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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.

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.

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 .

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.

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.

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

Brachial–ankle pulse wave velocity (baPWV), as a marker of arterial stiffness, has been demonstrated to be associated with blood pressure (BP) and onset of hypertension. However, little information is available on the associations between baPWV and BP indices [systolic BP (SBP), diastolic BP (DBP), pulse pressure (PP), mean arterial pressure (MAP)] in treated hypertensive patients. We aimed to assess the associations between BP indices and baPWV. In this cross-sectional study, 14,598 hypertensive patients from China Stroke Primary Prevention Trial (CSPPT) at the exit visit of the trial were analyzed. Elevated baPWV was defined as ≥18.3 m/s. Multivariate linear and logistic regression analyses were performed to evaluate the associations of BP indices with baPWV and elevated baPWV. Moreover, the smooth curve fitting (penalized spline method) was conducted. Multivariate linear regression analyses showed that continuous SBP, DBP, PP and MAP were independently and positively associated with baPWV (β = 0.081, 0.084, 0.078 and 0.115, respectively, all P  < 0.001). Compared with controlled SBP group (<140 mm Hg), uncontrolled SBP (≥140 mm Hg) was significantly associated with higher baPWV [β = 2.234, 95% confidence interval (CI): 2.137–2.332]. Similarly, compared with controlled DBP group (<90 mm Hg), uncontrolled DBP (≥90 mm Hg) was significantly associated with higher baPWV (β = 1.466, 95%CI: 1.341–1.590). Multiple logistic analyses also showed that SBP, DBP, PP and MAP were significantly and positively associated with elevated baPWV (OR = 1.056, 1.049, 1.052, and 1.075, respectively, all P  < 0.001). The fully-adjusted smooth curve fitting presented a linear association between BP indices with baPWV. In conclusion, among treated hypertensive patients, SBP, DBP, PP and MAP levels were independently and positively associated with baPWV and elevated baPWV, suggesting that baPWV might be a way to predict uncontrolled BP.

Purpose To investigate the influence of age on arterial stiffness and blood pressure after performing a resistance exercise bout. Methods Recreationally active men were separated into young (YG, n  = 12, 26.5 ± 3.3 years), middle (MG, n  = 14, 49.4 ± 5.7 years), and old (OG, n  = 10, 67.4 ± 6.3 years)-aged groups. In a randomized cross-over design, participants performed control and exercise conditions with at least 3 days separating conditions. The exercise condition consisted of leg press, chest press, knee flexion, lat pulldown and knee extension at ~65 % one-repetition maximum for three sets of 10 repetitions. Brachial and central blood pressures, augmented pressure, augmentation index, central and peripheral pulse wave velocities were measured prior to each condition and starting at 5 min post-exercise. Results Brachial systolic blood pressure (SBP) significantly increased similarly after exercise for all age groups (YG, 8 ± 8 mmHg; MG, 5 ± 5 mmHg; OG, 5 ± 6 mmHg; p  < 0.05). However, central SBP did not significantly increase for any age group after exercise. Augmentation index significantly increased after exercise only in the YG (11 ± 8 %, p  < 0.05). Central pulse wave velocity did not significantly increase in any age group after exercise when compared to the control condition. Conclusions When performing a whole body moderate resistance exercise bout, acute changes in arterial stiffness and blood pressure appear to be minimally affected by age.

Background Oxytocin is an uterotonic drug with profound cardiovascular effects, which in compromised patients could lead to serious events. The objective was to investigate whether oxytocin affects cardiac function and vascular tone in large and small arteries. We hypothesized that oxytocin decreases arterial vascular tone and elevates cardiac output. Methods 51 pregnant women were randomised to treatment with 8.3 μg (5 U) oxytocin or placebo injection during first trimester surgical evacuation of the gravid uterus under general anaesthesia. Oxytocin or placebo was administered once either early or late in the procedure, in a double-blind fashion. Digital photoplethysmography pulse wave analysis variables, heart rate, mean arterial blood pressure and electrocardiographic ST index were recorded before and after anaesthesia and after each injection. Non-parametric statistics were used with a two-sided P value < 0.05 considered significant. Results Anaesthesia induced a significant fall in blood pressure, heart rate and vascular tone in small and peripheral arteries. Oxytocin had a vasodilatory effect on small and peripheral arteries and increased the left cardiac ventricular ejection time. The ST index decreased. Conclusions Pulse wave analysis indicated peripheral vasodilation and increased cardiac output after oxytocin, implying increased myocardial oxygen demand. These effects might have been enhanced by the vasodilating effects of anaesthesia. Previous studies have demonstrated myocardial ischaemia after oxytocin, as reflected by a decrease in ST index in the present study. Trial registration Trial registration number ISRCTN17860978 , 2018/03/14, Retrospectively registered.