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Pulse pressure relation to aortic and left ventricular structure in the Age, Gene/Environment Susceptibility

Alyssa A Torjesen1, Sigurður Sigurðsson1, Jos J M Westenberg1

  • 1From the Cardiovascular Engineering, Inc, Norwood, MA (A.A.T., J.D.G., V.B.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, Leiden, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik, Iceland (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.).

Hypertension (Dallas, Tex. : 1979)
|July 16, 2014
PubMed

Insights

High pulse pressure in older adults is linked to a smaller aorta and stiffer arteries. This suggests a mismatch in how the heart and aorta handle blood flow, impacting cardiovascular health.

Area of Science:

  • Cardiovascular imaging and aging research.
  • Vascular biology and hemodynamics.

Background:

  • High pulse pressure is a known cardiovascular risk factor.
  • Traditionally linked to aortic dilation and collagen stiffening.
  • Recent findings suggest an association with smaller aortic diameter.

Purpose of the Study:

  • To investigate the relationship between pulse pressure, aortic stiffness, and cardiac dimensions.
  • To clarify the interplay between pulse pressure and aortic/cardiac structure in older adults.

Main Methods:

  • Utilized magnetic resonance imaging (MRI) in 526 older adults (Age, Gene/Environment Susceptibility-Reykjavik Study).
  • Examined pulse pressure associations with thoracic aortic lumen area, wall stiffness, and thickness.
  • Assessed relationships with left ventricular structure and carotid-femoral pulse wave velocity.

Main Results:

  • Central pulse pressure showed a negative relationship with aortic lumen area (B=-8.1±1.2, P<0.001).
  • Positive associations were found with left ventricular end-diastolic volume (B=3.8±1.0, P<0.001), aortic wall area (B=3.0±1.2, P=0.015), and pulse wave velocity (B=3.6±1.0, P<0.001).
  • Higher pulse pressure correlated with smaller aortic lumen, increased aortic wall stiffness/thickness, and larger left ventricular volume.

Conclusions:

  • Elevated pulse pressure in older individuals is associated with a smaller aortic lumen and increased aortic stiffness.
  • Findings suggest a hemodynamic mismatch between the heart and aorta in accommodating load in aging.
  • This mismatch may contribute to cardiovascular risk in the elderly.

Keywords:
blood pressurehypertensionmagnetic resonance imagingpulse wave analysisvascular stiffness

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