title: Brachial Pressure Control Fails to Account for Most Distending Pressure-Independent, Age-Related Aortic Hemodynamic Changes in Adults.
abstract: BACKGROUND
  Although several characteristics of aortic function, which are largely determined by age, predict outcomes beyond brachial blood pressure (BP), the extent to which brachial BP control accounts for age-related variations in aortic function is uncertain. We aimed to determine the extent to which brachial BP control in the general population (systolic/diastolic BP < 140/90 mm Hg) accounts for age-related aortic hemodynamic changes across the adult lifespan.
  
  
  METHODS
  Central aortic pulse pressure (PPc), backward wave pressure (Pb), pulse wave velocity (PWV), and PP amplification (PPamp) (applanation tonometry and SphygmoCor software) were determined in 1,185 participants from a community sample (age >16 years; 36.4% uncontrolled BP).
  
  
  RESULTS
  With adjustments for distending pressure (mean arterial pressure, MAP), no increases in PPc, Pb, or PWV and decreases in PPamp were noted in those with an uncontrolled brachial BP younger than 50 years. In those older than 50 years with an uncontrolled brachial BP, MAP-adjusted aortic hemodynamic variables were only modestly different to those with a controlled brachial BP (PPc, 46±14 vs. 42±15 mm Hg, P < 0.02, Pb, 23±8 vs. 21±8 mm Hg, PWV, 8.42±3.21 vs. 8.19±3.37 m/second, PPamp, 1.21±0.17 vs. 1.21±0.14). Nonetheless, with adjustments for MAP, marked age-related increases in PPc, Pb, and PWV and decreases in PPamp were noted in those with uncontrolled and controlled brachial BP across the adult lifespan (P < 0.0001).
  
  
  CONCLUSIONS
  Brachial BP control in the general population fails to account for most distending pressure-independent, age-related changes in aortic hemodynamics across the adult lifespan.
authors: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;
authors: Bryan
authors: B
authors: Hodson
authors: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;
authors: Gavin R
authors: GR
authors: Norton
authors: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;
authors: Hendrik L
authors: HL
authors: Booysen
authors: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;
authors: Moekanyi J
authors: MJ
authors: Sibiya
authors: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;
authors: Andrew
authors: A
authors: Raymond
authors: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;
authors: Muzi J
authors: MJ
authors: Maseko
authors: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;
authors: Olebogeng H I
authors: OH
authors: Majane
authors: School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors: Elena
authors: E
authors: Libhaber
authors: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;
authors: Pinhas
authors: P
authors: Sareli
authors: Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;
authors: Angela J
authors: AJ
authors: Woodiwiss
mesh_terms: D000328:Adult; D000367:Age Factors; D000375:Aging / Q000208:ethnology; D001011:Aorta / Q000503:physiopathology*; D062186:Arterial Pressure; D044383:Black People; D001916:Brachial Artery / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D063177:Pulse Wave Analysis; D013019:South Africa / Q000453:epidemiology; D059289:Vascular Stiffness
keywords: age; aortic pulse pressure; central blood pressure; hypertension; reflected waves.