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The relationship between systemic arterial stiffness and parameters of cerebral circulation is poorly understood. We aimed to assess the relation between pulsatility (PI) and resistance (RI) indexes of the middle cerebral artery (MCA) and aortic pulse wave velocity (PWV) and brachial pulse pressure (PP).Bilateral transcranial Doppler ultrasound (TCD) examination of the MCAs was performed using the GE Vivid 3 Ultrasound, equipped with a 2.5-MHz probe and PI and RI were calculated. Aortic PWV was obtained with the Complior device (Colson France). Conventional blood pressures were measured at the time of TCD. Data regarding risk-profile constituents, habits and medication use were recorded. Subjects with occlusion or significant stenosis of carotid arteries or MCA, previous or acute stroke, temporary ischaemic attack, bilaterally absent transtemporal sonographic windows, dysrhythmia, haematocrit value30% or48% were excluded.Of the 165 included subjects (mean age, 56.70+/-11.80 years, range 22-86 years), 50.3% were men, 20.9% smokers, 20.7% diabetic and 63.4% hypertensive. PWV correlated to both PI (r=0.45, p0.001) and RI (r=0.36, p0.001) of MCA. A similar relation was found for PP and PI (r=0.32, p0.001) or RI (r=0.30, p0.001). Age, diabetes and hypertension, but not chronic tobacco smoking, interfered with MCA flow parameters. In multivariate adjusted regression analysis, PP was related to both PI and RI of MCA (p0.001). In similar models, increased PWV was related to PI (p=0.007), but not RI (p=0.08) of MCA.Increased PI and RI of MCA are closely related to measures of increased aortic stiffness.

The aim of the study was to evaluate of the association between renal function and the intima-media thickness of common carotid artery (CCA-IMT) in treated hypertensive patients. Eighty-seven hypertensives (51.7% diabetic), aged45 years, were examined. Renal function was evaluated by plasma concentration of creatinine, cystatin C (in 64 patients) and creatinine clearance, calculated according to the Cockcroft-Gault formula. HbA1c measurement and blood pressure monitoring were performed. CCA-IMT was measured at near and far wall of the CCA and of the bulb on both sides and averaged. In 63 hypertensives (72.4%) IMT was over 0.9 mm. These subjects were older (71.17+/-9.72 vs 57.75+/-7.76 years; p0.0001), had higher pulse pressure (57.45+/-11.73 vs 49.35+/-8.35, p = 0.004), cystatin C concentration (1.25+/-0.34 vs 0.99+/-0.17 mg/l; p = 0.002), higher HbA1c (7.24+/-1.59 vs 6.25+/-1.28, p = 0.01), and lower creatinine clearance (71.28+/-28.32 vs 93.86+/-25.04; p0.0001) in comparison to patients with IMT0.9 mm. Groups did not differ with respect to creatinine concentration. The logistic regression analysis showed that CCA-IMT was independently influenced only by age, and the effect of age was stronger in older patients. After exclusion of age, 0.1 mg/l higher concentrations of cystatin C or 10 ml/min lower estimated creatinine clearance were significantly associated with 56% and 34%, respectively, higher probability of CCA-IMT of more than 0.9 mm. Cystatin C concentration seems to be a useful indicator of renal function impairment associated with carotid intima-media thickening. Similar information is obtained when estimated creatinine clearance is used.

The aim of our study was to assess the relationship between blood pressure and arterial stiffness in Polish centenarians.We examined 59 centenarians with the mean age of 101.3 years. Peripheral blood pressure was estimated upon mean value of three measurements and arterial stiffness by pulse wave analysis (PWA). Pressure waveforms were recorded from the radial artery and the waveform data were then processed by SphygmoCor to produce the estimated aortic pressure waveform. All subjects were divided into the three subgroups: normotensives (140/ 90 mmHg), systolic hypertensives (ISH, SBPor = 140 and DBP90 mmHg) and systolo-diastolic hypertensives (or = 140/90 or treated).The mean values of peripheral BP for the entire group were: 149.5/76.8 mmHg for SBPP/DBPP and 136.1/ 77.8 mmHg for central SBPC/DBPC, respectively. The mean value of pulse pressures were: 72.7/58.4 mmHg for peripheral (PPP)/central (PPc). Arterial stiffness indices calculated from PWA were: 96.6%, 33.2% and 32.2% for peripheral (AIxP), central (AIxC) and central normalized for heart rate (AIxC75) augmentation indexes, respectively. The PPc was the lowest in the normotensive group (40.1 mmHg) when compared both with the ISH group (71.1 mmHg) and the systolo-diastolic group (58.1 mmHg). The lowest arterial stiffness indices (AIxp, AIxC75) calculated from PWA were found in the normotensive group: 85.4% and 28.5%, comparing with 96.1% and 33.7% in the ISH group and 104.8% and 32.9% for the systolo-diastolic group.In centenarians, similarly to younger subjects, those with hypertension present with arterial stiffness.

Demographic, social and economic trends will serve to increase the importance of women as healthcare consumers. Design. The aim of the study was to assess cardiovascular (CV) risk in the normotensive female patients during single visit to primary care (PC) offices.Demographic data, history of coronary heart disease (CHD), diabetes (DM), smoking habit and family history of CV diseases were obtained from women who visited general practitioners. Moreover, blood pressure (BP), pulse rate, weight and height used to calculation body mass index (BMI) and waist circumference (WC) were performed. Prehypertension was defined as a systolic BP (SBP) of 120-139 mmHg, and/or a diastolic BP (DBP) of 80-89mmHg.Prehypertension was observed in 21.5% of the whole group of female PC patients. SBP, DBP, BMI and WC revealed significant trends towards increase with age among both prehypertensives (p0.001) and normotensives (SBP, BMI, WC: p0.001; DBP: p0.05) and in the whole group (p0.001). Nevertheless, heart rate (HR) significantly increased with age only among prehypertensive women (p0.05). The CV risk of the studied adult women increased progressively with presence of overweight, obesity and visceral obesity. The CV risk of the youngest groups was associated mainly with high prevalence of smoking, and with high prevalence of CHD and DM among the oldest female patients.The prevalence of majority of CV risk factors increase with age among both prehypertensive and normotensive women, which should stimulate PC practitioners to identify and modify them.