Medicine and Health Sciences Commons^™

Intracranial Carotid Arteriosclerosis Mediates The Association Between Blood Pressure And Cerebral Small Vessel Disease, Jesus D. Melgarejo, Meike W. Vernooij, M. Arfan Ikram, Zhen-Yu Zhang, Daniel Bos

School of Medicine Publications and Presentations

Background:

Intracranial arteriosclerosis could explain the association between blood pressure (BP) and cerebral small vessel disease (CSVD). Therefore, we tested whether intracranial carotid artery calcification (ICAC) mediates the association between BP and CSVD and determined pathophysiological mechanisms based on ICAC subtypes.

Methods:

One thousand four hundred fifty-eight stroke-free participants from the Rotterdam Study (mean age, 68 years; 52% women) underwent nonenhanced computed tomography scans to quantify ICAC volume (mm3) between 2003 and 2015. ICAC was categorized into intimal and internal elastic lamina calcifications. CSVD included white matter hyperintensities volume, the presence of lacunes, and cerebral microbleeds visualized on magnetic resonance …

Urinary Matrix Gla Protein Is Associated With Mortality Risk In Flemish Population: A Prospective Study, Dongmei Wei, Jesus D. Melgarejo, Thomas Vanassche, Lucas Van Aelst, Stefan Janssens, Peter Verhamme, Zhen-Yu Zhang

School of Medicine Publications and Presentations

Background: Vascular calcification is strongly related to the risk of mortality and cardiovascular (CV) diseases. In vascular calcification, matrix Gla protein (MGP), a small vitamin K-dependent protein, is an important mineralization inhibitor. Recent studies showed that circulating MGP is associated with mortality risk. However, the longitudinal association between urinary excretion of MGP and all-cause mortality was not established.

Materials and methods: Urinary MGP was measured in 776 randomly recruited Flemish population (mean age: 51.2 years; 50.9% women) at baseline (during 2005–2010) using capillary electrophoresis coupled with mass spectrometry. Plasma inactive MGP [desphospho-uncarboxylated MGP (dp-ucMGP)] levels were quantified in 646 individuals …

Urinary Proteomic Profile Of Arterial Stiffness Is Associated With Mortality And Cardiovascular Outcomes, Dongmei Wei, Jesus D. Melgarejo, Lutgarde Thijs, Xander Temmerman, Thomas Vanassche, Lucas Van Aelst, Stefan Janssens, Jan A. Staessen, Peter Verhamme, Zhen-Yu Zhang

School of Medicine Publications and Presentations

Background

The underlying mechanisms of arterial stiffness remain not fully understood. This study aimed to identify a urinary proteomic profile to illuminate its pathogenesis and to determine the prognostic value of the profile for adverse outcomes.

Methods and Results

We measured aortic stiffness using pulse wave velocity (PWV) and analyzed urinary proteome using capillary electrophoresis coupled with mass spectrometry in 669 randomly recruited Flemish patients (mean age, 50.2 years; 51.1% women). We developed a PWV‐derived urinary proteomic score (PWV‐UP) by modeling PWV with proteomics data at baseline through orthogonal projections to latent structures. PWV‐UP that consisted of 2336 peptides explained …

Open-Angle Glaucomatous Optic Neuropathy Is Related To Dips Rather Than Increases In The Mean Arterial Pressure Over 24-H, Jesus D. Melgarejo, Jan V. Eijgen, Gladys E. Maestre, Lama A. Al-Aswad, Lutgarde Thijs, Luis J. Mena, Joseph D. Terwilliger, Michele Petitto, Carlos A. Chavez, Miguel Brito

School of Medicine Publications and Presentations

Background

Mean arterial pressure (MAP) drives ocular perfusion. Excessive 24-h MAP variability relates to glaucoma, however, whether this is due to dips or increases in the blood pressure (BP) is undocumented. We investigated the association of open-angle glaucoma (OAG) in relation to the five largest MAP dips/increases over 24-h, henceforth called dips/blips.

Methods

In the Maracaibo Aging Study (MAS), 93 participants aged ≥40y (women, 87.1%; mean age, 61.9y) underwent baseline ophthalmological and 24-h ambulatory BP monitoring assessments. OAG was the presence of optic nerve damage and visual field defects. Statistical methods included logistic regression and the generalized R2 statistic. …

Normal-Tension Glaucomatous Optic Neuropathy Is Related To Blood Pressure Variability In The Maracaibo Aging Study, Jesus D. Melgarejo, Gladys E. Maestre, Luis J. Mena, Joseph H. Lee, Michele Petitto, Carlos A. Chavez, Gustavo Calmon, Egle Silva, Lutgarde Thijs, Lama A. Al-Aswad

School of Medicine Publications and Presentations

Hypoperfusion of the optic nerve might be involved in the pathogenesis of normal-tension glaucomatous optic neuropathy (GON). Mean arterial pressure (MAP) drives ocular perfusion, but no previous studies have addressed the risk of GON in relation to blood pressure (BP) variability, independent of BP level. In a cross-sectional study, 93 residents of Maracaibo, Venezuela, underwent optical coherence tomography, visual field assessments and 24-h ambulatory BP monitoring between 2011 and 2016. We investigated the association of normal-tension GON with or without visual field defects with reading-to reading variability of 24-h MAP, as captured by variability independent of the MAP level (VIMmap). …

