[PP.06.04] COMPARISON OF PULSE WAVE VELOCITY AND PULSE PRESSURE AMPLIFICATION IN THE ASSOCIATION WITH TARGET ORGAN DAMAGES IN THE COMMUNITY-BASED ELDERLY: THE NORTHERN SHANGHAI STUDY

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Abstract

Objective:

Pulse wave velocity (PWV) was a critical subclinical target organ damages, bearing significant prognostic value, and was tightly associated with other target organ damages (TODs). However, recent investigations indicated that, in the elderly population, pulse pressure amplification (PPA), rather than PWV, acted as an important biomarker and provided predictive value of cardiovascular events and mortality. The present study aimed to investigate the discrepancy between PWV and PPA in association with hypertensive TODs in the elderly population.

Design and method:

From June 2014 to August 2015, a total of 1599 community-based elderly subjects (age >65 years old) located in the northern Shanghai were recruited. The carotid-femoral pulse wave velocity (cfPWV), peripheral blood pressure (BP), central BP and other TODs indicators including the ratio of the early ventricular filling velocity (E) to the peak velocity of tissue doppler velocity of septal mitral annulus (E/Ea), left ventricular mass index (LVMI), carotid intima-medium thickness (IMT), estimated glomerular filtration rate (eGFR), urinary albumine-creatinine rate (ACR) were assessed on each participant. PPA was defined as the peripheral-to-central pulse pressure ratio.

Results:

cfPWV and PPA were both significantly and independently associated with age, male gender and systolic BP (p < 0.01), where cfPWV was also significantly associated with waist/hip ratio (p < 0.01). In the multivariable linear regression analysis, cfPWV was significantly associated with carotid IMT (β = 12.83 ± 4.28 μm per 1 SD; P = 0.003) and eGFR (β = 3.60 ± 1.06 ml/min/1.73m2 per 1 SD; P < 0.001) whereas PPA was significantly associated with cardiac TODs as E/Ea (β = −0.25 ± 0.10 per 1 SD; P = 0.01) and LVMI (β = −3.00 ± 0.78 per 1 SD; P < 0.001). Similarly, in the multivariable logistic regression analysis, cfPWV was significantly associated with vascular TODs as arterial plaque (odds ratio [OR], 1.21 [95%CI, 1.05–1.39] per 1 SD; P = 0.007) and peripheral artery disease (OR, 1.22 [95%CI, 1.06–1.42] per 1 SD; P = 0.007), while PPA was tightly associated with cardiac TODs as left ventricular hypertrophy (OR, 0.85 [95%CI, 0.72–0.99] per 1 SD; P = 0.04) and diastolic dysfunction (OR, 0.78 [95%CI, 0.64–0.96] per 1 SD; P = 0.02) (Fig. 1).

Conclusions:

In the community-based elderly, cfPWV seems to be a vessel-related biomarker, while PPA is the cardiac-related one.

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