ( P  = 0.019). Central retinal arteriolar equivalent (CRAE), the arteriolar-to-venular ratio (AVR), and endothelial and inflammatory serum/plasma markers showed no significant changes after almond consumption. Almond consumption reduced systolic blood pressure (SBP; -3 mmHg 24-hour P  = 0.035, -4 mmHg daytime P  = 0.046, and − 4 mmHg during nighttime P  = 0.029), SBP variability during 24-hour, daytime, and nighttime ( P  = 0.005, P  = 0.019, and P  = 0.003, respectively), and diastolic blood pressure variability during nighttime ( P  ≤ 0.001). Conclusion Almond consumption did not affect arterial stiffness, retinal microvasculature calibers, or serum and plasma markers for endothelial dysfunction and inflammation in participants with prediabetics, while BP and BP variability were improved. Clinical trial registration This clinical trial was registered in February 2018 as NCT03419702.

Although the association between persistent hypertension and the compromise of both micro‐ and macro‐circulatory functions is well recognized, a significant gap in quantitative investigations exploring the interplay between microvascular and macrovascular injuries still exists. In this study, the authors looked into the relationship between brachial‐ankle pulse wave velocity (baPWV) and hypertensive retinopathy in treated hypertensive adults. The authors conducted a cross‐sectional study of treated hypertensive patients with the last follow‐up data from the China Stoke Primary Prevention Trial (CSPPT) in 2013. With the use of PWV/ABI instruments, baPWV was automatically measured. The Keith‐Wagener‐Barker classification was used to determine the diagnosis of hypertensive retinopathy. The odds ratio (OR) and 95% confidence interval (CI) for the connection between baPWV and hypertensive retinopathy were determined using multivariable logistic regression models. The OR curves were created using a multivariable‐adjusted restricted cubic spline model to investigate any potential non‐linear dose‐response relationships between baPWV and hypertensive retinopathy. A total of 8514 (75.5%) of 11,279 participants were diagnosed with hypertensive retinopathy. The prevalence of hypertensive retinopathy increased from the bottom quartile of baPWV to the top quartile: quartile 1: 70.7%, quartile 2: 76.1%, quartile 3: 76.7%, quartile 4: 78.4%. After adjusting for potential confounders, baPWV was positively associated with hypertensive retinopathy (OR = 1.05, 95% CI, 1.03–1.07, p < .001). Compared to those in the lowest baPWV quartile, those in the highest baPWV quartile had an odds ratio for hypertensive retinopathy of 1.61 (OR = 1.61, 95% CI: 1.37–1.89, p < .001). Two‐piece‐wise logistic regression model demonstrated a nonlinear relationship between baPWV and hypertensive retinopathy with an inflection point of 17.1 m/s above which the effect was saturated .

Previous studies have demonstrated beneficial effects of regular consumption of pistachio nuts on glycemic, lipid, and oxidative stress parameters. The aim of this study was to determine its effect on vascular health, which has not been adequately studied so far. In this open label, randomized parallel-group study, 60 adults with mild dyslipidemia were randomized to lifestyle modification (LSM) alone or LSM with consumption of 80 g (in-shell) pistachios (equivalent to 40 g or 1.5 oz shelled pistachios) daily for 3 mo. Biochemical parameters, brachial artery flow-mediated vasodilation (BAFMD), and carotid-femoral and brachial-ankle pulse wave velocity (cfPWV and baPWV, respectively) were measured before and after the intervention. At 3 mo, there was no change in any of the clinical or biochemical parameters in the LSM group. However, the patients in the pistachio group had a significant increase in high-density lipoprotein cholesterol (HDL-C; 35.7 ± 8.8 mg/dL versus 37.8 ± 10.1 mg/dL; P = 0.04) and a reduction in low-density lipoprotein cholesterol (137.2 ± 32.6 mg/dL versus 127.6 ± 34.0 mg/dL; P = 0.02), total cholesterol (TC)-to-HDL-C ratio (5.8 ± 1.3 mg/dL versus 5.3 ± 1.1 mg/dL; P = 0.001), and fasting blood sugar (88.8 ± 7.1 mg/dL versus 86.6 ± 6.3 mg/dL; P = 0.05). Additionally, whereas LSM alone was associated with no improvement in BAFMD or PWV, individuals in the pistachio group had significant reduction in left baPWV (1261.7 ± 187.5 cm/sec versus 1192.4 ± 152.5 cm/sec; P = 0.02) and statistically nonsignificant improvement in most other parameters, including BAFMD. As a result, at 3 mo the patients in the pistachio group had lower cfPWV (770.9 ± 96.5 cm/sec versus 846.4 ± 162.0 cm/sec; P = 0.08), lower left baPWV (1192.4 ± 152.5 cm/sec versus 1326.3 ± 253.7 cm/sec; P = 0.05), and lower average baPWV (1208.2 ± 118.4 cm/sec versus 1295.8 ± 194.1 cm/sec; P = 0.08) compared with the LSM group. Two-way analysis of variance revealed significant treatment effect of pistachio consumption on cfPWV, left baPWV, average baPWV, and BAFMD (P = 0.037, 0.01, 0.07, and 0.046, respectively). The present study demonstrates that regular consumption of pistachio nuts not only improves glycemic and lipid parameters, but also results in improvements in vascular stiffness and endothelial function. Importantly, these improvements were seen in apparently healthy individuals and with a diet (including pistachios) and exercise regimen that every adult individual is expected to follow. •We conducted a 3-mo randomized parallel-group study of 60 adults with mild dyslipidemia.•Diet and exercise were compared with diet and exercise plus consumption of pistachios (80 g/d, in-shell).•Pistachios were found to lower fasting blood sugar and low-density lipoprotein cholesterol and to increase high-density lipoprotein cholesterol.•Pistachio consumption lowered fasting blood sugar and low-density lipoprotein cholesterol and raised high-density lipoprotein cholesterol.

Objective The aim of this study was to use a compositional analysis approach to account for the inherent co‐dependencies between behaviors and to explore how daily movement behaviors influence cardiovascular health in children with and without T1D. Research Design and Methods Augmentation index, pulse wave velocity (PWV) and heart rate variability were measured in 20 children with (11.9 ± 1.6 years) and 17 children without T1D (11.6 ± 2.2 years). Subsequently, physical activity and sleep were assessed at 20 Hz for 28 consecutive days using a wrist‐worn accelerometer. Compositional analyses were utilized to explore the relative effects of each movement behavior and the overall movement complex on cardiovascular parameters, with predictive modeling used to explore the effects of reallocating 20 min between behaviors. Results Arterial stiffness markers were most influenced by the total movement composition, whereas autonomic function was most influenced by sedentary time and sleep relative to all other behaviors. Reallocation of time from moderate‐to‐vigorous physical activity (MVPA) to any other behavior was predicted to negatively affect all cardiovascular measures, independent of disease status, whereas reallocating time to MVPA was consistently predicted to improve all outcome measures. Additionally, the same intensity of physical activity appeared to be more potent for cardiovascular health in T1D children compared to nondiabetic peers. Conclusions Intensity, rather than volume, of physical activity may be key in reducing risk of premature adverse changes in cardiovascular health, whereas increasing time in MVPA could potentially the slow progression of cardiovascular aging in children with diabetes.