Prospective risk factors for increased central augmentation index in men and women

Prithvi Shiva Kumar*, Josefina Medina-Lezama, Oscar Morey-Vargas, Payman Zamani, Juan F. Bolaños-Salazar, Diana Andrea Chirinos Medina, Philip Haines, Zubair A. Khan, Johanna C. Coacalla-Guerra, Maria E. Davalos-Robles, Gladys R. Llerena-Dongo, Mardelangel Zapata-Ponze, Julio A. Chirinos

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

BACKGROUND Arterial wave reflections are important determinants of central pressure pulsatility and left ventricular afterload. The augmentation index (AIx) is the most widely used surrogate of arterial wave reflections. Despite multiple cross-sectional studies assessing the correlates of AIx, little prospective data exist regarding changes in AIx over time. We aimed to assess the predictors of changes in AIx over time in adults from the general population. METHODS We performed radial arterial tonometry assessments a median of 3.18±0.4 years apart on 143 nondiabetic adult participants in the population-based PREVENCION study. Central AIx was obtained using the generalized transfer function of the Sphygmocor device. RESULTS Predictors of the change in AIx over time were investigated. Among men (n = 67), the change in AIx was predicted by abdominal obesity (standardized β for waist circumference = 0.34; P = 0.002), impaired fasting glucose (standardized β = 0.24; P = 0.009), and the change in heart rate (standardized β = -0.78; P < 0.001). Among women (n = 76), the change in AIx was predicted by non-high-density lipoprotein cholesterol (standardized β = 0.33; P = 0.001), C-reactive protein levels (standardized β = 0.24; P = 0.02), change in mean arterial pressure (standardized β = 0.33; P = 0.001), and change in heart rate (standardized β = -0.52; P < 0.001). CONCLUSIONS Metabolic and inflammatory factors predicted changes in AIx over time, with important sex differences. Metabolic factors, such as abdominal obesity and impaired fasting glucose, predicted changes in AIx in men, whereas C-reactive protein and non-high-density lipoprotein cholesterol levels predicted changes in women. Our findings highlight the impact of sex on arterial properties and may guide the design of interventions to favorably impact changes in late systolic pressure augmentation.

Original languageEnglish (US)
Pages (from-to)121-126
Number of pages6
JournalAmerican Journal of Hypertension
Volume28
Issue number1
DOIs
StatePublished - Jan 1 2015

Keywords

  • Augmentation index
  • Blood pressure
  • Gender differences
  • Hypertension
  • Prospective
  • Wave reflections

ASJC Scopus subject areas

  • Internal Medicine

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