Circulation, Vol 80, 1652-1659, Copyright © 1989 by American Heart Association
R Kelly, C Hayward, A Avolio and M O'Rourke
Arterial pressure waves were recorded noninvasively from the carotid,
radial, femoral, or all three of these arteries of 1,005 normal subjects,
aged 2-91 years, using a new transcutaneous tonometer containing a high
fidelity Millar micromanometer. Waves were ensemble- averaged into
age-decade groups. Characteristic changes were noted with increasing age.
In all sites, pulse amplitude increased with advancing age (carotid, 91.3%;
radial 67.5%; femoral, 50.1% from first to eighth decade), diastolic decay
steepened, and diastolic waves became less prominent. In the carotid pulse,
there was, in youth, a second peak on the downstroke of the waves in late
systole. After the third decade, this second peak rose with age to merge
with and dominate the initial rise. In the radial pulse, a late systolic
wave was also apparent, but this occurred later; with age, this second peak
rose but not above the initial rise in early systole, even at the eighth
decade. In the femoral artery, there was a single systolic wave at all
ages. Aging changes in the arterial pulse are explicable on the basis of
both an increase in arterial stiffness with increased pulse-wave velocity
and progressively earlier wave reflection. These two factors may be
separated and effects of the latter measured from pressure wave-contour
analysis using an "augmentation index," determined by a computer algorithm
developed from invasive pressure and flow data. Changes in peak pressure in
the central (carotid) artery show increasing cardiac afterload with
increasing age in a normal population; this can account for the cardiac
hypertrophy that occurs with advancing age (even as other organs atrophy)
and the predisposition to cardiac failure in the elderly. Identification of
mechanisms responsible offers a new approach to reduction of left
ventricular afterload.
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Noninvasive determination of age-related changes in the human arterial pulse
St. Vincent's Hospital, Sydney, Australia.
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A. K. Reddy, Y.-H. Li, T. T. Pham, L. N. Ochoa, M. T. Trevino, C. J. Hartley, L. H. Michael, M. L. Entman, and G. E. Taffet Measurement of aortic input impedance in mice: effects of age on aortic stiffness Am J Physiol Heart Circ Physiol, October 1, 2003; 285(4): H1464 - H1470. [Abstract] [Full Text] [PDF]
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J. Mayet and A. Hughes Cardiac and vascular pathophysiology in hypertension Heart, September 1, 2003; 89(9): 1104 - 1109. [Full Text] [PDF]
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J. R. Greenfield, K. Samaras, L. V. Campbell, A. B. Jenkins, P. J. Kelly, T. D. Spector, and C. S. Hayward Physical activity reduces genetic susceptibility to increased central systolic pressure augmentation: a study of female twins J. Am. Coll. Cardiol., July 16, 2003; 42(2): 264 - 270. [Abstract] [Full Text] [PDF]
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 P.-S. Tsai, C. B. Yucha, W. W. Nichols, and H. Yarandi Hemodynamics and Arterial Properties in Response to Mental Stress in Individuals with Mild Hypertension Psychosom Med, July 1, 2003; 65(4): 613 - 619. [Abstract] [Full Text] [PDF]
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T. J.L. Vuurmans, P. Boer, and H. A. Koomans Effects of Endothelin-1 and Endothelin-1 Receptor Blockade on Cardiac Output, Aortic Pressure, and Pulse Wave Velocity in Humans Hypertension, June 1, 2003; 41(6): 1253 - 1258. [Abstract] [Full Text] [PDF]
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 R Klocke, J R Cockcroft, G J Taylor, I R Hall, and D R Blake Arterial stiffness and central blood pressure, as determined by pulse wave analysis, in rheumatoid arthritis Ann Rheum Dis, May 1, 2003; 62(5): 414 - 418. [Abstract] [Full Text] [PDF]
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G. E. McVeigh Pulse Waveform Analysis and Arterial Wall Properties Hypertension, May 1, 2003; 41(5): 1010 - 1011. [Full Text] [PDF]
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S. C. Millasseau, S. J. Patel, S. R. Redwood, J. M. Ritter, and P. J. Chowienczyk Pressure Wave Reflection Assessed From the Peripheral Pulse: Is a Transfer Function Necessary? Hypertension, May 1, 2003; 41(5): 1016 - 1020. [Abstract] [Full Text] [PDF]
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J. J. Oliver and D. J. Webb Noninvasive Assessment of Arterial Stiffness and Risk of Atherosclerotic Events Arterioscler Thromb Vasc Biol, April 1, 2003; 23(4): 554 - 566. [Abstract] [Full Text] [PDF]
