title: Increased arterial stiffness weakens the relationship between wave reflection and the central pressure indexes in men younger than 60 years of age.
abstract: BACKGROUND
  Interactions among age, arterial stiffness, and pressure wave reflection affect the central blood pressure (CBP). We evaluated our hypothesis that the contribution of the wave reflection to the CBP indexes is reduced at higher levels of arterial stiffness, independent of the effect of age.
  
  
  METHODS
  In 2,691 Japanese men aged <60 years old who are not suffering from cardiovascular disease or receiving medications for cardiovascular risk factors, the brachial-ankle pulse wave velocity (PWV), radial augmentation index (AI), and second peak of the radial pressure waveform (SBP2), a marker of CBP, were measured.
  
  
  RESULTS
  The increase in the radial AI associated with increase of the brachial-ankle PWV became attenuated at brachial-ankle PWV values of ≥15 m/s. Stepwise multivariate linear regression analysis demonstrated that 33.6% of the total variation in the value of SBP2 and 54.0% of the total variation in the value of the SBP2 minus the diastolic blood pressure, a marker of the central pulse pressure (CPP), were accounted for by the change of the radial AI in the group with brachial-ankle PWV values of <15 m/s, with the corresponding percentages of 16.2 and 38.0% in the group with brachial-ankle PWV values of ≥15 m/s (P < 0.01).
  
  
  CONCLUSIONS
  In non-elderly Japanese men, the contribution of the wave reflection to the CBP indexes may be reduced in subjects with higher levels of arterial stiffness, independent of the effect of age. Notwithstanding, the wave reflection may still be the major determinant of the CPP at any given level of arterial stiffness.
authors.affiliation: Second Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Odaira
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Tomiyama
authors.forename: Hideki
authors.initials: H
authors.lastname: Hashimoto
authors.forename: Iwao
authors.initials: I
authors.lastname: Kojima
authors.forename: Chisa
authors.initials: C
authors.lastname: Matsumoto
authors.forename: Masanobu
authors.initials: M
authors.lastname: Yoshida
authors.forename: Kazuki
authors.initials: K
authors.lastname: Shiina
authors.forename: Mikio
authors.initials: M
authors.lastname: Nagata
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Miyawaki
authors.forename: Akira
authors.initials: A
authors.lastname: Yamashina
mesh_terms: D000328:Adult; D055109:Ankle Brachial Index; D044466:Asian People; D001783:Blood Flow Velocity; D001794:Blood Pressure / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow; D014655:Vascular Resistance; D059289:Vascular Stiffness