Glycemic index, glycemic load, and pulse wave reflection in adults.

BACKGROUND AND AIMS: Diets with a high glycemic index (GI), high glycemic load (GL), or both, increase the risk of cardiovascular disease. This study examined the association of GI and GL in a regular diet with the peripheral augmentation index (i.e., a marker of vascular aging) in a sample of adults. METHODS AND RESULTS: Cross-sectional study. The findings presented in this manuscript are a subanalysis of the EVIDENT study whose purpose was to analyze the relationship between lifestyle and arterial aging. For the sample population, 1553 individuals aged 20-80 years were selected through random sampling from the patients of general practitioners at six health centers in Spain. GI and GL for each patient's diet were calculated from a previously validated, semi-quantitative, 137-item food frequency questionnaire. The peripheral augmentation index corrected for a heart rate of 75 bpm (PAIx75) was measured with pulse-wave application software (A-Pulse CASP). Based on a risk factor adjusted regression model, for every 5 unit increase in GI, the PAIx75 increased by 0.11 units (95% CI: 0.04-0.19). Similarly, for every increase in 10 units in GL, the PAIx75 increased by 1.13 (95% CI: 0.21-2.05). High PAIx75 values were observed in individuals with diets in the third GI tertile (i.e., the highest), and lower PAIx75 values in those with diets in the first tertile (i.e., the lowest), (93.1 vs. 87.5, respectively, p = 0.001). CONCLUSIONS: GI and GL were directly associated with PAIx75 values in adults without cardiovascular diseases regardless of age, gender, physical activity, and other confounders.

[Relationship between physical activity and hemodynamic parameters in adults]. / Relación entre la actividad física y parámetros hemodinámicos en adultos.

OBJECTIVES: To analyze the relationship between physical activity, as assessed by accelerometer, with central and peripheral augmentation index and carotid intima media thickness (IMT) in adults. METHODS: This study analyzed 263 subjects who were included in the EVIDENT study. Physical activity was assessed during 7 days using the ActigraphGT3X accelerometer (counts/min). Carotid ultrasound was used to measure carotid IMT. The Sphygmo Cor System was used to measure central and peripheral augmentation index (CAIx and PAIx). RESULTS: Mean age 55.85±12 years; 59.30% female; 26.7 body mass index and blood pressure 120/77mmHg. Mean physician activity counts/min was 244.37 and 2.63±10.26min/day of vigorous or very vigorous activity. Physical activity showed an inverse correlation with PAIx (r=-0.179; P<.01) and vigorous activity day time with IMT(r=-0.174; P<.01), CAIx (r=-0.217; P<.01) and PAIx (r=-0.324; P<.01). After adjusting for confounding factors in the multiple regression analysis, the inverse association of CAIx with counts/min and the time spent in vigorous/very vigorous activity was maintained. CONCLUSION: The results suggest that both physical activity and time spent in vigorous or vigorous activity are associated with the central augmentation index in adults.

Relationship between electrocardiographic left ventricular hypertrophy criteria and vascular structure and function parameters in hypertensive patients.

The objective of this study was to determine the electrocardiographic left ventricular hypertrophy (LVH) criterion that best correlated with vascular structure and function parameters in hypertensive patients. A cross-sectional study involving 347 hypertensive patients was performed. The mean age of the subjects was 54.9±11.8 years, and 61% were male. Electrocardiography was used to detect LVH based on the evaluation of 10 criteria, and we defined the voltage-duration product (VDP) complex criterion. The vascular structure was evaluated according to carotid intima-media thickness (C-IMT), and vascular function was evaluated according to pulse wave velocity (PWV), the ambulatory arterial stiffness index (AASI), the home arterial stiffness index, and the peripheral (PAIx) and central (CAIx) augmentation indices. LVH according to at least some electrocardiographic criteria was recorded in 29.10% of the patients (34.10% of females; 25.90% of males). The vascular structure and function parameters showed higher values in the hypertensive patients with LVH. The criterion most closely correlated with C-IMT was Lewis-VDP (r=0.257); with PWV and AASI, the criterion was the Framingham-adjusted Cornell voltage (r=0.228 and r=0.195, respectively); and with CAIx and PAIx, the criterion was Novacode (r=0.226 and r=0.277, respectively). In the multivariate analysis, the association of the vascular structure and function parameters, the VDP complex (multiple linear regression) and the presence of LVH (logistic regression) disappeared after adjusting for age, sex and antihypertensive drugs. The relationship between the electrocardiographic criteria used to detect LVH in hypertensive patients and the vascular structure and function parameters were fundamentally conditioned by age and antihypertensive drug treatment.

