CLINICAL RESEARCH: AGING AND VASCULAR FUNCTION
Normal Vascular Aging: Differential Effects on Wave Reflection and Aortic Pulse Wave Velocity
The Anglo-Cardiff Collaborative Trial (ACCT)
Carmel M. McEniery, PhD*,*,
Yasmin, PhD*,
Ian R. Hall, MB, MRCP ,
Ahmad Qasem, PhD ,
Ian B. Wilkinson, MA, DM, MRCP*,
John R. Cockcroft, BSc, MB, FRCP on behalf of the ACCT Investigators
* Clinical Pharmacology Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom
Department of Cardiology, University of Wales, College of Medicine, University Hospital, Cardiff, United Kingdom
Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia
Manuscript received March 9, 2005;
revised manuscript received July 1, 2005,
accepted July 4, 2005.
* Reprint requests and correspondence: Dr. Carmel M. McEniery, University of Cambridge, Clinical Pharmacology Unit, Addenbrooke's Hospital, Box 110, Cambridge, Cambridgeshire CB2 2QQ, United Kingdom
(Email: cmm41{at}cam.ac.uk).
OBJECTIVES: The aim of the current investigation was to test the hypothesis that age-related changes in augmentation index (AIx) are more prominent in younger individuals (<50 years), whereas changes in aortic stiffness per se are more marked in older individuals (>50 years).
BACKGROUND: Aging exerts a number of deleterious changes in the cardiovascular system, and, in particular, on the large arteries. Previous studies have suggested that AIx and pulse wave velocity (PWV) increase linearly with age, yet epidemiological data concerning pulse pressure suggest that large artery stiffening predominantly occurs later in life.
METHODS: Peripheral and central blood pressure, augmentation pressure (AP), and AIx were determined in 4,001 healthy, normotensive individuals, aged 18 to 90 years. Aortic and brachial PWV were also determined in a subset of 998 subjects.
RESULTS: Peripheral and central pulse pressure, AP, AIx, and aortic and brachial PWV all increased significantly with age; however, the age-related changes in AIx and aortic PWV were non-linear, with AIx increasing more in younger individuals, whereas the changes in PWV were more prominent in older individuals.
CONCLUSIONS: These data suggest that AIx might be a more sensitive marker of arterial stiffening and risk in younger individuals but aortic PWV is likely to be a better measure in older individuals.
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Abbreviations and Acronyms
| | ACCT = Anglo-Cardiff Collaborative Trial | | AIx = augmentation index | | ANOVA = analysis of variance | | AP = augmentation pressure | | CSBP = central systolic pressure | | HR = heart rate | | MAP = mean arterial pressure | | PP = pulse pressure | | PPP = peripheral PP | | PWV = pulse wave velocity | | Tr = time to return of the reflected pressure wave |
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