Publications
2025
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Higher systemic vascular resistance in individuals with a family history of hypertension
CONCLUSION: Participants with a family history of hypertension were characterized by elevated central and peripheral BP probably due to higher SVR, whereas the stiffness of large arteries was not higher. These findings highlight the role of SVR in the pathogenesis of primary hypertension. -
Hyperdynamic circulation distinguishes predominantly diastolic hypertension from predominantly systolic hypertension
Elevated blood pressure is traditionally classified into systolic-diastolic hypertension, isolated systolic hypertension, and isolated diastolic hypertension. In this cross-sectional study, participants not using antihypertensive medications (n = 654) were divided into normotensive subjects (n = 421), and predominantly systolic (n = 130) versus predominantly diastolic hypertension (n = 103) based on the percentage elevation of aortic blood pressure above 125 mmHg systolic or 85 mmHg diastolic.... -
Impact of aging on cardiovascular dynamics and heart rate variability during passive head-up tilt
During aging, arterial stiffness and blood pressure (BP) increase, while heart rate variability (HRV) decreases. We examined age-related hemodynamics in 522 individuals without cardiovascular disease during passive head-up tilt (HUT) using pulse wave analysis, whole-body impedance cardiography, and HRV analysis. Mean age was 44 years, body mass index 26 kg/m², and office BP 138/88 mmHg. Cardiac output was 7% higher in the youngest quartile than the oldest. With increasing age, aortic BP, pulse... -
Eight months of marathon school training reduced blood pressure, systemic vascular resistance and extracellular water volume
The effects of an eight-month marathon school training program on blood pressure (BP) and underlying hemodynamics were examined in 45 participants and 43 controls. Hemodynamics were recorded using whole-body impedance cardiography, radial tonometric pulse wave analysis, and third-finger BP measurements during passive head-up tilt. The mean ages were 40.9 and 42.2 years, and body mass indexes (BMI) 25.1 and 25.8 kg/m², respectively. Marathon training decreased mean weight (-1.6 kg), fat... -
High variability in the reproducibility of key hemodynamic responses to head-up tilt
Increased blood pressure upon standing is considered a cardiovascular risk factor. We investigated the reproducibility of changes in aortic blood pressure, heart rate, stroke volume, cardiac output, and systemic vascular resistance during three passive head-up tilts (HUT) in 223 participants without cardiovascular medications (mean age 46 yr, BMI 28 kg/m², 54% male). The median time gap between the first and the second HUT was 9 wk and the second and the third HUT was 4 wk. We utilized whole...
2024
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Haemodynamics of hyperthyroidism: increased cardiac work and findings related to vasodilatation
CONCLUSIONS: Hyperthyroid patients exhibited hyperdynamic circulation, reduced vascular resistance, reduced peripheral but not central blood pressure, and higher pulse pressure amplification. Furthermore, left cardiac workload was increased in parallel with unfavourable changes in coronary perfusion conditions. -
Targeted Treatment Reverses Increased Left Cardiac Work in Unilateral vs. Bilateral Primary Aldosteronism
CONCLUSIONS: These results suggest that unilateral PA burdens the heart more than bilateral PA, providing a possible explanation for the higher incidence of cardiac complications in unilateral disease. A similar reduction in aldosterone-induced volume excess was obtained with targeted surgical and medical treatment of PA. -
Volume overload is a major characteristic in primary aldosteronism: a 3-year follow-up study
CONCLUSION: Compared with essential hypertension, the principal haemodynamic difference in primary aldosteronism was higher volume load. Volume excess elevated forward wave amplitude, which was subsequently reduced by targeted treatment of primary aldosteronism, along with normalization of volume load. We propose that incorporating extracellular water evaluation alongside routine diagnostics could enhance the identification and diagnosis of primary aldosteronism. -
Differences in heart rate responses to upright posture are associated with variations in the high-frequency power of heart rate variability
High resting heart rate is a cardiovascular risk factor, but limited data exist on the underlying hemodynamics and reproducibility of supine-to-upright increase in heart rate. We recorded noninvasive hemodynamics in 574 volunteers [age, 44.9 yr; body mass index (BMI), 26.4 kg/m²; 49% male] during passive head-up tilt (HUT) using whole body impedance cardiography and radial artery tonometry. Heart rate regulation was evaluated using heart rate variability (HRV) analyses. Comparisons were made...
