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First in man measurement of arterial stiffness using a connected bathroom scale: Calibration against SphygmoCor

Authors:
Artery Research
ISSN (Online): 1876-4401 ISSN (Print): 1872-9312
Journal Home Page: https://www.atlantis-press.com/journals/artres
PO-35: FIRST IN MAN MEASUREMENT OF ARTERIAL
STIFFNESS USING A CONNECTED BATHROOM SCALE:
CALIBRATION AGAINST SPHYGMOCOR
Pierre Boutouyrie, Hakim Khettab, David Campo, Roger Yu, Nadine Buard
To cite this article: Pierre Boutouyrie, Hakim Khettab, David Campo, Roger Yu, Nadine
Buard (2016) PO-35: FIRST IN MAN MEASUREMENT OF ARTERIAL STIFFNESS USING A
CONNECTED BATHROOM SCALE: CALIBRATION AGAINST SPHYGMOCOR, Artery
Research 16:C, 9898, DOI: https://doi.org/10.1016/j.artres.2016.08.038
To link to this article: https://doi.org/10.1016/j.artres.2016.08.038
Published online: 7 December 2019
4
School of Dietetics and Human Nutrition, McGill University, Sainte-Anne-
de-Bellevue, Canada
5
Department of Pharmaceutical Science, Faculty of Pharmacy, Universite
´de
Montre
´al, Montreal, Canada
6
Division of Internal Medicine, Department of Medicine, McGill University,
Montreal, Canada
Introduction: Calcium intake, recommended for osteoporosis prevention,
has been associated with cardiovascular (CV) outcomes. We examined the
association of dietary calcium intake (dCa) with surrogate CV markers,
including carotid intima-media thickness (cIMT), arterial stiffness and hemo-
dynamics in healthy postmenopausal women.
Methods: Healthy postmenopausal women without any CV risk factors, from a
randomized controlled trial studying the effect of calcium supplementation
vs. dietary calcium on vascular heath, were recruited. Cross-sectional analyses
of baseline data of the participants are presented. Peripheral systolic and dia-
stolic bloodpressures (pSBP, pDBP)were measured by BpTRU.cIMT of both com-
mon-carotid arteries was measured by B-mode ultrasonography (Philips-iU22).
Arterial stiffness (carotid-to-femoral pulse wave velocity [cfPWV] and carotid-
to-radial PWV), central SBP and DBP (cSBP, cDBP), mean arterial pressure
(MAP), and hemodynamic parameters (pulse pressure, augmentation pressure,
augmentation indexcorrected for 75 bpm) wereobtained non-invasively (Sphyg-
moCor). Usual dCa intakewas estimated usinga validated food frequency ques-
tionnaire. Measurements were compared across groups (<600, 600-1000 and
>1000 mg/day of dCa) by one-way analysis of variance and covariance.
Results: We evaluated 83 postmenopausal women (mean age 60.46.3
years; BMI 25.63.8 kg/m
2
). Mean dCa was 857333 mg/day. Although
within normal range, vascular parameters had a non-significant, U-shaped
relationship with dCa. In unadjusted analyses, women with dCa >1000
mg/day had significantly higher cfPWV, pSBP, cSBP, and MAP compared to
those with 600-1000 mg/day; however, significance was lost for all other pa-
rameters except for MAP after adjustment for pertinent covariates (Table).
Conclusion: In healthy postmenopausal women, a non-significant, U-shaped
relationship of vascular parameters across the 3 dCa groups was noted; die-
tary calcium may have favourable effect on MAP for those consuming 600-
1000 mg/day compared to >1000 mg/day intake. Of note, our population
had optimal/normal BP. Our ongoing study including a larger sample-size
will determine the relationship between dCa and surrogate CV markers.
PO-33
STATIN THERAPY IN RHEUMATOID ARTHRITIS MAY IMPROVE ARTERIAL
STIFFNESS IN WOMEN BUT NOT IN MEN: A PRELIMINARY ANALYSIS
Yessica-Haydee Gomez
1
, Shubhabrata Das
2
, Jessica Gorgui
1
,
Ines Colmegna
3
, Stella S. Daskalopoulou
1,2,4
1
Cardiovascular Health Across Lifespan Program, Research Institute of the
McGill University Health Centre, Montreal, Quebec, Canada
2
Division of Experimental Medicine, Department of Medicine, Faculty of
Medicine, McGill University, Montre
´al, Que
´bec, Canada
3
Division of Rheumatoid Arthritis, Department of Medicine, Faculty of
Medicine, Research Institute of the McGill University Health Centre,
Montre
´al, Que
´bec, Canada
4
Division of Internal Medicine, Department of Medicine, Faculty of
Medicine, McGill University Health Centre, Montre
´al, Que
´bec, Canada
Objectives: Patients with rheumatoid arthritis are at increased risk for car-
diovascular disease. Statins have anti-inflammatory and immunomodulatory
effects, thereby reducing cardiovascular risk. Arterial stiffness is a compos-
ite indicator of cardiovascular health and a predictor of cardiovascular risk.
