Re: Factors with Differential Effects on DBP and SBP

[Guest guest]

While this may be a semantic distinction, how about lowering SBP without lowering DBP? Isn't high SBP also bad?While I don't have a high degree of confidence in the BP meter at my dentist's office, and this is one rat anecdotal, but a recent reading of mine was higher SBP above my normal than the DBP was above normal while both were elevated. So the opposite of white coat hypertension is what, meditation ? Ommmmmm.JRPS: 137/76 is probably normal for ad libbers my age, but very high for me..On May 18, 2007, at 1:47 PM, Rodney wrote:SBP a HIGHER level of DBP

[Guest guest]

Hi Rodney,

How about exercise?

http://circ.ahajournals.org/cgi/content/full/104/2/221

Exercise Training Attenuates Age-Associated Diastolic Dysfunction in Rats

A. Brenner, MA; Carl S. Apstein, MD; Kurt W. Saupe, PhD

From the Cardiac Muscle Research Laboratory, Boston University School

of Medicine, Boston, Mass.

Correspondence to Kurt W. Saupe, PhD, Cardiac Muscle Research

Laboratory, 650 Albany St, X720, Boston, MA 02118. E-mail ksaupe@...

Background—— In contrast to systolic function, which is relatively

well preserved with advancing age, diastolic function declines

steadily after age 30. Our goal was to determine whether changes in

diastolic function that occur with aging could be reversed with

exercise training.

Methods and Results—— Adult (6-month-old) and old (24-month-old)

Fischer 344/BNF1 rats were studied after either 12 weeks of treadmill

training or normal sedentary cage life. Three aspects of diastolic

function were studied: (1) left ventricular (LV) filling in vivo via

Doppler echocardiograph, (2) LV passive compliance, and (3) the degree

of ischemia-induced LV stiffening. Maximal exercise capacity was lower

in the old rats (18±1 minutes to exhaustion on a standard treadmill)

than in the adult rats (25±1 minutes). Training increased exercise

capacity by 43% in the old rats and 46% in the adults (to 26±1 and

37±1 minutes, respectively). Echocardiographic indices of LV

relaxation were significantly lower in the old rats, but with

training, they increased back to the levels seen in the adults. LV

stiffness measured in the isolated, perfused hearts was not affected

by age or training. Also in the isolated hearts, the LV stiffened more

rapidly during low-flow ischemia in the old hearts than in the adults,

but training eliminated this age-associated difference in the response

to ischemia.

Conclusions—— Our findings indicate that in rats, some age-associated

changes in diastolic function are reversible and thus may not be

intrinsic to aging but instead secondary to other processes, such as

deconditioning.

>

> Hi folks:

>

> In post #25553 I provided some material on pulse pressure. It

> suggested that in older people for any given SBP a HIGHER level of DBP

> was healthier.

>

> Right at the end of the post I added a single question. No one seems

> to have responded to it so I wonder if anyone got that far reading the

> post (!)

>

> It may be an important issue if what was reported elsewhere in that

> post is accurate. So here is the question again:

>

> ************************************************************

> " Any suggestions for ways to raise DBP without raising SBP? "

> ************************************************************

>

> Any thoughts?

>

> Rodney.

>

[Guest guest]

Rodney wrote:

> In post #25553 I provided some material on pulse pressure. It

> suggested that in older people for any given SBP a HIGHER level

> of DBP was healthier.

<snip>

> Any thoughts?

The 2nd (older) study below shows reduced pulse pressures.

Thanks,

Todd

1: J Hypertens. 2007 Mar;25(3):577-83.

Advanced glycation endproduct crosslink breaker (alagebrium) improves

endothelial function in patients with isolated systolic hypertension.

Zieman SJ, Melenovsky V, Clattenburg L, Corretti MC, Capriotti A,

Gerstenblith G, Kass DA. Division of Cardiology, Department of

Medicine, The s Hopkins University School of Medicine

OBJECTIVES: Arterial stiffening and endothelial dysfunction

are hallmarks of aging, and advanced glycation endproducts (AGE)

may contribute to these changes. We tested the hypothesis that

AGE crosslink breakers enhance endothelial flow-mediated

dilation (FMD) in humans and examined the potential mechanisms

for this effect. METHODS: Thirteen adults (nine men, aged 65

+/- 2 years) with isolated systolic hypertension (systolic

blood pressure > 140 mmHg, diastolic blood pressure < 90 mmHg

or pulse pressure > 60 mmHg)

<snip>

RESULTS: Alagebrium reduced carotid AI by 37% (P = 0.007)

and augmented pressure (16.4 +/- 10 to 9.6 +/- 9 mmHg;

P < 0.001). Heart rate, arterial pressures, and ArtD,

were unchanged. FMD increased from 4.6 +/- 1.1 to 7.1 +/- 1.1%

with alagebrium (P < 0.05), and was unrelated to altered shear

stress or regional arterial distensibility.

