Diastolic blood pressure is an important determinant of augmentation index and pulse wave velocity in young, healthy males

Abstract

Pulse wave velocity (PWV) and augmentation index are widely used measures of arterial stiffness. The purpose of this study was to evaluate the role of blood pressure as a determinant of both indices independent of potentially confounding factors including gender, age and cardiovascular disorders. A total of 77 young, healthy subjects were investigated under resting conditions. Augmentation index was derived by pulse wave analysis using carotid applanation tonometry. PWV was determined from pressure tracing over the carotid and femoral artery. The relations between stiffness markers and haemodynamic parameters were analysed by simple (r) and multiple (b) regression analysis. Using simple regression analysis, augmentation index was correlated to age (r ¼ 0.292, P ¼ 0.0105), diastolic blood pressure (DBP, r ¼ 0.483, Po0.0001), mean arterial blood pressure (MAP, r ¼ 0.381, P ¼ 0.0007), pulse pressure (r ¼ À0.414, P ¼ 0.0002) and total peripheral resistance (r ¼ 0.266, P ¼ 0.0204). After multiple regression analysis, augmentation index remained significantly correlated only to DBP (b ¼ 0.347, P ¼ 0.0051). Using simple regression analysis, PWV was correlated to age (r ¼ 0.304, P ¼ 0.0067), systolic blood pressure (r ¼ 0.280, P ¼ 0.0129). DBP (r ¼ 0.455, Po0.0001), MAP (r ¼ 0.446, Po0.0001) and heart rate (r ¼ 0.348, P ¼ 0.0018). After multiple regression analysis, PWV remained correlated only to age (b ¼ 0.218, P ¼ 0.0422) and DBP (b ¼ 0.4105, P ¼ 0.0316). In summary, DBP is an important determinant of augmentation index and PWV in young, healthy males. Further studies are needed to characterize the impact of blood pressure on arterial stiffness in other populations including females and older subjects.

Relationship between blood pressure parameters and pulse wave velocity in normotensive and hypertensive subjects: invasive study

“…In combination with the previous studies, 18,[32][33][34] the present study also suggests that the role of BP parameters as a predictor of PWV could be different according to the age range of the population studied. Further large population-based studies are needed to characterize the age-related changes in the impact of BP on large artery stiffness.…”

“…K In normotensive and untreated hypertensive middle-aged and elderly subjects, pulse pressure showed the strongest correlation with aortic PWV over other BP parameters. K In combination with the previous studies, 18,[32][33][34] our findings also suggest that the role of BP parameters as a predictor of PWV could be different according to the age range of the population studied.…”

“…22 Sa Cunha et al 23 suggested gender difference; SBP showed correlation with PWV in both genders, whereas DBP was correlated with PWV only in women. In contrast to the previous studies, Nurnberger et al 18 reported that DBP was an only important haemodynamic determinant of PWV in young healthy males.…”

“…Because our results also showed prognostic significance of SBP and MAP for aortic PWV and no correlation of DBP with PWV, the findings were in agreement with the previous data. [32][33][34] Interestingly, Nurnberger et al 18 reported a contrary result. They showed DBP was the only important determinant of PWV among all BP parameters.…”

“…Although BP is one of the strongest factors influencing PWV, varying correlation coefficients have been reported between the various PWV (aorta-leg-arm) and BP (systolic, diastolic, mean, pulse) using non-invasive methods. 5,[18][19][20][21][22][23][24] This variation may be attributable, at least in part, to the inherent variability of both PWV and BP within and across individual subjects and also to the method of BP 25 and PWV measurements.…”