Role of Vascular Adaptation in Determining Systolic Blood Pressure in Young Adults

Background Two individuals can have a similar pulse pressure ( PP ) but different levels of systolic blood pressure ( SBP ), although the underlying mechanisms have not been described. We hypothesized that, for a given level of PP , differences in SBP relate to peripheral vascular resistance ( PVR ); and we tested this hypothesis in a large cohort of healthy young adults. Methods and Results Demographic, biochemical, and hemodynamic data from 3103 subjects were available for the current analyses. In both men and women, for a given level of PP , higher SBP was associated with significantly higher body weight, body mass index, heart rate, and PVR ( P <0.05 versus those with lower BP for all comparisons). Moreover, stratifying individuals by quartiles of PP and PVR revealed a stepwise increase in SBP from the lowest to highest quartile for each variable, with the highest SBP occurring in those in the highest quartile of both PP and PVR ( P <0.001 for overall trend for both sexes). PVR was also increased with increasing tertile of minimum forearm vascular resistance, in both men ( P =0.002) and women ( P =0.03). Conclusions Increased PVR , mediated in part through altered resistance vessel structure, strongly associates with the elevation of SBP for a given level of PP in young adults. An impaired ability to adapt PVR appropriately to a given level of PP may be an important mechanism underlying elevated SBP in young adults.