Thomas Weber

Thomas Weber
Klinikum Wels-Grieskirchen · Department of Cardiology

About

201
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Publications

Publications (201)
Article
Background Central SBP purports to aid hypertension management. This concept is founded on cross-sectional studies; however, findings are mixed and few report longitudinal relationships between changes in blood pressure (BP) and outcomes. This study aimed to determine associations of changes in brachial BP and central BP with changes in left ventri...
Article
The prevalence of systolic hypertension phenotypes based on simultaneous 24-h brachial (br) and aortic (ao) ambulatory blood pressure monitoring (ABPM) remains unknown. We sought to describe their prevalence and associations with hypertension mediated organ damage (HMOD). Participants with 24-h br and ao ABPM, carotid ultrasound and echocardiograph...
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Pulsatile hemodynamics have been shown to be independent predictors of cardiovascular events. The aim of the current study was to describe four pulsatile hemodynamic markers in a large, well-established, population-based cohort and to provide reference equations for sex- and age-based standardization of these measurements. 6828 adult participants f...
Article
George L. Bakris passed away on June 15, 2024 at the age of 72 years. This obituary aims at honoring his life and career by describing the stages in his personal and professional pathway, presenting some of his many remarkable accomplishments, and highlighting his exceptional clinical skills, mentorship, and friendship.
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Renal sympathetic denervation (RDN) is an interventional supplement to medical treatment in patients with arterial hypertension. While the first sham-controlled trial, SYMPLICITY HTN‑3 was neutral, with improved procedural details, patient selection and follow-up, recent randomized sham-controlled trials of second-generation devices show a consiste...
Article
Arterial hypertension is a major risk factor for cardiovascular morbidity and mortality, and highly prevalent in older age, underscoring the importance of its appropriate management. The population is ageing at an increasing rate, with those aged 80+ years being the fastest growing population characterized by high heterogeneity in terms of function...
Article
Background and objective Central blood pressure (BP) measurement purports to aid hypertension management. This concept is founded on cross-sectional studies, however, findings are mixed and none report longitudinal relationships between changes in BP and outcomes. This study aimed to determine associations of changes in cuff BP and central BP with...
Article
Full-text available
George L. Bakris passed away on 15 June 2024 at the age of 72 years. This obituary aims at honouring his life and career by describing the stages in his personal and professional pathway, presenting some of his many remarkable accomplishments, and highlighting his exceptional clinical skills, mentorship, and friendship.
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PLAIN LANGUAGE SUMMARY What is the context? Hypertension is a strong independent risk factor for development of chronic kidney disease (CKD) and progression of CKD to ESKD. Improved adherence to the guidelines in the treatment of CKD is believed to provide further reduction of cardiorenal events. European Society of Hypertension Excellence Centres...
Article
Background We aimed to determine the influence of coronavirus disease 2019 (COVID-19) pandemic on blood pressure (BP) control assessed by ambulatory blood pressure monitoring (ABPM). Methods Office BP and ABPM data from two visits conducted within a 9–15 months interval were collected from patients treated for hypertension. In the prepandemic grou...
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Vascular ageing is the deterioration of arterial structure and function which occurs naturally with age, and which can be accelerated with disease. Measurements of vascular ageing are emerging as markers of cardiovascular risk, with potential applications in disease diagnosis and prognosis, and for guiding treatments. However, vascular ageing is no...
Article
Rationale: Preserved ratio impaired spirometry (PRISm) is a recently recognized spirometric pattern defined by a ratio of forced expiratory volume in 1 second to forced vital capacity of at least 0.70 and a forced expiratory volume in 1 second <80% of reference. For unclear reasons, PRISm is associated with increased cardiovascular (CV) morbidity a...
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Objective There is considerable controversy concerning the physiology and prognostic significance of isolated systolic hypertension (ISH) in youth. We sought to address this by pooling hemodynamic and echocardiographic data from participants up to 40 years in a large international academic research consortium. Design and method In all 18 centers,...