<snip>

CONCLUSIONS: Alagebrium enhances peripheral artery

endothelial function and improves overall impedance

matching. Improved endothelial function correlates better

with reduced vascular fibrosis and inflammation markers

than with vessel distensibility. AGE-crosslink breakers may

reduce cardiovascular risk in older adults by reduced

central arterial stiffness and vascular remodeling.

PMID: 17278974 [PubMed - indexed for MEDLINE]

2: Circulation. 2001 Sep 25;104(13):1464-70.

Improved arterial compliance by a novel advanced glycation

end-product crosslink breaker.

Kass DA, Shapiro EP, Kawaguchi M, Capriotti AR, Scuteri A,

deGroof RC, Lakatta EG. Division of Cardiology, The s

Hopkins Medical Institutions, Baltimore, MD

BACKGROUND: Arterial stiffening with increased pulse pressure

is a leading risk factor for cardiovascular disease in the

elderly. We tested whether ALT-711, a novel nonenzymatic breaker

of advanced glycation end-product crosslinks, selectively

improves arterial compliance and lowers pulse pressure in older

individuals with vascular stiffening. METHODS AND RESULTS: Nine

US centers recruited and randomly assigned subjects with resting

arterial pulse pressures >60 mm Hg and systolic pressures >140

mm Hg to once-daily ALT-711 (210 mg; n=62)or placebo (n=31) for

56 days.

<snip>

ALT-711 netted a greater decline in pulse pressures than placebo

(-5.3 versus -0.6 mm Hg at day 56; P=0.034 for treatment effect

by repeated-measures ANOVA). Systolic pressure declined in both

groups, but diastolic pressure fell less with ALT-711 (P=0.056).

<snip>

PMID: 11571237 [PubMed - indexed for MEDLINE]

[Guest guest]

Seems the general scientific consensus is that a widening " pulse

pressure " is due (at least in part) due to large artery stiffness

(aorta etc). I, personally, would not want to increase any component

of my BP as the interrelationships are not perfectly understood.

Although my pulse pressure is ~30 at this time )

I guess the answer is continue to CRON, monitor cardio with frequent

ck'ups and tests and hope the stiffness attenuates.

1) What is the most important component of blood pressure:

systolic, diastolic or pulse pressure?

RECENT FINDINGS: Generally, in studies in which readings of systolic

and diastolic blood pressure have been compared, systolic blood

pressure has been a better predictor of risk. Moreover, isolated

systolic hypertension predicts risk better than isolated diastolic

hypertension, and the treatment of both isolated systolic hypertension

and combined hypertension has reduced cardiovascular events. There are

no treatment studies of isolated diastolic hypertension. Pulse

pressure reflects stiffening of large arteries and is associated with

several cardiovascular risk factors. Pulse pressure also predicts

events in epidemiologic studies, but elucidation of an independent

role is hampered by the close correlation between pulse pressure and

systolic blood pressure.

2)Is systolic pressure a better target for antihypertensive treatment

than diastolic pressure?

In elderly subjects the increased stiffness of large arteries is

responsible for the early reflection of pulse wave and for the

decrease in diastolic blood pressure due to reduced recoil of large

arteries. This is summarized in the increase in pulse pressure, which

is directly related to the risk of cardiovascular complications.

Last, but not least a mechanical description:

3)Increased elastance (or stiffness, inverse of compliance) of the

central elastic arteries is the primary cause of increased systolic

and pulse pressure with advancing age and in patients with

cardiovascular disease, including hypertension, and is due to

degeneration and hyperplasia of the arterial wall; diastolic pressure

decreases as arterial elastance increases. As elastance increases,

transmission velocity of both forward and backward (or reflected)

traveling waves increases, which causes the reflected wave to arrive

earlier in the central aorta and augments pressure in late systole.

J Cardiovasc Pharmacol Ther. 2001 Jan;6(1):5-21. Links

Arterial elastance and wave reflection augmentation of systolic

blood pressure: deleterious effects and implications for therapy.

PMID: 11452332

>

> Hi folks:

>

> In post #25553 I provided some material on pulse pressure. It

> suggested that in older people for any given SBP a HIGHER level of DBP

> was healthier.

>

> Right at the end of the post I added a single question. No one seems

> to have responded to it so I wonder if anyone got that far reading the

> post (!)

>

> It may be an important issue if what was reported elsewhere in that

> post is accurate. So here is the question again:

>

> ************************************************************

> " Any suggestions for ways to raise DBP without raising SBP? "

> ************************************************************

>

> Any thoughts?

>

> Rodney.

>

[Guest guest]

Hi Rodney

I can't offer technical references but can offer my

one rat experiment. Being vegetarian my sources of

protein have been brewer's yeast, rice bran powder,

whey powder and hemp powder. My DBP was going up

and up. I actually have stopped using these, except

in very small amounts, as for example a teaspoon of

brewer's yeast in a soup, for example, or some whey

poweder in the ingredients for a vegetarian

dehydrated jerkey I make. I also resumed my daily

yoga, which I had interrupted due to work related

travel. So in my personal case, some sodium, less

exercise and possible overconsumption of protein

supplements drove up the DBP. In my case, that is

not welcome, so I'm changing my behavior. I

wrote about it in an entry in my blog today. I

do not know if it is prudent to look for nutritional

ways to raise DBP. It's like when my cholesterol

levels were low and I was started consuming eggs.

