Background/Objectives: Available data regarding associations between sodium (Na) intake and biomarkers of subclinical arterial damage (SAD) are scarce. This study aimed to investigate the possible associations between Na intake and the 3-year progression of SAD in subjects with cardiovascular disease (CVD) risk factors. Methods: Participants underwent CVD risk assessment, vascular assessment [arterial stiffness by pulse wave velocity (PWV), and atheromatosis, as the existence of carotid and/or femoral plaques], anthropometric measurements [at baseline and 3-year follow-up (FU)], and dietary assessment at FU. Results: A total of 675 adults (47.9% males, 55.02 ± 13.79 years) were included. Na daily consumption quartiles (Qs) ranged from very low consumption in Q1 (811.72 ± 241.81 mg) up to twice the recommendations in Q4 (3487.92 ± 1025.92 mg). No statistically significant associations were observed between Na intake and changes in SAD biomarkers, after adjustment for age, sex, presence of hypertension, presence of dyslipidemia, smoking, mean arterial pressure, BMI, chronic inflammatory diseases, and energy intake. The results remained the same, even after the assessment of misreporting and the correction of Na intake. Conclusions: Dietary Na intake was not significantly associated with changes in PWV and carotid or femoral plaques, even in the high Q that was twice as high as the recommended intake. Research in different additional adult cohorts is needed to further investigate whether Na consumption independently affects vascular health.

Background: The mechanisms of vascular degeneration in PSV, although partly described so far, include among others the acceleration of the 3 classical types of arterial damage (inappropriate arterial remodeling, atheromatosis and arteriosclerosis), affecting both the micro- and macro-circulation [1]. This is attributed to the interplay between tissue and systemic inflammation, immunosuppressive therapy, and common cardiovascular disease (CVD) risk factors contributing to the observed increased CVD morbidity and mortality of these patients [2,3]. Based on easy to use, non-invasive vascular indices, the monitoring of subclinical vascular damage not only provides insights on the development of these vascular pathologies in PSV, but might be also used to guide treatment, in similar ways as in individuals with other non-inflammatory as well as systemic autoimmune rheumatic diseases with increased CVD risk including systemic lupus erythematosus and rheumatoid arthritis (RA) [4-6]. Objectives: To explore the presence and potential reversibility of subclinical vascular dysfunction and/or damage both in the micro- and macro-circulation in PSV by evaluating four main vascular pathologies (atheromatosis, arterial stiffening, arterial remodeling and pressure wave reflection impairment) in four different vascular beds (carotid, femoral arteries, aorta, and retina) using gold-standard in clinical practice, non-invasive vascular biomarkers. Methods: Seventy-three PSV patients [42 (57.5%) with a type of large (LVV), 4 (5.5%) with medium (MVV) and 27 (37%) with small vessel vasculitis (SVV), matched at 1:1 according to age/sex/all CVD risk factors and associated therapies with non-inflammatory controls-(NIC), RA and polymyalgia rheumatica (PMR) controls were studied. Atheromatosis (carotid/femoral plaques), arterial stiffening (carotid-femoral pulse wave velocity-cfPWV), pressure wave reflections (augmentation index-AIx) and arterial remodeling (carotid-intima media thickness-cIMT and retinal vessel calibers) in two time points (activity-remission) were evaluated. Results: Aortic PWV in PSV was higher by 0.7 m/sec compared to NIC, and by 1.3 m/sec to RA-controls (p=0.003) and was more pronounced in LVV/MVV patients (p=0.08 and p=0.001 respectively). AIx was decreased in all PSV (p=0.03) and predominantly in SVV compared to NIC (p=0.04) and RA-controls (p=0.09 all, p=0.07 active disease). Atherosclerotic plaque formation prevailed in all vascular beds at diagnosis being more enhanced in LVV/MVV (p=0.007, p=0.03, p=0.004), compared to NIC and only both carotid/femoral (p=0.02) to RA-controls. Carotid IMT was higher in LVV/MVV irrespectively to disease state and control group and was the most sensitive to change biomarker between activity-inactivity. Active giant cell arteritis (GCA) was associated with increased PWV/plaques/cIMT compared to matched-NIC, RA and PMR-controls. The retinal microcirculation exhibited vasodilation in at least partly reversible (venules), and irreversible manner [arterioles, NIC (p=0.029) and RA-controls (p=0.008)], associated with the level of the inflammatory response and irrespectively of the underlying disease-specific pathogenetic mechanisms, suggesting that digital retinoscopy might represent an easy direct tool to monitor disease activity in PSV. Conclusion: Accelerated atheromatosis and arteriosclerosis are present at diagnosis in PSV suggesting disease specific more than drug related pathogenetic links. Early identification and management of CVD risk may reduce long-term CVD morbidity and mortality in PSV patients. REFERENCES: [1] Argyropoulou OD et al. Curr Opin Rheumatol. 2018. [2] Savage COS et al. Lancet 1997. [3] Clifford AH et al. Atherosclerosis. 2021. [4] Vlachopoulos C et al. Atherosclerosis. 2015. [5] Drosos GC et al. Ann rheum Dis 2022. [6] Agca R et al. Ann rheum Dis 2016. Acknowledgements: Ourania D Argyropoulou and Petros P. Sfikakis (two of the listed authors) are members of the European Reference Network for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA-ERN). The study was partially funded by the Hellenic Rheumatology Society. Disclosure of Interests: None declared.

