Determinants of pulse pressure amplification in hypertensive and diabetic patients View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-12-14

AUTHORS

Alexandre Vallée, Alexandra Yannoutsos, Yi Zhang, Guillaume Henry-Bonniot, Athanase Protogerou, Jirar Topouchian, Michel E. Safar, Jacques Blacher

ABSTRACT

Hypertensive diabetic patients remain at high cardiovascular risk despite adequate blood pressure and glycemic control. Pulse pressure amplification (PPA) is expressed as the peripheral-to-central PP ratio and provides complementary information for use in assessing cardiovascular risk. The aim of our study was to determine the clinical and biological determinants of PPA in hypertensive and diabetic patients. A cross-sectional study was conducted in 624 patients. Applanation tonometry was used to determine hemodynamic parameters. Age, gender, and the association between hypertension and diabetes were the independent factors of PPA in our population (N = 624). A threshold of 55 years of age was chosen because of its link with menopause in our analysis. Multivariate regression analyses were performed to evaluate the independent determinants of PPA for hypertensive diabetic and hypertensive nondiabetic male and female patients. HbA1c level is the main factor of increased PPA regardless of age and gender (P < 0.05). Mean BP negatively regulates PPA in the overall study: men > 55 years (P = 0.0001) and women > 55 years (P = 0.03). The threshold calculated glomerular filtration rate (cGFR) < 60 mL/min/1.73 m2 was an independent and negative factor of PPA in hypertensive diabetic men regardless of age (P < 0.05) and in women > 55 years (P = 0.04). Mean BP negatively regulates PPA in hypertensive nondiabetic patients (P < 0.04) regardless of age and gender, except in women > 55 years, where cGFR < 60 (P = 0.04) negatively regulates the modulation of PPA. HbA1c and threshold cGFR < 60 have highly significant impacts on PPA in hypertensive diabetic patients, whereas mean BP appears as the main factor of PPA in hypertensive nondiabetic patients. More... »

PAGES

374-384

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/s41440-018-0161-y

DOI

http://dx.doi.org/10.1038/s41440-018-0161-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1110634440

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30552405


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35 schema:description Hypertensive diabetic patients remain at high cardiovascular risk despite adequate blood pressure and glycemic control. Pulse pressure amplification (PPA) is expressed as the peripheral-to-central PP ratio and provides complementary information for use in assessing cardiovascular risk. The aim of our study was to determine the clinical and biological determinants of PPA in hypertensive and diabetic patients. A cross-sectional study was conducted in 624 patients. Applanation tonometry was used to determine hemodynamic parameters. Age, gender, and the association between hypertension and diabetes were the independent factors of PPA in our population (N = 624). A threshold of 55 years of age was chosen because of its link with menopause in our analysis. Multivariate regression analyses were performed to evaluate the independent determinants of PPA for hypertensive diabetic and hypertensive nondiabetic male and female patients. HbA1c level is the main factor of increased PPA regardless of age and gender (P < 0.05). Mean BP negatively regulates PPA in the overall study: men > 55 years (P = 0.0001) and women > 55 years (P = 0.03). The threshold calculated glomerular filtration rate (cGFR) < 60 mL/min/1.73 m2 was an independent and negative factor of PPA in hypertensive diabetic men regardless of age (P < 0.05) and in women > 55 years (P = 0.04). Mean BP negatively regulates PPA in hypertensive nondiabetic patients (P < 0.04) regardless of age and gender, except in women > 55 years, where cGFR < 60 (P = 0.04) negatively regulates the modulation of PPA. HbA1c and threshold cGFR < 60 have highly significant impacts on PPA in hypertensive diabetic patients, whereas mean BP appears as the main factor of PPA in hypertensive nondiabetic patients.
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43 PP ratio
44 adequate blood pressure
45 age
46 aim
47 amplification
48 analysis
49 applanation tonometry
50 association
51 biological determinants
52 blood pressure
53 calculated glomerular filtration rate
54 cardiovascular risk
55 central PP ratio
56 complementary information
57 control
58 cross-sectional study
59 determinants
60 diabetes
61 diabetic men
62 diabetic patients
63 factors
64 female patients
65 filtration rate
66 gender
67 glomerular filtration rate
68 glycemic control
69 hemodynamic parameters
70 high cardiovascular risk
71 hypertension
72 hypertensive diabetic men
73 hypertensive diabetic patients
74 hypertensive nondiabetic patients
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76 independent determinants
77 independent factors
78 information
79 levels
80 link
81 m2
82 main factors
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84 men
85 menopause
86 modulation
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90 nondiabetic patients
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92 parameters
93 patients
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98 rate
99 ratio
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101 risk
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