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Age-related changes in total arterial capacitance from birth to maturity in a normotensive population
G de Simone1, M J Roman, S R Daniels
1Division of Cardiology, New York Hospital-Cornell Medical Center, New York 10021, USA. mjograd@mail.med.cornell.edu
Insights
The stroke volume to pulse pressure (SV/PP) ratio reflects arterial tree capacity in children and arterial compliance in adults. This ratio increases with growth and decreases with aging, indicating progressive arterial stiffening in adults.
Area of Science:
- Cardiovascular Physiology
- Pediatric Cardiology
- Geriatric Cardiology
Background:
- The arterial tree undergoes significant changes throughout human lifespan.
- Understanding age-related alterations in cardiovascular parameters is crucial for health assessment.
Purpose of the Study:
- To investigate the impact of body growth and aging on the echocardiographic stroke volume to pulse pressure (SV/PP) ratio.
- To differentiate the determinants of SV/PP ratio in children versus adults.
Main Methods:
- Analysis of echocardiographic (Teichholz) stroke volume and pulse pressure in 373 children/adolescents and 393 adults.
- Utilized Analysis of Covariance (ANCOVA) to adjust SV/PP ratio for body size.
- Multivariate regression analysis to identify predictors of SV/PP ratio.
Main Results:
- SV/PP ratio increased with age in children and decreased in adults.
- Body size-adjusted SV/PP ratio remained age-independent in children but showed a significant negative correlation with age in adults.
- Higher SV/PP ratio in children was associated with greater height, weight, and nonwhite race; in adults, it was linked to younger age, greater weight, and lower heart rate.
Conclusions:
- SV/PP ratio serves as an indicator of arterial tree capacity during growth and arterial compliance in adulthood.
- Arterial compliance demonstrably decreases with aging.
- Observed sex differences in SV/PP ratio may be attributable to variations in body size.
Abstract:
We evaluated the effect of body growth and aging on the ratio of echocardiographic (Teichholz) stroke volume to pulse pressure (SV/PP ratio) in 373 normal-weight, normotensive children to adolescents (1 day to 17 years old; 166 girls, 87 nonwhite) and 393 normal adults (17 to 85 years old; 164 women, 112 nonwhite). Stroke volume increased with age in children (r = .64, P < .0001) and was stable in adults; pulse pressure decreased slightly with age in children (r = -.10, P = .06) and increased in adults (r = .29, P < .0001). As a consequence, SV/PP ratio increased with age in children (r = .51, P < .0001) and decreased in adults (r = -.18, P = .0004). To control for changes in body size that influence the size of the arterial tree, we used ANCOVA to adjust SV/PP for body size. Body size-adjusted SV/PP ratio was no longer related to age in children, whereas the negative relation with aging in adults remained statistically significant (r = -.19, P < .0002). Heart rate was negatively related to SV/PP ratio in both children and adolescents and adults, but this relation did not influence the relation with age. In multivariate analysis, high SV/PP ratio was predicted by greater height (P < .002) and weight (P < .04) and nonwhite race (P < .001) in children and adolescents and by younger age (P < .0001), greater weight (P < .0001), and low heart rate (P < .001) in adults. Sex did not enter the regression models. Thus, (1) SV/PP ratio is a measure of increasing capacity of the arterial tree during growth, whereas it depends on arterial compliance during adulthood through old age; (2) arterial compliance decreases progressively with aging; (3) the apparent difference between males and females might be due to their different body sizes.