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Patrones hemodinámicos de cambios relacionados con la edad en la presión arterial. El estudio del corazón de
S S Franklin1, W Gustin, N D Wong
1Heart Disease Prevention Program, University of California, Irvine 92697, USA.
Circulation
|July 1, 1997
Resumen
La presión arterial cambia con la edad, mostrando un aumento de la presión sistólica y una disminución tardía de la presión diastólica. Este patrón, especialmente en la hipertensión no tratada, sugiere un aumento de la rigidez arterial.
Área de la Ciencia:
- Investigaciones cardiovasculares en la investigación cardiovascular.
- El envejecimiento y la fisiología.
- Mecanismos de los mecanismos de la hipertensión.
Sus antecedentes:
- Investigar los cambios en la presión arterial (BP) relacionados con la edad en individuos hipertensivos normotensos y no tratados.
- Utilizando una cohorte basada en la población del Estudio del Corazón de Framingham.
- Inferir los mecanismos hemodinámicos subyacentes de las alteraciones de la presión arterial.
Objetivo del estudio:
- Para caracterizar los cambios relacionados con la edad en la presión arterial sistólica (SBP) y la presión arterial diastólica (DBP).
- Para explorar los mecanismos hemodinámicos, incluyendo la presión arterial media (MAP) y la presión del pulso (PP).
- Examinar los patrones de seguimiento de la BP en relación con la SBP de referencia.
Principales métodos:
- Análisis de hasta 30 años de datos de BP bienal de 2036 participantes (exámenes 2-16).
- Exclusión de sujetos en terapia con fármacos antihipertensivos.
- Análisis de regresión de la presión arterial frente a la edad, comparando las estimaciones de pendiente y curvatura entre los grupos de SBP utilizando ANOVA.
Principales resultados:
- Aumento lineal en SBP (30-84 años) y aumento simultáneo en DBP y MAP.
- Después de la edad 50-60: DBP disminuyó, PP aumentó abruptamente, MAP se estabilizó.
- Los cambios en la presión arterial relacionados con la edad, particularmente el seguimiento divergente, fueron más pronunciados en individuos con SBP basal más alto.
Conclusiones:
- La caída tardía de la DBP después de los 60 años, con el aumento de la SBP, indica un aumento de la rigidez de las arterias grandes.
- Este fenómeno no se explica por la hipertensión "quemada" o la "supervivencia selectiva".
- Un SBP más alto sin tratar puede acelerar la rigidez arterial, creando un ciclo perjudicial.
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