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Pulse Wave Velocity Testing in the Baltimore Longitudinal Study of Aging
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Pulse Wave Velocity and Blood Pressure Variability as Prognostic Indicators in Very Elderly Patients
Alejandro de la Sierra1, Cristina Sierra2, Marcos Murillo3
1Department of Internal Medicine, Hospital Mútua Terrassa, University of Barcelona, 08221 Terrassa, Spain.
Journal of Clinical Medicine
|February 25, 2023
Summary
Hemodynamic measures like arterial stiffness and blood pressure variability predict mortality in very elderly patients with chronic conditions. These findings aid in prognostic evaluation for this vulnerable population.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Clinical Physiology
Background:
- Limited evidence exists on the prognostic value of hemodynamic measures in the very elderly with advanced chronic diseases.
- Key hemodynamic parameters include blood pressure (BP), BP variability, and arterial stiffness.
Purpose of the Study:
- To assess the prognostic significance of 24-hour BP, BP variability, and arterial stiffness.
- To evaluate these measures in hospitalized very elderly patients with decompensated chronic diseases.
Main Methods:
- A cohort of 249 patients over 80 years old was studied.
- Noninvasive 24-hour monitoring assessed brachial and central BP, BP and heart rate variability, aortic pulse wave velocity, and BP variability ratios.
- The primary endpoint was 1-year mortality.
Main Results:
- Increased aortic pulse wave velocity (arterial stiffness) was associated with higher 1-year mortality.
- Elevated BP variability ratio and systolic BP variability predicted increased mortality.
- Reduced heart rate variability also independently predicted 1-year mortality.
Conclusions:
- Increased aortic stiffness and heightened BP and heart rate variability are significant predictors of 1-year mortality.
- These hemodynamic assessments can aid in the prognostic evaluation of very elderly patients with decompensated chronic conditions.
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