Organ-Specific, Age-Dependent Associations of Steady-State Pressures and Pulsatile Pressure Wave Components With End-Organ Measures

BACKGROUND: The contribution of steady-state pressures and the forward (Pf) and backward (reflected) (Pb) wave pressure components of pulse pressure to risk prediction have produced contrasting results. We hypothesized that the independent contribution of steady-state pressures (mean arterial pressure [MAP]), Pf and Pb, to cardiovascular damage is organ specific and age dependent. METHODS: In 1,384 black South Africans from a community sample, we identified independent relations between MAP, Pf, or Pb (applanation tonometry and SphygmoCor software) and left ventricular mass index (LVMI) (n = 997) (echocardiography), carotid intima-media thickness (IMT) (n = 804) (B-mode ultrasound), or aortic pulse wave velocity (PWV) (n = 1,217). RESULTS: Independent of risk factors, relations between Pf and IMT were noted in those over 50 years (P 0.37) In contrast, independent relations between Pb and LVMI were noted in those less than (P 0.07) and Pf tended to show significant relations only in the elderly (P = 0.05). Moreover, although MAP (P 0.10). CONCLUSION: Independent of confounders, steady-state and aortic Pf and Pb show associations with end-organ measures that are organ specific and age dependent.