403 research outputs found
Is vascular stiffness associated with the diameter of the abdominal aorta?
No full textThe aim of this study was to assess the relationship between abdominal aortic diameter, arterial compliance and the traditional cardiovascular risk factors in a group of healthy elderly subjects. In this study we have described the relationships between abdominal aortic diameter and the most important cardiovascular risk factors, showing that arterial compliance plays an important role in explaining, and potentially determining the diameter of the abdominal aorta and may thus be a new index to early recognize people at higher risk of AAA
Irbesartan improves arterial compliance more than lisinopril.
No full textBACKGROUND:
Antihypertensive agents can reduce arterial stiffness. We hypothesized that an angiotensin receptor blocker (ARB) irbesartan and an angiotensin converting enzyme inhibitor (ACEI) lisinopril improved arterial compliance.
METHODS:
A randomized, double-blind, double-dummy, controlled crossover trial. Fifteen hypertensive patients, mean age 65.5 +/- 8.9 years (mean +/- SD) were given irbesartan (150 to 300 mg/day) or lisinopril (10 to 20 mg/day) for 12 weeks and then crossed over for 12 weeks. Pulse wave velocity (PWV) in the carotid-femoral (CF), carotid-radial (CR), and femoral dorsalis-pedis (FD) were measured using a Complior((R)) PWV system.
RESULTS:
After 12 weeks, systolic blood pressure (SBP) decreased from 162.4 +/- 12.9 to 134.5 +/- 14.8 with irbesartan and to 145.2 +/- 25 mmHg with lisinopril. Irbesartan and lisinopril reduced PWV (CF) in the elastic arterial system from 15.1 +/- 5 to 13.3 +/- 2.6 (p < 0.005) and to 14 +/- 4.7 (p < 0.05) m/s respectively (p = 0.345). Irbesartan reduced PWV (CR) and PWV (FD), whereas lisinopril did not. The difference between treatments was significant after SBP adjustment (p = 0.037 for PWV (CR) and p < 0.001 for PWV (FD)).
CONCLUSIONS:
Irbesartan improved arterial compliance in elastic and muscular arteries, whereas lisinopril improved it only in elastic arteries
Arterial compliance may be reduced by ingestion of red wine
No full textThe aim of this study was to assess the effect of alcohol on blood pressure and arterial compliance over 24 h in a group of volunteers, comparing the same group of subjects on two consecutive but separate days, one with alcohol intake (alcohol day) and one free of alcohol (control day). We studied 18 healthy subjects (mean age 34.2 years, range 25-53). The subjects received the two days in random order. On the alcohol day, the subjects were asked to drink two glasses of red wine (12% ethanol) between 1830 hours and 0430 hours. Measurements of heart rate, blood pressure and QKD interval (Q wave to Korotkoff (K) sound, diastolic phase (D) using Diasys Integra (Novacor, France)) were recorded (usually 1500 hours to 1500 hours). Three 'ingestion' periods were defined, from 1500 hours to 1830 hours ('before'), 1900 hours to 0430 hours ('during') and from 0430 hours to the following afternoon ('after') on both the alcohol day and on the control day. Red wine increased heart rate during alcohol ingestion and reduced arterial compliance after ingestion. The significant effect of interaction between day and ingestion period on heart rate, diastolic blood pressure and QKD were found, suggesting that the differences in response among the ingestion periods depended on whether alcohol has been consumed that day. For the first time our study indicates the effect of alcohol on 24 h arterial stiffness in a healthy group of volunteers
is augmentation index a good measure of vascular stiffness in the elderly?
No full textObjectives: we investigated the exact relationship between age and gender on augmentation pressure (AG) and augmentation
index (AI) measured over the radial (muscular) and carotid (elastic) arteries.
Design and Methods: AG is the contribution that wave reflection makes to systolic arterial pressure. AI is an indirect measure of arterial stiffness and is calculated as AG divided by pulse pressure (PP) ×100. AG and AI both increase with age.
AG and AI were measured in 458 subjects using SphygmoCor. A total of 755 readings were obtained (302 carotid, 453 radial).
The mean age was 57.5 ± 13.7 years. Diabetic subjects were excluded. Among the subjects, 13.5% were hypertensive.
Results: statistically, women had mean values of AI significantly higher than men in both radial and carotid arteries. These
differences were less marked with AG.
Quadratic equations better described the relationship between AI and age but not AG and age. Thus, AI increased with age up to our median age of 55 years but plateaued thereafter, whereas the AG continued to increase steadily with age. A multiple regression analysis demonstrated that both AI and AG were negatively related to height and positively related to
diastolic blood pressure (DBP).
Conclusions: AG continues to increase in the elderly over the age of 55, but not AI. AI is higher in women and higher when
measured over the carotid than the radial. AI is positively related to DBP and negatively to height. AG is proposed as a more
suitable measure of arterial stiffness than AI
SARCOPENIA AND VASCULAR RISK IN A HEALTHY ELDERLY UK POPULATION (BRAVES STUDY)
No full text[not available
Self management and patient understanding of diabetes in the older person.
