BackgroundIn contrast with the setting of acute myocardial infarction, there are limited data reg... more BackgroundIn contrast with the setting of acute myocardial infarction, there are limited data regarding the impact of diabetes mellitus on clinical outcomes in contemporary cohorts of patients with chronic coronary syndromes. We aimed to investigate the prevalence and prognostic impact of diabetes according to geographical regions and ethnicity.Methods and resultsCLARIFY is an observational registry of patients with chronic coronary syndromes, enrolled across 45 countries in Europe, Asia, America, Middle East, Australia, and Africa in 2009–2010, and followed up yearly for 5 years. Chronic coronary syndromes were defined by ≥1 of the following criteria: prior myocardial infarction, evidence of coronary stenosis >50%, proven symptomatic myocardial ischaemia, or prior revascularization procedure.Among 32 694 patients, 9502 (29%) had diabetes, with a regional prevalence ranging from below 20% in Northern Europe to ∼60% in the Gulf countries. In a multivariable-adjusted Cox proportion...
Obesity constitutes an important problem of public health in developed countries because of its h... more Obesity constitutes an important problem of public health in developed countries because of its high prevalence (affecting nearly one third of the population) and the reduction of life expectancy in this population. Every day new physiopathologic implications are discovered concerning obesity and other cardiovascular risk factors such as diabetes, hypertension and dyslipemia. We present the mechanisms that explain the physiopathology of obesity from the point of view of hemodynamic modifications, neurohormonal alterations (sympathetic nervous system, renin-angiotensin-aldosterone system, vasopressin, endothelin), and alterations in the glucidic metabolism (insulin-resistance and hyperinsulinism), the lipidic metabolism and the endothelium. The treatment of obese hypertensive patients is based on two principles: the correction of overweight and the treatment of hypertension, bearing ind mind the peculiarities in these patients.
Background. Dr. Halberg, the Lord of Time, showed that all biological functions, including gene f... more Background. Dr. Halberg, the Lord of Time, showed that all biological functions, including gene functions, follow a circadian rhythm. An earlier study revealed that births in September to November may program increased longevity up to 100 years. Recent studies showed that risk factors can predispose trans-generational inheritance of diseases or health from parents to offspring. This study examined the role of time of birth on the risk of cardiovascular diseases (CVDs) and other chronic diseases. Subjects and Methods. The pilot study included 100 adults aged 20 years and above to investigate any association of time of birth with future risk of CVDs and diabetes. After approval from the local Hospital Ethics Committee and obtaining written informed consent, subjects 20 years and older were recruited for the study. The sample size was based on known prevalence of hypertension, coronary artery disease (CAD), stroke and diabetes in the populations concerned. It was estimated that at least 9% of the population, aged 25 years and above, had any one or more of the above diseases. Time of birth for each subject was obtained from the individual's horoscope, in which the exact time and date of birth were recorded at the time of birth. The presence of diseases was recorded based on available records of diagnosis and treatment. Multivariate logistic regression analysis was employed to determine whether the time of birth predicts risk factors associated with various diseases. Results. The results of the study have shown that the incidence of hypertension, prehypertension and diabetes as well as prediabetes was lower among subjects who were born during the nighttime (18:00 to 6:00) compared to subjects who were born during the daytime (6:00 to 18:00). The second quarter of the day (06:00-12:00) is associated with increased sympathetic activity with its adverse effects, whereas the first quarter of the day (12:00-06:00) is associated with increased parasympathetic and low sympathetic activity with corresponding protective effects on the fetus, mother and newborn. An infant born in the second quarter may be exposed to high concentrations of catecholamines, cortisol, oxidative stress and inflammation, with low melatonin, which can damage the genome and epigenome as well as other tissues of the offspring, resulting in greater risk of diseases later in adult life. However, if the child is born during the first quarter of the day, this span is associated with increased concentrations of acetylcholine, nitric oxide and antioxidants in the tissues which have protective effects against diseases. Conclusions. Infants born in the first quarter of the 24-hour day may have lower risks of CVDs and other chronic diseases, whereas those born in the second quarter may have higher risks of diseases later in adult life
The American Journal of the Medical Sciences, 1996
... Opsahl JA, Abraham PA, Halstenson CE, Keane WF. ... 0193945906297378 CrossRef. The American J... more ... Opsahl JA, Abraham PA, Halstenson CE, Keane WF. ... 0193945906297378 CrossRef. The American Journal of the Medical Sciences Racial Differences in Ambulatory Blood Pressure and Echocardiographic Left Ventricular Geometry OLUTADE, BO; GBADEBO, T; PORTER, VD ...
