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Different Effects of Ageing on Central and Peripheral Blood Pressure: Invasive Study
고려대학교 순환기내과학 교실¹ 원광대학교 순환기내과학 교실²
김응주¹, 박창규¹ , 김지훈¹ , 주형준¹ , 신승용¹ , 나진오¹ , 서순용¹ , 최철웅¹ , 김진원¹ , 임홍의¹ , 김성환¹ , 이은미² , 나승운¹ , 안정천¹ , 송우혁¹ , 서홍석¹ , 오동주¹ , Seoul R & BD Program (10526)
Background: The relationships between ageing and blood pressure (BP) parameters in different arterial segments are not clear yet. We invasively measured the central and peripheral BP and pulse wave velocity (PWV) to determine the relationships between ageing and arterial mechanics. Methods: We prospectively enrolled 44 subjects aged 31 to 78 years undergoing coronary angiography. Systolic (SBP) and diastolic BP (DBP) were invasively measured at radial artery, abdominal aorta (AbA), aortic arch (AoA) and aortic root (AoR). AoA to AbA (aoPWV) and AoA to radial artery PWV (arPWV) were also assessed by foot-to-foot method using fluid-filled system. Results: In contrast to DBP and mean BP (MBP), SBP and pulse pressure (PP) were significantly correlated with age through the arterial tree and the more proximal the artery, the higher the correlation (for SBP, r=0.476, p=0.001 at radial artery, r=0.512, p<0.001 at AbA, r=0.532, p<0.001 at AoA, r=0.540, p<0.001 at AoR; for PP, r=0.591, p<0.001 at radial artery, r=0.697, p<0.001 at AbA, r=0.703, p<0.001 at AoA, r=0.724, p<0.001 at AoR). The correlation of PP with age was consistently higher than that of SBP with age at all studied segments. The associations of SBP and PP with age in all arterial sites remained significant after adjusting gender, coronary artery disease, diabetes, dyslipidemia, smoking status and the use of antihypertensive agent. A significant correlation between age and arterial stiffnesswas noted and it was more prominent in the central elastic artery (for aoPWV, r=0.513, p<0.001, for arPWV, r=0.347, p=0.021). The aoPWV maintained a significant association with age in the multivariate analysis, whereas the arPWV did not. Conclusions: SBP and particularly PP are significantly correlated with ageing, whereas DBP and MBP showed no correlation. Although the relationships between ageing and SBP and PP are consistently significant through the arterial tree, they were not homogenous: the more proximal the artery even in the aorta, the higher the correlation. The rapider progression of stiffness with ageing in the central elastic artery might be a cause of our observations.


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