No full textAIM: To examine knowledge and management of diabetes by older people. METHODS: A representative sample of 1047 people with Type 2 diabetes, aged 75 years and over, were asked a series of questions relating to their diabetes management and their understanding of self management. The impact of cognitive impairment and socio-economic status were assessed. RESULTS: The majority of people, 1015 (96.9%), were under the care of a health professional and 1018 (97.2%) were taking insulin, tablets, controlling their diet or a combination. Cognitive impairment (Mini-Mental State Examination ≤ 23) was found in 235 (22.5%) people. Recent eye, foot and dietician assessment was reported by 813 (77.7%), 836 (79.7%) and 326 (31.1%) people, respectively. A quarter overall and 70% of those taking insulin tested their blood glucose. In the insulin group, 78 (54.2%) reported hypoglycaemia and those with cognitive impairment gave more incorrect responses when asked about diabetes management. Socio-economic status made very little difference to any of these outcomes. CONCLUSIONS: Most older people with diabetes, regardless of their socio-economic status, are under the care of a healthcare professional and use medication or diet to manage their disease. Large numbers also attend foot and eye examinations. However, over one fifth of older people with diabetes have cognitive impairment. Older people had a reasonable understanding of their diabetes management but this was worse in those people with cognitive impairment
The prevalence of Type 2 diabetes and its associated health problems in a community-dwelling elderly population.
No full textAIMS: Prevalence estimates of Type 2 diabetes and its associated health problems in elderly populations are rare, especially in the very elderly. METHODS: A sample of 15 095 community-dwelling older people aged > or = 75 years were assessed. Type 2 diabetes and associated health problems were identified using self-reporting, general practitioner records, drug histories, and blood and urine measurements. RESULTS: There were 1177 people identified as having Type 2 diabetes mellitus, giving an overall prevalence of 7.8% (95% confidence interval 7.1, 8.5), 9.4% (8.4, 10.5) for men and 6.8% (6.1, 7.6) for women. The age, sex and smoking adjusted odds ratios for various health problems, comparing people with and without diabetes were: low vision 1.6 (1.3, 1.9), proteinuria 1.7 (1.4, 2.1), chronic kidney disease stage 4 or 5 1.5 (1.0, 2.1), angina 1.3 (1.1, 1.6), myocardial infarction 1.5 (1.2, 1.8), cerebrovascular event 2.0 (1.8, 2.1) and foot ulceration 1.7 (1.2, 2.4). CONCLUSIONS: The prevalence of Type 2 diabetes is not high in community-dwelling older people, but diabetes was a contributory factor to a number of health problems
Detection and differentiation of C-4 hydrocarbon isomers over the Pd-SnO2 compressed powder sensor
No full textThe detection and differentiation of C4 hydrocarbon gases, including n-butane, 1-butene, iso-butylene, cis- and trans-2-butene are investigated over a palladium-promoted tin oxide sensor using AC impedance. It is found that 1% Pd-SnO2 gives a good linear response and good sensitivity with respect to a wide range of n-butane concentrations (0-10,000 ppm). At high operation temperatures (≥400 °C), the tin oxide-based sensor offers no differentiation on different C4 gases and is consistent with the literature that this type of sensor is rather non-selective. However, at ≤300 °C, the sensor gave broadly two different types of sensitivity towards the C4 gases of the same concentration: the sensitivities of n-butane and trans-2-butene are analogous, while 1-butene, iso-butylene and cis-2-butene all show sensitivities a factor of 20-30 higher. The sensitivity difference apparently depends on the chemical reactivity of the particular C4 molecules, which in turn depends on the presence and position of their double bond. Hence, high sensitivity is obtained if the positions of their double bond are more susceptible for attack by surface oxygen species leading to total surface combustion of the C4 hydrocarbons. On the other hand, if there is an absence or a surface inaccessible double bond as in the cases of n-butane and the trans-2-butene, surface attack to the hydrocarbon gases involves a kinetically more difficult hydrogen abstraction reaction, hence giving a lower sensitivity
Antihypertensive drugs in very old people: a subgroup meta-analysis of randomised controlled trials. INDANA Group.
No full textBeneficial clinical effects of treatment with antihypertensive drugs have been shown in middle-aged patients and in those hypertensive patients over 60 years old, but whether treatment is beneficial in patients over 80 years old is not known.
METHODS:
We collected data from all participants aged 80 years and over in randomised controlled trials of antihypertensive drugs through direct contact with study investigators. Our primary outcome was fatal and non-fatal stroke. Secondary outcomes were death from all causes, cardiovascular death, fatal and non-fatal major coronary and cardiovascular events, and heart failure.
FINDINGS:
There were 57 strokes and 34 deaths among 874 actively treated patients, compared with 77 strokes and 28 stroke deaths among 796 controls, representing 1 non-fatal stroke prevented for about 100 patients treated each year. The meta-analysis of data from 1670 participants aged 80 years or older suggested that treatment prevented 34% (95% CI 8-52) of strokes. Rates of major cardiovascular events and heart failure were significantly decreased, by 22% and 39%, respectively. However, there was no treatment benefit for cardiovascular death, and a non-significant 6% (-5 to 18) relative excess of death from all causes.
INTERPRETATIONS:
The inconclusive findings for mortality contrast with the benefit of treatment for non-fatal events. Results of a large-scale specific trial are needed for definite conclusion that antihypertensive treatment is beneficial in very elderly hypertensive patients. Meanwhile, an age threshold beyond which hypertension should not be treated cannot be justified
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