(Hypertension. 1999;34:808-812.)
© 1999 American Heart Association, Inc.
Scientific Contributions |
Contribution of Stroke Volume to the Change in Pulse Pressure Pattern With Age
From the Hypertension Unit, Hospital Italiano de Buenos Aires, Argentina.
Correspondence to José Alfie, MD, Unidad de Hipertensión Arterial, Servicio de Clínica Médica, Hospital Italiano, Gascón 450 (1181), Buenos Aires, Argentina. E-mail alfie{at}connmed.com.ar
Abstract—This study investigated
the effect of age on pulse pressure and its underlying mechanisms in
unmedicated hypertensive men with the same level of mean
arterial pressure. We included 77 men 17 to 76 years old
with daytime mean arterial pressure between 95 and 114
mm Hg. In the supine position, pulse pressure showed a significant
widening in young (<30 years) and older (
60 years) patients. Pulse
pressure decreased in parallel with stroke index from age >30 to 40 to
49 years. Upright posture, however, eliminated this difference through
a larger orthostatic fall in stroke index and pulse
pressure in the youngest patients. After age 50 years, pulse pressure
exhibited a progressive widening despite the further age-related
decrease in stroke index. Supine, upright, and 24-hour pulse pressure
fitted a curvilinear correlation with age (r=0.55, 0.56,
and 0.68, respectively, P<0.001), with a transition at
age 50 years. Before age 50 years, 24-hour pulse pressure correlated
positively with stroke volume (r=0.5,
P<0.001) and negatively with arterial
compliance (SV/PP ratio, r=-0.37,
P<0.01). In contrast, in men 50 years old, 24-hour
pulse pressure correlated negatively with the SV/PP ratio
(r=-0.5; P<0.01), without significant
influence of stroke volume. Thus, in hypertensive men, the age-related
change in stroke volume significantly accounted for the change in
clinic and ambulatory pulse pressure during young adulthood, but its
contribution decreased after the fifth decade.
Key Words: : age • pulse pressure • stroke volume • hypertension, arterial • blood pressure monitoring
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