Wave reflections, arterial stiffness, and orthostatic hypotension

Shih Hsien Sung, Zu Yin Chen, Tzu Wei Tseng, Dai Yin Lu, Wen Chung Yu, Hao Min Cheng, Chen Huan Chen*

*此作品的通信作者

研究成果: Article同行評審

17 引文 斯高帕斯(Scopus)

摘要

Background: The effect of wave reflections on blood pressure change associated with posture remains unclear. We therefore applied a wave separation technique to investigate the relations of the backward pressure wave amplitude with orthostatic pressure changes and orthostatic hypotension (OH). Methods: We analyzed data from 613 subjects who had participated in our hemodynamic studies. Measurements of brachial systolic (SBP) and diastolic blood pressures (DBP), carotid-femoral pulse wave velocity (cf-PWV), and backward pressure wave amplitude from a decomposed carotid pressure wave (Pb) were obtained at supine position. SBP and DBP were measured again 3 minutes after standing. OH was defined as a fall of ≥20 mm Hg in SBP and/or ≥10 mm Hg in DBP. Results: Subjects with OH (n = 100) were characterized with significantly higher supine SBP and DBP and significantly lower standing SBP and DBP when compared with subjects without OH. Subjects with OH were also characterized with significantly higher cf-PWV and Pb. cf-PWV and Pb separately were significantly associated with the orthostatic SBP change in univariable and multivariable analyses. Also, cf-PWV and Pb separately were significant predictors of OH in univariable and multivariable analyses. cf-PWV predicted OH in the younger but less so in the older subgroup, whereas Pb demonstrated similar prediction in both subgroups. In a final multivariable model, both cf-PWV and Pb were significant independent predictors of OH. Conclusions: Wave reflections are an independent determinant of orthostatic SBP change and OH in both younger and older subjects.

原文English
頁(從 - 到)1446-1455
頁數10
期刊American Journal of Hypertension
27
發行號12
DOIs
出版狀態Published - 1 12月 2014

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