BACKGROUND There is a lack of information about the prognostic value of high velocity in coronary... more BACKGROUND There is a lack of information about the prognostic value of high velocity in coronary arteries during echocardiography. The present study was aimed at investigating the three-year prognostic value of coronary velocity assessment in all patients who were referred for echocardiography examination. METHODS The prospective study comprises 747 consecutive patients. Death, myocardial infarction (MI), acute coronary syndrome (ACS), and/or revascularisation were defined as major adverse cardiac events (MACE). Routine echocardiography was added with coronary velocity assessment in the left main, anterior descending, or circumflex coronary arteries by the Doppler method. RESULTS During a median follow-up of 36 months, 192 patients experienced MACE. Deaths occurred more frequently in patients with high local velocity in proximal left-sided segments vs. in middle left-sided segments vs. patients without high coronary velocity (9 vs. 3 vs. 1%, p < 0.0001). Death/MI/ACS occurred in 17 vs. 7 vs. 1%, p < 0.0001, respectively. Age (HR 1.04, 95% CI 1.00; 1.06; p < 0.04), a velocity more than 65 cm/s in any proximal segments of the arteries (HR 4.7, 95% CI 1.9; 11.9; p < 0.002), ejection fraction (HR 0.97, 95% CI 0.94; 0.99; p < 0.007) were strong independent prognostic predictors of death/MI/ACS. The maximal velocity of coronary flow velocity had a significant additive prognostic value to ejection fraction. CONCLUSIONS The coronary velocity parameters give long-term prognostic information that can be used to identify persons with a high risk of MACE in consecutive non-selected patients.
The variability expressed as CV during WT increased signifi cantly in P group (for SBP from 10.9 ... more The variability expressed as CV during WT increased signifi cantly in P group (for SBP from 10.9 ± 3.4 to 13.9 ± 3.9%, p = 0.002 and for DBP from 15.3 ± 5.6 to 19.2 ± 7.3 mmHg, p = 0.004) and in A group for SBP (from 12.0 ± 3.9 to 13.6 ± 3.3 %, p = 0.021). CV during ST increased in N group (for SBP from 9.3 ± 3.0 to 12.6 ± 4.6%, p = 0.015 and for DBP from 11.7 ± 4.8 to 18.0 ± 8.9 mmHg, p = 0.021) and in P group for SBP (from 9.5 ± 2.7 to 11.5 ± 2.5 %, p = 0.021). Conclusions: Perindopril increased variability of SBP and DBP during wake time, whereas nebivolol increased variability of blood pressure in the sleep time.
Parenteral heparin and oral coumarin preparations represent the standard antithrombotics widely u... more Parenteral heparin and oral coumarin preparations represent the standard antithrombotics widely used in the prevention and treatment of venous thromboembolism (VTE). Unfractionated heparin, low molecular weight heparins, and fondaparinux have been shown to be effective and safe in reducing VTE risk. Despite high efficacy these medicaments have limitations which become to be more apparent with current widening of the indications for either primary thromboprophylaxis (PTP) or indefinite and even lifelong secondary thromboprophylaxis (STP). There is a need for new effective and safe medicaments with specific antithrombotic action, oral administration and convenient dosing without monitoring. During the last decade new antithrombotics have been developed either blocking selectively one coagulation enzyme or inhibiting particular step in coagulation cascade. Document of the Angiologists Section of the Slovak Medical Chamber (AS SMC).
