부산대학교 도서관

OBJECTIVE:: There is paucity of data about central blood pressure (BP) and vascular phenotypes in young individuals. The identification of the main determinants of central BP parameters and the BP amplification phenomenon may help in defining the clinical relevance of BP patterns in adolescence. We aimed at evaluating the anthropometric and hemodynamic factors associated with central pulse pressure (cPP), peripheral pulse pressure (pPP) and central-to-peripheral PP amplification (PPamp) in a population of healthy adolescents. DESIGN AND METHOD:: We studied 459 subjects (boys 57%, mean age 16.8 ± 1.5y, SBP/DBP 124/67 ± 11/7 mmHg) attending the Liceo Donatelli High School in Terni, Italy. pPP was measured by validated oscillometry. cPP was estimated from radial applanation tonometry (SphygmoCor GTF) calibrated to brachial MAP/DBP. PPamp was expressed as pPP/cPP. Indexed left ventricular mass (iLVM = LVM/BSA) and stroke index (SI = stroke volume/BSA) were derived from 2D-echocardiography (Teicholzʼs formula, Devereux correction). Carotid-femoral (cf-PWV) and carotid-radial (cr-PWV) pulse wave velocities were measured by applanation tonometry (SphygmoCor). PWV ratio was expressed as cf-PWV/cr-PWV. cPP, pPP and PPamp were introduced as dependent variables in three separate stepwise multivariate regression models. Age, male sex, BSA, heart rate (HR), MAP, stroke index (SI:stroke volume/BSA) and cf-PWV were included in each model as independent factors. RESULTS:: average cPP was 36 ± 7 mmHg, PPamp 1.57 ± 0.13. cPP was positively associated with male sex, BSA, MAP, SI, and negatively with HR. The above variables explained 47% of the cPP variance. pPP was positively associated with male sex, BSA and SI (44% of pPP variance explained). PPamp was positively associated with age, HR and cf-PWV (17% of PPamp variance explained). Results did not change when BMI and height replaced BSA, iLVM replaced SI, and cr-PWV or PWV ratio replaced cf-PWV.(Figure is included in full-text article.) CONCLUSIONS:: Anthopometric and hemodynamic factors differently impact on cPP, pPP and PPamp. HR and MAP are significantly related to cPP, but not to pPP. HR, cf-PWV and age are all positively related to PPamp. These results could help in better elucidate the clinical relevance of some BP patterns frequently observed in adolescence, such as isolated systolic hypertension and spurious hypertension.