title: Pulse pressure relation to aortic and left ventricular structure in the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study.
abstract: High pulse pressure, a major cardiovascular risk factor, has been attributed to medial elastic fiber degeneration and aortic dilation, which transfers hemodynamic load to stiffer collagen. However, recent studies suggest higher pulse pressure is instead associated with smaller aortic diameter. Thus, we sought to elucidate relations of pulse pressure with aortic stiffness and aortic and cardiac dimensions. We used magnetic resonance imaging to examine relationships of pulse pressure with lumen area and wall stiffness and thickness in the thoracic aorta and left ventricular structure in 526 participants (72-94 years of age, 295 women) in the community-based Age, Gene/Environment Susceptibility-Reykjavik Study. In a multivariable model that adjusted for age, sex, height, weight, and standard vascular risk factors, central pulse pressure had a negative relationship with aortic lumen area (all effects expressed as mm Hg/SD; B=-8.1±1.2; P<0.001) and positive relationships with left ventricular end-diastolic volume (B=3.8±1.0; P<0.001), carotid-femoral pulse wave velocity (B=3.6±1.0; P<0.001), and aortic wall area (B=3.0±1.2; P=0.015). Higher pulse pressure in older people is associated with smaller aortic lumen area and greater aortic wall stiffness and thickness and left ventricular volume. Relationships of larger ventricular volume and smaller aortic lumen with higher pulse pressure suggest mismatch in hemodynamic load accommodation by the heart and aorta in older people.
authors.affiliation: From the Cardiovascular Engineering, Inc, Norwood, MA (A.A.T., J.D.G., V.B.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, Leiden, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik, Iceland (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.).
authors.forename: Alyssa A
authors.initials: AA
authors.lastname: Torjesen
authors.affiliation: From the Cardiovascular Engineering, Inc, Norwood, MA (A.A.T., J.D.G., V.B.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, Leiden, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik, Iceland (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.).
authors.forename: Sigurður
authors.initials: S
authors.lastname: Sigurðsson
authors.affiliation: From the Cardiovascular Engineering, Inc, Norwood, MA (A.A.T., J.D.G., V.B.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, Leiden, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik, Iceland (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.).
authors.forename: Jos J M
authors.initials: JJ
authors.lastname: Westenberg
authors.affiliation: From the Cardiovascular Engineering, Inc, Norwood, MA (A.A.T., J.D.G., V.B.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, Leiden, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik, Iceland (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.).
authors.forename: John D
authors.initials: JD
authors.lastname: Gotal
authors.affiliation: From the Cardiovascular Engineering, Inc, Norwood, MA (A.A.T., J.D.G., V.B.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, Leiden, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik, Iceland (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.).
authors.forename: Vanessa
authors.initials: V
authors.lastname: Bell
authors.affiliation: From the Cardiovascular Engineering, Inc, Norwood, MA (A.A.T., J.D.G., V.B.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, Leiden, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik, Iceland (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.).
authors.forename: Thor
authors.initials: T
authors.lastname: Aspelund
authors.affiliation: From the Cardiovascular Engineering, Inc, Norwood, MA (A.A.T., J.D.G., V.B.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, Leiden, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik, Iceland (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.).
authors.forename: Lenore J
authors.initials: LJ
authors.lastname: Launer
authors.affiliation: From the Cardiovascular Engineering, Inc, Norwood, MA (A.A.T., J.D.G., V.B.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, Leiden, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik, Iceland (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.).
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
authors.affiliation: From the Cardiovascular Engineering, Inc, Norwood, MA (A.A.T., J.D.G., V.B.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, Leiden, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik, Iceland (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.).
authors.forename: Vilmundur
authors.initials: V
authors.lastname: Gudnason
authors.affiliation: From the Cardiovascular Engineering, Inc, Norwood, MA (A.A.T., J.D.G., V.B.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, Leiden, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik, Iceland (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.).
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.affiliation: From the Cardiovascular Engineering, Inc, Norwood, MA (A.A.T., J.D.G., V.B.); Icelandic Heart Association, Kopavogur, Iceland (S.S., T.A., V.G.); Leiden University Medical Center, Leiden, The Netherlands (J.J.M.W., A.d.R.); University of Iceland, Reykjavik, Iceland (T.A., V.G.); and National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L., T.B.H.). GaryFMitchell@mindspring.com.
authors.forename: Gary F
authors.initials: GF
authors.lastname: Mitchell
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D001794:Blood Pressure / Q000235:genetics / Q000502:physiology*; D005260:Female; D059647:Gene-Environment Interaction; D006321:Heart / Q000503:physiopathology*; D006352:Heart Ventricles / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D015999:Multivariate Analysis; D009206:Myocardium / Q000473:pathology; D013318:Stroke Volume / Q000502:physiology; D059289:Vascular Stiffness
keywords: blood pressure; hypertension; magnetic resonance imaging; pulse wave analysis; vascular stiffness