Abstract 10245: Arterial Stiffness, Central Pulsatile Hemodynamic Load and Orthostatic Hypotension: A Cross-sectional Survey of Community Residents in Chengdu
Introduction: Orthostatic hypotension (OH) is an independent risk factor for cardiovascular morbidity and often unrecognized in the elderly. The association between measures of central pulsatile hemodynamic load or arterial stiffness with OH is unclear. This study evaluated the usefulness of these indexes to identify OH.
Hypothesis: We hypothesize that direct measures of central pulsatile hemodynamic load (e.g. central systolic blood pressure) and arterial stiffness (pulse wave velocity) both associated with OH. And Measures of central pulsatile hemodynamic load may represent a better indicator of OH.
Methods: A sample of 1099 participants was recruited from the general population who attended health check-ups. Questionnaire, physical examination and laboratory tests were performance by a standard protocol. To assess the correlation between central hemodynamic indexes and the probability of OH, multiple logistic regression analysis was used to estimate the odds ratio in different models, and the discriminatory power of hemodynamic indexes for OH was assessed by the area under the receiver operating curve (ROC).
Results: The prevalence of OH in this population was 5.6 %. Compared with those without OH, OH subjects had a higher age, SBP in sitting position, BP in supine position, brachial-ankle PWV (BaPWV) and central systolic blood pressure (CSBP) (all P<0.05). After adjusting for potential confounders, both CSBP (OR=1.039, 95%CI: 1.016-1.062, P=0.001) and BaPWV (OR=1.259, 95%CI: 1.130-1.402, P< 0.001) were significantly positive correlated with OH. However, in subgroup analysis, CSBP (OR=1.017, 95%CI: 0.985-1.050, P=0.310) was insignificantly associated with OH in non hypertension subgroup. In addition, BaPWV seemed to be a better discriminatory power than CSBP in both two subgroups (BaPWVAUC-CSBPAUC =0.127, 95%CI: 0.020-0.233, P=0.02 in non hypertension group; BaPWVAUC-CSBPAUC =0.118, 95%CI: -0.030-0.267, P=0.117 in hypertension group).
Conclusion: BaPWV appears to be a better indicator of OH in the elderly. If a patient’s BaPWV is greater than 18m/s, Clinicians should better to carry out supine to standing blood pressures measurement in routine clinical practice.
- Orthostatic hypotension
- brachial-ankle pulse wave velocity
- Central systolic blood pressure
- Augmentation index
Author Disclosures: K. Liu: None. X. Chen: None. S. Wang: None. S. Wan: None. Y. Zhou: None. P. Pan: None. B. Wen: None. X. Zhang: None. H. Liao: None. D. Shi: None. R. Shi: None.
- © 2015 by American Heart Association, Inc.