Age-Specific Acute Changes in Carotid-Femoral Pulse Wave Velocity With Head-up Tilt.


Journal

American journal of hypertension
ISSN: 1941-7225
Titre abrégé: Am J Hypertens
Pays: United States
ID NLM: 8803676

Informations de publication

Date de publication:
31 12 2020
Historique:
received: 22 05 2020
revised: 25 06 2020
accepted: 06 07 2020
pubmed: 8 7 2020
medline: 9 11 2021
entrez: 8 7 2020
Statut: ppublish

Résumé

Aortic stiffness as measured by carotid-femoral pulse wave velocity (cfPWV) is known to depend on blood pressure (BP), and this dependency may change with age. Therefore, the hydrostatic BP gradient resulting from a change in body posture may elicit a cfPWV change that is age-dependent. We aimed to analyze the relationship between BP gradient-induced by head-up body tilting-and related changes in cfPWV in individuals of varying age. cfPWV and other hemodynamic parameters were measured in 30 healthy individuals at a head-up tilt of 0° (supine), 30°, and 60°. At each angle, the PWV gradient and resulting cfPWV were also estimated (predicted) by assuming a global nonlinear, exponential, pressure-diameter relationship characterized by a constant β0, and taking into account that (diastolic) foot-to-foot cfPWV acutely depends on diastolic BP. cfPWV significantly increased upon body tilting (8.0 ± 2.0 m/s supine, 9.1 ± 2.6 m/s at 30°, 9.5 ± 3.2 m/s at 60°, P for trend <0.01); a positive trend was also observed for heart rate (HR; P < 0.01). When the observed, tilt-induced cfPWV change measured by applanation tonometry was compared with that predicted from the estimated BP hydrostatic gradient, the difference in observed-vs.-predicted PWV change increased nonlinearly as a function of age (R2 for quadratic trend = 0.38, P < 0.01, P vs. linear = 0.04). This result was unaffected by HR tilt-related variations (R2 for quadratic trend = 0.37, P < 0.01, P vs. linear = 0.04). Under a hydrostatic pressure gradient, the pulse wave traveling along the aorta undergoes an age-related, nonlinear PWV increase exceeding the increase predicted from BP dependency.

Sections du résumé

BACKGROUND
Aortic stiffness as measured by carotid-femoral pulse wave velocity (cfPWV) is known to depend on blood pressure (BP), and this dependency may change with age. Therefore, the hydrostatic BP gradient resulting from a change in body posture may elicit a cfPWV change that is age-dependent. We aimed to analyze the relationship between BP gradient-induced by head-up body tilting-and related changes in cfPWV in individuals of varying age.
METHODS
cfPWV and other hemodynamic parameters were measured in 30 healthy individuals at a head-up tilt of 0° (supine), 30°, and 60°. At each angle, the PWV gradient and resulting cfPWV were also estimated (predicted) by assuming a global nonlinear, exponential, pressure-diameter relationship characterized by a constant β0, and taking into account that (diastolic) foot-to-foot cfPWV acutely depends on diastolic BP.
RESULTS
cfPWV significantly increased upon body tilting (8.0 ± 2.0 m/s supine, 9.1 ± 2.6 m/s at 30°, 9.5 ± 3.2 m/s at 60°, P for trend <0.01); a positive trend was also observed for heart rate (HR; P < 0.01). When the observed, tilt-induced cfPWV change measured by applanation tonometry was compared with that predicted from the estimated BP hydrostatic gradient, the difference in observed-vs.-predicted PWV change increased nonlinearly as a function of age (R2 for quadratic trend = 0.38, P < 0.01, P vs. linear = 0.04). This result was unaffected by HR tilt-related variations (R2 for quadratic trend = 0.37, P < 0.01, P vs. linear = 0.04).
CONCLUSIONS
Under a hydrostatic pressure gradient, the pulse wave traveling along the aorta undergoes an age-related, nonlinear PWV increase exceeding the increase predicted from BP dependency.

Identifiants

pubmed: 32634245
pii: 5868452
doi: 10.1093/ajh/hpaa101
pmc: PMC7814224
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1112-1118

Commentaires et corrections

Type : CommentIn

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd.

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Auteurs

Giacomo Pucci (G)

Department of Medicine, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Terni, Italy.
Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

Bart Spronck (B)

Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA.
Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.

Alberto P Avolio (AP)

Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.

Lisanne Tap (L)

Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

Gaetano Vaudo (G)

Department of Medicine, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Terni, Italy.

Fabio Anastasio (F)

Unit of Cardiology, ASST-VAL Hospital of Sondrio, Sondrio, Italy.

Anton Van Den Meiracker (A)

Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

Francesco Mattace-Raso (F)

Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

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