Diastolic Left Ventricular Function In Relation To The Retinal Microvascular Fractal Dimension In A Flemish Population, Fang-Fei Wei, Lutgarde Thijs, Jesus D. Melgarejo, Nicholas Cauwenberghs, Zhen-Yu Zhang, Chen Liu, Tatiana Kuznetsova, Harry A. J. Struijker-Boudier, Peter Verhamme, Yu-Gang Dong

School of Medicine Publications and Presentations

Fractal analysis provides a global assessment of vascular networks (e.g., geometric complexity). We examined the association of diastolic left ventricular (LV) function with the retinal microvascular fractal dimension. A lower fractal dimension signifies a sparser retinal microvascular network. In 628 randomly recruited Flemish individuals (51.3% women; mean age, 50.8 years), we measured diastolic LV function by echocardiography and the retinal microvascular fractal dimension by the box-counting method (Singapore I Vessel Assessment software, version 3.6). The left atrial volume index (LAVI), e′, E/e′ and retinal microvascular fractal dimension averaged (±SD) 24.3 ± 6.2 mL/m2, 10.9 ± 3.6 cm/s, 6.96 ± 2.2, …

Outcome-Driven Thresholds For Ambulatory Blood Pressure Based On The New Acc/Aha Classification Of Hypertension, Yi-Bang Cheng, Lutgarde Thijs, Zhen-Yu Zhang, Masahiro Kikuya, Wen-Yi Yang, Jesus D. Melgarejo, Gladys E. Maestre

School of Medicine Publications and Presentations

The new ACC/AHA guideline reclassified office blood pressure (OBP) and proposed thresholds for ambulatory blood pressure (ABP). We derived outcome-driven ABP thresholds corresponding with the new OBP categories. We performed 24-h ABP monitoring in 11,152 participants (48.9% women; mean age 53.0 years) representative of 13 populations. We determined ABP thresholds resulting in multivariable-adjusted 10-year risks similar to those associated with elevated OBP (120/80 mm Hg) and stages 1 and 2 of office hypertension (130/80 and 140/90 mm Hg). Over 13.9 years (median), 2728 (rate per 1000 person-years, 17.9) people died, 1033 (6.8) from cardiovascular disease; furthermore, 1988 (13.8), 893 (6.0) …

Setting Thresholds To Varying Blood Pressure Monitoring Intervals Differentially Affects Risk Estimates Associated With White-Coat And Masked Hypertension In The Population, Kei Asayama, Yan Li, Yu-Mei Gu, Azusa Hara, Yan-Ping Liu, Zhenyu Zhang, Fang-Fei Wei, Inés Lujambio, Luis J. Mena, Gladys E. Maestre

School of Medicine Publications and Presentations

Outcome-driven recommendations about time intervals during which ambulatory blood pressure should be measured to diagnose white-coat or masked hypertension are lacking. We cross-classified 8237 untreated participants (mean age, 50.7 years; 48.4% women) enrolled in 12 population studies, using ≥140/≥90, ≥130/≥80, ≥135/≥85, and ≥120/≥70 mm Hg as hypertension thresholds for conventional, 24-hour, daytime, and nighttime blood pressure. White-coat hypertension was hypertension on conventional measurement with ambulatory normotension, the opposite condition being masked hypertension. Intervals used for classification of participants were daytime, nighttime, and 24 hours, first considered separately, and next combined as 24 hours plus daytime or plus nighttime, or plus …

Outcome-Driven Thresholds For Ambulatory Pulse Pressure In 9938 People Recruited From 11 Populations, Yu-Mei Gu, Lutgarde Thijs, Yan Li, Kei Asayama, José Boggia, Tine W. Hansen, Yan-Ping Liu, Takayoshi Ohkubo, Kristina Björklund-Bodegård, Gladys E. Maestre

School of Medicine Publications and Presentations

Evidence-based thresholds for risk stratification based on pulse pressure (PP) are currently unavailable. To derive outcome-driven thresholds for the 24–h ambulatory PP, we analyzed 9938 people randomly recruited from 11 populations (47.3% women). After age stratification (≥60 years) and using average risk as reference, we computed multivariable-adjusted hazard ratios (HRs) to assess risk by tenths of the PP distribution or risk associated with stepwise increasing (+1 mm Hg) PP levels. All adjustments included mean arterial pressure. Among 6028 younger participants (68,853 person-years), the risk of cardiovascular (HR, 1.58; P=0.011) or cardiac (HR, 1.52; P=0.056) events increased only in the top …

Blood Pressure And Cerebral White Matter Share Common Genetic Factors In Mexican Americans, Peter Kochunov, David C. Glahn, Jack Lancaster, Anderson M. Winkler, Rene L. Olvera, Joanne E. Curran, Thomas D. Dyer, Laura Almasy, Ravi Duggirala, Peter T. Fox, John Blangero

School of Medicine Publications and Presentations

Elevated arterial pulse pressure and blood pressure (BP) can lead to atrophy of cerebral white matter (WM), potentially attributable to shared genetic factors. We calculated the magnitude of shared genetic variance between BP and fractional anisotropy of water diffusion, a sensitive measurement of WM integrity in a well-characterized population of Mexican Americans. The patterns of whole-brain and regional genetic overlap between BP and fractional anisotropy were interpreted in the context the pulse-wave encephalopathy theory. We also tested whether regional pattern in genetic pleiotropy is modulated by the phylogeny of WM development. BP and high-resolution (1.7 × 1.7 × 3 mm; …