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, 24-hour blood pressure (24hBP) was measured with the same validated oscillometric upper arm device (Mobil-O-Graph, I.E.M., Germany), using a transfer function and ARCSolver algorithms for determination of central pressures (using mean/diastolic BP calibration), pulsatile (Pressure Augmentation-AP, amplitudes of Forward (Pf) and Backward (Pb) wave) and steady state (Cardiac Output-CO, Total Peripheral Resistance-TPR) hemodynamics. Hypertension phenotypes were defined according to average 24h brachial BP as normotension (NTN), isolated systolic (ISH) and diastolic (IDH) hypertension, and systolic/diastolic hypertension (SDH). Left ventricular mass was determined by echocardiography, and indexed to body surface area (LVMi). Results: Overall, 675 participants were included. 52.3, 5.9, 19.1 and 22.7% were classified as NTN, ISH, IDH, and SDH, with average 24h brachial BPs of 117/71, 134/75, 124/85 and 140/93 mmHg, respectively. Participants with ISH were the youngest and tallest among all 4 groups, and had the highest proportion of men. Average 24h central SBP and PP were 121/49, 143/66, 125/38 and 140/46 mmHg in NTN, ISH, IDH, and SDH, respectively. Participants with ISH had highest average 24h values for pulsatile hemodynamics (AP, Pf, Pb) and cardiac output (CO), and participants with SDH had highest average 24h values for TPR, respectively (see Table). LVMi was 76.9, 84.8, 78.2 and 96.3 g/m2 in participants with NTN, ISH, IDH, and SDH, respectively (p<0.0001). Conclusions: In this cohort of younger individuals, ISH was an infrequent condition with specific clinical and hemodynamic characteristics. The relatively high LVMi and central BPs in those with ISH as compared to IDH and NTN is a suspicious prognostic sign.

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). Design and method: Participants with 24hr br & ao ABPM (Mobil-O-Graph, IEM Germany) and echocardiography data from 21 centers worldwide were analyzed and categorized into the following 4 phenotypes: sustained [br & ao] systolic normotension (SSN), isolated br systolic hypertension (IbrSH), isolated ao systolic hypertension (IaoSH), and sustained [br & ao] systolic hypertension (SSH). These phenotypes were generated using 2 different calibration (C) methods and various proposed 24hr ao systolic pressure cut-off values (mmHg) (C1: systolic /diastolic pressure [120 and 114]; C2: mean/diastolic [135 and 132]). Results: We analysed 2367 individuals (49.5 ± 16.1 years, 54.5% men, 55.8% hypertensives). Depending on both cut-off values as well as on calibration method the phenotypes prevalence ranged: IaoSH 5.8% - 24.2%; IbrSH: 0.2% - 8.7%; SSN: 41.9% - 60.3%; SSH: 29.2% - 33.9%. In comparison to the SSN and after adjustment for age, sex and diastolic blood pressure: the SSH phenotype had 2.4 to 3.2 times more often LVH (statistically significant irrespectively of calibration and cut-off); the IaoSH had 1.7 to 2.4 times more often LVH (statistically significant with both C1 and C2); the IbrSH had 2.1 times more often LVH only with C1 and 120 mmHg cut-off. Conclusions: Individuals with the novel herein defined phenotype of 24hr IaoSH constitute a non-neglectable percentage of the population that cannot be identified by brachial arm ABPM, possibly carrying high cardiovascular risk as suggested by the more frequent LVH. Outcome studies are needed to verify these results.

