Explore the complexities of arterial stiffness with Dr. Bart Spronck, a researcher at Maastricht University. In this interview, Dr. Spronck navigates the challenges of measuring arterial stiffness, shedding light on innovative solutions, including smartwatches. The discussion also touches on the delicate balance between repurposing drugs and developing targeted treatments for effective arterial health. Join Dr. Spronck as he unravels the potential reversibility of arterial stiffness and advocates for a personalized approach in cardiovascular research.
So as the first question, could you tell us in a nutshell about your current research on arterial stiffness at Maastricht University and share some exciting recent results?
Arterial stiffness is a critical aspect of cardiovascular health, especially during aging. Stiffer arteries lose their ability to buffer blood pressure efficiently. In my research at Maastricht University, I focus on two primary avenues. The first revolves around developing accurate methods to measure arterial stiffness. This is crucial because there are various ways to measure stiffness, each with its pros and cons. Hence, in my work, I address confounding factors, such as blood pressure dependence, to provide a more accurate and reliable measure of arterial stiffness.
A second aspect of my research involves understanding why arteries stiffen with age. While it's a well-known phenomenon that arteries stiffen as we grow older, the underlying mechanisms are not fully elucidated. I aim to uncover the intricacies of arterial stiffening, exploring the roles of elastin, collagen, and smooth muscle cells — the primary constituents of the arterial wall. By being able to separate these components’ contributions to stiffening, we gain an in-depth insight in the mechanism(s) of arterial stiffening, providing novel avenues in managing arterial health.
Recent results from our studies are promising, shedding light on potential interventions and ways to mitigate age-related arterial stiffening. These findings contribute to the broader understanding of cardiovascular health and open avenues for targeted treatments.
How can one measure arterial stiffness? Should they consult a doctor?
Measuring arterial stiffness traditionally involves measuring the carotid-to-femoral pulse wave velocity. However, access to techniques that allow for such measurements is very limited (also in the Netherlands, where I conduct my own research). Unfortunately, as (most) general practitioners are not equipped to measure arterial stiffness, having your “arterial stiffness” measured is not commonly performed procedure.
Alternatively, in certain countries (e.g., Switzerland and Spain) there are initiatives at pharmacies where individuals can get their arterial stiffness measured. Additionally, advancements in technology have introduced innovative solutions such as specialized bathroom scales that measure pulse wave velocity. These scales combine the measurement of a tiny change in “weight” as the heart expels its blood, with a measurement of the impedance changes between the feet to estimate when blood reaches the lower extremities.
Furthermore, smartwatches are emerging as potential devices for measuring arterial stiffness. While not widely available yet, some models claim to provide such measurements by assessing the time delay between heart activity and the pressure wave reaching the wrist or finger.
Can new smartwatches accurately measure arterial stiffness, or do they merely provide blood pressure information?
Many smartwatches claim to measure arterial stiffness using a combination of ECG (electrocardiogram) for heart activity and PPG (photoplethysmogram) for assessing blood flow timing. These devices determine the time delay between heart activation and the pressure wave reaching the wrist or finger, from which they estimate arterial stiffness.
Interestingly, most watches claiming to measure blood pressure follow a reverse approach. They use stiffness, transit time, or pulse wave velocity to predict blood pressure changes based on a reference measurement. While this technology is evolving, and some watches provide valuable insights, the accuracy of these measurements compared to traditional methods remains an area of ongoing research.
As technology advances, there's potential for smartwatches to become valuable diagnostic tools for doctors. If these devices can accurately measure blood pressure and arterial stiffness, they might offer a more convenient and continuous monitoring solution, contributing to preventive healthcare.
Do you envision a future where smartwatches can be utilized as diagnostic tools by doctors, accurately measuring blood pressure and arterial stiffness?
Envisioning a future where smartwatches serve as diagnostic tools is certainly plausible. For this to happen, watches need to provide accurate and reliable measurements of both blood pressure and arterial stiffness. Ideally, a watch could integrate a cuff-like mechanism for measuring stiffness alongside its EKG and PPG capabilities.
