Noninvasive carotid pressure-diameter loops to identify viscoelastic properties in ageing, hypertension and type 2 diabetes.
J Hypertens
; 39(11): 2307-2317, 2021 11 01.
Article
in En
| MEDLINE
| ID: mdl-34620812
ABSTRACT
OBJECTIVES:
Arterial stiffness as pulse wave velocity (PWV) predicts cardiovascular events independently of blood pressure (BP). PWV does not distinguish between stiffness in systole and diastole. This cross-sectional study aimed to test the hypothesis that viscous and elastic carotid wall properties differ between systole and diastole, distinguishing effects of ageing, hypertension and T2 diabetes (T2DM).METHODS:
We examined carotid visco-elasticity in 307 people (180 men), with hypertension alone (nâ=â69), combined hypertension/T2DM (H-T2DM, nâ=â99), normotensive (N-T2DM, nâ=â25) and healthy controls (nâ=â114). Diameter (D)/pressure (P) waveforms were measured at right /left common carotid arteries, respectively. Local carotid PWV and distensibility in systole and diastole were evaluated by the D2P-loop method, and wall viscosity from hysteresis, the area (HA) within the P--D loop, as a dynamic measure of systolic loading and diastolic unloading.RESULTS:
Controls' hysteresis fell quadratically with age (R2â=â0.23, Pâ<â0.001). Yet mean HA in hypertensive patients (0.95, 95% CI 0.65-1.23) was six-fold higher than in age-matched controls (0.14, -0.20 to 0.49, Pâ<â0.001) with a 2.5× difference between diastolic (dDs) to systolic (sDs) distensibility (Pâ<â0.05) in hypertensive patients. HA was higher in hypertensive patients and H-T2DMs (0.80, 0.58-1.04) than N-T2DMs (0.20, -0.17 to 0.54, Pâ<â0.05), but similar between controls and N-T2DMs. BP-adjusted carotid diameters in all T2DM were significantly greater compared with controls and hypertensive patients.CONCLUSION:
Higher BP increased wall viscosity, hysteresis and relative difference between systolic and diastolic distensibility across groups. Carotid diameters were increased in all T2DMs, more in H-T2DM, probably altering BP-flow dynamics in T2DM.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Diabetes Mellitus, Type 2
/
Hypertension
Type of study:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limits:
Humans
/
Male
Language:
En
Journal:
J Hypertens
Year:
2021
Document type:
Article
Affiliation country:
United kingdom