Circulating amyloid-beta 1–40 (Αb40) has pro-atherogenic properties and could serve as a biomarker in atherosclerotic cardiovascular disease (ASCVD). However, the association of Ab40 levels with morphological characteristics reflecting atherosclerotic plaque echolucency and composition is not available. Carotid atherosclerosis was assessed in consecutively recruited individuals without ASCVD (n = 342) by ultrasonography. The primary endpoint was grey scale median (GSM) of intima-media complex (IMC) and plaques, analysed using dedicated software. Vascular markers were assessed at two time-points (median follow-up 35.5 months). In n = 56 patients undergoing carotid endarterectomy, histological plaque features were analysed. Plasma Αb40 levels were measured at baseline. Ab40 was associated with lower IMC GSM and plaque GSM and higher plaque area at baseline after multivariable adjustment. Increased Ab40 levels were also longitudinally associated with decreasing or persistently low IMC and plaque GSM after multivariable adjustment (p < 0.05). In the histological analysis, Ab40 levels were associated with lower incidence of calcified plaques and plaques without high-risk features. Ab40 levels are associated with ultrasonographic and histological markers of carotid wall composition both in the non-stenotic arterial wall and in severely stenotic plaques. These findings support experimental evidence linking Ab40 with plaque vulnerability, possibly mediating its established association with major adverse cardiovascular events.

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 detection of tARrget organ damage (SAFAR) study. Design and method: Participants with 24hr br & ao ABPM (Mobil-O-Graph, IEM Germany), carotid ultrasound and echocardiography data were analyzed and categorized into 4 systolic hypertension phenotypes: sustained systolic br & ao normotension (SSN), isolated br systolic hypertension (IbrSH), isolated ao systolic hypertension (IaoSH) and sustained br & ao systolic hypertension (SSH); using 2 different calibration peripheral waveform methods and different 24hr ao systolic proposed cut-off values (i.e., 120mmHg or 114mmHg for type 1 calibration; 135mmHg or 132mmHg for type 2 calibration [mean/ diastolic pressure]). We examined the prevalence of these phenotypes and their associations with carotid and cardiac damage. Results: Out of 1024 participants (55.0 ± 13.1 years, 58.1% males, 60.4% hypertensives) with ABPM, 684 (53.5 ± 12.4 years, 57.7% males, 61.0% hypertensives) had carotid and 423 (55.4 ± 14.3 years, 57.4% males, 60.3% hypertensives) had echocardiography data. IaSH ranged from 3.7% to 23.0% of the population depending on the calibration and the applied cut-off; (SSN: 37.0% – 56.3%, IbrSH: 0.6% – 9.5%, SSH: 30.5% – 39.4%). In comparison to SSN and IbrSH, IaoSH phenotype (only by calibration 2 - but independently of the applied cut-off) had significantly higher common carotid intimal-medial thickness, cross-sectional area and left ventricular mass. Irrespectively of the type of calibration and applied cut-off, SSH had consistently the highest carotid and cardiac damage. Conclusions: Individuals with 24hr IaoSH constitute a non-neglectable percentage (3.7% to 23.0%) of the population with otherwise normal 24hr br pressure, possibly carrying high cardiovascular risk. Further mortality outcome studies are needed to verify these results.

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 echocardiography data were categorized into 4 systolic hypertension phenotypes: sustained systolic br and ao normotension (SSN), isolated br systolic hypertension (IbrSH), isolated ao systolic hypertension (IaoSH) and sustained br and ao systolic hypertension (SSH). Different calibrations for peripheral waveforms and cut-offs for 24-h ao systolic pressure were applied. Out of 1024 participants with ABPM, 684 had carotid and 423 echocardiography data. IaoSH ranged from 3.7% to 23.0% of the population, depending on the calibration and the applied cut-off; (SSN: 37.0-56.3%, IbrSH: 0.6-9.5%, SSH: 30.5-39.4%). In adjusted models including diastolic pressure, in comparison with SSN and IbrSH, IaoSH phenotype by 90th percentile of normalcy for calibration 2 (mean/diastolic pressure) had significantly higher carotid intimal-medial thickness, carotid cross-sectional area and left ventricular mass; the odds ratio (95% confidence intervals) of IaoSH for carotid hypertrophy and left ventricular hypertrophy was 2.57 (1.01-6.56) and 3.29 (1.13-9.55), respectively. Individuals with 24-h IaoSH and IbrSH constitute a non-neglectable percentage (around 10%) of the population. IaoSH cannot be detected by brachial ABPM due to the per se normal 24-h br systolic pressure and it is associated with increased HMOD, possibly leading to increased cardiovascular risk. Further outcome and mortality studies are needed to verify these results.