2023
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Blood Haemoglobin Concentration Is Directly and Independently Related with Pulse Wave Velocity, a Measure of Large Artery Stiffness
High haemoglobin level has been associated with metabolic syndrome, elevated blood pressure (BP), and increased mortality risk. In this cross-sectional study, we investigated the association of blood haemoglobin with haemodynamics in 743 subjects, using whole-body impedance cardiography and pulse wave analysis. The participants were allocated to sex-stratified haemoglobin tertiles with mean values 135, 144, and 154 g/L, respectively. The mean age was similar in all tertiles, while body mass... -
Differences in heart rate responses to upright posture are associated with variations in the high-frequency power of heart rate variability
High resting heart rate is a cardiovascular risk factor, but limited data exist on the underlying hemodynamics and reproducibility of supine-to-upright increase in heart rate. We recorded noninvasive hemodynamics in 574 volunteers [age, 44.9 yr; body mass index (BMI), 26.4 kg/m²; 49% male] during passive head-up tilt (HUT) using whole body impedance cardiography and radial artery tonometry. Heart rate regulation was evaluated using heart rate variability (HRV) analyses. Comparisons were made... -
Low length-for-age Z-score within 1 month after birth predicts hyperdynamic circulation at the age of 21 years in rural Malawi
Low birth weight predisposes to the development of hypertension in middle- and high-income countries. We examined the relation of early life length-for-age score (Z-score) on cardiovascular function in young adults in Malawi, a low-income country. Capture of supine, seated, and standing brachial pulse waveforms (Mobil-O-Graph) were performed in 223 females and 152 males (mean age 21 years), and analyzed according to the length-for-age Z-score tertiles during the first month of life. Plasma LDL... -
Ambulatory daytime blood pressure versus tonometric blood pressure measurements in the laboratory: effect of posture
CONCLUSION: BP responses to upright posture were variable. When compared with ambulatory BP, mean(supine+upright) laboratory cutoff 136/82 mmHg classified 76% of subjects similarly as normotensive or hypertensive. In the remaining 24% the discordant results may be attributed to white-coat or masked hypertension, or higher physical activity during out-of-office recordings. -
The characteristics of elevated blood pressure in abdominal obesity correspond to primary hypertension: a cross-sectional study
CONCLUSION: Higher waist:height ratio was associated with elevated blood pressure, systemic vascular resistance, and arterial stiffness, but not with alterations in cardiac sympathovagal modulation or activation of the circulating renin-angiotensin-aldosterone system. Although obesity-related elevation of blood pressure has distinct phenotypic features, these results suggest that its main characteristics correspond those of primary hypertension. -
Urine sodium excretion is related to extracellular water volume but not to blood pressure in 510 normotensive and never-treated hypertensive subjects
CONCLUSION: In the absence of mineralocorticoid excess, Na^(+) intake, as evaluated from 24-h Na^(+) excretion, predominantly influences extracellular water volume without a clear effect on blood pressure.
2022
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Resting heart rate predicts cardiac autonomic modulation during passive head-up tilt in subjects without cardiovascular diseases
Background Resting heart rate (HR) and its variability (HRV) reflects the cardiac sympathovagal balance that is stimulated by head-up tilting. HRV is influenced by the level of HR, but how much HRV offers additional information about cardiac autonomic tone than HR alone remains unresolved. We examined the relation of resting HR with HRV during head-up tilt. Methods. Hemodynamics of 569 subjects without known cardiovascular diseases and medications with direct cardiovascular effects were recorded... -
Posture-Related Differences in Cardiovascular Function Between Young Men and Women: Study of Noninvasive Hemodynamics in Rural Malawi
Background Cardiovascular risk is higher in men than in women, but little information exists about sex-related differences in cardiovascular function from low-income countries. We compared hemodynamics between sexes in rural Malawi in a cohort followed up since their birth. Methods and Results Supine, seated, and standing hemodynamics were recorded from 251 women and 168 men (mean age, 21 years; body mass index, 21 kg/m²) using oscillometric brachial waveform analyses (Mobil-O-Graph). The... -
Disparate Information Provided by Pulse Wave Velocity versus Other Measures of Aortic Compliance in End-Stage Renal Disease
CONCLUSION: In the absence of differences in PWV, higher aortic pulse pressure and characteristic impedance, and lower ratio of stroke index to aortic pulse pressure, suggest reduced aortic compliance and impaired left ventricular function in CKD patients. A lower subendocardial viability ratio predisposes the CKD patients to impaired cardiac oxygen supply versus hypertensive patients and nonmedicated controls.
2021
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Disparate Information Provided by Pulse Wave Velocity versus Other Measures of Aortic Compliance in End-Stage Renal Disease
CONCLUSION: In the absence of differences in PWV, higher aortic pulse pressure and characteristic impedance, and lower ratio of stroke index to aortic pulse pressure, suggest reduced aortic compliance and impaired left ventricular function in CKD patients. A lower subendocardial viability ratio predisposes the CKD patients to impaired cardiac oxygen supply versus hypertensive patients and nonmedicated controls. -
Individual changes of central blood pressure in response to upright posture: different hemodynamic phenotypes
CONCLUSION: In participants without cardiovascular disease, the changes in central SBP during orthostatic challenge are not uniform. One-third presented with higher upright than supine aortic SBP with underlying differences in the regulation of systemic vascular resistance and cardiac output. These findings emphasize that resting blood pressure measurements give only limited information about the blood pressure status. -
Plasma uric acid is related to large arterial stiffness but not to other hemodynamic variables: a study in 606 normotensive and never-medicated hypertensive subjects
CONCLUSIONS: PUA concentration was independently and directly associated with large arterial stiffness in individuals without cardiovascular disease and PUA levels predominantly within the normal range. Trial registration ClinicalTrials.gov NCT01742702. -
Parathyroid hormone may play a role in the pathophysiology of primary hypertension
Parathyroid hormone has been related with the risk of hypertension, but the matter remains controversial. We examined the association of parathyroid hormone with central blood pressure and its determinants in 622 normotensive or never-treated hypertensive subjects aged 19-72 years without diabetes, cardiovascular or renal disease, or cardiovascular medications. The methods were whole-body impedance cardiography and analyses of pulse wave and heart rate variability. Cardiovascular function was...