The Relationship Between the Acute Changes of the Systolic Blood Pressure and the Brachial-Ankle Pulse Wave Velocity

Background and Purpose: Blood pressure variability (BPV) from beat to beat is associated with an increased risk of cardiovascular events and enables rapid assessment of BPV, but the underlying causes of elevated BPV are unclear. Methods: In consecutive patients within 4 to 6 weeks of transient ischemic attack or nondisabling stroke (OXVASC [Oxford Vascular Study]), continuous noninvasive blood pressure was measured beat to beat over 5 minutes (Finometer). Arterial stiffness was measured by carotid-femoral pulse wave velocity (Sphygmocor). After automated and manual data cleaning, associations between BPV (residual coefficient of variation), demographic factors, and arterial stiffness were determined for both systolic and diastolic blood pressure, by ANOVA and linear models. Relationships between demographic factors and arterial stiffness were determined by interaction terms and mediation. Results: Among 1013 patients, 54 (5.3%) were in AF, and 51 (5%) had low-quality recordings. In a general linear model including the remaining 908 participants, systolic BPV (SBPV) was most strongly associated with age ( P =0.00003), body mass index (BMI; P =0.003), and arterial stiffness ( P =0.008), with weaker independent associations with current smoking ( P =0.01) and a low diastolic blood pressure ( P =0.046). However, while there was a linear increase in SBPV with BMI in men, in women, SBPV was lowest for a BMI in the normal range but was greater below 20 or above 30 (ANOVA, P =0.012; BMI-sex interaction, P =0.03). Although BMI and pulse wave velocity were partially independent, increased pulse wave velocity mediated ≈32% of the relationship between increased BMI and SBPV ( P <0.001). Conclusions: Vascular aging, manifest as arterial stiffness, was a strong determinant of increased SBPV and partially mediated the effect of increased BMI. However, although high BMI was independently associated with SBPV in both sexes, a low BMI was associated with increased SBPV only in women. SBPV may partially mediate the relationship between BMI and cardiovascular events, while obesity may provide a modifiable target to reduce SBPV and cardiovascular events.

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Prediction Algorithms for Blood Pressure Based on Pulse Wave Velocity Using Health Checkup Data in Healthy Korean Men: Algorithm Development and Validation

JMIR Medical Informatics ◽

10.2196/29212 ◽

2021 ◽

Vol 9 (12) ◽

pp. e29212

Author(s):

Dohyun Park ◽

Soo Jin Cho ◽

Kyunga Kim ◽

Hyunki Woo ◽

Jee Eun Kim ◽

...

Keyword(s):

Blood Pressure ◽

Pulse Wave Velocity ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Wave Velocity ◽

Pulse Wave ◽

Clinical Variable ◽

Linear Regression Method ◽

Relative Importance ◽

Final Model

Background Pulse transit time and pulse wave velocity (PWV) are related to blood pressure (BP), and there were continuous attempts to use these to predict BP through wearable devices. However, previous studies were conducted on a small scale and could not confirm the relative importance of each variable in predicting BP. Objective This study aims to predict systolic blood pressure and diastolic blood pressure based on PWV and to evaluate the relative importance of each clinical variable used in BP prediction models. Methods This study was conducted on 1362 healthy men older than 18 years who visited the Samsung Medical Center. The systolic blood pressure and diastolic blood pressure were estimated using the multiple linear regression method. Models were divided into two groups based on age: younger than 60 years and 60 years or older; 200 seeds were repeated in consideration of partition bias. Mean of error, absolute error, and root mean square error were used as performance metrics. Results The model divided into two age groups (younger than 60 years and 60 years and older) performed better than the model without division. The performance difference between the model using only three variables (PWV, BMI, age) and the model using 17 variables was not significant. Our final model using PWV, BMI, and age met the criteria presented by the American Association for the Advancement of Medical Instrumentation. The prediction errors were within the range of about 9 to 12 mmHg that can occur with a gold standard mercury sphygmomanometer. Conclusions Dividing age based on the age of 60 years showed better BP prediction performance, and it could show good performance even if only PWV, BMI, and age variables were included. Our final model with the minimal number of variables (PWB, BMI, age) would be efficient and feasible for predicting BP.

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Abstract WP197: Race (Black-White) and Sex Divergences in the Relationship of Childhood Cardiovascular Risk Factors to Arterial Stiffness in Adulthood: The Bogalusa Heart Study

Stroke ◽

10.1161/str.44.suppl_1.awp197 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Shengxu Li ◽

Wei Chen ◽

Camilo Fernandez ◽

Sathanur R Srinivasan ◽

Gerald S Berenson

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Arterial Stiffness ◽

Pulse Wave Velocity ◽

Systolic Blood Pressure ◽

Wave Velocity ◽

White Women ◽

Pulse Wave ◽

Limited Information ◽

Race Difference

Arterial stiffness is an important risk factor for cardiovascular diseases including stroke. It has been established that childhood cardiovascular (CV) risk factors are predictive of adulthood arterial stiffness as measured by pulse wave velocity. Limited information is available on this relationship such as race- and sex-specific differential effects. This aspect was examined in a black-white, longitudinal cohort of 786 adults (28% blacks, 42% men) aged 23-44 years who were examined as both children (age<18 years) and adults (age≥18 years) for traditional CV risk factors with an average follow-up period of 24.2 years. Multiple childhood measurements were averaged and standardized to age-specific z-scores. Brachial-ankle pulse wave velocity (baPWV) measured by an automatic oscillometric technique was used as an index of arterial stiffness in adults. Systolic blood pressure in childhood was predictive of baPWA in adults (P=0.002) in the total cohort. However, nominally significant (P<0.05) childhood predictors of adult baPWV included body mass index (BMI), low-density lipoprotein cholesterol (LDL-C) and systolic blood pressure in white men; systolic blood pressure in white women; and BMI in black women. For race difference, childhood LDL-C tended to show a stronger effect on baPWA in adults in whites than in blacks (P=0.04). For sex difference, BMI tended to be a stronger predictor and LDL-C a weaker predictor in women than in men (P=0.0002 and P=0.003, respectively). Such differences persisted even after adjustment for adulthood risk factors (P<0.05 in all cases). In conclusion, the predictability of childhood CV risk factors for increased arterial stiffness in adulthood varies by race and sex, and this observation indicates that arterial stiffening is different in blacks vs whites and in men vs women.

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