Document Detail


Hemodynamic correlates of blood pressure across the adult age spectrum: noninvasive evaluation in the Framingham Heart Study.
MedLine Citation:
PMID:  20855656     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Systolic blood pressure and pulse pressure are substantially higher in older adults. The relative contributions of increased forward versus reflected pressure wave amplitude or earlier arrival of the reflected wave to elevated pulse pressure remain controversial.
METHODS AND RESULTS: We measured proximal aortic pressure and flow, forward pressure wave amplitude, global wave reflection, reflected wave timing, and pulse wave velocity noninvasively in 6417 (age range, 19 to 90 years; 53 women) Framingham Heart Study Third Generation and Offspring participants. Variation in forward wave amplitude paralleled pulse pressure throughout adulthood. In contrast, wave reflection and pulse pressure were divergent across adulthood: In younger participants, pulse pressure was lower and wave reflection was higher with advancing age, whereas in older participants, pulse pressure was higher and wave reflection was lower with age. Reflected wave timing differed modestly across age groups despite considerable differences in pulse wave velocity. Forward wave amplitude explained 80 (central) and 66 (peripheral) of the variance in pulse pressure in younger participants (<50 years) and 90 and 84 in the older participants (≥ 50 years; all P<0.0001). In a stepwise model that evaluated age-pulse pressure relations in the full sample, the late accelerated increases in central and peripheral pulse pressure were markedly attenuated when variation in forward wave amplitude was considered.
CONCLUSIONS: Higher pulse pressure at any age and higher pulse pressure with advancing age is associated predominantly with a larger forward pressure wave. The influence of wave reflection on age-related differences in pulse pressure was minor.
Authors:
Gary F Mitchell; Na Wang; Joseph N Palmisano; Martin G Larson; Naomi M Hamburg; Joseph A Vita; Daniel Levy; Emelia J Benjamin; Ramachandran S Vasan
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-09-20
Journal Detail:
Title:  Circulation     Volume:  122     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-05     Completed Date:  2010-10-29     Revised Date:  2012-05-07    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1379-86     Citation Subset:  AIM; IM    
Affiliation:
Cardiovascular Engineering Inc., 1 Edgewater Drive, Norwood, MA 02062, USA. GaryFMitchell@mindspring.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aging / physiology*
Blood Pressure / physiology*
Body Mass Index
Cardiovascular Diseases / epidemiology
Female
Heart Rate
Hemodynamics / physiology*
Humans
Hypertension / epidemiology
Lipids / blood
Male
Middle Aged
Pulse
Smoking / epidemiology
Young Adult
Grant Support
ID/Acronym/Agency:
2-K24-HL04334/HL/NHLBI NIH HHS; AG028321/AG/NIA NIH HHS; HL060040/HL/NHLBI NIH HHS; HL070100/HL/NHLBI NIH HHS; HL071039/HL/NHLBI NIH HHS; HL076784/HL/NHLBI NIH HHS; HL077447/HL/NHLBI NIH HHS; HL080124/HL/NHLBI NIH HHS; K24 HL004334-08/HL/NHLBI NIH HHS; N01 HC025195/HC/NHLBI NIH HHS; N01-HC-25195/HC/NHLBI NIH HHS; R01 AG028321-05/AG/NIA NIH HHS; R01 HL060040-04/HL/NHLBI NIH HHS; R01 HL070100-04/HL/NHLBI NIH HHS; R01 HL071039-02/HL/NHLBI NIH HHS; R01 HL076784-05/HL/NHLBI NIH HHS; R01 HL077447-05/HL/NHLBI NIH HHS; R01 HL080124-05/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Lipids
Comments/Corrections

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