A double-blind, crossover study of
Effects of cranberry juice consumption
Doxazosin and Enalapril on peripheral
on vascular function in patients with
vascular tone and nocturnal blood
coronary artery disease.
pressure in sleep apnea patients.
Mustali M Dohadwala, Monika Holbrook, Naomi M Hamburg,
Zou D, Grote L, Eder DN, Radlinski J, Hedner J.
Sherene M Shenouda, William B Chung, Megan Titas,
Matthew A Kluge, Na Wang, Joseph Palmisano, Paul E Milbury,
Jeffrey B Blumberg, and Joseph A Vita
Compared Doxazosin (DO - peripheral alpha-receptor inhibitor) and
Enalapril (EN, - ACE inhibitor), on PAT and nocturnal blood pressure(BP) in 16 hypertensive OSA patients. Full-night polysomnography,
Examined the effects of cranberry juice on vascular function in patients
PAT, beat-to-beat finger BP (Finapres), 24 H ambulatory BP, and
with coronary artery disease in an acute pilot study with no placebo
nighttime BP and PAT associated with apneas were tested at the end
(n=15), and in a chronic placebo-controlled crossover study (n=44),
before and after active and control beverages, and at ≥12h after the
No differences between treatments in 24h BP profile and
OSA severity. Nighttime finger BP was significantly higher under DO.
Mean carotid-femoral pulse wave velocity decreased after
PAT ratio during apnea increased 5.3% under DO vs. EN (P<0.0001).
active juice vs. placebo (P = 0.003), but not Brachial FMD, EndoPAT
Apnea desaturation was associated with a 0.9% decrease in PAT
index, blood pressure, or carotid-radial pulse wave velocity. In the
ratio/-1% SaO2 (P<0.0001). REM sleep was associated with 2.2%
pilot study, brachial FMD improved (P=0.01), as did EndoPAT index
decrease of PAT ratio vs. NREM sleep (P=0.002).
Digital vasoconstrictions associated with apneas are
Chronic cranberry juice reduced carotid femoral pulse
alpha-receptor mediated. DO has a poorer effect on nocturnal BP
wave velocity. The uncontrolled pilot study suggested an acute but
not chronic benefit on endothelial function.
Relation of brachial and digital measures
Effect of periodontal treatment on
of vascular function in the community:
circulating CD34(+) cells and peripheral
the Framingham heart study.
vascular endothelial function: a
randomized controlled trial.
Hamburg NM, Palmisano J, Larson MG, Sullivan LM, Lehman BT,
Vasan RS, Levy D, Mitchell GF, Vita JA, Benjamin EJ.
Li X, Tse HF, Yiu KH, Li LS, Jin L.
J Clin Periodontol. 2011 Feb;38(2):148-56
Noninvasively compared vasodilator function in the brachial artery
Investigated the effect of periodontal treatment on circulating
- (FMD, n=7031; age 48 ± 13, 54% women), and digital arteries
progenitor cell (CPC) count and vascular endothelial function in
using EndoPAT- (PAT ratio , n=4352; age 55 ± 16, 51% women), in
moderate-to-severe chronic Periodontitis in 25 patients assigned to
Framingham Offspring, Third Generation and Omni Cohorts.
3 month of treatment, and 25 untreated controls. CPCs and
Abnormality thresholds were defined respectively as the sex-specific
endothelial function using EndoPAT2000 were evaluated at baseline
fifth percentile in a reference group free of conventional cardiovascular
Periodontal treatment exhibited neutral effects on endothelial
Abnormal FMD but not PAT ratio prevalence increased with
function while Circulating CD34(+) cells count significantly decreased
age and higher systolic blood pressure. Higher BMI was associated
with increased abnormality prevalence in both. Abnormal PAT ratio
Treatment of Periodontitis has neutral effects on
correlates included lower systolic blood pressure, increasing total/high-
peripheral endothelial function but significantly decreases circulating
density lipoprotein cholesterol ratio, diabetes, smoking, and lipid-
lowering medication. In 1,843 concurrent tests, PAT ratio and FMD
were not significantly associated.Conclusions:
FMD and PAT ratio might provide distinct information
regarding vascular function in conduit versus smaller digital vessels.
