Background
Two individuals can have a similar pulse pressure (
PP
) but different levels of systolic blood pressure (
SBP
), although the underlying mechanisms have not been described. We hypothesized that, for a given level of
PP
, differences in
SBP
relate to peripheral vascular resistance (
PVR
); and we tested this hypothesis in a large cohort of healthy young adults.
Methods and Results
Demographic, biochemical, and hemodynamic data from 3103 subjects were available for the current analyses. In both men and women, for a given level of
PP
, higher
SBP
was associated with significantly higher body weight, body mass index, heart rate, and
PVR
(
P
<0.05 versus those with lower
BP
for all comparisons). Moreover, stratifying individuals by quartiles of
PP
and
PVR
revealed a stepwise increase in
SBP
from the lowest to highest quartile for each variable, with the highest
SBP
occurring in those in the highest quartile of both
PP
and
PVR
(
P
<0.001 for overall trend for both sexes).
PVR
was also increased with increasing tertile of minimum forearm vascular resistance, in both men (
P
=0.002) and women (
P
=0.03).
Conclusions
Increased
PVR
, mediated in part through altered resistance vessel structure, strongly associates with the elevation of
SBP
for a given level of
PP
in young adults. An impaired ability to adapt
PVR
appropriately to a given level of
PP
may be an important mechanism underlying elevated
SBP
in young adults.
The Role of Rare Variants in Systolic Blood Pressure: Analysis of ExomeChip Data in HyperGEN African Americans
