Blood pressure and arterial stiffness indices in 5-years follow-up

Abstract

Background Augmentation index (AI) a measure of enhanced wave reflection and pulse pressure have been proposed as a bedside measure of aortic stiffness. The objective of the present study was to assess changes in blood pressure (BP) parameters and AI in general population after 5-years follow-up.
Material and methods From the general population we recruited 197 members from random families (99 parents and 98 offspring [age at baseline: 51.4 and 25.5 years] who constituted 110 normotensives and 87 hypertensives). Initially and after mean follow-up 4.8 ± 0.3 years we recorded the radial arterial waveform using the SphygmoCor device. We evaluated peripheral AI (PAI) and central AI (CAI). Significance levels of betweengroup comparisons of the change from baseline were assessed by a general linear model that adjusted for baseline value.
Results In both generations as well as in normo- and hypertensive groups we observed comparable increase in BMI and decrease in heart rate. We found higher increase in aortic SBP with lesser decrease in central DBP in offspring and in normotensives while CPP increase was higher in parents and in participants with initially diagnosed hypertension (p < 0.005). We observed greater elevation of brachial SBP with simultaneous lesser reduction in DBP with similar increase in peripheral PP in offspring and in normotensives. Changes in PAI and CAI were more pronounced in younger generation and resulted respectively 4.4 vs 2.9%; p = 0.004 and 5.2 vs 3.7%; p = 0.0001. Moreover we observed higher increase in PAI (4.6 vs 4.3%; p = 0.006) and in CAI (4.8 vs 4.6%; p = 0.005) in hypertensives.
Conclusions The aortic pulse pressure more effectively indicate age and blood pressure related changes in arterial wall stiffening than brachial pressure. Our findings indicate that AI increased in offspring and can be used as effective tool to detect the progressive increase in aortic stiffness in younger individuals.
Arterial Hypertension 2010, vol. 14, no 6, pages 443-450