Tracking of aortic systolic pressure over the entire life course

A. Adji, M. F. O'Rourke, A. P. Avolio

    Research output: Contribution to journalMeeting abstract

    Abstract

    Background: Recent studies clarify the tracking of brachial cuff systolic blood pressure (BP) over the extremes of age: from birth to adolescence (NHANES and OLAF) and early adulthood to old age (FHS). Principal features are rapid increase in infancy, less rapid increase in childhood, relative plateau in late adolescence and slow increase from age 40. Gender differences become apparent at age 14, whereafter systolic BP is higher in males than females. No such studies are available for central aortic pressure. Aim: To describe change in central aortic systolic pressure over the whole lifespan from published papers and to compare with brachial cuff pressure tracking. Methods: From the three brachial BP studies (NHANES. Pediatrics. 2004;114(2S):555–576; OLAF. J Hypertens. 2012;30:1942–1954; Framingham. Hypertension. 2012;60:1393–1399), we estimated central aortic systolic pressure using their respective cuff brachial values. For adults (age >18 years), we applied a validated generalized transfer function in a normal adult population. For children up to age 18 years, we used the "second systolic shoulder" method from a normal pediatric population to calculate central aortic pressure. Near-identity of the two methods was established in adults and children. Neonatal central and peripheral pressures were based on invasive measurements. Results: While there was no difference between central and estimated brachial pressure in neonates, the difference became apparent by age of 4 years, and extreme at 18 years when aortic systolic pressure was 15–20 mmHg less than brachial. There was no gender difference between central pressure up to age 14, whereafter central and brachial pressure and body height in males continued to increase up to age 18. Conclusion: Findings suggest that systolic aortic BP increases progressively throughout life, with the major changes in brachial values attributable to bodily growth, and variable distortion in the pulse wave during transmission from aorta to periphery of the body. Gender differences become apparent in early adult life, and lessen in later adult life. At the extremes of age, there are no gender-differences in systolic BP between aorta and brachial artery. Approximate asymptotic values are 50 mmHg at birth and 150 mmHg at age 100.
    Original languageEnglish
    Pages (from-to)E144
    Number of pages1
    JournalHypertension
    Volume63
    Issue number6
    Publication statusPublished - Jun 2014
    EventAnnual Scientific Meeting of the High Blood Pressure Research Council of Australia (HBPRCA) (35th : 2013) / Annual Scientific Meeting of the Australian Atherosclerosis Society (AAS) (39th : 2013) - Melbourne, Australia, Australia
    Duration: 5 Dec 20137 Dec 2013

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