Impaired vascular function in
Modified-release sildenafil reduces
asymptomatic young adult survivors of
Raynaud's phenomenon attack
Hodgkin Lymphoma following
frequency in limited cutaneous systemic
Zelcer S, Chen B, Mangel J, Vujovic O, Thiessen-Philbrook HR,
Herrick AL, van den Hoogen F, Gabrielli A, Tamimi N, Reid C,
Reider M, Mahmud FH
O'Connell D, V·zquez-Abad MD, Denton CP.
J Cancer Surviv. 2010 Sep; 4(3):218-24
Arthritis Rheum. 2011 Mar;63(3):775-82
Evaluated endothelial function (EndoPAT2000), cardiovascular risk
Examined the effect of sildenafil in 57 patients with Raynaud's
factors, and activity level in 26 Hodgkin lymphoma survivors (HLS)
phenomenon (RP) secondary to limited cutaneous systemic sclerosis
aged 12-30, (>2 years from therapy) vs. 26 matched controls, and
(lcSSc), randomized to modified-release sildenafil 100 mg once daily
also determined the influence of mediastinal radiation.
for 3 days followed by modified-release sildenafil 200 mg once daily
HLS were on average 6.7±4.6 yrs post treatment. No
for 25 days or placebo. Primary end point was percentage change
differences in endothelial function or cardiovascular risk factors were
in weekly RP attacks; secondary end points included Raynaud's
observed between HLS and control groups, but endothelial function
Condition Score, duration of attacks, RP pain score, endothelial
was impaired in those HLS who received mediastinal radiation (n=13),
dysfunction (EndoPAT2000), and serum biomarkers.
vs. controls (1.67±0.39 vs. 2.03±0.37, p<0.01).
Mean percentage reduction in attacks per week was greater
Impaired endothelial function was preferentially
for modified-release sildenafil than for placebo (-44.0% vs. -18.1%,
observed in HLS who received mediastinal radiation, confirming that
P = 0.034); while secondary end points were similar between groups.
mediastinal radiation is an additional cardiovascular risk factor in this
Modified-release sildenafil reduced attack frequency in
patients with RP secondary to lcSSc and may thus be a treatmentoption.
Increased arterial stiffness in patients
Plasma leptin levels and digital pulse
with psoriasis is associated with active
volume in obese patients without
metabolic syndrome - A pilot study.
Yiu KH, Yeung CK, Chan HT, Wong RM, Tam S, Lam KF, Yan GH,
Lin YH, Ho YL, Lee JK, Huang HL, Huang KC, Chen MF.
Yue WS, Chan HH, Tse HF.
Clin Chim Acta. 2011 Apr 11;412(9-10):730-4
Br J Dermatol. 2011 Mar;164(3):514-20
Investigated the relationship between disease activity, systemic
Assessed the relationship among endothelial dysfunction
inflammation, macrovascular and microvascular function in 52 patients
(EndoPAT2000), anthropometric indices, adipokines and inflammatory
with psoriasis, vs. 50 matched controls. Baseline demographics, hs-
cytokines in 35 obese patients without metabolic syndrome, 11 of
CRP, Psoriasis Area and Severity Index (PASI), arterial stiffness and
whom had been diagnosed with endothelial dysfunction.
endothelial function were assessed using brachial - ankle pulse wave
There was a significant difference of ln leptin (p=0.007), ln
[leptin/visceral fat thickness] (p=0.004) and ln [leptin/subcutaneous
Patients with psoriasis had significantly higher hs-CRP (P<0.01)
fat thickness] (p<0.001) between patients with and without endothelial
and baPWV, (P< 0.01) but did not differ in their EndoPAT index vs.
dysfunction. ln [leptin/subcutaneous fat thickness] was significantly
controls. There was significant correlation of hs-CRP with baPWV
related to the ln (PAT ratio) (p=0.002). Using ln [leptin/subcutaneous
(r=0.51, P< 0.01) and with PASI (r=0.48, P< 0.01).
fat thickness] to detect endothelial dysfunction provided area under
Young patients with psoriasis have increased arterial
stiffness but not microvascular dysfunction compared with healthy
Abnormal digital vascular function occurs in obese
patients without metabolic syndrome. Low plasma leptin/subcutaneousfat ratio is associated with endothelial dysfunction in this population.