Objectives: To investigate vasomotion in diabetic patients who underwent sessions of hyperbaric o... more Objectives: To investigate vasomotion in diabetic patients who underwent sessions of hyperbaric oxygen (HBO2) therapy. Materials and methods: Seventy-one patients with diabetes Type 2 and lower-extremity neuropathy were enrolled in a prospective matched case-control study. A total of 39 patients underwent 15 sessions of HBO2 therapy consisting of 90 minutes of breathing 100% oxygen at 2.5 atmospheres; 32 were included in the control group without exposure to hyperbaric oxygen. We used laser Doppler flowmetry for measurement of flowmotion. Spectral analysis of laser Doppler flowmetry signals was performed using the Fast Fourier transform algorithm. The total spectral activity was divided into the subgroup of endothelium, adrenergic, intrinsic smooth muscle, respiratory and cardiac spectral activity. The lateral ankle and the dorsum of the foot were chosen for this study. Heating provocation test was performed on both sites. The measurement was performed 24 hours before the first HBO2 session and 24 hours after the last (15th) session of therapy. Results: We observed a significant increase in respiratory, cardiac and total spectral activity of flowmotion on the ankle as well as a significant increase in cardiac and total spectral activity on the dorsum of the foot in patients without a foot ulcer. In the subgroup of patients with a diabetic ulcer, a decrease of total spectral activity of flowmotion on the dorsum of the foot was observed. Conclusion: Flowmotion (indirectly vasomotion) measured by laser Doppler flowmetry changed significantly after HBO2 therapy. Flowmotion dynamics may partly explain the positive effect of HBO2 on the healing process of a diabetic ulcer.
The aim of Guidelines of the Angiology Section of the Slovak Medical Chamber (AS SMC) is to addre... more The aim of Guidelines of the Angiology Section of the Slovak Medical Chamber (AS SMC) is to address a last european guidelines for the management of thrombophlebitis superficialis, as well as results in evidence based medicine (EBM) in order to assess their contribution to our expanding knowledge on rational management of thrombophlebitis superficialis. Discussion: Superficial thrombophlebitis is a common disease, usually considered to be benign. However, the practice of systemic duplex ultrasonography has revealed a large number of cases of deep vein thrombosis concomitant with superficial thrombophlebitis. Assessment of clinical probability of deep vein thrombosis and venous tromboembolism and systematic duplex ultrasound investigation has been proposed in the initial management of superficial thrombophlebitis, to detect the presence of any underlying deep vein thrombosis. In contrast with extensive information on the management of deep vein thrombosis, there is little knowledge about the most appropriate treatment of the superficial thrombophlebitis. Conclusion: The treatment of superficial thrombophlebitis should improve local symptoms while preventing the development of complications such as venous thromboembolism. The most effective therapeutic approach to superficial thrombophlebitis seems to be represented by fondaparinux (a synthetic selective indirect inhibitor of factor Xa) which have been shown to prevent VTE events and the extension and/ or recurrence of superficial thrombophlebitis.
The issue of resistant hypertension is complex and from the clinical aspect very current, especia... more The issue of resistant hypertension is complex and from the clinical aspect very current, especially in the elderly. For the diagnosis of resistant hypertension in routine practice, ambulatory blood pressure monitoring is a proven method to distinguish it from the white coat hypertension. Fixed combinations of antihypertensive drugs helps to improve compliance not only in geriatric patients, but are also indicated in hypertensive patients with diabetes mellitus, metabolic syndrome, in patients with target organ damage, renal disease, coronary heart disease and post stroke conditions. Especially in the population of older hypertensive patients, listed diseases with polymorbidity are frequently present.
OBJECTIVES: Central systolic blood pressure (CSBP) is the pressure in the root of aorta, which di... more OBJECTIVES: Central systolic blood pressure (CSBP) is the pressure in the root of aorta, which directly infl uences organs such as brain, heart and kidneys and is related to organ damage. Its value increases with the aortic stiffness. The aim of this study was to analyze the relationships of CSBP to aortic stiffness parameters. METHODS: Central blood pressure (BP) and related parameters were measured by Arteriograph, working based on oscillometric principle, using pulse wave analysis (PWA) approach. We examined 123 patients (69 females, 54 males) with a primary hypertension. RESULTS: Using a linear correlation analysis, we found that CSBP was correlated to aortic pulse wave velocity (PWV), aortic and brachial pulse pressure (PP), aortic augmentation index, return time of refl ected pressure wave (RT) and aortic and brachial augmentation indexes. Multivariate analysis defi nes the aortic pulse pressure (PPao) as the most powerful parameter infl uencing CSBP. By an individual analysis of BP in each patient separately, we defi ned two different types of central hemodynamics; those with a higher CSBP than brachial SBP occur in stiffer aorta. CONCLUSION: The CSBP increases with aortic PP, the most powerful stiffness parameter of aorta. Higher CSBP than brachial SBP usually accompanies a stiffer aorta (Tab. 5, Ref. 19).
