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Titolo:
DIASTOLIC PRESSURE UNDERESTIMATES AGE-RELATED HEMODYNAMIC IMPAIRMENT
Autore:
GALARZA CR; ALFIE J; WAISMAN GD; MAYORGA LM; CAMERA LA; DELRIO M; VASVARI F; LIMANSKY R; FARIAS J; TESSLER J; CAMERA MI;
Indirizzi:
HOSP ITALIANO BUENOS AIRES,UNIDAD HIPERTENS ARTERIAL,SERV CLIN MED,GASCON 450 RA-1181 BUENOS AIRES DF ARGENTINA HOSP ITALIANO BUENOS AIRES,SERV CLIN MED,UNIDAD FISIOL CLIN & HIPERTENS ARTERIAL BUENOS AIRES DF ARGENTINA
Titolo Testata:
Hypertension
fascicolo: 4, volume: 30, anno: 1997,
pagine: 809 - 816
SICI:
0194-911X(1997)30:4<809:DPUAHI>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
ISOLATED SYSTOLIC HYPERTENSION; CARDIAC-OUTPUT; IMPEDANCE CARDIOGRAPHY; BLOOD-PRESSURE; ARTERIAL COMPLIANCE; AORTIC COMPLIANCE; HEART-DISEASE; STROKE VOLUME; EXERCISE; REST;
Keywords:
HEMODYNAMICS; ARTERIAL COMPLIANCE; BLOOD PRESSURE; HYPERTENSION, SYSTOLIC; VASCULAR RESISTANCE; AGE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
54
Recensione:
Indirizzi per estratti:
Citazione:
C.R. Galarza et al., "DIASTOLIC PRESSURE UNDERESTIMATES AGE-RELATED HEMODYNAMIC IMPAIRMENT", Hypertension, 30(4), 1997, pp. 809-816

Abstract

It has been hypothesized that as large arteries become more rigid with age, the pattern of hypertension changes from diastolic to systolic. Thus, diastolic blood pressure (DBP) may lose its ability to reflect the increase in vascular resistance with age. To assess this, we studied the age-related changes in blood pressure pattern and its steady-state and pulsatile determinants. We performed an epidemiological analysis based on a national survey of 10 462 subjects from Argentina. A hemodynamic analysis (impedance cardiography) was then carried out in 636consecutive hypertensive patients (age, 25 to 74 years). Whereas the rate of increment in the prevalence of mild to moderate hypertension (MMH) reached a plateau after the sixth decade, isolated and borderlinesystolic forms of hypertension began a steep and sustained rise. Among patients with MMH, DBP remained stable from the third to the seventhdecade, whereas SEP maintained a sustained increase. Despite similar DBP, the systemic vascular resistance index increased 47% (P<.01) and the cardiac index decreased 27% (P<.01), whereas the ratio of stroke volume to pulse pressure, an index of arterial compliance, decreased 45% (P<.01). However, there were no significant differences be tween older patients with MMH and those with isolated systolic hypertension in the level of SEP, vascular resistance, stroke volume, and cardiac index. Compared with age-matched normotensive control subjects, the ratio of stroke volume to pulse pressure was much more reduced in isolated systolic hypertension (48%) than in MMH (30%). In summary, the present study, carried out in a large sample of hypertensive subjects with a wide age range, showed a simultaneous impairment in vascular resistanceand arterial compliance associated with aging in different patterns of hypertension. The magnitude of these changes, with opposite effects on DBP but additive effects on SEP, suggests that a hemodynamic mechanism could determine the transition in the prevalence of diastolic hypertension toward a systolic pattern of hypertension with aging. Also, the results suggest that SEP, but not DBP, is a reliable indicator of the underlying hemodynamic abnormalities (high resistance and low arterial compliance) in the elderly.

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Documento generato il 04/04/20 alle ore 02:55:46