Increased Wave Reflection Rather Than Central Arterial Stiffness Is the Main Determinant of Raised Pulse Pressure in Women and Relates to Mismatch in Arterial DimensionsA Twin Study
Marina Cecelja, BSc*,
Benyu Jiang, PhD*,
Karen McNeill*,
Bernet Kato, PhD ,
James Ritter, PhD*,
Tim Spector, MD and
Phil Chowienczyk, BSc*,*
* King's College London, Cardiovascular Division, London, United Kingdom
Department of Twin Research and Genetic Epidemiology, London, United Kingdom
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Figure 1 Aortic and Peripheral Pressure Waveforms
Aortic and peripheral pressure waveforms showing central systolic pressure (cSBP), peripheral systolic pressure (pSBP), central pulse pressure (cPP), and peripheral pulse pressure (pPP). cPP can be divided into 2 components: the height of the first systolic shoulder (P1) above diastolic blood pressure (DBP) (equal at central and peripheral sites) and augmentation pressure ( Paug), thought to be determined by wave reflection. T1, the time of the first systolic shoulder, is thought to be determined by the time of arrival of the reflected wave.
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Figure 2 Central Pulse Pressure
Mean values of P1 and augmentation pressure in relation to central pulse pressure in women <60 and  60 years of age. P1 = height of first systolic shoulder.
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