BackgroundIn contrast with the setting of acute myocardial infarction, there are limited data reg... more BackgroundIn contrast with the setting of acute myocardial infarction, there are limited data regarding the impact of diabetes mellitus on clinical outcomes in contemporary cohorts of patients with chronic coronary syndromes. We aimed to investigate the prevalence and prognostic impact of diabetes according to geographical regions and ethnicity.Methods and resultsCLARIFY is an observational registry of patients with chronic coronary syndromes, enrolled across 45 countries in Europe, Asia, America, Middle East, Australia, and Africa in 2009–2010, and followed up yearly for 5 years. Chronic coronary syndromes were defined by ≥1 of the following criteria: prior myocardial infarction, evidence of coronary stenosis >50%, proven symptomatic myocardial ischaemia, or prior revascularization procedure.Among 32 694 patients, 9502 (29%) had diabetes, with a regional prevalence ranging from below 20% in Northern Europe to ∼60% in the Gulf countries. In a multivariable-adjusted Cox proportion...
Obesity constitutes an important problem of public health in developed countries because of its h... more Obesity constitutes an important problem of public health in developed countries because of its high prevalence (affecting nearly one third of the population) and the reduction of life expectancy in this population. Every day new physiopathologic implications are discovered concerning obesity and other cardiovascular risk factors such as diabetes, hypertension and dyslipemia. We present the mechanisms that explain the physiopathology of obesity from the point of view of hemodynamic modifications, neurohormonal alterations (sympathetic nervous system, renin-angiotensin-aldosterone system, vasopressin, endothelin), and alterations in the glucidic metabolism (insulin-resistance and hyperinsulinism), the lipidic metabolism and the endothelium. The treatment of obese hypertensive patients is based on two principles: the correction of overweight and the treatment of hypertension, bearing ind mind the peculiarities in these patients.
Background. Dr. Halberg, the Lord of Time, showed that all biological functions, including gene f... more Background. Dr. Halberg, the Lord of Time, showed that all biological functions, including gene functions, follow a circadian rhythm. An earlier study revealed that births in September to November may program increased longevity up to 100 years. Recent studies showed that risk factors can predispose trans-generational inheritance of diseases or health from parents to offspring. This study examined the role of time of birth on the risk of cardiovascular diseases (CVDs) and other chronic diseases. Subjects and Methods. The pilot study included 100 adults aged 20 years and above to investigate any association of time of birth with future risk of CVDs and diabetes. After approval from the local Hospital Ethics Committee and obtaining written informed consent, subjects 20 years and older were recruited for the study. The sample size was based on known prevalence of hypertension, coronary artery disease (CAD), stroke and diabetes in the populations concerned. It was estimated that at least 9% of the population, aged 25 years and above, had any one or more of the above diseases. Time of birth for each subject was obtained from the individual's horoscope, in which the exact time and date of birth were recorded at the time of birth. The presence of diseases was recorded based on available records of diagnosis and treatment. Multivariate logistic regression analysis was employed to determine whether the time of birth predicts risk factors associated with various diseases. Results. The results of the study have shown that the incidence of hypertension, prehypertension and diabetes as well as prediabetes was lower among subjects who were born during the nighttime (18:00 to 6:00) compared to subjects who were born during the daytime (6:00 to 18:00). The second quarter of the day (06:00-12:00) is associated with increased sympathetic activity with its adverse effects, whereas the first quarter of the day (12:00-06:00) is associated with increased parasympathetic and low sympathetic activity with corresponding protective effects on the fetus, mother and newborn. An infant born in the second quarter may be exposed to high concentrations of catecholamines, cortisol, oxidative stress and inflammation, with low melatonin, which can damage the genome and epigenome as well as other tissues of the offspring, resulting in greater risk of diseases later in adult life. However, if the child is born during the first quarter of the day, this span is associated with increased concentrations of acetylcholine, nitric oxide and antioxidants in the tissues which have protective effects against diseases. Conclusions. Infants born in the first quarter of the 24-hour day may have lower risks of CVDs and other chronic diseases, whereas those born in the second quarter may have higher risks of diseases later in adult life
The American Journal of the Medical Sciences, 1996
... Opsahl JA, Abraham PA, Halstenson CE, Keane WF. ... 0193945906297378 CrossRef. The American J... more ... Opsahl JA, Abraham PA, Halstenson CE, Keane WF. ... 0193945906297378 CrossRef. The American Journal of the Medical Sciences Racial Differences in Ambulatory Blood Pressure and Echocardiographic Left Ventricular Geometry OLUTADE, BO; GBADEBO, T; PORTER, VD ...