We assessed the effect of statin therapy on arterial stiffness and hemody-
namics in subjects with rheumatoid arthritis.
Methods: A prospective cohort study including adults with rheumatoid
arthritis and an indication for statin therapy (cases) or not (controls) is being
conducted. Peripheral systolic and diastolic blood pressures were measured
by BpTRU. Arterial stiffness (carotid-to-femoral pulse wave velocity [cfPWV]
and carotid-to-radial PWV), central systolic and diastolic blood pressures,
mean arterial pressure, and augmentation index corrected for 75 bpm were
obtained non-invasively (SphygmoCor, AtCor, Australia). All measurements
were performed prior to statin initiation and at 6-month post-treatment. In-
dependent t-tests evaluated differences in changes between groups. Carotid
intima-media thickness (cIMT) measurements were also performed.
Results: To date, 14 subjects (mean age 61.49.5 years, 9 females), have
completed the study. All cases achieved recommended lipid level targets
by 6 months. There were no statistical differences in patient characteristics
(beyond lipid levels) at baseline or 6-months between cases and controls
among the whole cohort. In sex-specific analyses, statin therapy was associ-
ated with a significant decrease in cfPWV in women taking statins compared
to women in the control group (-0.710.18 m/s vs +0.961.13 m/s, respec-
tively; p<0.05), which was not observed in men. No other associations were
observed. cIMT analyses are underway.
Conclusion: Our preliminary results suggest that in women with rheumatoid
arthritis,statin therapy may reducecfPWV, a predictive marker of cardiovascu-
lar diseaseand events, which was notobserved in men. Whethersex differences
in the effect of statinon arterial stiffnessare sustained with a larger samplesize
of rheumatoid arthritis patients will be addressed in our ongoing study.
PO-35
FIRST IN MAN MEASUREMENT OF ARTERIAL STIFFNESS USING A
CONNECTED BATHROOM SCALE: CALIBRATION AGAINST SPHYGMOCOR
Pierre Boutouyrie, Hakim Khettab, David Campo, Roger Yu, Nadine Buard
AP-HP, Pharmacology Unit, Ho
ˆpital Europe
´en Georges Pompidou, INSERM,
U970, Paris Cardiovascular Research CenterdPARCC, University Paris
Descartes, Sorbonne Paris Cite
´, Paris, Withings, Issy le Moulineaux, France
Background: Measurement of arterial stiffness (AS) is still considered difficult. We
developed a non- invasive technique to assess AS from a connected bathroom
scale, based on ballistocardiography (BCG) and impedance plethysmography
(IPG).
Methods: We included 192 subjects and patients, 106 for calibration study
(cal), 86 for validation study (val), 33% hypertensives, mean age 4817
years, 48% women. The scale pulse transit time (WS- PTT) was calculated
as the difference between BCG systolic signals and IPG blood flow in the
foot. Distance was estimated from body height and PWV was calculated. Ca-
rotid to femoral transit time (CF-PTT) was measured using SphygmoCor.
Spearman and robust multivariate regressions were used.
Results: The WS-PTT correlated well with CF-PTT with RZ0.73 in pooled
population (cal 0.79, val 0.66). WS-PWV correlated with CF-PWV with
RZ0.76 (cal 0.80, val 0.70). The standard deviation of difference was 1.39
m/s with a bias of 0.25 m/s compared with CF-PWV. Correlations of WS-
PWV with age and blood pressure were similar (RZ0.72 and 0.59, resp.)
to those of CF-PWV (RZ0.67 and 0.61, resp.). These good correlations
were non-trivial given the differences in wave paths, the fact that measure-
ments are made in orthostatic position and totally investigator-free.
Conclusion: We show in two distinct populations that a simple user-oriented
instrument such as a connected bathroom scale can estimate arterial stiff-
ness with accuracy close to healthcare-oriented systems. Because these de-
vices will be used by the general population, the availability of arterial
stiffness data on very large, non-medicalized populations will change our
management of well-being and health.
