Amplification of the Pressure Pulse in the Upper Limb in Healthy, Middle-Aged Men and Women

被引:155
作者
Segers, Patrick [1 ]
Mahieu, Dries [2 ]
Kips, Jan [1 ,2 ]
Rietzschel, Ernst [4 ]
De Buyzere, Marc [4 ]
De Bacquer, Dirk [5 ]
Bekaert, Sofie [3 ]
De Backer, Guy [5 ]
Gillebert, Thierry [4 ]
Verdonck, Pascal [1 ]
Van Bortel, Luc [2 ]
机构
[1] Univ Ghent, Inst Biomed Technol, B-9000 Ghent, Belgium
[2] Univ Ghent, Heymans Inst Pharmacol, B-9000 Ghent, Belgium
[3] Univ Ghent, Dept Mol Biotechnol, Fac Biosci Engn, B-9000 Ghent, Belgium
[4] Ghent Univ Hosp, Dept Cardiovasc Dis, B-9000 Ghent, Belgium
[5] Ghent Univ Hosp, Dept Publ Hlth, B-9000 Ghent, Belgium
关键词
cardiovascular physiology; blood pressure; large arteries; wave reflection; hemodynamics; AORTIC PRESSURE; BLOOD-PRESSURE; NONINVASIVE ASSESSMENT; HYPERTENSIVE SUBJECTS; INPUT IMPEDANCE; WAVE-FORM; IMPACT; CALIBRATION; TONOMETRY;
D O I
10.1161/HYPERTENSIONAHA.109.133009
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Central-to-peripheral amplification of the pressure pulse leads to discrepancies between central and brachial blood pressures. This amplification depends on an individual's hemodynamic and (patho)physiological characteristics. The aim of this study was to assess the magnitude and correlates of central-to-peripheral amplification in the upper limb in a healthy, middle-aged population (the Asklepios Study). Carotid, brachial, and radial pressure waveforms were acquired noninvasively using applanation tonometry in 1873 subjects (895 women) aged 35 to 55 years. Carotid, brachial, and radial pulse pressures were calculated, as well as the absolute and relative (with carotid pulse pressure as reference) amplifications. With subjects classified per semidecade of age, carotid-to-radial amplification varied from approximate to 25% in the youngest men to 8% in the oldest women. Amplification was higher in men (20 +/- 14%) than in women (13 +/- 12%; P < 0.001) and decreased with age (P < 0.001) in both. Amplification over the brachial-to-radial path contributed substantially to the total amplification. In univariate analysis, the strongest correlation was found with the carotid augmentation index (-0.51 in women; -0.47 in men; both P < 0.001). In a multiple linear regression model with carotid-to-radial amplification as the dependent variable, carotid augmentation index, total arterial compliance, and heart rate were identified as the 3 major determinants of upper limb pressure amplification (R(2) = 0.36). We conclude that, in healthy middle-aged subjects, the central-to-radial amplification of the pressure pulse is substantial. Amplification is higher in men than in women, decreases with age, and is primarily associated with the carotid augmentation index. (Hypertension. 2009; 54: 414-420.)
引用
收藏
页码:414 / 420
页数:7
相关论文
共 22 条
[1]   How to assess mean blood pressure properly at the brachial artery level [J].
Bos, Willem J. W. ;
Verrij, Elisabeth ;
Vincent, Hieronymus H. ;
Westerhof, Berend E. ;
Parati, Gianfranco ;
van Montfrans, Gert A. .
JOURNAL OF HYPERTENSION, 2007, 25 (04) :751-755
[2]  
Chemla D, 2002, CLIN SCI, V103, P7
[3]   NONINVASIVE DETERMINATION OF AORTIC INPUT IMPEDANCE AND EXTERNAL LEFT-VENTRICULAR POWER OUTPUT - A VALIDATION AND REPEATABILITY STUDY OF A NEW TECHNIQUE [J].
KELLY, R ;
FITCHETT, D .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1992, 20 (04) :952-963
[4]   Heart rate and pulse pressure amplification in hypertensive subjects [J].
Laurent, P ;
Albaladejo, P ;
Blacher, J ;
Rudnichi, A ;
Smulyan, H ;
Safar, ME .
AMERICAN JOURNAL OF HYPERTENSION, 2003, 16 (05) :363-370
[5]   Expert consensus document on arterial stiffness: methodological issues and clinical applications [J].
Laurent, Stephane ;
Cockcroft, John ;
Van Bortel, Luc ;
Boutouyrie, Pierre ;
Giannattasio, Cristina ;
Hayoz, Daniel ;
Pannier, Bruno ;
Vlachopoulos, Charalambos ;
Wilkinson, Ian ;
Struijker-Boudier, Harry .
EUROPEAN HEART JOURNAL, 2006, 27 (21) :2588-2605
[6]   Central pressure: Variability and impact of cardiovascular risk factors - The Anglo-Cardiff Collaborative Trial II [J].
McEniery, Carmel M. ;
McDonnell, Barry ;
Munnery, Margaret ;
Wallace, Sharon M. ;
Rowe, Chloe V. ;
Cockcroft, John R. ;
Wilkinson, Ian B. .
HYPERTENSION, 2008, 51 (06) :1476-1482
[7]  
Milnor W.R., 1989, HEMODYNAMICS, V2nd
[8]  
Nichols W.W., 2005, McDonald's Blood Flow in Arteries
[9]  
O'Rourke MF, 2005, HYPERTENSION, V46, pE15, DOI 10.1161/01.HYP.0000188391.12174.60
[10]   Prospective evaluation of a method for estimating ascending aortic pressure from the radial artery pressure waveform [J].
Pauca, AL ;
O'Rourke, MF ;
Kon, ND .
HYPERTENSION, 2001, 38 (04) :932-937