BACKGROUND There is a lack of information about the prognostic value of high velocity in coronary... more BACKGROUND There is a lack of information about the prognostic value of high velocity in coronary arteries during echocardiography. The present study was aimed at investigating the three-year prognostic value of coronary velocity assessment in all patients who were referred for echocardiography examination. METHODS The prospective study comprises 747 consecutive patients. Death, myocardial infarction (MI), acute coronary syndrome (ACS), and/or revascularisation were defined as major adverse cardiac events (MACE). Routine echocardiography was added with coronary velocity assessment in the left main, anterior descending, or circumflex coronary arteries by the Doppler method. RESULTS During a median follow-up of 36 months, 192 patients experienced MACE. Deaths occurred more frequently in patients with high local velocity in proximal left-sided segments vs. in middle left-sided segments vs. patients without high coronary velocity (9 vs. 3 vs. 1%, p < 0.0001). Death/MI/ACS occurred in 17 vs. 7 vs. 1%, p < 0.0001, respectively. Age (HR 1.04, 95% CI 1.00; 1.06; p < 0.04), a velocity more than 65 cm/s in any proximal segments of the arteries (HR 4.7, 95% CI 1.9; 11.9; p < 0.002), ejection fraction (HR 0.97, 95% CI 0.94; 0.99; p < 0.007) were strong independent prognostic predictors of death/MI/ACS. The maximal velocity of coronary flow velocity had a significant additive prognostic value to ejection fraction. CONCLUSIONS The coronary velocity parameters give long-term prognostic information that can be used to identify persons with a high risk of MACE in consecutive non-selected patients.
The variability expressed as CV during WT increased signifi cantly in P group (for SBP from 10.9 ... more The variability expressed as CV during WT increased signifi cantly in P group (for SBP from 10.9 ± 3.4 to 13.9 ± 3.9%, p = 0.002 and for DBP from 15.3 ± 5.6 to 19.2 ± 7.3 mmHg, p = 0.004) and in A group for SBP (from 12.0 ± 3.9 to 13.6 ± 3.3 %, p = 0.021). CV during ST increased in N group (for SBP from 9.3 ± 3.0 to 12.6 ± 4.6%, p = 0.015 and for DBP from 11.7 ± 4.8 to 18.0 ± 8.9 mmHg, p = 0.021) and in P group for SBP (from 9.5 ± 2.7 to 11.5 ± 2.5 %, p = 0.021). Conclusions: Perindopril increased variability of SBP and DBP during wake time, whereas nebivolol increased variability of blood pressure in the sleep time.
Parenteral heparin and oral coumarin preparations represent the standard antithrombotics widely u... more Parenteral heparin and oral coumarin preparations represent the standard antithrombotics widely used in the prevention and treatment of venous thromboembolism (VTE). Unfractionated heparin, low molecular weight heparins, and fondaparinux have been shown to be effective and safe in reducing VTE risk. Despite high efficacy these medicaments have limitations which become to be more apparent with current widening of the indications for either primary thromboprophylaxis (PTP) or indefinite and even lifelong secondary thromboprophylaxis (STP). There is a need for new effective and safe medicaments with specific antithrombotic action, oral administration and convenient dosing without monitoring. During the last decade new antithrombotics have been developed either blocking selectively one coagulation enzyme or inhibiting particular step in coagulation cascade. Document of the Angiologists Section of the Slovak Medical Chamber (AS SMC).
