Role of Vascular Adaptation in Determining Systolic Blood Pressure in Young Adults

Abstract

Background Two individuals can have a similar pulse pressure ( PP ) but different levels of systolic blood pressure ( SBP ), although the underlying mechanisms have not been described. We hypothesized that, for a given level of PP , differences in SBP relate to peripheral vascular resistance ( PVR ); and we tested this hypothesis in a large cohort of healthy young adults. Methods and Results Demographic, biochemical, and hemodynamic data from 3103 subjects were available for the current analyses. In both men and women, for a given level of PP , higher SBP was associated with significantly higher body weight, body mass index, heart rate, and PVR ( P <0.05 versus those with lower BP for all comparisons). Moreover, stratifying individuals by quartiles of PP and PVR revealed a stepwise increase in SBP from the lowest to highest quartile for each variable, with the highest SBP occurring in those in the highest quartile of both PP and PVR ( P <0.001 for overall trend for both sexes). PVR was also increased with increasing tertile of minimum forearm vascular resistance, in both men ( P =0.002) and women ( P =0.03). Conclusions Increased PVR , mediated in part through altered resistance vessel structure, strongly associates with the elevation of SBP for a given level of PP in young adults. An impaired ability to adapt PVR appropriately to a given level of PP may be an important mechanism underlying elevated SBP in young adults.

The association between isolated systolic or diastolic hypertension and cardiovascular risk

“…Many investigators and physicians hold the view that, from the perspective of pathophysiology, ISH in young people is caused by the increased pulse pressure amplification, which is believed to be related to the high elasticity of arteries, and thus ISH is a benign status [4]. Contrarily, other investigators revealed that ISH in the young is caused by increased stroke volume and arterial stiffness [5] and vascular maladaptation [6]; from this perspective view of point, ISH is not benign. Importantly, many data exploring the long-term cardiovascular risk of young people with ISH from large cohorts were published recently and demonstrated that ISH in young people is significantly associated with increased risk of cardiovascular events and mortality in their later life [7,8].…”

Differential central integration of left versus right baroreceptor afferent input in spontaneously hypertensive rats

“…In hypertension, the elevation in BP is mostly driven by increases in PVR [33]. It is also known that smaller diameter arteries contribute more to the mediation of PVR relative to larger diameter arteries such as the aorta, which mainly serves a conduit function [34].…”

Comparison of direct intra-arterial pressure and ClearSight finger cuff arterial pressure measurements in elderly patients undergoing transcatheter aortic valve replacement

“…One possible explanation is the potential impact of arterial compliance and peripheral vascular resistance on SBP measurements [22]. Age-related vascular changes and arterial stiffness could affect the accuracy of non-invasive measurements, leading to differences between ClearSight finger cuff arterial pressure and intra-arterial pressure [23]. Additionally, the finger cuff technology itself may have limitations in accurately capturing rapid changes in SBP [24].…”