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OPEN ACCESS PLUS
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Contents
9(1): Pp. 66 - 75
Kohji Shirai, Junji Utino, Atsuhito Saiki, Kei Endo, Masahiro Ohira, Daiji Nagayama, Ichiro Tatsuno, Kazuhiro Shimizu, Mao Takahashi and Akira Takahara
[Open Access Plus] |
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Arterial stiffness has been known to be a surrogate marker of arteriosclerosis, and also of vascular function. Pulse wave velocity (PWV) had been the most popular index and was known to be a predictor of cardiovascular events. But, it depends on blood pressure at measuring time. To overcome this problem, cardio-ankle vascular index (CAVI) is developed. CAVI is derived from stiffness parameter β by Hayashi, and the equation of Bramwell-Hill, and is independent from blood pressure at a measuring time. Then, CAVI might reflect the proper change of arterial wall by antihypertensive agents. CAVI shows high value with aging and in many arteriosclerotic diseases and is also high in persons with main coronary risk factors. Furthermore, CAVI is decreased by an administration of α1 blocker, doxazosin for 2-4 hours, Those results suggested that CAVI reflected the arterial stiffness composed of organic components and of smooth muscle cell contracture. Angiotensin II receptor blocker, olmesartan decreased CAVI much more than that of calcium channel antagonist, amlodipine, even though the rates of decreased blood pressure were almost same. CAVI might differentiate the blood pressure-lowering agents from the point of the effects on proper arterial stiffness. This paper reviewed the principle and rationale of CAVI, and the possibilities of clinical applications, especially in the studies of hypertension.
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8(2): Pp. 80 - 90
Hiroshi Miyashita
[Open Access Plus] |
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Central aortic blood pressure (CBP) is increasingly considered a better cardiovascular prognostic marker than conventional cuff brachial blood pressure. Because CBP cannot be directly measured noninvasively, it has to be estimated from peripheral pressure pulses. To assess estimated CBP appropriately, the accuracy and features of the estimation method should be considered. The aim of this review is to provide basic knowledge and information useful for interpreting and assessing estimated CBP from a methodological point of view. Precise peripheral pressure pulse recording has been enabled by the introduction of arterial applanation tonometry, for which the radial artery may be the optimal site. An automated tonometry device utilizing a sensor array is preferable in terms of reproducibility and objectivity. Calibration of a peripheral pressure waveform has unresolved problems for any estimation method, due to imperfect brachial sphygmomanometry. However, if central and peripheral pressure calibrations are equivalent, two major methods to estimate CBP—those based on generalized pressure transfer function or radial late systolic pressure—may be comparable in their accuracy of CBP parameter estimation.
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7(4): Pp. 228 - 239
Natalie O. Karpinich, Samantha L. Hoopes, Daniel O. Kechele, Patricia M. Lenhart and Kathleen M. Caron
[Open Access Plus] |
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Adrenomedullin is a highly conserved peptide implicated in a variety of physiological processes ranging from pregnancy and embryonic development to tumor progression. This review highlights past and present studies that have contributed to our current appreciation of the important roles adrenomedullin plays in both normal and disease conditions. We provide a particular emphasis on the functions of adrenomedullin in vascular endothelial cells and how experimental approaches in genetic mouse models have helped to drive the field forward.
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7(2): Pp. 111 - 117
Sabry Gohara, Sandeep Vetteth, Deepak Malhotra and Joseph I. Shapiro
[Open Access Plus] |
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It has been known for some time that dietary salt intake correlates with the prevalence of cardiovascular disease. However, the molecular link between dietary salt and cardiovascular disease is poorly understood. On this background, it has been observed that there are a class of hormones called cardiotonic steroids whose concentrations increase in response to increases in dietary salt. We have shown that some of these hormones may be natriuretic, but we have also shown that they may also be responsible for progressive renal and cardiac injury. Based on data summarized in this review, we propose cardiotonic steroids may serve as the molecular link between dietary salt and cardiovascular disease.
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4(3): Pp. 167 - 176
Ehte Bahiru and Robert A. Kloner
[Open Access Plus] |
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Approximately 65 million individuals in the United States suffer from systemic hypertension. Hypertension leads to various cardiovascular diseases including myocardial infarction, stroke, kidney disease, and others. Hypertension is commonly linked to other risk factors for cardiovascular diseases such as diabetes, dyslipidemia, and smoking. For this study, we reviewed 24 recently published papers that compared different hypertension drugs with other drugs or placebo in their effectiveness to reduce blood pressure and major primary end points. We hypothesized that some drugs reduce the primary end point above and beyond simply reducing the blood pressure. We categorized papers into a number of groups to determine how many papers showed that drug vs. placebo or one drug regimen versus another drug regimen could better reduce a primary clinical end point independent of a better reduction in blood pressure. We found four papers that showed a benefit of a pharmacological regimen on major clinical end points above and beyond reduction of blood pressure. These findings primarily involve drugs that affect the renin-angiotensin-aldosterone system.
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