Objectives: To investigate vasomotion in diabetic patients who underwent sessions of hyperbaric o... more Objectives: To investigate vasomotion in diabetic patients who underwent sessions of hyperbaric oxygen (HBO2) therapy. Materials and methods: Seventy-one patients with diabetes Type 2 and lower-extremity neuropathy were enrolled in a prospective matched case-control study. A total of 39 patients underwent 15 sessions of HBO2 therapy consisting of 90 minutes of breathing 100% oxygen at 2.5 atmospheres; 32 were included in the control group without exposure to hyperbaric oxygen. We used laser Doppler flowmetry for measurement of flowmotion. Spectral analysis of laser Doppler flowmetry signals was performed using the Fast Fourier transform algorithm. The total spectral activity was divided into the subgroup of endothelium, adrenergic, intrinsic smooth muscle, respiratory and cardiac spectral activity. The lateral ankle and the dorsum of the foot were chosen for this study. Heating provocation test was performed on both sites. The measurement was performed 24 hours before the first HBO2 session and 24 hours after the last (15th) session of therapy. Results: We observed a significant increase in respiratory, cardiac and total spectral activity of flowmotion on the ankle as well as a significant increase in cardiac and total spectral activity on the dorsum of the foot in patients without a foot ulcer. In the subgroup of patients with a diabetic ulcer, a decrease of total spectral activity of flowmotion on the dorsum of the foot was observed. Conclusion: Flowmotion (indirectly vasomotion) measured by laser Doppler flowmetry changed significantly after HBO2 therapy. Flowmotion dynamics may partly explain the positive effect of HBO2 on the healing process of a diabetic ulcer.
The aim of Guidelines of the Angiology Section of the Slovak Medical Chamber (AS SMC) is to addre... more The aim of Guidelines of the Angiology Section of the Slovak Medical Chamber (AS SMC) is to address a last european guidelines for the management of thrombophlebitis superficialis, as well as results in evidence based medicine (EBM) in order to assess their contribution to our expanding knowledge on rational management of thrombophlebitis superficialis. Discussion: Superficial thrombophlebitis is a common disease, usually considered to be benign. However, the practice of systemic duplex ultrasonography has revealed a large number of cases of deep vein thrombosis concomitant with superficial thrombophlebitis. Assessment of clinical probability of deep vein thrombosis and venous tromboembolism and systematic duplex ultrasound investigation has been proposed in the initial management of superficial thrombophlebitis, to detect the presence of any underlying deep vein thrombosis. In contrast with extensive information on the management of deep vein thrombosis, there is little knowledge about the most appropriate treatment of the superficial thrombophlebitis. Conclusion: The treatment of superficial thrombophlebitis should improve local symptoms while preventing the development of complications such as venous thromboembolism. The most effective therapeutic approach to superficial thrombophlebitis seems to be represented by fondaparinux (a synthetic selective indirect inhibitor of factor Xa) which have been shown to prevent VTE events and the extension and/ or recurrence of superficial thrombophlebitis.
The issue of resistant hypertension is complex and from the clinical aspect very current, especia... more The issue of resistant hypertension is complex and from the clinical aspect very current, especially in the elderly. For the diagnosis of resistant hypertension in routine practice, ambulatory blood pressure monitoring is a proven method to distinguish it from the white coat hypertension. Fixed combinations of antihypertensive drugs helps to improve compliance not only in geriatric patients, but are also indicated in hypertensive patients with diabetes mellitus, metabolic syndrome, in patients with target organ damage, renal disease, coronary heart disease and post stroke conditions. Especially in the population of older hypertensive patients, listed diseases with polymorbidity are frequently present.
OBJECTIVES: Central systolic blood pressure (CSBP) is the pressure in the root of aorta, which di... more OBJECTIVES: Central systolic blood pressure (CSBP) is the pressure in the root of aorta, which directly infl uences organs such as brain, heart and kidneys and is related to organ damage. Its value increases with the aortic stiffness. The aim of this study was to analyze the relationships of CSBP to aortic stiffness parameters. METHODS: Central blood pressure (BP) and related parameters were measured by Arteriograph, working based on oscillometric principle, using pulse wave analysis (PWA) approach. We examined 123 patients (69 females, 54 males) with a primary hypertension. RESULTS: Using a linear correlation analysis, we found that CSBP was correlated to aortic pulse wave velocity (PWV), aortic and brachial pulse pressure (PP), aortic augmentation index, return time of refl ected pressure wave (RT) and aortic and brachial augmentation indexes. Multivariate analysis defi nes the aortic pulse pressure (PPao) as the most powerful parameter infl uencing CSBP. By an individual analysis of BP in each patient separately, we defi ned two different types of central hemodynamics; those with a higher CSBP than brachial SBP occur in stiffer aorta. CONCLUSION: The CSBP increases with aortic PP, the most powerful stiffness parameter of aorta. Higher CSBP than brachial SBP usually accompanies a stiffer aorta (Tab. 5, Ref. 19).
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