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ISH ADA-02 COMPARISON OF PULSE WAVE VELOCITY AND PULSE PRESSURE AMPLIFICATION IN THE ASSOCIATION WITH TARGET ORGAN DAMAGES IN THE COMMUNITY-BASED ELDERLY: THE NORTHERN SHANGHAI STUDY.
Journal of Hypertension 2016 September
OBJECTIVE: To investigate the discrepancy between PWV and PPA in association with hypertensive TODs in the elderly population.
DESIGN AND METHOD: From June 2014 to August 2015, a total of 1599 community-based elderly subjects (age > 65 years old) located in the northern Shanghai were recruited. The carotid-femoral pulse wave velocity (cfPWV), peripheral blood pressure (BP), central BP and other TODs indicators including the ratio of the early ventricular filling velocity (E) to the peak velocity of tissue Doppler velocity of septal mitral annulus (E/Ea), left ventricular mass index (LVMI), carotid intima-medium thickness (IMT), estimated glomerular filtration rate (eGFR), urinary albumin-creatinine rate (ACR) were assessed on each participant. PPA was defined as the peripheral-to-central pulse pressure ratio.
RESULTS: cfPWV and PPA were both significantly and independently associated with age, male gender and systolic BP (p < 0.01), where cfPWV was also significantly associated with waist/hip ratio (p < 0.01). In the multivariable linear regression analysis, cfPWV was significantly associated with carotid IMT (β = 12.83 ± 4.28 μm per SD; P = 0.003) and eGFR (β = -1.85 ± 0.69 ml/min/1.73m per SD; P = 0.007) whereas PPA was significantly associated with cardiac TODs as E/Ea (β = -0.25 ± 0.10 per SD; P = 0.01) and LVMI (β = -3.00 ± 0.78 g/m per SD; P < 0.001). Similarly, in the multivariable logistic regression analysis, cfPWV was significantly associated with vascular TODs and renal TODs as arterial plaque (odds ratio [OR], 1.21 [95%CI, 1.05-1.39] per SD; P = 0.007), peripheral artery disease (OR, 1.22 [95%CI, 1.06-1.42] per SD; P = 0.007), chronic kidney diseases (OR, 1.24 [95%CI, 1.01-1.54] per SD; P = 0.04) and microalbuminuria (OR, 1.21 [95%CI, 1.07-1.37] per SD; P = 0.002) while PPA was tightly associated with cardiac TODs as left ventricular hypertrophy (OR, 0.85 [95%CI, 0.72-0.99] per SD; P = 0.04) and diastolic dysfunction (OR, 0.78 [95%CI, 0.64-0.96] per SD; P = 0.02).
CONCLUSIONS: In the community-based elderly, cfPWV seems to be a vessel-related and renal-related biomarker, while PPA is the cardiac-related one.
DESIGN AND METHOD: From June 2014 to August 2015, a total of 1599 community-based elderly subjects (age > 65 years old) located in the northern Shanghai were recruited. The carotid-femoral pulse wave velocity (cfPWV), peripheral blood pressure (BP), central BP and other TODs indicators including the ratio of the early ventricular filling velocity (E) to the peak velocity of tissue Doppler velocity of septal mitral annulus (E/Ea), left ventricular mass index (LVMI), carotid intima-medium thickness (IMT), estimated glomerular filtration rate (eGFR), urinary albumin-creatinine rate (ACR) were assessed on each participant. PPA was defined as the peripheral-to-central pulse pressure ratio.
RESULTS: cfPWV and PPA were both significantly and independently associated with age, male gender and systolic BP (p < 0.01), where cfPWV was also significantly associated with waist/hip ratio (p < 0.01). In the multivariable linear regression analysis, cfPWV was significantly associated with carotid IMT (β = 12.83 ± 4.28 μm per SD; P = 0.003) and eGFR (β = -1.85 ± 0.69 ml/min/1.73m per SD; P = 0.007) whereas PPA was significantly associated with cardiac TODs as E/Ea (β = -0.25 ± 0.10 per SD; P = 0.01) and LVMI (β = -3.00 ± 0.78 g/m per SD; P < 0.001). Similarly, in the multivariable logistic regression analysis, cfPWV was significantly associated with vascular TODs and renal TODs as arterial plaque (odds ratio [OR], 1.21 [95%CI, 1.05-1.39] per SD; P = 0.007), peripheral artery disease (OR, 1.22 [95%CI, 1.06-1.42] per SD; P = 0.007), chronic kidney diseases (OR, 1.24 [95%CI, 1.01-1.54] per SD; P = 0.04) and microalbuminuria (OR, 1.21 [95%CI, 1.07-1.37] per SD; P = 0.002) while PPA was tightly associated with cardiac TODs as left ventricular hypertrophy (OR, 0.85 [95%CI, 0.72-0.99] per SD; P = 0.04) and diastolic dysfunction (OR, 0.78 [95%CI, 0.64-0.96] per SD; P = 0.02).
CONCLUSIONS: In the community-based elderly, cfPWV seems to be a vessel-related and renal-related biomarker, while PPA is the cardiac-related one.
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