Heart disease and changes in pulse wave velocity and pulse pressure amplification in the elderly over 80 years: the...

Pulse wave velocity (PWV) and pulse pressure amplification (PPA) are independent predictors of cardiovascular risk, mainly in the elderly. The aim of the current research was to determine the influence of PPA and PWV, both manifestations of arterial stiffness, on heart disease in the elderly.

The study population consisted of 1042 participants (814 women) aged 80 years and over who participated in the PARTAGE study. Carotid-femoral PWV was determined in order to assess aortic stiffness. Central aortic blood pressure values and central pulse wave analysis were obtained using the calibration method applied on the common carotid artery by a PulsePen tonometer. Amplification phenomenon was expressed as PPA, that is, the percentage of increase of pulse pressure in the brachial artery relative to central pulse pressure. Heart disease was defined as presence of heart failure, ischemic heart disease or atrial fibrillation.

PPA was significantly lower in patients with heart disease, independently of the presence of hypertension, diabetes or both. Heart disease was present in 61.8% of participants with PPA less than 10%, in 46.2% of participants with PPA between 10 and 20% (P < 0.01), in 42.6% of participants with PPA between 20 and 30% (P < 0.005) and in 32.5% of participants with PPA more than 30% (P < 0.001). PWV, on the contrary, was not influenced by the presence of heart disease (12.3 ± 4.0 vs. 13.5 ± 4.6 m/s) but significantly increased in presence of hypertension (14.4 ± 5.0 m/s, P < 0.001) or diabetes (16.1 ± 5.1 m/s, P < 0.001).

In the very elderly, low brachial/aortic PPA is associated with higher prevalence of heart disease.