Article
Objective The COVID-19 pandemic had a huge impact on access to healthcare and on the presence of follow-up visits in ambulatory care. This study evaluated the influence of the COVID-19 pandemic on blood pressure (BP) control and phenotypes as assessed by office and 24-hour ambulatory BP monitoring (ABPM). Design and method Clinical and BP data wer...
Article
Objective Brachial and central systolic blood pressure (BP) is different, which may have implications for BP classification and cardiovascular risk stratification. We investigated the association between BP phenotypes, based on brachial versus central SBP, and left ventricular mass, an important intermediate endpoint in hypertension. Design and me...
Article
Objective Hypertension (HTN) is the main cause of premature death worldide. Previous studies in Portugal, Austria and Spain have shown that estimating arterial stiffness in Community Farmacies (CPh) improves its management. The main objective is to evaluate whether empowering hypertensive subjects by determining arterial stiffness in CPh increases...
Article
Objective To describe the prevalence of systolic hypertension phenotypes based on simultaneous 24hr ambulatory blood pressure monitoring (ABPM) of the brachial (br) and aortic (ao) systolic pressure, as well as their association with left ventricular hypertrophy (LVH), using data from the international 24hr aortic blood pressure consortium (i24ABC)...
Article
Objective Treatment specificities of hypertension in older adults remains a matter of debate. We therefore investigated the clinical practices on the treatment of hypertension in adults >75 years in ESH Excellence Centres (EC). Design and method A survey with 24 questions was developed by the Working Group Hypertension in Older Adults and addresse...
Article
Objective Healthcare providers are faced with an increasing number of patients with obesity and arterial hypertension. Preventing obesity-associated hypertension and appropriately managing patients with established disease are both important. Hence, the aim of our study was to evaluate the clinical care of patients with obesity and hypertension amo...
Article
Objective To describe the prevalence of systolic hypertension phenotypes according to simultaneous 24hr brachial systolic pressure (br) and aortic (ao) ambulatory blood pressure monitoring (ABPM) and their association with carotid and left ventricular damage, using data from the NoninvaSive Aortic ambulatory blood pressure monitoring for the detect...
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Background Healthcare providers are faced with an increasing number of patients with obesity and arterial hypertension. Preventing obesity-associated hypertension and appropriately managing patients with established disease are both important. Hence, the aim of our study was to evaluate the clinical care of patients with obesity and hypertension am...
Article
BACKGROUND Arterial stiffness, as measured by arterial pulse wave velocity (PWV), is an established biomarker for cardiovascular risk and target-organ damage in individuals with hypertension. With the emergence of new devices for assessing PWV, it has become evident that some of these devices yield results that display significant discrepancies com...
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Purpose To describe the history of the Excellence Centre (EC) programme of the European Society of Hypertension (ESH) since the beginning in 2006, its achievements, and its future developments. Materials and Methods We list the number of ECs per country, the research projects performed so far, and the organisational steps needed to reshape the EC...
Article
Objective: Hypertension management is directed by cuff blood pressure (BP), but this may be inaccurate, potentially influencing cardiovascular disease (CVD) events and health costs. This study aimed to determine the impact on CVD events and related costs of the differences between cuff and invasive SBP. Methods: Microsimulations based on Markov...
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Document Reviewers Luis Alcocer (Mexico), Christina Antza (Greece), Mustafa Arici (Turkey), Eduardo Barbosa (Brazil), Adel Berbari (Lebanon), Luís Bronze (Portugal), John Chalmers (Australia), Tine De Backer (Belgium), Alejandro de la Sierra (Spain), Kyriakos Dimitriadis (Greece), Dorota Drozdz (Poland), Béatrice Duly-Bouhanick (France), Brent M. E...
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Objective Central systolic blood pressure (cSBP) may be closer associated with hypertensive organ damage, namely left ventricular mass (LVM) and hypertrophy (LVH), as compared to brachial SBP (bSBP), and 24hour ambulatory SBP may be closer associated with LVM and LVH, as compared to office SBP. We sought to address this by pooling data from 21 cent...
Article
Objective The diagnostic approach as well as drug treatment algorithms for hypertensive urgencies(HU), hypertensive emergencies(HE) and malignant hypertension(MH)may be different across Europe,which may also be true for the knowledge of recently updated scientific information. We aimed to explore these items in the Excellence Center(EC)network of t...
