title: Arterial waveform parameters in a large, population-based sample of adults: relationships with ethnicity and lifestyle factors.
abstract: Little is known about how aortic waveform parameters vary with ethnicity and lifestyle factors. We investigated these issues in a large, population-based sample. We carried out a cross-sectional analysis of 4798 men and women, aged 50-84 years from Auckland, New Zealand. Participants were 3961 European, 321 Pacific, 266 Maori and 250 South Asian people. We assessed modifiable lifestyle factors via questionnaires, and measured body mass index (BMI) and brachial blood pressure (BP). Suprasystolic oscillometry was used to derive aortic pressure, from which several haemodynamic parameters were calculated. Heavy alcohol consumption and BMI were positively related to most waveform parameters. Current smokers had higher levels of aortic augmentation index than non-smokers (difference=3.7%, P<0.0001). Aortic waveform parameters, controlling for demographics, antihypertensives, diabetes and cardiovascular disease (CVD), were higher in non-Europeans than in Europeans. Further adjustment for brachial BP or lifestyle factors (particularly BMI) reduced many differences but several remained. Despite even further adjustment for mean arterial pressure, pulse rate, height and total:high-density lipoprotein cholesterol, compared with Europeans, South Asians had higher levels of all measured aortic waveform parameters (for example, for backward pressure amplitude: β=1.5 mm Hg; P<0.0001), whereas Pacific people had 9% higher loge(excess pressure integral) (P<0.0001). In conclusion, aortic waveform parameters varied with ethnicity in line with the greater prevalence of CVD among non-white populations. Generally, this was true even after accounting for brachial BP, suggesting that waveform parameters may have increased usefulness in capturing ethnic variations in cardiovascular risk. Heavy alcohol consumption, smoking and especially BMI may partially contribute to elevated levels of these parameters.
authors.affiliation: School of Population Health, University of Auckland, Auckland, New Zealand.
authors.forename: J D
authors.initials: JD
authors.lastname: Sluyter
authors.affiliation: Institute of Cardiovascular Sciences, University College London, London, UK.
authors.forename: A D
authors.initials: AD
authors.lastname: Hughes
authors.affiliation: International Centre for Circulatory Health, Imperial College London, London, UK.
authors.forename: S A McG
authors.initials: SA
authors.lastname: Thom
authors.affiliation: Institute for Biomedical Technologies, Auckland University of Technology, Auckland, New Zealand.
authors.forename: A
authors.initials: A
authors.lastname: Lowe
authors.affiliation: Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Camargo
authors.affiliation: Health & Environment Department, AIT Austrian Institute of Technology, Vienna, Austria.
authors.forename: B
authors.identifier: 0000-0003-2048-1019
authors.initials: B
authors.lastname: Hametner
authors.affiliation: Health & Environment Department, AIT Austrian Institute of Technology, Vienna, Austria.
authors.forename: S
authors.initials: S
authors.lastname: Wassertheurer
authors.affiliation: Department of Bioengineering, Imperial College London, London, UK.
authors.forename: K H
authors.initials: KH
authors.lastname: Parker
authors.affiliation: School of Population Health, University of Auckland, Auckland, New Zealand.
authors.forename: R K R
authors.initials: RK
authors.lastname: Scragg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology; D001795:Blood Pressure Determination / Q000379:methods; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000208:ethnology*; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008019:Life Style / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D063177:Pulse Wave Analysis / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology