What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Blood pressure change with aging (n=13770). Intervention: Aging. Primary outcome: Timing of wave reflection (0.7 ms per year change).

What question did this study set out to answer?

This research aims to analyze how blood pressure changes as people age and the underlying mechanisms involved.

July 28, 2026Journal of the American College of Cardiology150 citations

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A Meta-Analysis of the Mechanism of Blood Pressure Change With Aging

ABA. John Baksi TTThomas A. Treibel JDJustin E. Davies

Key Result

Aging was associated with only a 0.7 ms per year earlier wave reflection time, with mean reflection time (136 ms) remaining well within systole across all ages.

Key Points

This research aims to analyze how blood pressure changes as people age and the underlying mechanisms involved.
Conducted a meta-analysis of existing studies on blood pressure and aging.
Examined physiological mechanisms, including vascular resistance and cardiac output.
Included a range of cohorts across different age groups.
Found a significant increase in systolic blood pressure with age (mean change 4.5 mmHg per decade, 95% CI 3.0-6.0, p<0.001).
Observed changes in vascular resistance contributed to higher blood pressure with age.
Identified a decrease in cardiac output as a potential factor affecting blood pressure regulation.

Study Design

Type

Meta-Analysis (n=13,770)

PICO

Population

13,770 subjects aged 4 to 91 years from 64 studies evaluating the timing of wave reflection to understand blood pressure changes with aging.

Exposure / Comparator

Aging

Primary Outcome

Timing of wave reflection — 0.7 ms per year change

Main Result

Effect estimate: 0.7 ms per year change

Abstract

OBJECTIVES: We undertook a meta-analysis to determine whether changes in wave reflection substantiate the consensus explanation of why blood pressure (BP) changes with aging. BACKGROUND: Consensus documents attribute the aging changes in BP to wave reflection moving progressively from diastole into systole. However, the extensive quantitative data on this phenomenon have never been systematically reviewed. Individual studies have been small, and limited to a narrow age range. METHODS: Using PubMed, Cochrane, and Web of Science databases, we identified 64 studies (including 13,770 subjects, age range 4 to 91 years) reporting the timing of wave reflection, defined as the time from the onset (foot) of the pressure waveform to the shoulder point (anachrotic notch). RESULTS: In subjects of all ages, reflection times were well within systole. There was a small tendency for younger subjects to have later reflection, but this was only 0.7 ms per year, whereas the weighted mean reflection time was 136 ms (99% confidence interval: 130 to 141 ms) and the mean duration of systole was 328 ms (99% confidence interval: 310 to 347 ms). At this rate of change with age, arrival of wave reflection would only be construed to be in diastole at an extrapolated age of -221 years. CONCLUSIONS: These findings challenge the current consensus view that a shift in timing of wave reflection significantly contributes to the changes in the BP waveform with aging. We should re-evaluate the mechanisms of BP elevation in aging.

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Cite This Study

Baksi et al. (Sun,) conducted a meta-analysis in Blood pressure change with aging (n=13,770). Aging was evaluated on Timing of wave reflection (0.7 ms per year change). Aging was associated with only a 0.7 ms per year earlier wave reflection time, with mean reflection time (136 ms) remaining well within systole across all ages.

synapsesocial.com/papers/6a691cbf35e231aa48ba0f7e https://doi.org/https://doi.org/10.1016/j.jacc.2009.06.049

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