Relación entre la actividad física y parámetros hemodinámicos en adultos / Relationship between physical activity and hemodynamic parameters in adults

Objetivo: Analizar la relación entre la actividad física, medida con acelerómetro, con índices de aumento central y periférico, y el grosor intima media (GIM) de carótida en adultos. Métodos: Se analizó a 263 pacientes incluidos en el estudio EVIDENT. La actividad física se evaluó con el acelerómetro Actigraph GT3X (counts/min) durante 7 días. La ecografía carotídea se utilizó para medir el grosor de íntima media de la carótida. El Sistema Sphygmo Cor se utilizó para medir el índice de aumento central y periférico (CAIx y PAIx). Resultados: Edad media 55,85 ± 12,21 años; 59,30% mujeres, índice de masa corporal 26,7 y presión arterial 120/77 mmHg. La actividad física media fue 244,37 counts/min. La media de tiempo dedicado a la actividad vigorosa o muy vigorosa fue 2,63 ± 10,26 min/día. Se observó una correlación inversa entre la actividad física y el PAIx (r = -0,179; p < 0,01), y entre el tiempo dedicado a la actividad vigorosa o muy vigorosa con el GIM (r = -0,174; p < 0,01), el CAIx (r = -0,217; p < 0,01) y el PAIx (r = -0,324; p < 0,01). Después de ajustar por diferentes factores de confusión, en el análisis de regresión múltiple se mantiene la asociación entre CAIx y la actividad física evaluada tanto con counts/min (p < 0,01) como con el tiempo dedicado a la actividad vigorosa o muy vigorosa (p < 0,01). Conclusiones: Los resultados indican que tanto la actividad física como el tiempo dedicado a la actividad vigorosa o muy vigorosa se asocian con el índice de aumento central en adultos

Objectives: To analyze the relationship between physical activity, as assessed by accelerometer, with central and peripheral augmentation index and carotid intima media thickness (IMT) in adults. Methods: This study analyzed 263 subjects who were included in the EVIDENT study. Physical activity was assessed during 7 days using the ActigraphGT3X accelerometer (counts/min). Carotid ultrasound was used to measure carotid IMT. The Sphygmo Cor System was used to measure central and peripheral augmentation index (CAIx and PAIx). Results: Mean age 55.85 ± 12 years; 59.30% female; 26.7 body mass index and blood pressure 120/77 mmHg. Mean physician activity counts/min was 244.37 and 2.63 ± 10.26 min/day of vigorous or very vigorous activity. Physical activity showed an inverse correlation with PAIx (r = -0.179; P<.01) and vigorous activity day time with IMT(r = -0.174; P<.01), CAIx (r = -0.217; P<.01) and PAIx (r =-0.324; P<.01). After adjusting for confounding factors in the multiple regression analysis, the inverse association of CAIx with counts/min and the time spent in vigorous/very vigorous activity was maintained. Conclusion: The results suggest that both physical activity and time spent in vigorous or vigorous activity are associated with the central augmentation index in adults

Monitorización ambulatoria de la presión arterial y actividad física en pacientes hipertensos / Ambulatory blood pressure monitoring and physical activity in hypertensive patients. Circadian pattern and physical activity

Objetivo: Analizar la relación entre el patrón circadiano de la presión arterial ambulatoria de 24h y la actividad física habitual en sujetos hipertensos. Material y métodos: Estudio transversal en el que se incluyeron 552 pacientes hipertensos del estudio EVIDENT (edad media 61 ± 55 años; 49,5% mujeres). La presión arterial ambulatoria se valoró con un tonómetro radial (dispositivo-B pro) y la actividad física se evaluó con un acelerómetro Actigraph GT3X (counts/minuto) durante 7días. Resultados: Los pacientes con patrón circadiano dipper realizaban mayor actividad física habitual que los no dipper. Las medidas de la actividad física (counts/minuto) presentaron correlación negativa con el ratio noche/día de las presiones arteriales sistólica y diastólica (ρ = -0,227 y ρ = -0,205; p < 0,001), respectivamente. Esta asociación se mantuvo en la regresión lineal múltiple después de ajustar por factores de confusión (β = -0,016; p < 0,001). En la regresión logística, considerando el patrón circadiano como variable dependiente (1: dipper; 0: no dipper), la odds ratio del tercer tertil de counts/minuto respecto del primero fue de 2,80 (IC95%: 1,73-4,51; p < 0,001) después de ajustar por las variables de confusión. Conclusiones: La actividad física evaluada con acelerómetro se asoció con un mayor descenso nocturno de la presión arterial y, en consecuencia, un menor ratio noche/día de la presión arterial sistólica y diastólica en sujetos hipertensos

