Age, Arterial Stiffness, and Components of Blood Pressure in Chinese Adults

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Abstract

Blood pressure (BP) changes with age. We conducted a cross-sectional study in rural Chinese adults to investigate: (1) what is the relationship between age, arterial stiffness, and BP in Chinese men and women; and (2) to what degree can the age–BP relationship be explained by arterial stiffness, controlling for other covariables.

These analyses included a total of 1688 subjects (males/females: 623/1065), aged 40 to 88 years. Among them, 353 (20.9%) had hypertension (defined as systolic blood pressure (SBP) ≥140 mm Hg or diastolic blood pressure (DBP) ≥90 mm Hg). Arterial stiffness was measured by brachial–ankle pulse wave velocity (baPWV).

baPWV appeared to be more strongly correlated with BP (including SBP, DBP, mean arterial pressure [MAP], pulse pressure [PP]) than age ( P < 0.001 for comparisons between Spearman correlation coefficients). Furthermore, baPWV was associated with BP (including SBP, DBP, MAP, and PP) and risk of hypertension in a dose–response fashion, independent of age; in contrast, the age–BP associations were either attenuated or became negative after adjusting for baPWV.

Arterial stiffness appears to be an independent contributor to hypertension, even after adjusting for age and other covariables. In contrast, age–BP associations became attenuated or negative after adjusting for baPWV. The utility of baPWV as a diagnostic, prognostic, and therapeutic indicator for hypertension warrants further investigation.

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Effects of age and aerobic capacity on arterial stiffness in healthy adults.

P. V. Vaitkevicius, J L Fleg, J. Engel … (1993)

It has been well established that arterial stiffness, manifest as an increase in arterial pulse wave velocity or late systolic amplification of the carotid artery pressure pulse, increases with age. However, the populations studied in prior investigations were not rigorously screened to exclude clinical hypertension, occult coronary disease, or diabetes. Furthermore, it is unknown whether exercise capacity or chronic physical endurance training affects the age-associated increase in arterial stiffness. Carotid arterial pressure pulse augmentation index (AGI), using applanation tonometry, and aortic pulse wave velocity (APWV) were measured in 146 male and female volunteers 21 to 96 years old from the Baltimore Longitudinal Study of Aging, who were rigorously screened to exclude clinical and occult cardiovascular disease. Aerobic capacity was determined in all individuals by measurement of maximal oxygen consumption (VO2max) during treadmill exercise. In this healthy, largely sedentary cohort, the arterial stiffness indexes AGI and APWV increased approximately fivefold and twofold, respectively, across the age span in both men and women, despite only a 14% increase in systolic blood pressure (SBP). These age-associated increases in AGI and APWV were of a similar magnitude to those in prior studies of less rigorously screened populations. Both AGI and APWV varied inversely with VO2max, and this relationship, at least for AGI, was independent of age. In endurance trained male athletes, 54 to 75 years old (VO2max = 44 +/- 3 mL.kg-1.min-1), the arterial stiffness indexes were significantly reduced relative to their sedentary age peers (AGI, 36% lower; APWV, 26% lower) despite similar blood pressures. Even in normotensive, rigorously screened volunteers in whom SBP increased an average of only 14% between ages 20 and 90 years, major age-associated increases of arterial stiffness occur. Higher physical conditioning status, indexed by VO2max, was associated with reduced arterial stiffness, both within this predominantly sedentary population and in endurance trained older men relative to their less active age peers. These findings suggest that interventions to improve aerobic capacity may mitigate the stiffening of the arterial tree that accompanies normative aging.

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Comparison between carotid-femoral and brachial-ankle pulse wave velocity as measures of arterial stiffness.

