Published Online
on December 24, 2007

A more recent version of this article appeared on February 1, 2008

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Submitted on August 8, 2007
Revised on August 30, 2007

Pulse Pressure Is Inversely Related to Aortic Root Diameter Implications for the Pathogenesis of Systolic Hypertension

S. Morteza Farasat; Christopher H. Morrell; Angelo Scuteri; Chih-Tai Ting; Frank C.P. Yin; Harold A. Spurgeon; Chen-Huan Chen; Edward G. Lakatta; and Samer S. Najjar^*

From the Laboratory of Cardiovascular Science (S.M.F., C.H.M., H.A.S., E.G.L., S.S.N.), and the Clinical Research Branch (S.M.F.), National Instituteon Aging, National Institutes of Health, Baltimore, Md; Mathematical Sciences Department (C.H.M.), Loyola College, Baltimore, Md; Unitá Operativa Geriatria (A.S.), Istituto Nazionale Ricovero E Cura Anziani, Rome, Italy; Institute of Clinical Medicine and Cardiovascular Research Institute (C.-T.T.,C.-H.C.), National Yang-Ming University, Taipei, Taiwan; Cardiovascular Center (C.-T.T.), Taichung Veterans General Hospital, Taichung, Taiwan; and the Department of Biomedical Engineering (F.C.P.Y.), Washington University, St Louis, Mo.

^* To whom correspondence should be addressed. E-mail: najjarsa{at}mail.nih.gov.

Abstract—Hypertension accelerates the age-associated increase in aortic root diameter (AoD), likely because of chronically elevated distending pressures. However, the pulsatile component of blood pressure may have a different relationship with AoD. We sought to assess the relationship between AoD and pulse pressure (PP) while accounting for left ventricular and central arterial structural and functional properties, which are known to influence PP. The study population was composed of 1256 individuals, aged 30 to 79 years (48% women and 48% hypertensive), none of whom were on antihypertensive medications. Blood pressure was measured in the sitting position with conventional sphygmomanometry. PP was calculated as the difference between systolic and diastolic blood pressures. AoD was measured at end diastole at the level of the sinuses of Valsalva with echocardiography. The relationship between AoD and PP was evaluated with multiple regression analyses. PP was 50±14 mm Hg in men and 54±18 mm Hg in women, and AoD was 31.9±3.5 mm in men and 28.9±3.5 mm in women. After adjusting for age, age², height, weight, and mean arterial pressure, AoD was independently and inversely associated with PP in both sexes. After further adjustments for central arterial stiffness and wall thickness, reflected waves, and left ventricular geometry, AoD remained inversely associated with PP in both men (coefficient=-0.48; P=0.0003; model R²=0.51) and women (coefficient=-0.40; P=0.01; model R²=0.61). Thus, AoD is inversely associated with PP, suggesting that a small AoD may contribute to the pathogenesis of systolic hypertension. Longitudinal studies are needed to examine this possibility.

Key words: aorta • sinus of Valsalva • pulse pressure • systolic hypertension

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