Department of Cardiology, Klinikum Wels-Grieskirchen, Wels.
Department of Health and Environment, Center for Health & Bioresources, Austrian Institute of Technology, Vienna, Austria.
J Hypertens. 2019 Dec;37(12):2404-2413. doi: 10.1097/HJH.0000000000002178.
Pulsatile hemodynamics predict major cardiovascular events. We aimed to provide comprehensive population-based reference values and to compare different measures of pulsatile hemodynamics to define early vascular aging (EVA) as well as healthy vascular aging (HVA).
In 2721 participants from the population-based Heinz Nixdorf Recall Study and the associated MultiGeneration Study, free from diabetes, cardiovascular disease, and antihypertensive drugs, we performed high-fidelity radial tonometry, calibrated waveforms with brachial blood pressures and processed them with a validated transfer function, pulse wave analysis, and wave separation analysis. Aortic pulse wave velocity (aoPWV) was estimated with a validated regression formula. HVA was defined as the lowest, EVA as the highest age-specific decile of central pulse pressure (cPP), backward wave amplitude, and aoPWV.
Overall, 56.4% of participants were female, age range 18-90 years. Brachial PP increased from middle age, whereas cPP increased across the entire adult life span. Wave reflections increased across all age groups, apart from a plateau in older male participants. Indices of wave reflection were higher in women than in men. AoPWV showed the most prominent rise with age in both sexes. EVA and HVA, defined by cPP and backward wave amplitude, differed mainly by hemodynamic variables. In contrast, EVA participants were characterized by a worse hemodynamic, anthropometric, metabolic, and inflammatory profile, if aoPWV was used to discriminate EVA and HVA.
Age-specific and sex-specific reference values for central pulsatile hemodynamics in a general white population cohort are provided and may be utilized to define HVA and EVA.
脉动血流动力学可预测主要心血管事件。我们旨在提供全面的基于人群的参考值，并比较脉动血流动力学的不同指标，以定义早期血管老化（EVA）和健康血管老化（HVA）。
在来自基于人群的Heinz Nixdorf 回顾研究和相关的多代研究的 2721 名参与者中，无糖尿病、心血管疾病和抗高血压药物，我们进行了高精度的桡动脉张力测量，用肱动脉血压校准波形，并使用经过验证的传递函数、脉搏波分析和波分离分析对其进行处理。主动脉脉搏波速度（aoPWV）采用经过验证的回归公式进行估计。HVA 定义为中央脉搏压（cPP）、反向波幅度和 aoPWV 的最低年龄特异性十分位数，EVA 定义为最高年龄特异性十分位数。
总体而言，56.4%的参与者为女性，年龄范围为 18-90 岁。肱动脉 PP 从中年开始增加，而 cPP 则在整个成年期增加。除了老年男性参与者的平台期外，所有年龄组的波反射均增加。女性的波反射指数高于男性。AoPWV 在两性中均随年龄增长而最为显著增加。以 cPP 和反向波幅度定义的 EVA 和 HVA，主要通过血流动力学变量来区分。相比之下，如果使用 aoPWV 来区分 EVA 和 HVA，则 EVA 参与者的血流动力学、人体测量、代谢和炎症特征较差。
提供了一般白人群体中心脉动血流动力学的年龄特异性和性别特异性参考值，可用于定义 HVA 和 EVA。