Article
Objective Transition refers to the process of changeover from pediatric to adult health care. In the light of the increasing prevalence of arterial hypertension in children and adolescents we aimed to assess transition practices from pediatric to adult health care among Excellence Centres of the European Society of Hypertension (ESH). Design and m...
Article
Objective We aimed to assess the impact of the COVID-19 pandemic on blood pressure (BP) control assessed by office and ambulatory blood pressure monitoring (ABPM) in patients with treated hypertension. Design and method Clinical and BP data were collected from 32 centres including Excellence Centres of the European Society of Hypertension. Two gro...
Article
Objective Vascular aging (VA) is an important and prognostically relevant aspect of biological aging. Its determinants are incompletely understood, and a holistic view is missing. Design and method The LEAD (Lung, Heart, Social, Body) study is an ongoing, longitudinal, population-based observational study, which started in 2011 in Vienna and six v...
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Background: Vascular age (VA) is independent and chronological age for assessing cardiovascular disease (CVD) risk. However, tools for the implementation of VA are currently lacking. We aimed to develop a questionnaire to assess the current knowledge gaps related to VA and barriers to its implementation in routine practice. Methods: Using a step...
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Purpose The coronavirus disease 2019 (COVID-19) pandemic and the subsequent lockdown profoundly affected almost all aspects of daily life including health services worldwide. The established risk factors for increased blood pressure (BP) and hypertension may also demonstrate significant changes during the pandemic. This study aims to determine the...
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Background: Pressure wave reflections (PWRs) within the circulation are assessed at various arterial sites by various noninvasive methods. We aimed at reviewing the conflicting data regarding the hypothesis that higher PWRs are associated with higher left ventricular mass and tested whether this association stands for all available indices of PWRs...
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Arterial hypertension is a global burden leading to over 10.8 million deaths per year worldwide. May Measurement Month (MMM) is a global project initiated by the International Society of Hypertension to raise the awareness of high blood pressure (BP) in the population. Following the MMM protocol 2508 participants ≥18 years had their BP measured in...
Article
Background Accurate blood pressure (BP) measurement is critical for optimal cardiovascular risk management. Age-related trajectories for cuff-measured BP accelerate faster in women compared with men, but whether cuff BP represents the intraarterial (invasive) aortic BP is unknown. This study aimed to determine the sex-differences between cuff BP, i...
Article
Objective: Heart failure with reduced ejection fraction (HFrEF) is a significant health problem. Early diagnosis, using widely available, cheap methods, remains an important goal. Therefore, we investigated whether individuals with normal left ventricular ejection fraction (EF) can be discriminated from patients with reduced EF with contemporary,...
Article
Objective: The Covid-19 pandemic necessitated a decrease in non-Covid-19 related diagnostic and therapeutic procedures in many countries. We explored the impact on hypertension care in the Excellence Center (EC) network of the European Society of Hypertension. Design and method: We conducted an electronic survey regarding 6 key procedures in hyp...
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Objective: Despite current evidence demonstrating the important role of Vascular ageing (VA) in cardiovascular risk assessment, its awareness and mostly implementation in everyday practice still lags significantly. To effectively assess the need for future target strategies for health providers, a qualitative questionnaire was developed. The aim o...
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Background: Renal denervation (RDN) lowers blood pressure (BP), but BP response is variable in individual patients. We investigated whether measures of pulsatile hemodynamics, obtained during 24-hour ambulatory BP monitoring, predict BP drop following RDN. Methods: From the randomized, sham-controlled SPYRAL HTN-OFF MED Pivotal trial, we perform...
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Background The Covid-19 pandemic necessitated a decrease in non-Covid-19 related diagnostic and therapeutic procedures in many countries. We explored the impact on tertiary hypertension care. Methods We conducted an electronic survey regarding 6 key procedures in hypertension care within the Excellence Center network of the European Society of Hyp...
Chapter
Measurements of arterial stiffness and pulsatile hemodynamics undoubtedly led to enormous progress in our understanding of cardiovascular physiology, aging, and development of diseases. Until very recently, these measurements were confined primarily to research laboratories and hospitals and less to the doctor's office. In contrast, we know from th...
