Second Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan.
Am J Hypertens. 2011 Aug;24(8):881-6. doi: 10.1038/ajh.2011.56. Epub 2011 Apr 14.
Interactions among age, arterial stiffness, and pressure wave reflection affect the central blood pressure (CBP). We evaluated our hypothesis that the contribution of the wave reflection to the CBP indexes is reduced at higher levels of arterial stiffness, independent of the effect of age.
In 2,691 Japanese men aged <60 years old who are not suffering from cardiovascular disease or receiving medications for cardiovascular risk factors, the brachial-ankle pulse wave velocity (PWV), radial augmentation index (AI), and second peak of the radial pressure waveform (SBP2), a marker of CBP, were measured.
The increase in the radial AI associated with increase of the brachial-ankle PWV became attenuated at brachial-ankle PWV values of ≥15 m/s. Stepwise multivariate linear regression analysis demonstrated that 33.6% of the total variation in the value of SBP2 and 54.0% of the total variation in the value of the SBP2 minus the diastolic blood pressure, a marker of the central pulse pressure (CPP), were accounted for by the change of the radial AI in the group with brachial-ankle PWV values of <15 m/s, with the corresponding percentages of 16.2 and 38.0% in the group with brachial-ankle PWV values of ≥15 m/s (P < 0.01).
In non-elderly Japanese men, the contribution of the wave reflection to the CBP indexes may be reduced in subjects with higher levels of arterial stiffness, independent of the effect of age. Notwithstanding, the wave reflection may still be the major determinant of the CPP at any given level of arterial stiffness.
年龄、动脉僵硬度和压力波反射之间的相互作用会影响中心血压(CBP)。我们评估了我们的假设,即在动脉僵硬度较高的情况下,波反射对 CBP 指标的贡献会降低,而与年龄的影响无关。
在 2691 名年龄<60 岁且未患有心血管疾病或正在接受心血管危险因素药物治疗的日本男性中,测量了肱踝脉搏波速度(PWV)、桡动脉增强指数(AI)和桡动脉压力波形的第二峰(SBP2),这是 CBP 的一个标志物。
与肱踝 PWV 增加相关的桡动脉 AI 增加在肱踝 PWV 值≥15 m/s 时减弱。逐步多元线性回归分析表明,SBP2 值总变异的 33.6%和 SBP2 减去舒张压(CPP 的标志物)值总变异的 54.0%可由桡动脉 AI 的变化来解释,在肱踝 PWV 值<15 m/s 的组中,这一比例分别为 16.2%和 38.0%,而在肱踝 PWV 值≥15 m/s 的组中,这一比例分别为 16.2%和 38.0%(P<0.01)。
在非老年日本男性中,波反射对 CBP 指标的贡献可能会在动脉僵硬度较高的受试者中降低,而与年龄的影响无关。然而,在任何给定的动脉僵硬度水平下,波反射仍然可能是 CPP 的主要决定因素。