Arteryel sertliğin halihazırda ''altın standart'' ölçümü aortik (karotis-femoral) nabız dalga hızıdır.Obezite genellikle hipertansiyon ve hiperglisemi gibi kardiyovasküler risk faktörleri ile birliktelik gösteren bir hastalıktır. Biz hipertansif ve normotansif obez olgularda, Aortik nabız dalga hızı ve vücut kitle indeksi arasındaki ilişkiyi araştırmayı amaçladık.Kan basıncı ve vücut kitle indeksine göre iki grup olmak üzere toplam 109 olgu alındı. Vücut kitle indeksine göre olgular 30.0-34.9 kg/ m2 olanlar Clas I, >=35 kg/m2 olanlar Clas II olarak tanımlandı. Sonrasında Clas I ve II grupları kan basıncına göre iki gruba normotansif-Clas I, II ve hipertansif-Clas I, II olarak ayrıldı. Tüm grupta (n:109) nabız dalga hızı, yaş, sistolik kan basıncı ve diyastolik kan basıncı ile korelasyon göstermekteydi (sırasıyla, r=0.229; p=0.017, r=0.301; p=0.001 ve r=0.323; p=0.001). Nabız dalga hızının Clas I ve Clas II grupta vücut kitle indeksi ile korelasyonu yoktu. Bu verilere göre, vücut kitle indeksi 30 kg/ m2 üzerindeki olgularda nabız dalga hızının artması vücut kitle indeksi ile ilişkili değildir, fakat yaş, sistolik ve diyastolik kan basıncı ile ilişkili olabilir.
Aortic pulse wave velocity is currently the 'gold standard' measure of arterial stiffness.In this study we aimed to investigatethe relationships betweenAortic pulse wave velocity and body mass index in hypertensive andnormotensiveobesesubjects.A total of109 obese subjects were divided into two groups according to arterial blood pressures andbody mass index. Subjects with a body mass index of 30.0-34.9 kg/m2 were defined as Class I, and >=35.0 kg/m2 as Class II. Then Class I and II groups were divided into two groups according to blood pressures as normotensive-Class I, II and hypertensive-Class I, II.In the whole group (n:109) pulse wave velocity was significantly correlated with age, systolic blood pressure and diastolic blood pressure (r=0.229; p=0.017, r=0.301; p=0.001 and r=0.323; p=0.001, respectively). Pulse wave velocity was not significantly correlated with body mass index neither in the whole group nor in the Class I and Class II groups.These results suggest that in the patients with a body mass index of >=30.0 kg/m2, increase ofpulse wave velocity is not associated with body mass index, but can be related with age, systolic and diastolic blood pressure.
Wormser D, Kaptoge S, Di Angelantonio E, et al. Separate and combined associations of body-mass index and ab- dominal adiposity with cardiovascular disease: collabora- tive analysis of 58 prospective studies. Lancet. 2011 Mar 26;377(9771):1085-95.
WHO. Obesity and overweight. [Internet]. 2013 [cited 2013 Aug 6]. Available from: http://www.who.int/media- centre/factsheets/fs311/en.
Henry SL, Barzel B, Wood-Bradley RJ, Burke SL, Head GA, Armitage JA. Developmental origins of obesity-rela- ted hypertension. Clinical and experimental pharmaco- logy & physiology. 2012 Sep;39(9):799-806.
Kotchen TA. Obesity-related hypertension: epidemiology, pathophysiology, and clinical management. American jo- urnal of hypertension. 2010 Nov;23(11):1170-1178.
Laurent S, Cockcroft J, Van Bortel L, et al. Expert con- sensus document on arterial stiffness: methodologi- cal issues and clinical applications.Eur Heart J. 2006 Nov;27(21):2588-605.
Kostis JB, Lawrence-Nelson J, Ranjan R, Wilson AC, Kostis WJ, Lacy CR. Association of increased pulse pressure with the development of heart failure in SHEP. Systolic Hypertension in the Elderly (SHEP) Cooperative Research Group. American journal of hypertension. 2001 Aug;14(8 Pt 1):798-803.
Heitzer T, Schlinzig T, Krohn K, Meinertz T, Münzel T. En- dothelial dysfunction, oxidative stress, and risk of cardio- vascular events in patients with coronary artery disease. Circulation. 2001 Nov 27;104(22):2673-8.
Van Bortel LM, Laurent S, Boutouyrie P, et al. Expert consensus document on the measurement of aortic stiff- ness in daily practice using carotid-femoral pulse wave velocity.J Hypertens. 2012; 30:445-448.
Mattace-Raso F, Hofman A, Verwoert GC, et al. Deter- minants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: 'establis- hing normal and reference values'. Eur Heart J. 2010 Oct;31(19):2338-50.
Qureshi G, Brown R, Salciccioli L, et al. Relations- hip between aortic atherosclerosis and non-invasive measures of arterial stiffness. Atherosclerosis. 2007 Dec;195(2):e190-194.
