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Central pulse pressure is inversely associated with proximal aortic remodelling

Francesco Tosello1, Andrea Guala2, Fabrizio D'ascenzo3

  • 1Division of Internal Medicine, Department of Medical Sciences, Hypertension Unit, AO "Città della Salute e della Scienza", University of Turin, Italy.

Journal of Hypertension
|March 12, 2021
PubMed

Insights

Higher central pulse pressure in patients undergoing invasive coronary assessment is linked to a lower aortic root Z-score. This suggests aortic remodelling may help limit pulse pressure, offering new insights into hypertension and aortic health.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Hypertension Research

Background:

  • Hypertension is known to cause aortic stiffening and dilatation.
  • Unexpected findings from the Framingham Heart Study indicated an inverse relationship between brachial pulse pressure and aortic diameter.
  • Aortic dilatation is associated with a poorer prognosis, including cardiac events and heart failure.

Purpose of the Study:

  • To investigate the relationship between invasively measured central blood pressure and proximal aortic diameter.
  • To evaluate aortic remodelling in relation to invasive hemodynamic measurements.

Main Methods:

  • Invasive hemodynamic study conducted on 71 consecutive patients.
  • Proximal aortic diameter at the sinus of Valsalva was measured and compared to expected diameters based on age, sex, and body height (Z-score).
  • Pressures were directly recorded in the proximal aorta using a catheter prior to coronary assessment.

Main Results:

  • Mean invasive aortic systolic blood pressure (SBP) was 146 ± 23 mmHg and diastolic blood pressure (DBP) was 78 ± 13 mmHg, yielding a central pulse pressure (cPP inv) of 68 ± 21 mmHg.
  • A significantly inverse relationship was observed between higher cPPinv and lower aortic root Z-score (P = 0.001).
  • cPPinv was inversely related to Z-score (R = -0.271, P = 0.022) independently of age, mean blood pressure, and heart rate.

Conclusions:

  • Aortic root Z-score is inversely associated with invasively measured central pulse pressure in patients undergoing invasive coronary assessment.
  • Aortic remodelling at the sinuses of Valsalva may function as a compensatory mechanism to reduce central pulse pressure.
Abstract

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