title: Prospective risk factors for increased central augmentation index in men and women.
abstract: BACKGROUND
  Arterial wave reflections are important determinants of central pressure pulsatility and left ventricular afterload. The augmentation index (AIx) is the most widely used surrogate of arterial wave reflections. Despite multiple cross-sectional studies assessing the correlates of AIx, little prospective data exist regarding changes in AIx over time. We aimed to assess the predictors of changes in AIx over time in adults from the general population.
  
  
  METHODS
  We performed radial arterial tonometry assessments a median of 3.18 ± 0.4 years apart on 143 nondiabetic adult participants in the population-based PREVENCION study. Central AIx was obtained using the generalized transfer function of the Sphygmocor device.
  
  
  RESULTS
  Predictors of the change in AIx over time were investigated. Among men (n = 67), the change in AIx was predicted by abdominal obesity (standardized β for waist circumference = 0.34; P = 0.002), impaired fasting glucose (standardized β = 0.24; P = 0.009), and the change in heart rate (standardized β = -0.78; P < 0.001). Among women (n = 76), the change in AIx was predicted by non-high-density lipoprotein cholesterol (standardized β = 0.33; P = 0.001), C-reactive protein levels (standardized β = 0.24; P = 0.02), change in mean arterial pressure (standardized β = 0.33; P = 0.001), and change in heart rate (standardized β = -0.52; P < 0.001).
  
  
  CONCLUSIONS
  Metabolic and inflammatory factors predicted changes in AIx over time, with important sex differences. Metabolic factors, such as abdominal obesity and impaired fasting glucose, predicted changes in AIx in men, whereas C-reactive protein and non-high-density lipoprotein cholesterol levels predicted changes in women. Our findings highlight the impact of sex on arterial properties and may guide the design of interventions to favorably impact changes in late systolic pressure augmentation.
authors.affiliation: Division of Cardiology, Philadelphia VA Medical Center and University of Pennsylvania, Philadelphia, Pennsylvania; prithvisk@gmail.com.
authors.forename: Prithvi
authors.initials: P
authors.lastname: Shiva Kumar
authors.affiliation: Department of Medicine, Santa Maria Catholic University and Santa Maria Research Institute, Arequipa, Peru;
authors.forename: Josefina
authors.initials: J
authors.lastname: Medina-Lezama
authors.affiliation: Department of Medicine, Mayo Clinic, Rochester, Minnesota;
authors.forename: Oscar
authors.initials: O
authors.lastname: Morey-Vargas
authors.affiliation: Division of Cardiology, Philadelphia VA Medical Center and University of Pennsylvania, Philadelphia, Pennsylvania;
authors.forename: Payman
authors.initials: P
authors.lastname: Zamani
authors.affiliation: Division of Cardiology, Philadelphia VA Medical Center and University of Pennsylvania, Philadelphia, Pennsylvania;
authors.forename: Juan F
authors.initials: JF
authors.lastname: Bolaños-Salazar
authors.affiliation: Department of Psychology, University of Miami, Miami, Florida.
authors.forename: Diana A
authors.initials: DA
authors.lastname: Chirinos
authors.affiliation: Division of Cardiology, Philadelphia VA Medical Center and University of Pennsylvania, Philadelphia, Pennsylvania;
authors.forename: Philip
authors.initials: P
authors.lastname: Haines
authors.affiliation: Division of Cardiology, Philadelphia VA Medical Center and University of Pennsylvania, Philadelphia, Pennsylvania;
authors.forename: Zubair A
authors.initials: ZA
authors.lastname: Khan
authors.affiliation: Department of Medicine, Santa Maria Catholic University and Santa Maria Research Institute, Arequipa, Peru;
authors.forename: Johanna C
authors.initials: JC
authors.lastname: Coacalla-Guerra
authors.affiliation: Department of Medicine, Santa Maria Catholic University and Santa Maria Research Institute, Arequipa, Peru;
authors.forename: Maria E
authors.initials: ME
authors.lastname: Davalos-Robles
authors.affiliation: Department of Medicine, Santa Maria Catholic University and Santa Maria Research Institute, Arequipa, Peru;
authors.forename: Gladys R
authors.initials: GR
authors.lastname: Llerena-Dongo
authors.affiliation: Department of Medicine, Santa Maria Catholic University and Santa Maria Research Institute, Arequipa, Peru;
authors.forename: Mardelangel
authors.initials: M
authors.lastname: Zapata-Ponze
authors.affiliation: Division of Cardiology, Philadelphia VA Medical Center and University of Pennsylvania, Philadelphia, Pennsylvania;
authors.forename: Julio A
authors.initials: JA
authors.lastname: Chirinos
mesh_terms: D000328:Adult; D001011:Aorta / Q000503:physiopathology*; D062186:Arterial Pressure; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D002784:Cholesterol / Q000097:blood; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000175:diagnosis / Q000453:epidemiology; D010568:Peru / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D002097:C-Reactive Protein; D002784:Cholesterol
keywords: augmentation index; blood pressure; gender differences; hypertension; prospective; wave reflections.