Evaluating the hemodynamic basis of age-related central blood pressure change using aortic flow triangulation

Mayooran Namasivayam, Audrey Adji, Michael F. O'Rourke*

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    10 Citations (Scopus)


    BACKGROUND Pulsatile blood pressure rises with age, especially in the aorta. The comparative role of forward and reflected pressure waves (FW and RW, respectively), determined by aortic flow triangulation has not previously been explored in a large clinical cohort. This study aimed to identify the role of FW and RW in the rise in aortic pulse pressure with age. METHODS For 879 outpatients, aortic pressure waveforms were generated using a validated generalized transfer function applied to radial pressure waves recorded using applanation tonometry. FW and RW were subsequently determined using aortic flow triangulation. Contributions of FW and RW to rise in aortic pulse pressure with age were determined using multivariate linear regression and product of coefficient mediation analysis, with adjustment for height, weight, heart rate, and mean arterial pressure. Comparisons were made by gender and before and after age 60. RESULTS In subjects aged 60 and below, RW was an important contributor to pulsatile pressure elevation with age, but FW was non-contributory in either gender after multivariate correction. In subjects aged above 60, both FW and RW were significant and equal contributors in both genders. CONCLUSIONS In a clinical setting, both FW and RW are important to pulsatile aortic blood pressure across the lifespan, but RW appears to have a more pronounced effect across all ages, whereas FW has less effect in younger persons.

    Original languageEnglish
    Pages (from-to)178-184
    Number of pages7
    JournalAmerican Journal of Hypertension
    Issue number2
    Publication statusPublished - 1 Feb 2016


    • aging
    • arterial stiffness
    • blood pressure
    • central pressure
    • hemodynamics
    • hypertension
    • wave reflection


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