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Perfusion and pulsatile pressure: their relationship with target organ damage in the African-PREDICT study

Donavan Rooi1, Shani Botha-Le Roux1,2, Yolandi Breet3,4

  • 1Hypertension in Africa Research Team (HART), North-West University, Private Bag X 1290, Potchefstroom, 2520, South Africa.

BMC Cardiovascular Disorders
|August 1, 2024
PubMed

Insights

Perfusion pressure, not pulsatile pressure, is more strongly linked to early signs of organ damage in young adults. This finding helps understand cardiovascular changes and informs future interventions for hypertension.

Area of Science:

  • Cardiovascular Research
  • Hypertension Studies
  • Preventive Cardiology

Background:

  • Hypertension is a primary risk factor for subclinical target-organ damage (TOD) and cardiovascular disease (CVD).
  • Limited understanding exists regarding the association between different blood pressure measures and subclinical TOD, particularly in younger populations.
  • This study investigates the relationship between pressure measures and early signs of organ damage in young adults.

Purpose of the Study:

  • To compare the strength of associations between subclinical TOD markers and perfusion pressure versus pulsatile pressure in young adults.
  • To identify which pressure measure is a better indicator of subclinical TOD in a young population.
  • To provide insights into the early mechanisms of cardiovascular changes related to hypertension.

Main Methods:

  • Analysis of data from 1,187 young adults in the African-PREDICT study.
  • Measurement of ambulatory mean arterial pressure (MAP) and pulse pressure (PP).
  • Assessment of subclinical TOD markers: left ventricular mass index (LVMi), carotid intima-media thickness (cIMT), carotid-femoral pulse wave velocity (cfPWV), central retinal arteriolar equivalent (CRAE), and albumin to creatinine ratio (ACR).

Main Results:

  • Subclinical TOD markers (cIMT, cfPWV, CRAE) showed stronger associations with perfusion pressure than pulsatile pressure in unadjusted models.
  • Adjusted analyses confirmed stronger associations between cfPWV and CRAE with perfusion pressure compared to pulsatile pressure.
  • These associations remained significant after accounting for non-modifiable and modifiable risk factors.

Conclusions:

  • Perfusion pressure is more strongly associated with subclinical TOD markers than pulsatile pressure in young, healthy adults.
  • Findings enhance the understanding of early cardiovascular changes and the development of TOD.
  • Results may inform future intervention strategies for managing hypertension and preventing CVD.
Abstract

Keywords:
Arterial stiffnessCarotid intima media thicknessEchocardiographyEndothelial functionMean arterial pressurePulse pressureRetinal vessel calibres

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