Yu S, Middlemiss JE, Nardin C, Hickson SS, Miles KL, Yasmin, Maki-Petaja KM, McDonnell BJ, Cockcroft JR, Wilkinson IB, McEniery CM. Role of Vascular Adaptation in Determining Systolic Blood Pressure in Young Adults.
J Am Heart Assoc 2020;
9:e014375. [PMID:
33044913 PMCID:
PMC7428627 DOI:
10.1161/jaha.119.014375]
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Abstract
Background
Two individuals can have a similar pulse pressure (PP) but different levels of systolic blood pressure (SBP), although the underlying mechanisms have not been described. We hypothesized that, for a given level of PP, differences in SBP relate to peripheral vascular resistance (PVR); and we tested this hypothesis in a large cohort of healthy young adults.
Methods and Results
Demographic, biochemical, and hemodynamic data from 3103 subjects were available for the current analyses. In both men and women, for a given level of PP, higher SBP was associated with significantly higher body weight, body mass index, heart rate, and PVR (P<0.05 versus those with lower BP for all comparisons). Moreover, stratifying individuals by quartiles of PP and PVR revealed a stepwise increase in SBP from the lowest to highest quartile for each variable, with the highest SBP occurring in those in the highest quartile of both PP and PVR (P<0.001 for overall trend for both sexes). PVR was also increased with increasing tertile of minimum forearm vascular resistance, in both men (P=0.002) and women (P=0.03).
Conclusions
Increased PVR, mediated in part through altered resistance vessel structure, strongly associates with the elevation of SBP for a given level of PP in young adults. An impaired ability to adapt PVR appropriately to a given level of PP may be an important mechanism underlying elevated SBP in young adults.
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