title: Arterial stiffness, central blood pressure and body size in health and disease.
abstract: BACKGROUND
  Body size is associated with increased brachial systolic blood pressure (SBP) and aortic stiffness. The aims of this study were to determine the relationships between central SBP and body size (determined by body mass index (BMI), waist circumference and waist/hip ratio) in health and disease. We also sought to determine if aortic stiffness was correlated with body size, independent of BP.
  
  
  METHODS
  BMI, brachial BP and estimated central SBP (by SphygmoCor and radial P2) were recorded in controls (n=228), patients with diabetes (n=211), coronary artery disease (n=184) and end-stage kidney disease (n=68). Additional measures of waist circumference and arterial stiffness (aortic and brachial pulse wave velocity (PWV)) were recorded in a subgroup of 75 controls (aged 51 ± 12 years) who were carefully screened for factors affecting vascular function.
  
  
  RESULTS
  BMI was associated with brachial (r=0.30; P<0.001) and central SBP (r=0.29; P<0.001) in the 228 controls, but not the patient populations (r<0.13; P>0.15 for all comparisons). In the control subgroup, waist circumference was also significantly correlated with brachial SBP (r=0.29; P=0.01), but not central SBP (r=0.22; P=0.07). Independent predictors of aortic PWV in the control subgroup were brachial SBP (β=0.43; P<0.001), age (β=0.37; P<0.001), waist circumference (β=0.39; P=0.02) and female sex (β=-0.24; P=0.03), but not BMI.
  
  
  CONCLUSIONS
  In health, there are parallel increases in central and brachial SBP as BMI increases, but these relationships are not observed in the presence of chronic disease. Moreover, BP is a stronger correlate of arterial stiffness than body size.
authors.affiliation: The University of Queensland, School of Human Movement Studies, Brisbane, Queensland, Australia.
authors.forename: O O
authors.initials: OO
authors.lastname: Kolade
authors.forename: T M
authors.initials: TM
authors.lastname: O'Moore-Sullivan
authors.forename: M
authors.initials: M
authors.lastname: Stowasser
authors.forename: J S
authors.initials: JS
authors.lastname: Coombes
authors.forename: R G
authors.initials: RG
authors.lastname: Fassett
authors.forename: T H
authors.initials: TH
authors.lastname: Marwick
authors.forename: J E
authors.initials: JE
authors.lastname: Sharman
mesh_terms: D001783:Blood Flow Velocity; D001794:Blood Pressure; D015992:Body Mass Index; D001916:Brachial Artery / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D004452:Echocardiography; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011237:Predictive Value of Tests; D011673:Pulsatile Flow; D012307:Risk Factors; D019722:Sphygmomanometers; D059289:Vascular Stiffness; D055105:Waist Circumference; D049629:Waist-Hip Ratio