PO-36
EFFECTS OF FIXED VERSUS AUTO-TITRATING CONTINUOUS POSITIVE
AIRWAY PRESSURE ON VASCULAR FUNCTION IN PATIENTS WITH
RESISTANT HYPERTENSION AND OBSTRUCTIVE SLEEP APNEA
Karen Tran
1
, R. J. Kimoff
2,3
, S. S. Daskalopoulou
2
1
Department of Medicine, University of British Columbia, Vancouver, British
Columbia, Canada
2
Department of Medicine, Faculty of Medicine, McGill University, Montreal,
Quebec, Canada
3
Respiratory Division and Sleep Laboratory, McGill University Health
Centre, Montreal, Quebec, Canada
Introduction: Obstructive sleep apnea (OSA) is a common cause of resistant
hypertension. We investigated the effects of 2 modalities of positive airway
pressure; fixed continuous airway pressure (fCPAP) versus auto-titrating pos-
itive airway pressure (APAP) on arterial function in subjects with resistant
hypertension and severe OSA.
Objective: To assess in participants with resistant hypertension and OSA the
effects of fCPAP vs. APAP on 24h ambulatory blood pressure monitoring
(ABPM), as well as sleep indices, heart rate variability (HRV), and arterial
stiffness.
Methods: We randomized 14 subjects (5611 years, baseline SBP and
DBP 13710 and 7712 mm Hg, respectively, apnea-hypopnea index
[AHI] 5831 events/h, Epworth sleepiness scale 75) to fC PAP or APAP
for 6 weeks, followed by crossover to the other modality for another
6 weeks. Overnight polysomnography, 24h ABPM, HRV, and carotid-
femoral pulse wave velocity (cfPWV, arterial stiffness ‘gold-
98 Abstracts
... [3][4][5][6][7][8][9][10] PWV has traditionally been measured in a controlled setting using a Sphygmometer and applanation tonometry but can now be accurately measured out-of-the-office using smart weight scales. 11,12 Similarly, BP, a powerful contributor to cardiovascular disease, 13 is still measured predominantly in a clinical setting but can now be measured accurately at home using wireless BP monitors. In fact, the American College of Cardiology and American Heart Association 2017 guidelines recommend taking BP measurements at home, citing strong evidence that an individual's BP outside the clinical setting is more predictive of health outcomes. ...
Article
Full-text available
Cardiovascular disease remains the leading cause of death and disease worldwide. As demands on an already resource-constrained healthcare system intensify, disease prevention in the future will likely depend on out-of-office monitoring of cardiovascular risk factors. Mobile health tracking devices that can track blood pressure and heart rate, in addition to new cardiac vital signs, such as physical activity level and pulse wave velocity (PWV), offer a promising solution. An initial barrier is the development of accurate and easily-scalable platforms. In this study, we made a customized smartphone app and used mobile health devices to track PWV, blood pressure, heart rate, physical activity, sleep duration, and multiple lifestyle risk factors in ≈250 adults for 17 continual weeks. Eligible participants were identified by a company database and then were consented and enrolled using only a smartphone app, without any special training given. Study participants reported high overall satisfaction, and 73% of participants were able to measure blood pressure and PWV, <1 hour apart, for at least 14 of 17 weeks. The study population's blood pressure, PWV, heart rate, activity levels, sleep duration, and the interrelationships among these measurements were found to closely match either population averages or values obtained from studies performed in a controlled setting. As a proof-of-concept, we demonstrated the accuracy and ease, as well as many challenges, of using mHealth technology to accurately track PWV and new cardiovascular vital signs at home.
... Because of the relative inaccessibility of high-quality applanation tonometry for measuring cfPWV, simpler methods have been developed, including the Mobil-O-Graph ® system (IEM GmbH, Stolberg, Germany) [9,10] and the Arteriograph ® system (TensioMed Kft., Budapest, Hungary) [11] (both estimating aortic PWV from the oscillometric determination of the brachial artery waveform), the pOpmetre ® system (Axelife SAS, Saint Nicolas de Redon, France) that measures the finger-toe transit time overlapping the aortic pathway [12] , and a connected bathroom scale (Withings, Issy-les-Moulineaux, France) using ballistocardiography and impedance photoplethysmography [13] . ...
Article
In a recently published paper, Greve et al [J Hypertens 2016;34:1279-1289] investigate whether the estimated carotid-femoral pulse wave velocity (ePWV), calculated using an equation derived from the relationship between carotid-femoral pulse wave velocity (cfPWV), age, and blood pressure, predicts cardiovascular disease (CVD) as good as the measured cfPWV. Because ePWV predicts CVD as good as cfPWV, some might wonder whether ePWV could be replaced by cfPWV, which is a time-consuming measurement requiring an expensive apparatus. This question is addressed in this mini-review.
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