H Yasuda, Hirofumi Tanaka, T Ozawa … (2009)

Arterial stiffness is an important risk factor for cardiovascular disease. Carotid-femoral pulse wave velocity (cfPWV) is the most recognized and established index of arterial stiffness. An emerging automatic measure of PWV primarily used in the Asian countries is brachial-ankle PWV (baPWV). To systematically compare these two methodologies, we conducted a multicenter study involving a total of 2287 patients. There was a significant positive relation between baPWV and cfPWV (r = 0.73). Average baPWV was approximately 20% higher than cfPWV. Both cfPWV and baPWV were significantly and positively associated with age (r = 0.56 and 0.64), systolic blood pressure (r = 0.49 and 0.61), and the Framingham risk score (r = 0.48 and 0.63). The areas under the receiver operating curves (ROCs) of PWV to predict the presence of both stroke and coronary artery disease were comparable between cfPWV and baPWV. Collectively, these results indicate that cfPWV and baPWV are indices of arterial stiffness that exhibit similar extent of associations with cardiovascular disease risk factors and clinical events.

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Influences of age and gender on results of noninvasive brachial-ankle pulse wave velocity measurement--a survey of 12517 subjects.

Hirofumi Tomiyama, Akira Yamashina, Tomio Arai … (2003)

The present study was conducted to evaluate the influences of age and gender on the results of noninvasive brachial-ankle pulse wave velocity (baPWV). In 12517 subjects who had no medication and no history of cardiovascular diseases, multiple regression analysis demonstrated that age, blood pressure, body mass index, triglycerides, blood glucose, and uric acid were significant variables for baPWV in both genders. From this population, we extracted 7881 "healthy subjects" (4488 males and 3393 females, 25-87 years) without any of the atherogenic risk factors, and the results of baPWV were analyzed chronologically in 5-year age intervals. baPWV was lower in females than in males until age 60, and became similar in both genders over age 60. Multiple regression analysis demonstrated that not only the value of R(2) but also the coefficient of the effect of age on baPWV are larger in females than in males. In the estimation of the regression curve, the relationship between age and baPWV demonstrated a quadratic curve in both genders. Thus, aging influences baPWV, and its effect is more prominent in female. Menopause seems to be the crucial phenomenon to explain the augmented increase in arterial stiffness with aging in females.

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Author and article information

Journal

Journal ID (nlm-ta): Medicine (Baltimore)

Journal ID (iso-abbrev): Medicine (Baltimore)

Journal ID (publisher-id): MEDI

Title: Medicine

Publisher: Wolters Kluwer Health

ISSN (Print): 0025-7974

ISSN (Electronic): 1536-5964

Publication date Collection: December 2014

Publication date (Electronic): 02 December 2014

Volume: 93

Issue: 29

Electronic Location Identifier: e262

Affiliations

From the Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China (MZ, XY); Guangdong Institute of Nephrology, Southern Medical University, Guangzhou, China (XX, XX, XQ); Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins, University Bloomberg School of Public Health, Baltimore, MD, USA (XW); Cardiology Department, Peking University First Hospital, Beijing, China (YH, FF); and Institute of Biomedicine, Anhui Medical University, Hefei, China (GT, HX, WC).

Author notes

Correspondence: Xinchun Yang, Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, 8# Gong-Ti South Road, Beijing, China (e-mail: yangxc99@ 123456gmail.com ).

Article

Accession ID: 00262

DOI: 10.1097/MD.0000000000000262

PMC ID: 4602627

PubMed ID: 25546666

SO-VID: 2affdb34-8932-4e62-8425-21312aa6045e

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This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

History

Date received : 21 August 2014

Date revision received : 14 October 2014

Date accepted : 14 October 2014

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Age, Arterial Stiffness, and Components of Blood Pressure in Chinese Adults

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Most cited references 23

Effects of age and aerobic capacity on arterial stiffness in healthy adults.

Comparison between carotid-femoral and brachial-ankle pulse wave velocity as measures of arterial stiffness.

Influences of age and gender on results of noninvasive brachial-ankle pulse wave velocity measurement--a survey of 12517 subjects.

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