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Aortic Pulse Pressure Does Not Adequately Index Cardiovascular Risk Factor-Related Changes in Aortic Stiffness and

Tshegofatso H Motau1, Gavin R Norton1, Pinhas Sareli1

  • 1Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

American Journal of Hypertension
|April 24, 2018
PubMed

Insights

Central aortic pulse pressure (PPc) does not adequately reflect arterial changes from diabetes or hypertension. These findings suggest PPc is not a reliable indicator for assessing cardiovascular risk related to these common conditions.

Area of Science:

  • Cardiovascular science
  • Vascular function
  • Hypertension research

Background:

  • Conventional risk factors impact arteries, influencing aortic function and cardiovascular events.
  • The utility of central aortic pulse pressure (PPc) in reflecting these arterial changes is uncertain.
  • This study investigates the relationship between modifiable risk factors and aortic function, specifically concerning PPc.

Purpose of the Study:

  • To determine if changes in central aortic pulse pressure (PPc) accurately reflect arterial functional changes caused by modifiable risk factors.
  • To assess the relationship between diabetes mellitus and hypertension with aortic function parameters.
  • To evaluate the adequacy of PPc as an index for cardiovascular risk associated with these conditions.

Main Methods:

  • A study involving 1,232 black South Africans from Johannesburg (SOWETO).
  • Assessment of risk factors and aortic function using carotid-femoral pulse wave velocity (PWV), PPc, forward wave pressures (Pf), and backward wave pressures (Pb).
  • Measurements were taken using applanation tonometry and SphygmoCor software.

Main Results:

  • Diabetes mellitus was associated with increased PWV and Pf, but not with brachial or central aortic pulse pressure (PPc).
  • Uncontrolled hypertension was associated with increased Pf, but not with brachial or central aortic pulse pressure (PPc).
  • Adjustments were made for alternative risk factors and mean arterial pressure (MAP).

Conclusions:

  • Neither brachial nor central aortic pulse pressure (PPc) adequately represent the relationship between modifiable risk factors (hypertension, diabetes) and aortic functional changes.
  • PPc is not a sufficient index for assessing cardiovascular risk related to uncontrolled hypertension or diabetes mellitus.
  • Further research may be needed to identify better indicators of vascular changes associated with these risk factors.
Abstract

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