P3.03 INTERNATIONAL COMPARISON OF ESTIMATED AORTIC PULSE WAVE VELOCITY (APWV) IN 3 SETTINGS OF AFRICAN- AND EUROPEAN- ORIGIN PATIENTS AND CONTROLS – GHANA, BRITAIN AND BARBADOS

Abstract

Objectives: In resource-poor settings, aPWV’s prognostic power, independent of blood pressure (BP), has potential as an intervention target against ‘hypertension’ and diabetes (T2DM). We compared simple determinants of aPWV in 3 African-origin settings and British Europeans. Methods: Using methods standardised across 3 hospital sites in Ghana, Britain and Barbados, aPWV was estimated over 8 cardiac cycles up to 3 times by the single cuff-based Arteriograph, whose prognostic impact was recently reported. Sub-samples had repeatability measured separately. With basic anthropometry, data were analysed by regression (MRA), adjusting for temperature (co-linear with site). Results: 527 people, (Ghana 296; UK 128 (35% African-origin); Barbados 103) 54% women, had satisfactory measurements, in 125 hypertensives without T2DM, 248 T2DMs and 154 apparently healthy controls, mean±SD age 50±15, range 20–87y, BMI 28.1±6 kg/m2. Cross-site age-/sex / adjusted mean (SD) aPWV were 8.8±1.6, 9.3±2.3 and 8±1.8 m/sec for Ghana, UK & Barbados respectively, with sys/diasBP 147±23/ 85±13, 136±17/82±13 and 126±26/72±15 mmHg. Forced into the MRA model, patient group, BMI and temperature did not contribute while systolic BP (standardized Beta (=B) 0.28), age (0.26) site (0.22) or ethnicity as West African, African-Caribbean > European (0.3), heart rate (0.21) and gender (0.17), were all related to aPWV, p<0.002. Pulse, rather than systolic, pressure did not contribute, but central sysBP did (0.3, p<0.0001). Conclusions: These data suggest that aPWV is not only a robust prognostic indicator but a potential treatment target, across the range of BP less affected by anthropometry and these ‘disease’ states. Are ethnic effects confounded by BP?