P4.1 Impact of Age and Gender on the Determinants of Pulse Pressure and Isolated Systolic Hypertension

Abstract

Background: Research shows an association between particulate air pollution exposure and cardiovascular morbidity and mortality, with atherosclerosis as an implied underlying mechanism. The accurate assessment of personal exposure is a major challenge in epidemiological research since it is strongly related to time-activity patterns. We investigated carotid intima-media thickness (CIMT) in association with subchronic personal exposure to black carbon (BC) in a panel of healthy adults. Methods: Personal BC exposure of 54 participants (92.3% female; mean age 40.7 years) was measured during one average workweek as a proxy for subchronic exposure. Within this week, the CIMT of each participant was measured ultrasonographically on two separate days. The effect of personal BC exposure on CIMT was estimated using mixed models adjusted for covariates including gender, age, exposure to secondhand smoke and general health indicators. Results: The analyses showed a strong positive association between CIMT and personally measured BC. An interquartile range (320.8 ng/m 3 ) higher personal BC exposure was associated with a 40.7 mm (95% CI: 16.0 to 65.5 mm; pZ0.0026) thicker CIMT. Each year increase in age was associated with a 5.02 mm (3.30 to 6.74; p<0.0001) thicker CIMT, suggesting that an IQR higher personal BC exposure is equivalent to 8 years of ageing. Conclusion: Based on individually measured BC exposures in a relatively young cohort of healthy nurses, our results suggest a larger impact of BC on CIMT than reported so far for other measures of pollution, including particulate matter.

Gender Disparity in the Risk of Hypertension in Subjects With Major Depressive Disorder

“…This approach was superior to the approach used in the previous study (25), which used risk ratios to analyze the prevalence (only in 2005) and incidence (2006–2008) of hypertension in patients with major depression. In the proportional hazards model analysis of the total cases, the results of our study were similar to previous research (48, 49), with male and older subjects having a higher rate of hypertension.…”

Effect of angiotensin receptor blockade on central aortic systolic blood pressure in hypertensive Asians measured using radial tonometry: an open prospective cohort study

“…(14) Data from the Anglo-Cardiff Collaborative Trial II study suggested that the CASP cut-off value might approximate 125 mmHg; this value was 'translated' from the usual 140/90 mmHg brachial SBP cut-off for healthy and treatment-naïve hypertensive persons. (3) We acknowledge that there was a lack of a comparative or control arm in the present study; we demonstrated only the pre-and post-effect of valsartan treatment on CASP. This weakness, which would have led to a regression artefact, could have resulted in overestimation of the treatment effect of valsartan.…”

“…While it is true that brachial SBP is generally higher than CASP and a relatively high correlation exists between the two, we cannot predict the degree of BP amplification with accuracy using statistical calculations. (2,3) This is because pulse wave reflection is affected by arterial compliance, and factors such as age, height, heart rate and type of drug used. It has also been reported that different drugs have differential effects on CASP beyond peripheral BP lowering.…”