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

Wiktoria Wojciechowska, Katarzyna Stolarz-Skrzypek, Agnieszka Olszanecka, Magdalena Loster, Marcin Cwynar, Tomasz Grodzicki, Jan A. Staessen, Kalina Kawecka-Jaszcz

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

Keywords

blood pressure; arterial stiffness; augmentation index; longitudinal observation

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