Objective; To analyze the relationship between the circadian pattern of 24hour ambulatory blood pressure and regular physical activity in hypertensive patients. Material and methods: A cross-sectional study that included 552 hypertensive patients from EVIDENT study (mean age 61 ± 55 years, 49.5% women) was performed. Ambulatory blood pressure was measured with a radial tonometer (pro-B device) and physical activity was assessed with an accelerometer Actigraph GT3X (counts/min) for 7 days. Results: Patients with dipper circadian pattern performed more regular physical activity than non-dipper patients. The measures of physical activity (counts/min) showed negative correlation with the night/day systolic and diastolic blood pressures ratio (ρ = -.227 and ρ = -.205, P < .001), respectively. This association remained in the multiple linear regression after adjusting for confounders (β = -.016, P < .001). In the logistic regression, considering the circadian pattern as the dependent variable (1: dipper, 0: no dipper), the odds ratio for third tertile of counts/minute, compared to the first one was 2.80 (95% CI: 1.73-4.51, P < .001) after adjusting for confounding variables. Conclusions: Physical activity assessed by accelerometer was associated with increased nocturnal blood pressure and, consequently, a lower night/day systolic and diastolic blood pressure ratio in hypertensive patients

El papel de las venas de la retina en el riesgo cardiovascular / The role of the retinal veins in cardiovascular risk

Objetivo Analizar la relación del calibre de los vasos de la retina con el riesgo cardiovascular estimado en una muestra de sujetos hipertensos. Métodos Seleccionamos 202 pacientes hipertensos de 34 a 75 años. Con un retinógrafo Topcon TRC NW 200 se obtuvieron imágenes digitalizadas de la retina; mediante el software semiautomático AV Index Calculator se midió el grosor de los vasos temporales superior e inferior en una área de 0,5 a 1 diámetros del disco óptico y se calculó el índice arteriovenoso. El riesgo cardiovascular fue estimado con el Framingham-D’Agostino score. Se ha considerado riesgo bajo < 10%; riesgo moderado entre 10-20% y riesgo alto ≥ 20%. Resultados La edad media fue de 59,1 ± 8,4 años, siendo mujeres el 41,6% (84). Los grosores de las arterias y las venas tienden a incrementarse a medida que aumenta el riesgo, mientras que el índice arteriovenoso tiende a disminuir, aunque solo alcanza la significación estadística la diferencia de grosor de las venas entre los 3 grupos de riesgo. El calibre arterial y venoso tiene correlación positiva con el riesgo cardiovascular, aunque solo alcanza la significación estadística con el calibre venoso (r = 0,189; p < 0,010). Esta asociación se mantiene la regresión lineal múltiple, después de ajustar por edad y sexo. Conclusión Los hallazgos encontrados con esta nueva herramienta desarrollada para evaluar los vasos de la retina apoyan el papel más relevante que podría tener la valoración del calibre venoso, y no solo del arterial o el índice arteriovenoso, como se ha visto en estudios previos, en la evaluación del riesgo cardiovascular asociado a las alteraciones de la circulación retiniana (AU)

Objective To analyze the association between retinal vessel caliber and cardiovascular risk estimated in a sample of hypertensive patients. Methods We selected 202 hypertensive patients aged 34 to 75 years. Retinal photographs, obtained by Topcon TRC NW 200, were digitized, and superior and inferior temporal caliber vessel were measured in an area 0.5 to 1 disc diameter from the optic disc with semiautomatic software (AV Index Calculator), followed by calculation of the estimated arteriole/venule index. Cardiovascular risk was estimated through the Framingham-D’Agostino score. Risk was classified as follows: low risk < 10%, moderate risk 10-20%, and high risk ≥ 20%. Results The mean age of the patients was 59.1 ± 8.4 years and 41.6% (84) were women. The caliber of arterial and venous vessels tended to increase with higher cardiovascular risk, while the arteriole/venule index tended to decrease, but the only factor that was statistically significant was differences in caliber among the 3 cardiovascular risk groups. Arterial and venous caliber showed a positive correlation with cardiovascular risk, although this association was significant only for venous caliber (r=.189; P<.010). This association was maintained in a multiple linear regression model after adjustment by age and sex. Conclusion The findings with this new tool, which was developed to evaluate retinal vessels, indicate the importance of assessing venous caliber, and not just the arterial or arteriole/venule index, as in previous studies, when evaluating cardiovascular risk associated with changes in the retinal vessels (AU)