Pressure-dependence of arterial stiffness: potential clinical implications

B. Spronck, M.H.G. Heusinkveld, F.H. Vanmolkot, J. Roodt, Op 't, E. Hermeling, T. Delhaas, A.A. Kroon, K.D. Reesink

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Abstract

BACKGROUND:
Arterial stiffness measures such as pulse wave velocity (PWV) have a known dependence on actual blood pressure, requiring consideration in cardiovascular risk assessment and management. Given the impact of ageing on arterial wall structure, the pressure-dependence of PWV may vary with age.
METHODS:
Using a noninvasive model-based approach, combining carotid artery echo-tracking and tonometry waveforms, we obtained pressure-area curves in 23 hypertensive patients at baseline and after 3 months of antihypertensive treatment. We predicted the follow-up PWV decrease using modelled baseline curves and follow-up pressures. In addition, on the basis of these curves, we estimated PWV values for two age groups (mean ages 41 and 64 years) at predefined hypertensive (160/90 mmHg) and normotensive (120/80 mmHg) pressure ranges.
RESULTS:
Follow-up measurements showed a near 1 m/s decrease in carotid PWV when compared with baseline, which fully agreed with our model-prediction given the roughly 10 mmHg decrease in diastolic pressure. The stiffness-blood pressure-age pattern was in close agreement with corresponding data from the 'Reference Values for Arterial Stiffness' study, linking the physical and empirical bases of our findings.
CONCLUSION:
Our study demonstrates that the innate pressure-dependence of arterial stiffness may have implications for the clinical use of arterial stiffness measurements, both in risk assessment and in treatment monitoring of individual patients. We propose a number of clinically feasible approaches to account for the blood pressure effect on PWV measurements.
Original languageEnglish
Pages (from-to)330-338
JournalJournal of Hypertension
Volume33
Issue number2
DOIs
Publication statusPublished - Feb 2015

Keywords

  • carotid artery
  • hypertension
  • pulse wave velocity
  • remodelling
  • ultrasonography

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