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Current Hypertension Reviews

Editor-in-Chief

ISSN (Print): 1573-4021
ISSN (Online): 1875-6506

Research Article

Characteristics and Determinants of Pulse Pressure-Age Relationship in Healthy and Non-treated Hypertensive Subjects of Argentinean Population

Author(s): Alejandro Díaz*, Ariel F. Pascaner, Sandra Wray and Edmundo C. Fischer

Volume 17, Issue 2, 2021

Published on: 10 December, 2020

Page: [137 - 148] Pages: 12

DOI: 10.2174/1573402116999201210195123

Price: $65

Abstract

Background: The relationship between the increases in pulse pressure (PP) and arterial stiffness determined by aging or systemic hypertension has been widely reported. These findings are supported by large-cohort analyzes conducted in well-known populations, such as Framingham Study. However, there is evidence that an age-PP curvilinear relationship may exist in hypertensive subjects. This study aimed to evaluate the age-related change in pulse pressure and arterial stiffness in a population-based study.

Methods: Carotid-femoral Pulse Wave Velocity (cfPWV) were obtained in 2075 subjects.

Results: Age-related changes of PP showed a curvilinear relationship (R=0.39, p<0.0001) in normotensive subjects, with a nadir at around 50 years of age. On the other hand, the age-cfPWV relationship showed a linear and positive correlation (R=0.72, p<0.0001). PP also showed a curvilinear relationship with age (R=0.36, p<0.0001) in hypertensive subjects, with a nadir around 50 years of age. The age-cfPWV relationship showed a linear and positive correlation (R=0.55, p<0.0001). Similar results were observed in the adult population (age≥16 years). Multivariate analysis showed that age, sex, cfPWV, and mean arterial pressure are determinants of PP values in the entire population; however, this result was not uniform when different subgroups were analyzed.

Conclusion: In conclusion, age-related changes in PP showed a curvilinear relationship and no parallelism with the age-cfPWV relationship for both normotensive and hypertensive subjects. The determinants of PP impact it differently depending on age and the pathological condition of the subject.

Keywords: Pulse pressure, pulse wave velocity, arterial, stiffness, ageing, cfPWV, hypertension.

