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Subclinical atherosclerosis and risk factors in relation to autonomic indices in the general population

Zambach, Christian LU orcid ; Fedorowski, Artur LU orcid ; Gerward, Sofia LU ; Johansson, Madeleine LU orcid ; Engström, Gunnar LU and Hamrefors, Viktor LU orcid (2023) In Journal of Hypertension 41(5). p.759-767
Abstract

OBJECTIVE: Orthostatic hypotension and resting heart rate (RHR) are associated with cardiovascular disease (CVD). However, it is unknown how these factors relate to subclinical CVD. We examined the relationship between orthostatic blood pressure (BP) response, RHR and cardiovascular risk factors, including coronary artery calcification score (CACS) and arterial stiffness, in the general population.

METHODS: We included 5493 individuals (age 50-64 years; 46.6% men) from The Swedish CArdioPulmonary-bio-Image Study (SCAPIS). Anthropometric and haemodynamic data, biochemistry, CACS and carotid-femoral pulse wave velocity (PWV) were retrieved. Individuals were categorized into binary variables that manifest orthostatic hypotension and... (More)

OBJECTIVE: Orthostatic hypotension and resting heart rate (RHR) are associated with cardiovascular disease (CVD). However, it is unknown how these factors relate to subclinical CVD. We examined the relationship between orthostatic blood pressure (BP) response, RHR and cardiovascular risk factors, including coronary artery calcification score (CACS) and arterial stiffness, in the general population.

METHODS: We included 5493 individuals (age 50-64 years; 46.6% men) from The Swedish CArdioPulmonary-bio-Image Study (SCAPIS). Anthropometric and haemodynamic data, biochemistry, CACS and carotid-femoral pulse wave velocity (PWV) were retrieved. Individuals were categorized into binary variables that manifest orthostatic hypotension and in quartiles of orthostatic BP responses and RHR, respectively. Differences across the various characteristics were tested using χ2 for categorical variables and analysis of variance and Kruskal-Wallis test for continuous variables.

RESULTS: The mean (SD) SBP and DBP decrease upon standing was -3.8 (10.2) and -9.5 (6.4) mmHg, respectively. Manifest orthostatic hypotension (1.7% of the population) associated with age (P = 0.021), systolic, diastolic and pulse pressure (P < 0.001), CACS (<0.001), PWV (P = 0.004), HbA1c (P < 0.001) and glucose levels (P = 0.035). Age (P < 0.001), CACS (P = 0.045) and PWV (P < 0.001) differed according to systolic orthostatic BP, with the highest values seen in those with highest and lowest systolic orthostatic BP-responses. RHR was associated with PWV (P < 0.001), SBP and DBP (P < 0.001) as well as anthropometric parameters (P < 0.001) but not CACS (P = 0.137).

CONCLUSION: Subclinical abnormalities in cardiovascular autonomic function, such as impaired and exaggerated orthostatic BP response and increased resting heart rate, are associated with markers of increased cardiovascular risk in the general population.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Atherosclerosis, Orthostatic hypotension, POPULATION STUDIES
in
Journal of Hypertension
volume
41
issue
5
pages
759 - 767
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:85152168036
  • pmid:36883449
ISSN
1473-5598
DOI
10.1097/HJH.0000000000003397
language
English
LU publication?
yes
additional info
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
id
6248ed7c-6057-4d2e-b3f0-2b6bddba5ffa
date added to LUP
2023-03-10 13:15:40
date last changed
2024-06-15 01:33:43
@article{6248ed7c-6057-4d2e-b3f0-2b6bddba5ffa,
  abstract     = {{<p>OBJECTIVE: Orthostatic hypotension and resting heart rate (RHR) are associated with cardiovascular disease (CVD). However, it is unknown how these factors relate to subclinical CVD. We examined the relationship between orthostatic blood pressure (BP) response, RHR and cardiovascular risk factors, including coronary artery calcification score (CACS) and arterial stiffness, in the general population.</p><p>METHODS: We included 5493 individuals (age 50-64 years; 46.6% men) from The Swedish CArdioPulmonary-bio-Image Study (SCAPIS). Anthropometric and haemodynamic data, biochemistry, CACS and carotid-femoral pulse wave velocity (PWV) were retrieved. Individuals were categorized into binary variables that manifest orthostatic hypotension and in quartiles of orthostatic BP responses and RHR, respectively. Differences across the various characteristics were tested using χ2 for categorical variables and analysis of variance and Kruskal-Wallis test for continuous variables.</p><p>RESULTS: The mean (SD) SBP and DBP decrease upon standing was -3.8 (10.2) and -9.5 (6.4) mmHg, respectively. Manifest orthostatic hypotension (1.7% of the population) associated with age (P = 0.021), systolic, diastolic and pulse pressure (P &lt; 0.001), CACS (&lt;0.001), PWV (P = 0.004), HbA1c (P &lt; 0.001) and glucose levels (P = 0.035). Age (P &lt; 0.001), CACS (P = 0.045) and PWV (P &lt; 0.001) differed according to systolic orthostatic BP, with the highest values seen in those with highest and lowest systolic orthostatic BP-responses. RHR was associated with PWV (P &lt; 0.001), SBP and DBP (P &lt; 0.001) as well as anthropometric parameters (P &lt; 0.001) but not CACS (P = 0.137).</p><p>CONCLUSION: Subclinical abnormalities in cardiovascular autonomic function, such as impaired and exaggerated orthostatic BP response and increased resting heart rate, are associated with markers of increased cardiovascular risk in the general population.</p>}},
  author       = {{Zambach, Christian and Fedorowski, Artur and Gerward, Sofia and Johansson, Madeleine and Engström, Gunnar and Hamrefors, Viktor}},
  issn         = {{1473-5598}},
  keywords     = {{Atherosclerosis; Orthostatic hypotension; POPULATION STUDIES}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{759--767}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Journal of Hypertension}},
  title        = {{Subclinical atherosclerosis and risk factors in relation to autonomic indices in the general population}},
  url          = {{http://dx.doi.org/10.1097/HJH.0000000000003397}},
  doi          = {{10.1097/HJH.0000000000003397}},
  volume       = {{41}},
  year         = {{2023}},
}