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L. R. Peterson, M. R. Rinder, K. B. Schechtman, R. J. Spina, K. L. Glover, D. T. Villareal, and A. A. Ehsani Peak exercise stroke volume: associations with cardiac structure and diastolic function J Appl Physiol, March 1, 2003; 94(3): 1108 - 1114. [Abstract] [Full Text] [PDF]
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M. Miyachi, A. J. Donato, K. Yamamoto, K. Takahashi, P. E. Gates, K. L. Moreau, and H. Tanaka Greater Age-Related Reductions in Central Arterial Compliance in Resistance-Trained Men Hypertension, January 1, 2003; 41(1): 130 - 135. [Abstract] [Full Text] [PDF]
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M. Tamminen, J. Westerbacka, S. Vehkavaara, and H. Yki-Jarvinen Insulin-Induced Decreases in Aortic Wave Reflection and Central Systolic Pressure Are Impaired in Type 2 Diabetes Diabetes Care, December 1, 2002; 25(12): 2314 - 2319. [Abstract] [Full Text] [PDF]
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 G. M. London, S. J. Marchais, A. P. Guerin, F. Metivier, and H. Adda Arterial structure and function in end-stage renal disease Nephrol. Dial. Transplant., October 1, 2002; 17(10): 1713 - 1724. [Full Text] [PDF]
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K. E. North, J. W. MacCluer, R. B. Devereux, B. V. Howard, T. K. Welty, L. G. Best, E. T. Lee, R. R. Fabsitz, and M. J. Roman Heritability of Carotid Artery Structure and Function: The Strong Heart Family Study Arterioscler Thromb Vasc Biol, October 1, 2002; 22(10): 1698 - 1703. [Abstract] [Full Text] [PDF]
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S. A. Hope, D. B. Tay, I. T. Meredith, and J. D. Cameron Comparison of generalized and gender-specific transfer functions for the derivation of aortic waveforms Am J Physiol Heart Circ Physiol, September 1, 2002; 283(3): H1150 - H1156. [Abstract] [Full Text] [PDF]
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C. S. Hayward, M. Kraidly, C. M. Webb, and P. Collins Assessment of endothelial function using peripheral waveform analysis: A clinical application J. Am. Coll. Cardiol., August 7, 2002; 40(3): 521 - 528. [Abstract] [Full Text] [PDF]
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M Takagaki, P M McCarthy, M Chung, J Connor, R Dessoffy, Y Ochiai, M Howard, K Doi, M Kopcak, T N Mazgalev, et al. Preload-adjusted maximal power: a novel index of left ventricular contractility in atrial fibrillation Heart, August 1, 2002; 88(2): 170 - 176. [Abstract] [Full Text] [PDF]
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S. Soderstrom, G. Nyberg, M. F. O'Rourke, J. Sellgren, and J. Ponten Can a clinically useful aortic pressure wave be derived from a radial pressure wave?{dagger} Br. J. Anaesth., April 1, 2002; 88(4): 481 - 488. [Abstract] [Full Text] [PDF]
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I. B. Wilkinson, K. Prasad, I. R. Hall, A. Thomas, H. MacCallum, D. J. Webb, M. P. Frenneaux, and J. R. Cockcroft Increased central pulse pressure and augmentation index in subjects with hypercholesterolemia J. Am. Coll. Cardiol., March 20, 2002; 39(6): 1005 - 1011. [Abstract] [Full Text] [PDF]
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 J. L. Tycho Vuurmans, W. H. Boer, W.-J. W. Bos, P. J. Blankestijn, and H. A. Koomans Contribution of Volume Overload and Angiotensin II to the Increased Pulse Wave Velocity of Hemodialysis Patients J. Am. Soc. Nephrol., January 1, 2002; 13(1): 177 - 183. [Abstract] [Full Text] [PDF]
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C. Vlachopoulos, K. Hirata, and M. F. O'Rourke Pressure-Altering Agents Affect Central Aortic Pressures More Than Is Apparent From Upper Limb Measurements in Hypertensive Patients: The Role of Arterial Wave Reflections Hypertension, December 1, 2001; 38(6): 1456 - 1460. [Abstract] [Full Text] [PDF]
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I. B. Wilkinson, S. S. Franklin, I. R. Hall, S. Tyrrell, and J. R. Cockcroft Pressure Amplification Explains Why Pulse Pressure Is Unrelated to Risk in Young Subjects Hypertension, December 1, 2001; 38(6): 1461 - 1466. [Abstract] [Full Text] [PDF]
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J. L. Izzo Jr, T. S. Manning, and B. E. Shykoff Office Blood Pressures, Arterial Compliance Characteristics, and Estimated Cardiac Load Hypertension, December 1, 2001; 38(6): 1467 - 1470. [Abstract] [Full Text] [PDF]
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J. Westerbacka, A. Seppala-Lindroos, and H. Yki-Jarvinen Resistance to Acute Insulin Induced Decreases in Large Artery Stiffness Accompanies the Insulin Resistance Syndrome J. Clin. Endocrinol. Metab., November 1, 2001; 86(11): 5262 - 5268. [Abstract] [Full Text] [PDF]
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