Higher central pulse pressure in older adults was associated with smaller aortic lumen area (B=-8.1±1.2 mm Hg/SD; P<0.001), greater aortic wall stiffness, and larger left ventricular volume.
Cross-Sectional (n=526)
No
Is higher pulse pressure associated with adverse aortic and left ventricular structural changes in older adults?
Higher pulse pressure in older adults is associated with smaller aortic lumen area, greater aortic wall stiffness, and larger left ventricular volume, suggesting a mismatch in hemodynamic load accommodation.
Effect estimate: B=-8.1±1.2 mm Hg/SD
p-value: p=<0.001
High pulse pressure, a major cardiovascular risk factor, has been attributed to medial elastic fiber degeneration and aortic dilation, which transfers hemodynamic load to stiffer collagen. However, recent studies suggest higher pulse pressure is instead associated with smaller aortic diameter. Thus, we sought to elucidate relations of pulse pressure with aortic stiffness and aortic and cardiac dimensions. We used magnetic resonance imaging to examine relationships of pulse pressure with lumen area and wall stiffness and thickness in the thoracic aorta and left ventricular structure in 526 participants (72-94 years of age, 295 women) in the community-based Age, Gene/Environment Susceptibility-Reykjavik Study. In a multivariable model that adjusted for age, sex, height, weight, and standard vascular risk factors, central pulse pressure had a negative relationship with aortic lumen area (all effects expressed as mm Hg/SD; B=-8.1±1.2; P<0.001) and positive relationships with left ventricular end-diastolic volume (B=3.8±1.0; P<0.001), carotid-femoral pulse wave velocity (B=3.6±1.0; P<0.001), and aortic wall area (B=3.0±1.2; P=0.015). Higher pulse pressure in older people is associated with smaller aortic lumen area and greater aortic wall stiffness and thickness and left ventricular volume. Relationships of larger ventricular volume and smaller aortic lumen with higher pulse pressure suggest mismatch in hemodynamic load accommodation by the heart and aorta in older people.
Torjesen et al. (Tue,) conducted a cross-sectional in Community-dwelling older adults (n=526). Central pulse pressure was evaluated on Aortic lumen area (B=-8.1±1.2 mm Hg/SD, p=<0.001). Higher central pulse pressure in older adults was associated with smaller aortic lumen area (B=-8.1±1.2 mm Hg/SD; P<0.001), greater aortic wall stiffness, and larger left ventricular volume.