Vascular aging and its associated pathophysiological hemodynamic implications are strongly related to the development of cardiovascular disease (CVD) and CVD mortality. Arterial stiffness, as an index of vascular aging, is most commonly assessed by pulse wave velocity (PWV). Around the same time of the introduction of the concept of early vascular aging, clinical guidelines initially focusing in the management of arterial hypertension have incorporated available evidence regarding the potential clinical role of PWV. In this chapter we follow the changes in these clinical recommendations (from 2003 and on) regarding the use of PWV in clinical practice. We highlight the similarities as well as the differences between the recommendations of the various scientific boards throughout the time and the countries. While the concept of early vascular aging is not explicitly mentioned in all international consensus papers and guidelines, most of them emphasize the importance of assessing vascular health and considering vascular aging as part of CVD risk assessment, since many of these guidelines recognize the value of measuring arterial stiffness, by exclusively focusing on PWV measurement. In our view, it becomes also clear that due to the very recent, promising—yet inconclusive—evidence on the role of PWV to guide antihypertensive treatment, more evidence from high quality, randomized clinical trials is needed. Furthermore, targeted guidance is warranted on the role and implementation of the early vascular aging concept in clinical practice and clinical scenarios by very careful and wise use of all the available evidence.

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, all (proximal or distal to the heart) sites of assessment, and is modified by sex, age and heart rate. Methods: Based on a predefined protocol applying the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines, we identified eligible for meta-analysis data regarding: augmentation index, augmentation pressure, backward pressure (Pb), reflection index, and their association with left ventricular mass index (19 studies, total population n=8686). Results: We found statistically significant associations, independent from blood pressure level, for all indices of PWRs at all arterial sites (carotid augmentation index; odds ratio; standardized beta coefficient [β]: 0.14 [95% CI, 0.07% to 0.21%], per SD increase), radial augmentation index (β: 0.21; 0.11 to 0.31), central augmentation pressure (β: 0.15; 0.03 to 0.27), central Pb (β: 0.23; 0.05 to 0.42), and central reflection index (β: 0.14; 0.06 to 0.22), except for aortic augmentation index as estimated by generalized transfer functions. Meta-regression analysis showed that the association between carotid augmentation index and left ventricular mass was higher among populations with higher heart rate ( P =0.036, beta: 0.017 [95% CI, 0.001 to 0.033]) and tended to be higher in middle-aged ( P =0.07, beta: −0.001; −0.021 to 0.001). Conclusions: A clinically meaningful association between PWRs and left ventricular mass, assessed at either central or peripheral arterial sites by most available methods was shown, suggesting that PWR reduction strategies might be useful. Based on the present evidence, such trials should target middle-aged populations with high normal heart rate.

Background: Breakfast consumption has been associated with the improvement of many cardiovascular disease (CVD) risk factors, yet data regarding its association with subclinical vascular damage, which precedes the onset of CVD, are scarce. The aim of this study is to investigate this association in a large sample of adults with CVD risk factors. Methods: Anthropometric measurements, vascular biomarkers and dietary intake with two 24-h dietary recalls, focusing on breakfast frequency and its quantity and content, were assessed in 902 adults (45.2% males). Breakfast quality was assessed by identifying a posteriori breakfast dietary pattern (DP) by using principal component analysis (PCA). Results: Systematic breakfast consumption (SBC) was inversely associated with central systolic blood pressure (b: −3.28, 95% C.I.: −5.7 to −0.86), diastolic blood pressure (b: −1.85, 95% C.I.: −3.34 to −0.36), augmentation index (b: −3.17, 95% C.I.:−4.98 to 1.35) and left carotid intima media thickness (b: −0.03, 95% C.I.:−0.06 to −0.01) compared to breakfast skipping independently of age, sex, hypertension, diabetes, dyslipidemia, smoking, and BMI. SBC of 10–20% of daily total energy intake (dTEI) was inversely associated with Aix (b: −2.31, 95% C.I.:−4.05 to −0.57) compared to <10% dTEI after adjustment for the aforementioned confounders. DP1 (high coffee and sugar consumption, low consumption of low- and full-fat dairy products, fruits, and fresh juices) was positively associated with Aix (b: 1.19, 95% C.I.: 0.48 to 1.90). Conclusion: SBC comprised of medium-energy density and high-nutrient content food items may be a simple daily habit associated with better vascular health.