Graphical Abstract

[1]
Franklin SS, Gustin W IV, Wong ND, et al. Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study. Circulation 1997; 96(1): 308-15.
[http://dx.doi.org/10.1161/01.CIR.96.1.308] [PMID: 9236450]
[2]
Safar ME, Levy BI, Struijker-Boudier H. Current perspectives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases. Circulation 2003; 107(22): 2864-2869..
[http://dx.doi.org/10.1161/01.CIR.0000069826.36125.B4]
[3]
Mitchell GF, Wang N, Palmisano JN, et al. Hemodynamic correlates of blood pressure across the adult age spectrum: noninvasive evaluation in the Framingham Heart Study. Circulation 2010; 122(14): 1379-86.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.109.914507] [PMID: 20855656]
[4]
Mancusi C, Losi MA, Izzo R, et al. Higher pulse pressure and risk for cardiovascular events in patients with essential hypertension: The Campania Salute Network. Eur J Prev Cardiol 2018; 25(3): 235-43.
[http://dx.doi.org/10.1177/2047487317747498] [PMID: 29226693]
[5]
Alfie J, Galarza C, Waisman G. Noninvasive hemodynamic assessment of the effect of mean arterial pressure on the amplitude of pulse pressure. Am J Hypertens 2005; 18(2 Pt 2): 60S-4S.
[http://dx.doi.org/10.1016/j.amjhyper.2004.11.026] [PMID: 15752934]
[6]
Tringler M, Rodriguez EM, Aguera D, Molina JD, Canziani GA, Diaz A. High blood pressure, overweight and obesity among rural scholars from the Vela Project: a population-based study from South America. High Blood Press Cardiovasc Prev 2012; 19(1): 41-6.
[http://dx.doi.org/10.2165/11632090-000000000-00000] [PMID: 22670586]
[7]
Díaz A, Zócalo Y, Bia D, Wray S, Fischer EC. Reference intervals and percentiles for carotid-femoral pulse wave velocity in a healthy population aged between 9 and 87 years. J Clin Hypertens (Greenwich) 2018; 20(4): 659-71.
[http://dx.doi.org/10.1111/jch.13251] [PMID: 29532992]
[8]
Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: Executive Summary: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018; 71(6): 1269-324.
[http://dx.doi.org/10.1161/HYP.0000000000000066] [PMID: 29133354]
[9]
El Assaad MA, Topouchian JA, Asmar RG. Evaluation of two devices for self-measurement of blood pressure according to the international protocol: the Omron M5-I and the Omron 705IT. Blood Press Monit 2003; 8(3): 127-33.
[http://dx.doi.org/10.1097/00126097-200306000-00006] [PMID: 12900590]
[10]
Díaz A, Tringler M, Galli C, Ramirez A, Fischer EI. Arterial stiffness in a rural population of argentina: Pilot study. High Blood Press Cardiovasc Prev 2015; 22(4): 403-9.
[http://dx.doi.org/10.1007/s40292-015-0110-7] [PMID: 26068976]
[11]
Diaz A, Tringler M, Wray S, Ramirez AJ, Cabrera Fischer EI. The effects of age on pulse wave velocity in untreated hypertension. J Clin Hypertens (Greenwich) 2018; 20(2): 258-65.
[http://dx.doi.org/10.1111/jch.13167] [PMID: 29267992]
[12]
Mattace-Raso FUS, Hofman A, Verwoert GC, et al. Reference Values for Arterial Stiffness’ Collaboration. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘establishing normal and reference values’. Eur Heart J 2010; 31(19): 2338-50.
[http://dx.doi.org/10.1093/eurheartj/ehq165] [PMID: 20530030]
[13]
Van Bortel LM, Laurent S, Boutouyrie P, et al. Artery Society; European Society of Hypertension Working Group on Vascular Structure and Function; European Network for Noninvasive Investigation of Large Arteries. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens 2012; 30(3): 445-8.
[http://dx.doi.org/10.1097/HJH.0b013e32834fa8b0] [PMID: 22278144]
[14]
Huybrechts SAM, Devos DG, Vermeersch SJ, et al. Carotid to femoral pulse wave velocity: a comparison of real travelled aortic path lengths determined by MRI and superficial measurements. J Hypertens 2011; 29(8): 1577-82.
[http://dx.doi.org/10.1097/HJH.0b013e3283487841] [PMID: 21666491]
[15]
Avolio AP, Chen SG, Wang RP, Zhang CL, Li MF, O’Rourke MF. Effects of aging on changing arterial compliance and left ventricular load in a northern Chinese urban community. Circulation 1983; 68(1): 50-8.
[http://dx.doi.org/10.1161/01.CIR.68.1.50] [PMID: 6851054]
[16]
Avolio AP, Kuznetsova T, Heyndrickx GR, Kerkhof PLM, Li JK. Arterial flow, pulse pressure and pulse wave velocity in men and women at various age. In: Kerkhof PLM, Miller VM. Sex specific analysis in cardiovascular function. Springer International Publishing AG, part of Springer Nature. 2018; pp. 153-69.
[http://dx.doi.org/10.1007/978-3-319-77932-4_10]
[17]
Schillaci G, Pucci G. Aging and pulse pressure widening: the inseparable duo? J Hypertens 2015; 33(12): 2389-91.
[http://dx.doi.org/10.1097/HJH.0000000000000788] [PMID: 26536088]
[18]
Butler KR Jr, Penman AD, Minor DS, Mosley TH Jr. Determinants of pulse pressure and annual rates of change in the Atherosclerosis Risk in Communities study. J Hypertens 2015; 33(12): 2463-70.
[http://dx.doi.org/10.1097/HJH.0000000000000731] [PMID: 26378679]
[19]
Gutierrez J, Elkind MSV, Cheung K, Rundek T, Sacco RL, Wright CB. Pulsatile and steady components of blood pressure and subclinical cerebrovascular disease: the Northern Manhattan Study. J Hypertens 2015; 33(10): 2115-22.
[http://dx.doi.org/10.1097/HJH.0000000000000686] [PMID: 26259124]
[20]
Fischer EI, Levenson J, Barra JG, Armentano RL, Pichel RH, Simon A. Preventive effect of chronic converting enzyme inhibition on aortic stiffening induced by renovascular hypertension in conscious dogs. Cardiovasc Res 1993; 27(6): 1039-44.
[http://dx.doi.org/10.1093/cvr/27.6.1039] [PMID: 8221761]
[21]
Alfie J, Waisman GD, Galarza CR, Cámera MI. Contribution of stroke volume to the change in pulse pressure pattern with age. Hypertension 1999; 34(4 Pt 2): 808-12.
[http://dx.doi.org/10.1161/01.HYP.34.4.808] [PMID: 10523365]
[22]
Alfie J, Majul C, Paez O, Galarza C, Waisman G. Hemodynamic significance of high brachial pulse pressure in young men. Clin Exp Hypertens 2004; 26(3): 199-207.
[http://dx.doi.org/10.1081/CEH-120030229] [PMID: 15132298]

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