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Central (aortic) systolic blood pressure (cSBP) is the pressure seen by the heart, the brain, and the kidneys. If properly measured, cSBP is closer associated with hypertension-mediated organ damage and prognosis, as compared with brachial SBP (bSBP). We investigated 24-hour profiles of bSBP and cSBP, measured simultaneously using Mobilograph devic...
Article
Background The renin-angiotensin-aldosterone system plays a key role in blood pressure (BP) regulation and is the target of several anti-hypertensive medications. Renal denervation (RDN) is thought to interrupt the sympathetic-mediated neurohormonal pathway as part of its mechanism of action to reduce BP. Objectives To evaluate plasma renin activi...
Article
Objective Vascular aging is an attractive concept for simplified risk stratification. Longitudinal data regarding its predictive value, additive to traditional and new risk factors, are sparse. Design and method We recently established population-based reference values for healthy (HVA), normal (NVA) and early (EVA) vascular aging in the Heinz Nix...
Article
Objective To investigate whether hemodynamic measures obtained during regular 24-hour blood pressure (BP) monitoring may predict BP response to renal denervation (RDN) using the SYMPLICITY SPYRAL renal denervation system. Design and method This was a post-hoc analysis from the SPYRAL HTN-OFF MED pilot and pivotal trials. We used the raw BP wavefor...
Article
Isolated systolic hypertension (ISH) is the most common form of hypertension and is highly prevalent in older people. We recently showed differences between upper-arm cuff and invasive blood pressure (BP) become greater with increasing age, which could influence correct identification of ISH. This study sought to determine the difference between id...
Article
Aortic pulse wave velocity (PWV) is directly related to arterial stiffness. Different methods for the determination of PWV coexist. The aim of this prospective study was to evaluate the prognostic value of PWV in high-risk patients with suspected coronary artery disease undergoing invasive angiography and to compare 3 different methods for assessin...
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In December 2019, an outbreak of pneumonia caused by a novel Coronavirus (COVID-19) spread rapidly worldwide. Although the clinical manifestations of COVID-19 are dominated by respiratory symptoms, the cardiovascular system is extensively affected at multiple levels. Due to the unprecedented consequences of the COVID-19 pandemic, the ARTERY society...
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Background: Steady state hemodynamics [Stroke Volume - SV, cardiac output, peripheral resistance (Rp)] have attracted researchers in hypertension for decades. However, due to technical difficulties, they never entered clinical medicine. Objective: To investigate the performance of a model-based algorithm, utilizing brachial pressure waveforms obtai...
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Introduction: Arterial properties are linked to the presence and severity of coronary artery disease (CAD). Coronary blood flow is strongly and inversely related to arterial stiffness. Thus, the aim of this prospective study was to evaluate the prognostic value of PWV in high-risk patients with suspected CAD and to compare three different methods f...
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Background: Accurate measurement of cuff systolic BP (SBP) and diastolic BP (DBP) is contingent on the assumption of oscillometric MAP being accurate. If MAP is inaccurate this is likely to impact the accuracy of cuff SBP and DBP, but this has never been determined and was the aim of the study. Methods: In five independent studies, MAP was measured...
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Introduction: Isolated systolic hypertension (ISH) is the most common form of hypertension in older people. However, accurate identification of ISH may be hindered because cuff blood pressure (BP) underestimates systolic BP (SBP) and overestimates diastolic BP (DBP). This study aimed to determine the influence of cuff BP accuracy on the identificat...
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Background: Cuff blood pressure (BP) is intended to approximate central aortic BP and accuracy is paramount. Sex differences in BP physiology could influence the accuracy of cuff BP as an estimate of invasive aortic BP, but this has not been explored in-depth and was the aim of this study. Methods: Cuff and invasive aortic BP were measured in 1701...
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Background: There is evidence of a closer relation between 24 hour aortic systolic blood pressure (aSBP) and left ventricular mass (LVM) compared with 24 hour brachial SBP. However, sample sizes are relatively small and there is some inconsistency in findings. We sought to address this by pooling data from 16 centers in Asia, Europe and Latin Ameri...