I realized that raising dietary cholesterol might

raise my blood cholesterol, but also increase

atherogenesis. So I stopped consuming eggs.

Cheers,

Arturo

--------------------------

Factors with Differential Effects on DBP and SBP

Posted by: " Rodney " perspect1111@... perspect1111

Fri May 18, 2007 11:50 am (PST)

Hi folks:

<snip>

************************************************************

" Any suggestions for ways to raise DBP without raising SBP? "

************************************************************

Any thoughts?

Rodney.

[Guest guest]

Hi Arturo:

Thanks for that input. Perhaps I need to elaborate on my original

question and ask you a couple too : ^ )))

First, in my own one-mouse experiment as my weight varies, my blood

pressure varies with it. But not only that. What I found is that

when my weight dropped ~25 pounds my systolic dropped by quite a bit

MORE than 25 points, while my diastolic dropped by quite a lot LESS

than 25 points. So my pulse pressure (PP) improved with declining

weight.

And this has seemed to be true with each of the gyrations (there were

several, lol) in my weight on the way down. So this was not just a

single isolated aberration.

One implication of this is that studies which claim to have found

that a particular behaviour benefits pulse pressure had better take

account of changing body weight, or it may be that the pulse pressure

benefit may have been attributable to the change in weight rather

than the 'treatment' being studied.

Of course, when I asked if anyone knew of ways to raise diastolic

while keeping systolic unchanged, lowering systolic while keeping

diastolic unchanged would be just about as good. The situation I was

thinking of when I asked the question was how those, like the WUSTL

subjects, who already had their SBP down to 100 could get their PP

below 40 by raising their diastolic.

For most people over age 60 diastolic tends to fall anyway, while

systolic generally rises. So it would be helpful if we could do

something to prevent this fall in diastolic, and keep PP under 40.

Also, logical though it is, I am skeptical about claims that high PP

reflects poor elasticity of the arteries. Since PP can be improved

(at least in my case) simply by going on CRON are we to suppose that

CRON improves elasticity? Or is it that the elasticity is purely a

function of plaque deposits in the arteries, which CRON seems to

clean out - according to the carotid IMT data?

You mention yeast, rice bran, whey and hemp as apparently raising

your DBP. Are you saying that your impression is that they did not

raise your SBP at the same time?

You mention also the rise in your cholesterol. I am not suggesting

that it is a good idea to raise low lipids values. Only that there

may very well be benefit in raising DBP in order to lower PP to a

level consistently below 40.

Rodney.

>

> Hi Rodney

> I can't offer technical references but can offer my

> one rat experiment. Being vegetarian my sources of

> protein have been brewer's yeast, rice bran powder,

> whey powder and hemp powder. My DBP was going up

> and up. I actually have stopped using these, except

> in very small amounts, as for example a teaspoon of

> brewer's yeast in a soup, for example, or some whey

> poweder in the ingredients for a vegetarian

> dehydrated jerkey I make. I also resumed my daily

> yoga, which I had interrupted due to work related

> travel. So in my personal case, some sodium, less

> exercise and possible overconsumption of protein

> supplements drove up the DBP. In my case, that is

> not welcome, so I'm changing my behavior. I

> wrote about it in an entry in my blog today. I

> do not know if it is prudent to look for nutritional

> ways to raise DBP. It's like when my cholesterol

> levels were low and I was started consuming eggs.

> I realized that raising dietary cholesterol might

> raise my blood cholesterol, but also increase

> atherogenesis. So I stopped consuming eggs.

>

> Cheers,

> Arturo

> --------------------------

> Factors with Differential Effects on DBP and SBP

> Posted by: " Rodney " perspect1111@... perspect1111

> Fri May 18, 2007 11:50 am (PST)

> Hi folks:

> <snip>

>

> ************************************************************

> " Any suggestions for ways to raise DBP without raising SBP? "

> ************************************************************

>

> Any thoughts?

>

> Rodney.

>

[Guest guest]

Hi Rodney

Yes, my impression is that in the past three weeks my

DBP was moving up (84, 88, 90, etc) while the SBP was

not moving up, staying in the range of 131. The SBP

moved up to 139 only on the day that the DBP shot way

up to 97. For me at least that means an episode of

borderline hypertension based on past advice from

physicians, hence that is why I'm experimenting with

greatly reducing these protein supplements. I'm

planning to keep my protein consumption ratio to

about 15% daily instead of 25% daily.

Thanks,

Arturo

Re: Factors with Differential Effects on DBP and SBP

Posted by: " Rodney " perspect1111@... perspect1111

Sun May 20, 2007 1:46 pm (PST)

Hi Arturo:

Thanks for that input. Perhaps I need to elaborate on my original

question and ask you a couple too : ^ )))

<snip>

You mention yeast, rice bran, whey and hemp as apparently raising

your DBP. Are you saying that your impression is that they did not

raise your SBP at the same time?