title: Ethnic Differences in Arterial Wave Reflection Are Mostly Explained by Differences in Body Height - Cross-Sectional Analysis of the HELIUS Study.
abstract: BACKGROUND
  Differences in arterial wave reflection and central blood pressure (BP) have been associated with cardiovascular disease (CVD) in various populations and may contribute to ethnic differences in CVD. Whether ethnic differences in wave reflection and central BP can be explained by conventional risk factors for CVD or may result from physiological differences remains undetermined.
  
  
  METHODS
  We examined ethnic differences in augmentation index (AIx) and central systolic BP and their determinants in a large multi-ethnic cohort study in Amsterdam, the Netherlands. A total of 8812 (46% male) participants aged 18-70 years of Dutch, South-Asian Surinamese, African Surinamese and Ghanaian origin were included. AIx and central BP were measured in duplicate using the Arteriograph system.
  
  
  RESULTS
  AIx and central systolic BP were significantly higher in South-Asian Surinamese (35±17%, 126±22 mmHg), African Surinamese (33±17%, 129±23 mmHg) and Ghanaian (33±16%, 135±24 mmHg) as compared with Dutch (27±17%, 118±20 mmHg, all p<0.001). Correction for cardiovascular risk factors only slightly reduced the difference in AIx, whereas correction for body height attenuated age and gender corrected ethnic differences in AIx the most. Differences in central systolic BP were primarily determined by differences in AIx for South-Asian Surinamese and by differences in peripheral systolic BP for subjects of African origin.
  
  
  CONCLUSIONS
  Substantial differences in AIx and central BP exist across different ethnic groups that cannot be explained by differences in conventional risk factors for CVD. These findings may explain part of the underestimation of cardiovascular risk observed in populations of African and South-Asian descent.
authors.affiliation: Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Daan W
authors.initials: DW
authors.lastname: Eeftinck Schattenkerk
authors.affiliation: Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: van Gorp
authors.affiliation: Department of Public Health, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Marieke B
authors.initials: MB
authors.lastname: Snijder
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Aeilko H
authors.initials: AH
authors.lastname: Zwinderman
authors.affiliation: Department of Public Health, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Charles O
authors.initials: CO
authors.lastname: Agyemang
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Ron J G
authors.initials: RJ
authors.lastname: Peters
authors.affiliation: Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Bert-Jan H
authors.initials: BJ
authors.lastname: van den Born
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001158:Arteries / Q000502:physiology*; D001794:Blood Pressure; D001827:Body Height; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D055815:Young Adult