Article
Blood pressure (BP) is a leading global risk factor. Increasing age is related to changes in cardiovascular physiology that could influence cuff BP measurement, but this has never been examined systematically and was the aim of this study. Cuff BP was compared with invasive aortic BP across decades of age (from 40 to 89 years) using individual-leve...
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Zusammenfassung Erhöhter Blutdruck bleibt eine Hauptursache von kardiovaskulären Erkrankungen, Behinderung und frühzeitiger Sterblichkeit in Österreich, wobei die Raten an Diagnose, Behandlung und Kontrolle auch in rezenten Studien suboptimal sind. Das Management von Bluthochdruck ist eine häufige Herausforderung für Ärztinnen und Ärzte vieler Fach...
Preprint
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This is a comment on Salvi et al. Hypertension 2019;74:117-129.
Preprint
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This is a preprint of a comment on an article of P. Salvi et al . published in JAHA: DOI: 10.1161/JAHA.118.011440
Article
Objectives: Three recently published sham-controlled studies proved the efficacy of renal denervation (RDN) in hypertensive patients. The study presented here analyzed a nationwide multicentre registry database to clarify which patient subgroups benefit most from radiofrequency RDN. Methods: This is a post hoc analysis from the multicentre Austr...
Article
Background: Pulsatile hemodynamics predict major cardiovascular events. We aimed to provide comprehensive population-based reference values and to compare different measures of pulsatile hemodynamics to define early vascular aging (EVA) as well as healthy vascular aging (HVA). Methods: In 2721 participants from the population-based Heinz Nixdorf...
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Full-text available
Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programs worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried o...
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Full-text available
Background: Wave reflection parameters predict cardiovascular events, but 24-hour profiles in large samples of healthy adults are unknown. Methods: In 1645 individuals free from antihypertensive drugs from 11 centers in Europe and Asia, 24-hour blood pressure monitoring with a validated oscillometric brachial cuff (Mobilograph, I.E.M., Stolberg; Ge...
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Background: Conventional brachial cuff BP is known to vary according to age and gender, but the influence of these factors on 24-hour ambulatory central BP is unknown. We sought to determine this in a large healthy population from 11 centers in Europe and Asia. Methods: 24-hour ambulatory BP using a validated oscillometric device (Mobilograph, I.E....
Article
Background: There is increasing evidence that the method of calibration directly influences the association between brachial systolic blood pressure (bSBP) and estimated aortic systolic blood pressure (aSBP) and subsequently affects prognostic and diagnostic differentiation power of the latter. Objective: The aim of this study was to investigate...
Article
We investigated the relationship between left ventricular mass, and brachial office as well as brachial and central ambulatory systolic blood pressure in 7 European centres. Central systolic pressure was measured with a validated oscillometric device, using a transfer function, and mean/diastolic pressure calibration. M-mode images were obtained by...
Article
The ejection duration (ED) is an important indicator of ventricular function as well as ventriculo-arterial coupling, especially for heart failure with reduced ejection fraction. Thus, the non-invasive oscillometric determination of ED from arterial pressure waves could enhance methods of pulse wave analysis. The aim of this work was to compare dif...
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Full-text available
Brachial cuff blood pressure (BP) is clinically important, but may be an inaccurate substitute for central BP. Many non-invasive devices have been developed that purport to estimate central BP from peripheral artery sites, yet with no standardized guidelines; the accuracy testing of these new devices has not been undertaken in a uniform fashion wit...
Article
We investigated the relationship between left ventricular mass and brachial office as well as brachial and central ambulatory systolic blood pressure in 7 European centers. Central systolic pressure was measured with a validated oscillometric device, using a transfer function, and mean/diastolic pressure calibration. M-mode images were obtained by...
Article
Full-text available
The original Riva-Rocci method to measure blood pressure (BP) using a cuff at the upper arm assumed the pressure obtained by this technique was a good proxy for central aortic BP.1,2 The clinical (prognostic) importance of brachial cuff BP is undeniable for both the assessment of cardiovascular risk associated with elevated BP and the benefits of t...