title: The role of arterial elasticity and cardiovascular peripheral resistance as clinically relevant indices of health status in people with psychosis.
abstract: Hypertension is one of the most important risk factors for cardiovascular disease (CVD). Systolic and diastolic blood pressure (BP) are higher in people with psychosis compared to the general population, but there is little research into measures of the elasticity of the arterial wall (pulse pressure; PP) and peripheral resistance (mean arterial pressure; MAP). PP and MAP can provide an additional perspective on the functioning of the circulatory system. This study investigated PP and MAP in people with psychosis, using factors known to be related to PP and MAP in the general population.
  
  
  
  Participants included 1421 people aged 18-64years, from the second Australian national survey of psychosis, untreated with antihypertensive medication. We tested the interaction and main effects between age and gender on PP, MAP, systolic BP and diastolic BP. Odds ratios were calculated in people exceeding the at-risk thresholds for PP and MAP. Multiple linear regression was used to test whether factors associated with at-risk PP and MAP in the general population were similarly associated in the psychosis population.
  
  
  
  The interaction effect between age and gender on PP, MAP, systolic BP and diastolic BP was not statistically significant. Variables that retained significance in the regression model in explaining higher PP and MAP were: male gender, higher age, and having a family history of hypertension.
  
  
  
  Clinicians monitoring and treating CV risk in this population need to ensure that they have recorded whether there is a family history of hypertension, and should be especially, more vigilant in men and in older patients.
authors.affiliation: Level 4, Eleanor Harrald Building, Royal Adelaide Hospital, University of Adelaide, Discipline of Psychiatry, Adelaide, SA 5000, Australia. Electronic address: lisa.hahn@student.adelaide.edu.au.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Hahn
authors.affiliation: Black Dog Institute and University of New South Wales, Sydney, NSW, Australia; Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia. Electronic address: Andrew.Mackinnon@biostats.com.au.
authors.forename: Andrew
authors.initials: A
authors.lastname: Mackinnon
authors.affiliation: Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, VIC, Australia. Electronic address: dfoley@unimelb.edu.au.
authors.forename: Debra L
authors.initials: DL
authors.lastname: Foley
authors.affiliation: Neuropsychiatric Epidemiology Research Unit, School of Psychiatry & Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia. Electronic address: vera.morgan@uwa.edu.au.
authors.forename: Vera A
authors.initials: VA
authors.lastname: Morgan
authors.affiliation: Neuropsychiatric Epidemiology Research Unit, School of Psychiatry & Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia. Electronic address: anna.waterreus@uwa.edu.au.
authors.forename: Anna
authors.initials: A
authors.lastname: Waterreus
authors.affiliation: Cardiometabolic Clinic, Department of Cardiology, Royal Perth Hospital, School of Medicine and Pharmacology, The University of Western Australia, Crawley, WA, Australia. Electronic address: gerald.watts@uwa.edu.au.
authors.forename: Gerald F
authors.initials: GF
authors.lastname: Watts
authors.affiliation: St Vincent's Hospital, Melbourne and Department of Psychiatry, The University of Melbourne, VIC, Australia. Electronic address: djcastle@unimelb.edu.au.
authors.forename: David J
authors.initials: DJ
authors.lastname: Castle
authors.affiliation: Discipline of Psychiatry, School of Medicine, University of Adelaide, Northern Adelaide Local Area Health Network, Adelaide, SA, Australia. Electronic address: Dennis.liu@health.sa.gov.au.
authors.forename: Dennis
authors.initials: D
authors.lastname: Liu
authors.affiliation: Discipline of Psychiatry, School of Medicine, University of Adelaide Ramsay Health Care, Mental Health Services, Northern Adelaide Local Health Network, Adelaide, SA, Australia. Electronic address: cherrie.galletly@adelaide.edu.au.
authors.forename: Cherrie A
authors.initials: CA
authors.lastname: Galletly
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D062186:Arterial Pressure / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000503:physiopathology*; D012737:Sex Factors; D014655:Vascular Resistance / Q000502:physiology*; D055815:Young Adult
keywords: Cardiovascular disease; Hypertension; Mean arterial pressure; Mortality; Psychosis; Pulse pressure