Background: The arterial pathology and mechanisms of increased cardiovascular disease (CVD) risk in HCV-infected individuals are not yet clear. The aim of this study was to identify types of arterial pathology in treatment-naive chronic HCV patients and to test their reversibility after successful treatment. Methods: Consecutive, never-treated, HCV-infected patients were compared with age and CVD-related risk factors, matched controls, healthy individuals (HI), patients with rheumatoid arthritis (RA) and people living with HIV (PLWH), in terms of arterial stiffening by pulse wave velocity, arterial atheromatosis/hypertrophy by carotid plaques/intima-media thickness and impaired pressure wave reflections by augmentation index. After three months of sustained virological response (SVR) administered using direct-acting antivirals, vascular examination was repeated in HCV-infected patients to test drug and viral-elimination effect in subclinical CVD. Results: Thirty HCV patients were examined at baseline; fourteen of them were re-examined post-SVR. Compared with HI, HCV patients had significantly more plaques, which is similar to that of RA patients and the PLWH group. No other differences were found in all other vascular biomarkers, and regression among HCV patients also revealed no differences 3 months post-SVR. Conclusions: Accelerated atheromatosis, rather than arterial stiffening, arterial remodeling and peripheral impaired hemodynamics is the underlying pathology leading to increased CVD risk in HCV patients.

Objective: Blood pressure variability (BPV) is an independent cardiovascular risk factor in CKD. Kidney transplantation (KTx) is associated with improved BP levels for kidney transplant recipient (KTRs), without evoking significant changes in donors. The aim of this study was to assess the short- and mid-time effects of KTx and donation on short-term BPV in KTRs and their respective living kidney donors. Design and method: Forty KTRs and their respective donors were evaluated with 24-h ABPM (Mobil-O-Graph-NG) at baseline (1 month before), 3-months and 12-months after KTx. Standard-deviation (SD), weighted-SD (wSD), coefficient-of-variation (CV), average-real-variability (ARV) and variability independent of mean (VIM) for SBP/DBP were calculated with validated formulas. Results: All 24-h systolic and diastolic BPV indexes studied did not change significantly from baseline to 3-month (SBP-wSD: 12.8±3.0 vs 13.2±3.4 mmHg, p = 0.608; SBP-ARV: 10.3±2.4 vs 10.8±2.6 mmHg, p = 0.463) and 12-month evaluation (SBP-wSD 12.8±3.0 vs 12.1±2.8; p = 0.424 and SBP-ARV: 10.3±2.4 vs 10.2±2.5; p = 0.615) after kidney transplantation in the KTRs. In kidney donors, all 24-h systolic BPV indices displayed a trend towards higher values at 3 months compared to baseline, but without reaching statistical significance (SBP-wSD: 12.2±2.8 vs 13.6±4.2 mmHg, p = 0.107 and SBP-ARV: 10.1±2.1 vs 11.2±3.1 mmHg, p = 0.099), the levels of 24-h systolic SBP indices at 12-months were almost identical to baseline values. 24-h diastolic BPV indices at 3-month and 12-month evaluation were similar to baseline. Conclusions: Short-term BPV did not change significantly 3 and 12 months after kidney transplantation/donation neither in KTRs nor in living kidney donors. Longitudinal studies examining associations of BPV with adverse outcomes in these individuals are needed.

