Pulse Wave Velocity as Marker of Preclinical Arterial Disease: Reference Levels in a Uruguayan Population Considering Wave Detection Algorithms, Path Lengths, Aging, and Blood Pressure

Carotid-femoral pulse wave velocity (PWV) has emerged as the gold standard for non-invasive evaluation of aortic stiffness; absence of standardized methodologies of study and lack of normal and reference values have limited a wider clinical implementation. This work was carried out in a Uruguayan (South American) population in order to characterize normal, reference, and threshold levels of PWV considering normal age-related changes in PWV and the prevailing blood pressure level during the study. A conservative approach was used, and we excluded symptomatic subjects; subjects with history of cardiovascular (CV) disease, diabetes mellitus or renal failure; subjects with traditional CV risk factors (other than age and gender); asymptomatic subjects with atherosclerotic plaques in carotid arteries; patients taking anti-hypertensives or lipid-lowering medications. The included subjects (n = 429) were categorized according to the age decade and the blood pressure levels (at study time). All subjects represented the “reference population”; the group of subjects with optimal/normal blood pressures levels at study time represented the “normal population.” Results. Normal and reference PWV levels were obtained. Differences in PWV levels and aging-associated changes were obtained. The obtained data could be used to define vascular aging and abnormal or disease-related arterial changes

Integrated Evaluation of Age-Related Changes in Structural and Functional Vascular Parameters Used to Assess Arterial Aging, Subclinical Atherosclerosis, and Cardiovascular Risk in Uruguayan Adults: CUiiDARTE Project

This work was carried out in a Uruguayan (South American) population to characterize aging-associated physiological arterial changes. Parameters markers of subclinical atherosclerosis and that associate age-related changes were evaluated in healthy people. A conservative approach was used and people with nonphysiological and pathological conditions were excluded. Then, we excluded subjects with (a) cardiovascular (CV) symptoms, (b) CV disease, (c) diabetes mellitus or renal failure, and (d) traditional CV risk factors (other than age and gender). Subjects (n = 388) were submitted to non-invasive vascular studies (gold-standard techniques), to evaluate (1) common (CCA), internal, and external carotid plaque prevalence, (2) CCA intima-media thickness and diameter, (3) CCA stiffness (percentual pulsatility, compliance, distensibility, and stiffness index), (4) aortic stiffness (carotid-femoral pulse wave velocity), and (5) peripheral and central pressure wave-derived parameters. Age groups: ≤20, 21–30, 31–40, 41–50, 51–60, 61–70, and 71–80 years old. Age-related structural and functional vascular parameters profiles were obtained and analyzed considering data from other populations. The work has the strength of being the first, in Latin America, that uses an integrative approach to characterize vascular aging-related changes. Data could be used to define vascular aging and abnormal or disease-related changes

Pulse wave velocity as marker of preclinical arterial disease: reference levels in a uruguayan population considering wave detection algorithms, path lengths, aging, and blood pressure

Carotid-femoral pulse wave velocity (PWV) has emerged as the gold standard for non-invasive evaluation of aortic stiffness; absence of standardized methodologies of study and lack of normal and reference values have limited a wider clinical implementation. This work was carried out in a Uruguayan (South American) population in order to characterize normal, reference, and threshold levels of PWV considering normal age-related changes in PWV and the prevailing blood pressure level during the study. A conservative approach was used, and we excluded symptomatic subjects; subjects with history of cardiovascular (CV) disease, diabetes mellitus or renal failure; subjects with traditional CV risk factors (other than age and gender); asymptomatic subjects with atherosclerotic plaques in carotid arteries; patients taking anti-hypertensives or lipid-lowering medications. The included subjects (n = 429) were categorized according to the age decade and the blood pressure levels (at study time). All subjects represented the "reference population"; the group of subjects with optimal/normal blood pressures levels at study time represented the "normal population." Results. Normal and reference PWV levels were obtained. Differences in PWV levels and aging-associated changes were obtained. The obtained data could be used to define vascular aging and abnormal or disease-related arterial changes

Efecto agudo del consumo de yerba mate (Ilex paraguariensis) sobre el ritmo cardíaco en pacientes derivados para estudio Holter

Resumen: Introducción: El consumo de yerba mate (YM) (Ilex paraguariensis) es común en Sudamérica y se extiende a todo el mundo. Contiene muchas sustancias bioactivas que pueden ser beneficiosas. También existe la opinión de que puede tener efectos nocivos sobre el ritmo cardíaco, pero no encontramos investigaciones al respecto. Objetivo: Nuestro objetivo fue evaluar el efecto agudo de YM sobre el ritmo, en pacientes enviados para realizar un Holter. Método: Realizamos un estudio clínico seudoexperimental, de tipo antes y después. Tomamos 50 pacientes consumidores habituales de YM y se les realizó un Holter tomando YM y otro luego de 24 sin consumir. También se controló el uso de otros productos que pudieran interferir. Resultados: El 52% fueron mujeres y la edad, de 55 ± 15 años. El 78% tenía al menos un factor de riesgo vascular, el 44% cardiopatía estructural y el 90% tomaba medicación cardiovascular. La frecuencia cardíaca (FC) con y sin YM fue similar. Solo la FC mínima horaria fue menor tomando YM (61 ± 10 vs. 63 ± 9, p = 0.021). No hubo diferencia significativa en la incidencia de arritmias sostenidas, no sostenidas ni en la extrasistolia ventricular. El total de extrasístoles supraventriculares fue mayor sin YM (952 ± 3,538 vs. 1,294 ± 5,201, p = 0.014) y la cantidad máxima horaria también (86 ± 302 vs. 107 ± 360, p = 0.032). No hubo diferencia en la variabilidad de la FC. Conclusiones: En pacientes cardiológicos tomadores de YM, su consumo de la forma habitual no se asoció con cambios importantes de la FC ni con un aumento en la incidencia de arritmias. Hubo menos actividad ectópica supraventricular. Abstract: Introduction: The consumption of yerba mate (YM) (Ilex paraguariensis) is common in South America and is now used all over the world. It contains many bioactive substances that can be beneficial. There is also the opinion that it may have harmful effects on heart rhythm, but no studies have been found on this. Objective: The aim of this study was to evaluate the acute effect of YM on heart rhythm in patients referred for a Holter study. Method: A before and after pseudo-experimental clinical study was conducted by performing a Holter on 50 habitual users of YM, and another one after 24 without YM consumption. The use of other products that could interfere was also controlled. Results: The mean age of the subjects was 55 ± 15 years, and 52% were women. At least one vascular risk factor was found in 78%, with 44% structural heart disease, and 90% taking cardiovascular medication. The heart rate (HR) with and without YM was similar. Only the minimum hourly HR was lower when taking YM (61 ± 10 vs. 63 ± 9, P = .021). There was no significant difference in the incidence of sustained or non-sustained arrhythmias, or in ventricular extrasystoles. The total number of supra-ventricular premature beats was higher without YM (952 ± 3,538 vs. 1,294 ± 5,201, P = .014) and also the maximum hourly (86 ± 302 vs. 107 ± 360, P = .032). There was no difference in HR variability. Conclusions: In cardiology patients, usual users of YM, habitual consumption was not associated with significant changes in HR or an increase in the incidence of arrhythmias. There was less ectopic supraventricular activity. Palabras clave: Ilex paraguariensis, Yerba mate, Arritmias, Extrasístoles supraventriculares, Uruguay, Keywords: Ilex paraguariensis, Yerba mate, Arrhythmias, Supraventricular extrasystoles, Urugua