Inoue N, Maeda R, Kawakami H, et al. Aortic pulse wave velocity predicts cardiovascular mortality in middle-aged and elderly Japanese men. Circ J. 2009 Mar;73(3):549- 553.
Shokawa T, Imazu M, Yamamoto H, et al. Pulse wave velocity predicts cardiovascular mortality: findings from the Hawaii-Los Angeles-Hiroshima study. Circ J. 2005 Mar;69(3):259-264.
Laurent S, Boutouyrie P, Asmar R, et al. Aortic stiffness is an independent predictor of all-cause and cardiovascu- lar mortality in hypertensive patients. Hypertension. 2001 May;37(5):1236-1241.
Mitchell GF, Hwang S-J, Vasan RS, et al. Arterial stiffness and cardiovascular events: the Framingham Heart Study. Circulation. 2010 Feb 2;121(4):505-511.
Palatini P, Casiglia E, G?sowski J, et al. Arterial stiffness, central hemodynamics, and cardiovascular risk in hyper- tension. Vasc Health Risk Manag. 2011 Jan;7:725-739.
Zebekakis PE, Nawrot T, Thijs L, et al. Obesity is associa- ted with increased arterial stiffness from adolescence until old age. J Hypertens. 2005 Oct;23(10):1839-1846.
Urbina EM, Kimball TR, Khoury PR, Daniels SR, Dolan LM. Increased arterial stiffness is found in adolescents with obesity or obesity-related type 2 diabetes mellitus. J Hypertens. 2010 Aug;28(8):1692-1698.
Celik A, Ozçetin M, Yerli Y, et al. Increased aortic pulse wave velocity in obese children. Turk Kardiyol Dern Ars. 2011 Oct;39(7):557-562.
Sutton-Tyrrell K, Newman A, Simonsick EM, et al. Aor- tic stiffness is associated with visceral adiposity in older adults enrolled in the study of health, aging, and body composition. Hypertension. 2001 Sep;38(3):429-33.
Safar ME, Czernichow S, Blacher J. Obesity, arterial stiff- ness, and cardiovascular risk. J Am Soc Nephrol. 2006 Apr;17(4 Suppl 2):S109-111.
Asmar R, Topouchian J, Potocka AC, Pannier B, Rud- nichi A, Safar M. [Evaluation of the effect of an antihy- pertensive treatment on arterial distensibility in essential arterial hypertension. The Complior study. A preliminary analysis of data at inclusion]. Arch Mal Coeur Vaiss. 1999 Aug;92(8):949-955.
Yıldız M, İnnice M, Aykut P, Gül Ç, Vardar S, Kürüm T. As- sessment of Carotid-Femoral Pulse Wave Velocity in Pati- ents with Hypertension and Different Levels of Body-Mass Index. Medical Network Kardiyoloji. 2004;11(2):105-9.
Longo D, Zaetta V, Perkovic D, et al. Impaired arterial elasticity in young patients with white-coat hypertension. Blood Press Monit. 2006 Oct;11(5):243-249.
Saladini F, Santonastaso M, Mos L, et al. Isolated systolic hypertension of young-to-middle-age individuals implies a relatively low risk of developing hypertension needing tre- atment when central blood pressure is low. J Hypertens. 2011 Jul;29(7):1311-1319.
Gardner AW, Parker DE. Association between arterial compliance and age inparticipants 9 to 77 years old. Angi- ology. 2010 Feb-Mar;61(1):37-41.
Jatoi NA, Jerrard-Dunne P, Feely J, Mahmud A. Impact of smoking and smoking cessation on arterial stiffness and aortic wave reflection in hypertension. Hypertension. 2007 May;49(5):981-5.
Palatini P, Benetos A, Grassi G, et al. Identification and management of the hypertensive patient with elevated he- art rate: statement of a European Society of Hypertension Consensus Meeting. J Hypertens. 2006 Apr;24(4):603- 610.
Willum-Hansen T, Staessen JA, Torp-Pedersen C, et al. Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population. Circulation. 2006 Feb 7;113(5):664-70.
Weisbrod RM, Shiang T, Al Sayah L, et al. Arterial Stif- fening Precedes Systolic Hypertension in Diet-Induced Obesity. Hypertension 2013 Dec;62(6):1105-1110.
Arslan E, Çakar M, Şarlak H, et al.Investigation of the aor- tic pulse wave velocity in patients with Gilbert's syndrome. Clin Exp Hypertens. 2013;35(7):512-5.
Selcuk A, Bulucu F, Kalafat F, et al.Skinfold thickness as a predictor of arterial stiffness: obesity and fatness linked to higher stiffness measurements in hypertensive patients. Clin Exp Hypertens. 2013;35(6):459-64.
Cakar M, Bulucu F, Karaman M, et al. Asymmetric dimeth- ylarginine and augmentation index in newly diagnosed pa- tients with hypertension.Angiology. 2015 Jan;66(1):43-8.
Aghamohammadzadeh R, Heagerty AM. Obesity-related hypertension: epidemiology, pathophysiology, treatments, and the contribution of perivascular adipose tissue. Ann Med. 2012 Jun;44 Suppl 1:S74-84.