Joseph A. Vita, M.D.
for Diagnosis of Obstructive
Dr. Joseph A. Vita is a Professor of Medicine atBoston University School of Medicine and aSenior Cardiologist in the Section of
Cardiovascular Medicine. His research focuseson vascular biology and inflammation, andparticularly on endothelial dysfunction in
13th World Congress on Menopause
atherosclerosis and associated risk factors,
diabetes mellitus and obesity, and the effectsof drug, lifestyle, and dietary interventions on
American Academy of Dental Sleep Medicine
Dr. Vita's research is supported by several grants from the NIH and by
industry,and he is the principal investigator of an NIH Vascular SCCOR
grant, and is the director of an NIH K12 Vascular Medicine training program.
Dr. Vita currently serves as the Deputy Editor of Circulation.
Dr. Vita has been involved in several groundbreaking studies which have
significantly advanced the scientific base and clinical acceptance of
June 13th – 15th, 2011Minneapolis, MN, USA
Effects of cranberry juice consumption on vascular function in patients
with coronary artery disease. Mustali M Dohadwala, Monika Holbrook,
Naomi M Hamburg, Sherene M Shenouda, William B Chung, Megan Titas,
NYC College of Dentistry
Matthew A Kluge, Na Wang, Joseph Palmisano, Paul E Milbury, Jeffrey B
Blumberg, and Joseph A Vita.
Am J Clin Nutr. 2011 May;93(5):934-40.
Vascular Function to Cardiovascular Risk Factors in the Framingham
Heart Study. Naomi M. Hamburg, Michelle J. Keyes, Martin G. Larson,
Ramachandran S. Vasan, Renate Schnabel, Moria M. Pryde, Gary F. Mitchell,
Jacob Sheffy, Joseph A. Vita, Emelia J. Benjamin
of Digital Circulation 2008; 117(19): 2467-2474.
Cardiovascular risk factors in the community: The Framingham Heart
Study. N. Hamburg, M.J. Keyes, M.G. Larson, R.S. Vasan, R. Schnabel,
M.M. Pryde, J.A. Vita, E.J. Benjamin.
Digital microvascular function is related
to Circulation 2007; 116: II_846.
AACP Annual Symposium
July 29 – 30
Relation of Cardiovascular Risk Factors with Abnormal Brachial and
Digital Vascular Function in the Community: The Framingham Heart
IN Annual Sleep Meeting
Study. NM Hamburg, J Palmisano, L M Sullivan, M G Larson, M J Keyes,
G F Mitchell, R S Vasan, J A Vita, E J Benjamin.
Circulation 9002; 021
Chronic Study of the Effect of Grape Seed Extract plus Ascorbic Acid
European Society of Cardiovascular
on Endothelial Function in Patients with Coronary Artery Disease. NM
Hamburg, M Holbrook, W Chung, T Caiano, MA Duess, M Kluge, V Chernyshev,
C Tabit, T McKinnon, T Wood, J Cuomo, B Dixon, N Eich, JA Vita.
www.itamar-medical.com firstname.lastname@example.org 1 - 8 8 8 - 7 - I T A M A R + 9 7 2 - 4 - 6 1 7 - 7 0 0 0
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Rakel & Bope_Section-14 10/29/03 12:55 PM Page 959 TREATMENT OF TOURETTE’S 5. Use of stimulants . Because stimulants can maketics worse, it is often assumed that stimulants are con- SYNDROME traindicated in the treatment of TS. In reality, the ticsare often mild and easy to treat, and it is the co-morbidADHD that causes the greatest disability. Failureto address and treat the ADHD