Abstract
The increase in pulse pressure (PP) that occurs with advancing age is predominantly due to reduced arterial distensibility leading to decreased aortic compliance, particularly in the elderly, in whom high blood pressure mainly manifests as isolated systolic hypertension. Since age-related changes in stroke volume are minimal compared with changes in PP, PP is often considered a surrogate measure of arterial stiffness. However, since PP is determined by both cardiac and arterial function, a more precise and reliable means of assessment of arterial stiffness is arterial pulse wave velocity (PWV), a parameter that is only dependent on arterial properties. Arterial stiffness as measured by PWV has been found to be a powerful pressure-related indicator for cardiovascular morbidity and mortality. We analyzed PP and PWV in men and women of various age groups in healthy volunteers as well as cardiac patients with different types of diseases. The findings identified several striking sex-specific differences which demand consideration in guidelines for diagnostic procedures, for epidemiological analysis, and in evaluation of therapeutic interventions.
Art work by Piet Michiels, Leuven, Belgium
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Li JK-J. The arterial circulation: physical principles and clinical applications. Totowa: Humana Press; 2000.
O’Rourke MF, Taylor MG. Input impedance of the systemic circulation. Circ Res. 1967;20(4):365–80.
Vatner SF, et al. Effects of isoproterenol on regional myocardial function, electrogram, and blood flow in conscious dogs with myocardial ischemia. J Clin Invest. 1976;57(5):1261–71.
Kerkhof PLM. Beat-to-beat analysis of high-fidelity signals obtained from the left ventricle and aorta in chronically instrumented dogs. Automedica. 1986;7:83–90.
Pagani M, et al. Effects of age on aortic pressure-diameter and elastic stiffness-stress relationships in unanesthetized sheep. Circ Res. 1979;44(3):420–9.
Hayashi K, et al. Single-beat estimation of ventricular end-systolic elastance-effective arterial elastance as an index of ventricular mechanoenergetic performance. Anesthesiology. 2000;92(6):1769–76.
Vaccarino V, Holford TR, Krumholz HM. Pulse pressure and risk for myocardial infarction and heart failure in the elderly. J Am Coll Cardiol. 2000;36(1):130–8.
Franklin SS, et al. Is pulse pressure useful in predicting risk for coronary heart disease? The Framingham heart study. Circulation. 1999;100(4):354–60.
Kannel WB. Historic perspectives on the relative contributions of diastolic and systolic blood pressure elevation to cardiovascular risk profile. Am Heart J. 1999;138(3 Pt 2):S205–10.
Herbert A, et al. Establishing reference values for central blood pressure and its amplification in a general healthy population and according to cardiovascular risk factors. Eur Heart J. 2014;35(44):3122–33.
Garcia J, et al. Distribution of blood flow velocity in the normal aorta: effect of age and gender. J Magn Reson Imaging. 2017;47:487–98.
Avolio AP, et al. Effects of aging on arterial distensibility in populations with high and low prevalence of hypertension: comparison between urban and rural communities in China. Circulation. 1985;71(2):202–10.
Chen CH, et al. Estimation of central aortic pressure waveform by mathematical transformation of radial tonometry pressure. Validation of generalized transfer function. Circulation. 1997;95(7):1827–36.
Namasivayam M, Adji A, O'Rourke MF. Influence of aortic pressure wave components determined noninvasively on myocardial oxygen demand in men and women. Hypertension. 2011;57(2):193–200.
Namekata T, et al. Establishing baseline criteria of cardio-ankle vascular index as a new indicator of arteriosclerosis: a cross-sectional study. BMC Cardiovasc Disord. 2011;11:51.
Spronck B, et al. Direct means of obtaining CAVI0-a corrected cardio-ankle vascular stiffness index (CAVI)-from conventional CAVI measurements or their underlying variables. Physiol Meas. 2017;38(10):N128–37.
Leeson P. Hypertension and cardiovascular risk in young adult life: insights from CAVI. Eur Heart J. 2017;19(Suppl B):B24–9.
Schillaci G, et al. The impact of the cardio-ankle vascular index on left ventricular structure and function. Eur Heart J Suppl. 2017;19(Suppl B):B30–4.
Ayer JG, et al. Central arterial pulse wave augmentation is greater in girls than boys, independent of height. J Hypertens. 2010;28(2):306–13.
Barraclough JY, et al. Sex differences in aortic augmentation index in adolescents. J Hypertens. 2017;35(10):2016–24.
Ye Z, Pellikka PA, Kullo IJ. Sex differences in associations of cardio-ankle vascular index with left ventricular function and geometry. Vasc Med. 2017;22(6):465–72.
Hayward CS, Kelly RP. Gender-related differences in the central arterial pressure waveform. J Am Coll Cardiol. 1997;30(7):1863–71.
Jiang X, et al. Blood pressure tables for Chinese adolescents: justification for incorporation of important influencing factors of height, age and sex in the tables. BMC Pediatr. 2014;14:10.
Staessen J, Fagard R, Amery A. Isolated systolic hypertension in the elderly: implications of Systolic Hypertension in the Elderly Program (SHEP) for clinical practice and for the ongoing trials. J Hum Hypertens. 1991;5(6):469–74.
Li JK, et al. Pulse wave propagation. Circ Res. 1981;49(2):442–52.
Li JK-J. Dynamics of the vascular system. Singapore: World Scientific; 2004.
Mohiaddin RH, et al. Regional aortic compliance studied by magnetic resonance imaging: the effects of age, training, and coronary artery disease. Br Heart J. 1989;62(2):90–6.
Berger DS, Li JK. Concurrent compliance reduction and increased peripheral resistance in the manifestation of isolated systolic hypertension. Am J Cardiol. 1990;65(1):67–71.
Li JK, et al. Allometric hemodynamic analysis of isolated systolic hypertension and aging. Cardiovasc Eng. 2007;7(4):135–9.
Berger DS, Li JK, Noordergraaf A. Differential effects of wave reflections and peripheral resistance on aortic blood pressure: a model-based study. Am J Phys. 1994;266(4 Pt 2):H1626–42.
Li JK-J, et al. Noninvasive pulse wave velocity and apparent phase velocity in normal and hypertensive subjects. J Cardiovas Diagn Procedures. 1996;13:31–6.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Avolio, A.P., Kuznetsova, T., Heyndrickx, G.R., Kerkhof, P.L.M., Li, J.KJ. (2018). Arterial Flow, Pulse Pressure and Pulse Wave Velocity in Men and Women at Various Ages. In: Kerkhof, P., Miller, V. (eds) Sex-Specific Analysis of Cardiovascular Function. Advances in Experimental Medicine and Biology, vol 1065. Springer, Cham. https://doi.org/10.1007/978-3-319-77932-4_10
Download citation
DOI: https://doi.org/10.1007/978-3-319-77932-4_10
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-77931-7
Online ISBN: 978-3-319-77932-4
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)