Ethnic Differences in Arterial Wave Reflections and Normative Equations for Augmentation Index

Hypertension. 2011 Jun;57(6):1108-16. doi: 10.1161/HYPERTENSIONAHA.110.166348. Epub 2011 May 2.

Abstract

Data regarding ethnic differences in wave reflections, which markedly affect the central pressure profile, are very limited. Furthermore, because age, heart rate, and body height are strong determinants of augmentation index, relating single measurements to normative data (in which augmentation index values correspond with average population values of its determinants) is challenging. We studied subject-level data from 10 550 adults enrolled in large population-based studies. In a healthy reference sample (n=3497), we assessed ethnic differences in augmentation index (ratio of second/first systolic peaks) and generated equations for adjusted z scores, allowing for a standardized comparison between individual augmentation index measurements and the normative population mean from subjects of the same age, sex, ethnic population, body height, and heart rate. After adjustment for age, body height, heart rate, and mean arterial pressure, African blacks (women: 154%; men: 138%) and Andean Hispanics (women: 152%; men: 133%) demonstrated higher central (aortic) augmentation index values than British whites (women: 140%; men: 128%), whereas American Indians (women: 133%; men: 122%) demonstrated lower augmentation index (all P<0.0001), without significant differences between Chinese and British whites. Similar results were found for radial augmentation index. Nonlinear ethnic/sex-specific equations for z scores were successfully generated to adjust individual augmentation index values for age, body height, and heart rate. Marked ethnic differences in augmentation index exist, which may contribute to ethnic differences in hypertensive organ damage. Our study provides normative data that can be used to complement the interpretation of individual hemodynamic assessments among men and women of various ethnic populations, after removing the effect of various physiological determinants.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • African Continental Ancestry Group / statistics & numerical data
  • Aged
  • Aged, 80 and over
  • Aorta / physiology*
  • Asian Continental Ancestry Group / statistics & numerical data
  • Blood Pressure / physiology*
  • Brachial Artery / physiology
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Hemodynamics
  • Hispanic Americans / statistics & numerical data
  • Humans
  • Indians, North American / statistics & numerical data
  • Male
  • Manometry / methods
  • Manometry / statistics & numerical data
  • Middle Aged
  • Posture / physiology
  • Pulsatile Flow / physiology*
  • Pulse / statistics & numerical data
  • Radial Artery / physiology*
  • Regression Analysis
  • Young Adult