OBJECTIVES:Ambulatory blood pressure (BP) control is worse in men compared with women with chronic kidney disease (CKD) and this may partially explain the faster CKD progression in men. This is the first study investigating possible sex differences in prevalence, control and phenotypes of hypertension in kidney transplant recipients (KTRs) with office-BP and 24-h ambulatory BP monitoring (ABPM).METHODS:This cross-sectional study included 136 male and 69 female stable KTRs who underwent office-BP measurements and 24-h ABPM. Hypertension thresholds for office and ambulatory BP were defined according to the 2017 ACC/AHA and 2021 KDIGO guidelines for KTRs.RESULTS:Age, time from transplantation, eGFR and history of major comorbidities did not differ between groups. Office SBP/DBP levels were insignificantly higher in men than women (130.3 ± 16.3/77.3 ± 9.4 vs. 126.4 ± 17.8/74.9 ± 11.5 mmHg; P = 0.118/0.104) but daytime SBP/DBP was significantly higher in men (128.5 ± 12.1/83.0 ± 8.2 vs. 124.6 ± 11.9/80.3 ± 9.3 mmHg; P = 0.032/P = 0.044). No significant between-group differences were detected for night-time BP. The prevalence of hypertension was similar by office-BP criteria (93.4 vs. 91.3%; P = 0.589), but higher in men than women with ABPM (100 vs. 95.7%; P = 0.014). The use of ACEIs/ARBs and CCBs was more common in men. Office-BP control was similar (43.3 vs. 44.4%, P = 0.882), but 24-h control was significantly lower in men than women (16.9 vs. 30.3%; P = 0.029). White-coat hypertension was similar (5.1 vs. 7.6%; P = 0.493), whereas masked hypertension was insignificantly more prevalent in men than women (35.3 vs. 24.2%; P = 0.113).CONCLUSION:BP levels, hypertension prevalence and control are similar by office criteria but significantly different by ABPM criteria between male and female KTRs. Worse ambulatory BP control in male compared with female KTRs may interfere with renal and cardiovascular outcomes.

Late-night overeating (LNO) is associated with several cardiovascular disease (CVD) risk factors. Limited data exist regarding the association between late-night (LN) systematic food consumption, LNO, and LN poor food quality with subclinical vascular damage (SVD) which precedes the onset of CVD. This study aimed to investigate the above associations with SVD in a large sample of adults, free of established CVD, with one or more CVD risk factors. In total, 901 adults (45.2% males) underwent anthropometric, dietary (through two 24 h dietary recalls) and vascular assessment. LN systematic eating was defined as consumption of food after 19:00 h in both dietary recalls and LNO was defined as systematic consumption of >40% of daily total energy intake (dTEI) after 19:00 h. Systematic LN food consumption was inversely associated with diastolic blood pressure (DBP) (−1.44 95% C.I. (−2.76, −0.12)) after adjusting for age, sex, hypertension, diabetes, dyslipidemia, smoking, BMI and dTEI. LNO was positively associated with existence of carotid plaques (1.70 95% C.I. (1.07, 2.68)), while LN increased consumption of red meat, refined grains and wine and low consumption of whole wheat grains was positively associated with Aix (Augmentation Index) (0.84 95% C.I. (0.09, 1.59)), after adjusting for all the mentioned confounders. Systematic LN eating is associated with lower DBP while systematic LNO and consumption of poor-quality food late at night, is associated with SVD. Further research is needed to define more accurately the impact of LN eating habits on vascular health.

OBJECTIVE:Kidney transplant recipients (KTRs) display higher cardiovascular morbidity and mortality than the general population. Increased short-term blood pressure variability (BPV) is associated with a higher risk of adverse cardiovascular outcomes in chronic kidney disease (CKD). The aim of this study is to investigate sex differences in short-term BPV in KTRs.METHODS:In total, 136 male and 69 female KTRs with valid 24 h ambulatory blood pressure monitoring were included in this analysis. Systolic and diastolic BPV indices [SD, weighted SD (wSD), coefficient of variation (CV), average real variability (ARV) and variability independent of the mean (VIM)] were calculated with validated formulas for the 24 h, daytime and nighttime periods.RESULTS:Age, time from transplantation surgery and history of major comorbidities did not differ between men and women. During the 24-h period, systolic BPV indices did not differ between men and women (SBP-ARV: 9.4 ± 2.2 vs. 9.9 ± 2.5; P = 0.212). During the daytime period, SBP-CV and SBP-VIM were significantly higher in females compared with male participants (SBP-CV: 9.9 ± 2.4 vs. 11 ± 3.1%; P = 0.022 and SBP-VIM: 12.6 ± 3.0 vs 14.2 ± 3.9; P = 0.008); daytime SBP-SD and SBP-ARV, and all studied indexes during nighttime did not differ between groups. No significant between-group differences in 24 h and daytime diastolic BPV indices were detected. Nighttime DBP-CV was marginally higher in men (12.0 ± 3.6 vs. 11.4 ± 4.0; P = 0.053); the rest nighttime diastolic BPV indices measured were also nonsignificantly higher in men.CONCLUSION:In conclusion, 24-h systolic and diastolic BPV parameters did not differ between male and female KTRs, but short-term BPV over the respective day- and nighttime periods showed different trends in men and women. Further studies are needed to examine possible differences in long-term BPV in KTRs.