1.3 DETERMINANTS OF CENTRAL AND PERIPHERAL PULSE PRESSURE IN A POPULATION OF HEALTHY ADOLESCENTS. THE MACISTE STUDY

Abstract

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 healthy adolescents. We studied 459 subjects (boys 57%, 16.8 ± 1.5 y) attending the Liceo Donatelli High School in Terni, Italy. cPP was estimated from radial applanation tonometry (SphygmoCor GTF) calibrated to brachial MAP/DBP. Indexed left ventricular mass (iLVM = LVM/BSA) and stroke index (SI = stroke volume/BSA) were derived from 2D-echocardiography (Teicholz’s formula, Devereux correction). Carotid-femoral (cf-PWV) and carotid-radial (cr-PWV) pulse wave velocities were measured by SphygmoCor. 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. 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 (47% of cPP variance explained). 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 (cfPWV/crPWV) replaced cf-PWV. Anthropometric and hemodynamic factors differently impact on cPP, pPP and PPamp. HR and MAP are 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. cPP pPP PPamp Standardized β Standardized β Standardized β Male sex 0.33 0.40 – BSA, m2 0.28 0.32 – Heart rate, bpm −0.21 – 0.32 Mean arterial pressure, mmHg 0.11 – – Stroke index, ml/m2 0.09 0.09 – Carotid-femoral PWV, m/s – – 0.11 Age, years – – 0.10 Tableindependent determinants of cPP, pPP and PPamp. All the showed coefficients had p < 0.05.