Hemodynamic correlates of blood pressure across the adult age spectrum: noninvasive evaluation in the Framingham Heart Study.
Hemodynamic correlates of blood pressure across the adult age spectrum: noninvasive evaluation in the Framingham Heart Study.
复制标题
DOI：
10.1161/circulationaha.109.914507
复制
发表时间：
2010-10-05
期刊：
影响因子：
37.8
通讯作者：
Vasan RS
中科院分区：
文献类型：
--
作者：
Mitchell GF;Wang N;Palmisano JN;Larson MG;Hamburg NM;Vita JA;Levy D;Benjamin EJ;Vasan RS
老年人的收缩压和脉压要高得多。增加的前向与反射压力波振幅或反射波的提前到达对升高的脉压的相对贡献仍然存在争议。我们测量近端主动脉压力和流量，前向压力波振幅，全球波反射，反射波时间和脉搏波速度无创6417（年龄范围，19至90岁; 53%的女性）心脏研究第三代和后代参与者。成年期前向波振幅与脉压的变化。相反，波反射和脉压在成年期是不同的：在年轻的参与者中，随着年龄的增长，脉压较低，波反射较高，而在老年参与者中，脉压较高，波反射较低。尽管脉搏波速度存在相当大的差异，但不同年龄组的反射波时间略有不同。前向波振幅在年轻参与者（<50岁）中解释了80%（中央）和66%（外周）的脉压变异，在老年参与者（≥50岁）中解释了90%和84%，所有P<0.0001）。在一个逐步模型，评估年龄-脉压关系在整个样本中，后期加速增加，中央和外周脉压显着衰减时，前向波振幅的变化被认为是。任何年龄的较高脉压和随着年龄增长的较高脉压主要与较大的前向压力波相关。波反射对年龄相关的脉压差异的影响很小。
Systolic blood pressure and pulse pressure are substantially higher in older adults. The relative contributions of increased forward versus reflected pressure wave amplitude or earlier arrival of the reflected wave to elevated pulse pressure remain controversial. We measured proximal aortic pressure and flow, forward pressure wave amplitude, global wave reflection, reflected wave timing and pulse wave velocity noninvasively in 6417 (age range, 19 to 90 years; 53% women) Framingham Heart Study Third Generation and Offspring participants. Variation in forward wave amplitude paralleled pulse pressure throughout adulthood. In contrast, wave reflection and pulse pressure were divergent across adulthood: in younger participants, pulse pressure was lower and wave reflection higher with advancing age whereas in older participants, pulse pressure was higher and wave reflection lower with age. Reflected wave timing differed modestly across age groups despite considerable differences in pulse wave velocity. Forward wave amplitude explained 80% (central) and 66% (peripheral) of the variance in pulse pressure in younger participants (<50 years) and 90% and 84% in the older participants (≥50 years, all P<0.0001). In a stepwise model that evaluated age-pulse pressure relations in the full sample, the late accelerated increases in central and peripheral pulse pressure were markedly attenuated when variation in forward wave amplitude was considered. Higher pulse pressure at any age and higher pulse pressure with advancing age is predominantly associated with a larger forward pressure wave. The influence of wave reflection on age-related differences in pulse pressure was minor.