Hypertension. 2005;45:652-658
Published online before print February 7, 2005, doi: 10.1161/01.HYP.0000153793.84859.b8
Published online before print February 7, 2005, doi: 10.1161/01.HYP.0000153793.84859.b8
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(Hypertension. 2005;45:652.)
© 2005 American Heart Association, Inc.
Brief Review |
Aortic Diameter, Aortic Stiffness, and Wave Reflection Increase With Age and Isolated Systolic Hypertension
From the VCCRI/University of New South Wales/St. Vincent’s Clinic (M.O.), Sydney, Australia; and the Departments of Medicine and Physiology (W.N.), University of Florida, Gainesville.
Correspondence to M. O’Rourke, Suite 810, St. Vincent’s Clinic, 438 Victoria St, Darlinghurst, NSW 2010, Australia. E-mail M.ORourke@unsw.edu.au
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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Introduction |
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The October 2004 High Blood Pressure Research Council meeting of the American Heart Association included a debate on the proposition that "aortic diameter, aortic stiffness, and wave reflection all increase with age and in isolated systolic hypertension." This was stimulated by a series of articles1–5 that took a contrary position to change in aortic diameter and wave reflection and placed emphasis on aortic stiffness over wave reflection with aging and isolated systolic hypertension. The purpose of this review is to summarize the conventional view that has evolved over decades6–12 but is not precisely argued in recent literature. According to this view, early wave reflection from peripheral arteries is the dominant ill effect of aging and the most logical target for therapy.12–14
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Observations and Measurements |
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"Premature arterial senility" as a cardiovascular risk factor has long been of intense interest in actuarial studies, even before introduction of the cuff sphygmomanometer,6 as it had been in clinical medicine. The latter is apparent in the textbooks of Osler and Mackenzie >100 years ago.7,8 In these, premature arteriosclerotic change was assessed from the pulse waveform palpated at the wrist or measured from the radial artery by sphygmography. The first graphic recording studies of the arterial pulse by Marey in 18639 noted characteristic differences between young and old persons (Figure 1), with prominent late systolic augmentation ("tidal wave") in the latter. Mahomed10,11 confirmed these changes in the 1870s, stressing that "the tidal wave is prolonged and too much sustained," and noting similar pulse waveform changes in asymptomatic
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