The evolving landscape of artificial intelligence presents opportunities for refining algorithms based on the waveform data collected by these watches. By analyzing more than just minimum and maximum values, algorithms could extract nuanced information from the waveforms, enhancing diagnostic capabilities. While challenges exist, including standardization and validation of these measurements, the potential for smartwatches in healthcare diagnostics is an exciting avenue worth exploring.
Could smartwatches with accurate blood pressure measurements and arterial stiffness estimates become integral in managing blood pressure effectively?
The prospect of integrating accurate blood pressure and arterial stiffness measurements into smartwatches raises the question of whether these devices could play a crucial role in blood pressure management. If a smartwatch can provide reliable data, including stiffness and transit time, it could potentially aid doctors in tailoring interventions more precisely.
For effective blood pressure management, a holistic approach is necessary. Combining accurate measurements with personalized treatment plans could enhance outcomes. While challenges like standardization and validation persist, the continuous monitoring capabilities of smartwatches offer the potential for real-time insights into cardiovascular health. However, it's essential to strike a balance between technological advancements and ensuring the medical community embraces and trusts these innovations.
Regarding research on arterial stiffness, should scientists explore repurposing existing drugs or focus on developing new treatments specifically targeting arterial stiffness?
The decision between repurposing existing drugs and developing new treatments for arterial stiffness involves a trade-off. Repurposing drugs offers advantages like bypassing lengthy approval processes, saving time and costs. However, the effects of repurposed drugs on arterial stiffness may vary.
On the other hand, developing new treatments tailored for arterial stiffness might yield more targeted and efficacious solutions. Given the intricate mechanisms involved in arterial stiffening, understanding how different drugs impact arteries individually is crucial. Personalized studies exploring the differential effects of antihypertensive medications on both blood pressure and arterial stiffness could provide valuable insights.
The multifaceted nature of arterial stiffening suggests a need for a nuanced approach. While repurposing has its merits, investing in targeted treatments may lead to more effective and personalized solutions for combating arterial stiffness.
Is arterial stiffness reversible with potent drugs? Can the future hold treatments capable of reversing or significantly decreasing arterial stiffness?
Addressing the reversibility of arterial stiffening with potent drugs is a complex task. Arterial stiffness, to some extent, has shown reversibility, as observed in individuals engaging in regular exercise. The turnover of the collagen matrix within arterial walls contributes to this reversibility.
Developing potent drugs capable of inducing significant reversibility in arterial stiffness is an ongoing challenge. While exercise has proven beneficial, finding pharmaceutical alternatives that can effectively mimic these effects remains elusive. The longevity and stability of elastin, coupled with the intricate interplay of various mechanisms, make it a challenging target.
Understanding the mechanisms contributing to arterial stiffening and developing interventions that not only address the symptoms but also promote sustained reversibility is an area of active research. Achieving this goal would mark a significant breakthrough in cardiovascular medicine.
For young researchers interested in arterial stiffness, what aspects should they focus on? How can personalized medicine contribute to advancing arterial stiffness research?
Young researchers delving into the field of arterial stiffness should consider the potential of personalized medicine as a focal point. The current one-size-fits-all approach to treating hypertension may not fully capture the variability in individuals' arterial responses.
Exploring how different arterial components, such as elastin, collagen, and smooth muscle cells, contribute to stiffness in unique ways is an avenue ripe for investigation. This entails not only understanding the mechanisms but also finding ways to tailor interventions based on individual arterial characteristics.
Moreover, the integration of advanced technologies, such as artificial intelligence and smartwatches, into arterial stiffness research can revolutionize measurement methods. Striving for simplicity in measurement techniques, akin to the ease of traditional blood pressure measurements, can facilitate widespread adoption in clinical settings.
In essence, combining mechanistic insights with personalized approaches and leveraging technological innovations can propel arterial stiffness research into a new era of understanding and treatment customization.
The article was written by Lorenzo Cianni and Cedric Neutel
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