ARTERIAL STIFFNESS AND BLOOD PRESSURE AMPLIFICATION IN THE PRESENCE OF CARDIAC DISEASE IN ELDERLY OVER 80 YEARS. THE PARTAGE STUDY: 6D.06

Abstract

Objectives: PWV and PPA are independently predictors of cardiovascular risk, mainly in the elderly. The aim of the present research was to determine the influence of pulse pressure amplification (PPA) and pulse wave velocity (PWV), both manifestations of arterial stiffness, on heart disease in the elderly. Methods: The study population consisted of 1042 subjects (814 women) aged 80 and over who participated in the PARTAGE study. Carotid-femoral PWV was determined in order to assess aortic stiffness. Central aortic blood pressure values and central pulse wave analysis were obtained using the calibration method applied on the common carotid artery by a PulsePen tonometer. Amplification phenomenon was expressed as PPA i.e. the percentage of increase of pulse pressure in the brachial artery relative to central pulse pressure. Heart disease was defined as presence of heart failure, ischemic heart disease or atrial fibrillation. Results: PPA was significantly lower in patients with heart disease, independently of the presence of hypertension and/or diabetes. Heart disease was present in 61.8% of subjects with PPA < 10%, in 46.2% of subjects with PPA between 10% and 20% (p < 0.01), in 42.6% of subjects with PPA between 20% and 30% (p < 0.005), and in 32.5% of subjects with PPA >30% (p < 0.001). PWV, on the other hand, was not influenced by the presence of heart disease (12.3 ± 4.0 m/s vs. 13.5 ± 4.6 m/s) but significantly increased in presence of hypertension (14.4 ± 5.0 m/s, p < 0.001) or diabetes (16.1 ± 5.1 m/s, p < 0.001). Conclusions: In the very elderly, low brachial/aortic PPA is associated with higher prevalence of heart disease.