Pulse pressure amplification and its relationship with age in young, apparently healthy black and white adults: The African-PREDICT study.
BACKGROUND
Pulse pressure amplification (PPA), i.e. the amplification from central arteries to the periphery, is inversely related to arterial stiffness, organ damage and mortality. It is known that arterial stiffness is higher in black than white populations, but it is unclear if this is due to early vascular aging. We therefore investigated whether PPA declines earlier in young normotensive black South Africans, when compared to their white counterparts.


METHODS
We included 875 black and white men and women from the African-PREDICT study (55% black, 41% men), aged 20-30years, with no prior diagnosis of chronic disease, screened for normotensive clinic blood pressure (BP). We determined supine central PP (cPP), and supine brachial systolic- and diastolic BP, from which brachial PP (bPP) was calculated. PPA was defined as the ratio of the amplitude of the PP between these distal and proximal locations (bPP/cPP).


RESULTS
We found the mean PPA to be lower in black compared to white participants (1.43 vs. 1.46; P=0.013). In black adults PPA declined earlier with increasing age (P-trend<0.001), with a weak trend in whites (P=0.069) after adjustment for sex, socio-economic status, height, heart rate and mean arterial pressure. In multivariable-adjusted regression, we found an independent inverse association between PPA and age only in the black group (β=-0.18, P=0.002).


CONCLUSION
PPA declines earlier with age in normotensive black adults younger than 30years, exemplifying early vascular aging which may predispose black individuals to future cardiovascular outcomes.
['Breet|Yolandi|Y|', 'Huisman|Hugo W|HW|', 'Kruger|Ruan|R|', 'van Rooyen|Johannes M|JM|', 'Gafane-Matemane|Lebo F|LF|', 'Ware|Lisa J|LJ|', 'Schutte|Aletta E|AE|']
D000328:Adult D000367:Age Factors D044383:Blacks D001794:Blood Pressure D015331:Cohort Studies D003430:Cross-Sectional Studies D005260:Female D006801:Humans D008297:Male D011237:Predictive Value of Tests D011446:Prospective Studies D063177:Pulse Wave Analysis D012923:Social Class D013019:South Africa D044465:Whites D055815:Young Adult
Arterial stiffness Early vascular aging Blood pressure Ethnicity