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Arterial stiffness is independently related to increased cardiovascular risk in the hypertensive population. The aim of the present study was to investigate whether various stages of abnormal glucose metabolism may differently affect arterial stiffness in hypertensive patients and whether there is any difference in arterial stiffness among patients with normal glucose regulation. We studied 1375 never-treated hypertensive subjects. Participants were divided into four metabolic groups: normal glucose regulation (NG), impaired fasting glucose, impaired glucose tolerance and type-2 diabetes mellitus (DM 2). Hypertensive subjects with NG were subdivided into three groups according to glucose levels. Arterial stiffness was estimated by carotid-femoral pulse wave velocity (PWV). PWV showed a significant increase from patients with NG to DM 2 (from 7.74 +/- 1.38 to 8.40 +/- 1.30 to 8.86 +/- 1.30 to 10.09 +/- 2.07 m/s respectively, p

Background: Arterial stiffness and wave reflections are independent predictors of cardiovascular disease. Metabolic syndrome (MS) is related to increased aortic stiffness in several populations. However, it is unclear whether the association of MS with aortic stiffness differs according to the considered definition. Moreover, data regarding the association of wave reflections with MS are limited. For this purpose, we examined the relationship of arterial stiffness and wave reflections with MS by using four current definitions and a score. Methods: We studied 732 never treated, non-diabetic hypertensive patients. Metabolic syndrome was defined by Adult Treatment Panel III, American Heart Association, World Health Organization (WHO), International Diabetes Federation criteria and MS (GISSI) score. Arterial stiffness was assessed by measuring carotid-femoral pulse wave velocity (PWVc-f). Heart rate-corrected augmentation index (AIx75) was estimated as a measure of wave reflections. Results: By all definitions, hypertensive patients with MS had higher PWVc-f compared to hypertensives without MS. On the contrary, no significant difference was observed in AIx75 between patients with and those without MS except when MS was defined by WHO criteria. An independent association emerged between PWVc-f and GISSI score and MS components (p=0.038 and 0.033 respectively) in patients with MS, after adjustment for age, gender, LDL cholesterol and smoking. Nevertheless, after further adjustment for systolic blood pressure or body mass index, the strength of this association was reduced to a non-significant level. Conclusion: Arterial stiffness is increased in patients with metabolic syndrome irrespective of the definition criteria. On the contrary, metabolic syndrome has no effect on wave reflections, except when this is defined by WHO criteria. Regarding the high prognostic significance of both arterial stiffness and wave reflections, these findings might have important clinical implications. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

Background Arterial stiffness and wave reflection alterations may be implicated in the association between cardiovascular mortality, meteorological variables and ambient particulate matter air pollution. The present study explored the cross-sectional relations between ambient environmental parameters, arterial stiffness, peripheral and central hemodynamics in a large-scale cohort of hypertensive patients and normotensive controls. Methods The study comprised 1222 consecutive individuals who sought medical consultation in the hypertension outpatient clinics of the Hippokration’ and ‘Onassis’ Hospitals (Athens, Greece) during a 3-year period (2004-2006). All individuals underwent a complete clinical and lipid-profile assessment at drug-free baseline. Carotid radial, carotid-femoral pulse wave velocity measurements and aortic pressure waveform analysis were performed noninvasively to all participants. Data from the National Technical University of Athens and the air quality department of the Hellenic Ministry for the Environment were used to estimate daily meteorological conditions and PM10 exposure. Results In the total population, multiple-linear regression analysis revealed no significant associations between environmental variables and arterial stiffness. However, in men, the mean 5 day PM10 air concentration was independently associated with the augmentation pressure [2.0 mmHg (95% confidence interval (CI) 0.56-3.39) per 43.4 mu g/m(3)] and the aortic-pulse pressure [2.78 mmHg (95% CI 3.91-5.12)] denoting a significant effect of particulate matter on the aortic-wave reflection magnitude and central hemodynamics. In addition, globally, the mean-daily temperature was related to the aortic-pulse pressure [-2.38 mmHg (95% CI -4.51 to -0.26) per 23.6 degrees C change] and the subendocardial viability ratio [5.85% (95% CI 1.1-10.6 per 23.6 degrees C)]. Conclusion The exposure to lower environmental temperatures is related to impaired hemodynamics not only to the periphery but also to the aorta. In men, PM10 air-pollution levels are associated with heightened amplitude of the reflection wave leading to significant alterations in central-pulse pressure. J Hypertens 28:903-909 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.

The purpose of the present study was to assess angiotensin receptor blocker (ARB) treatment on arterial stiffness in select hypertensive patients and define possible differences between smokers and nonsmokers. The authors evaluated 81 consecutive, nondiabetic patients (mean age, 52 years; 47 men) with uncomplicated essential hypertension with high plasma renin activity who were administered monotherapy with irbesartan, an ARB, at maximal dose. Patients were divided into smokers (n=24) and nonsmokers (n=57). Carotid-radial pulse wave velocity (PWVc-r), carotid-femoral pulse wave velocity (PWVc-f) and augmentation index (AIx) were measured before and 6 months after ARB antihypertensive treatment. All mean values of elastic effect indices were decreased after irbesartan monotherapy (AIx, from 26.3% to 21.2% [P