Identification of Distinct Arterial Waveform Clusters and a Longitudinal Evaluation of Their Clinical Usefulness.
Clustering of arterial blood pressure (BP) waveform parameters could summarize complex information into distinct elements, which could be used to investigate cumulative (nonredundant) associations. We investigated this hypothesis in a large, adult population-based study (ViDA trial [Vitamin D Assess...
| Published in: | Hypertension (0194911X) Vol. 74; no. 4; pp. 921 - 929 |
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| Main Authors: | , , , , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Lippincott Williams & Wilkins
Oct2019
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=138573444&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 138573444 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0194911X 1FX jtl: Hypertension (0194911X) issn: 0194911X maglogo: N pubinfo: dt: Oct2019 vid: 74 iid: 4 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 138573444 138573444 NLM31446803 138573444 10.1161/HYPERTENSIONAHA.119.12625 NLM31446803 138573444 ppf: 921 ppct: 8 formats: tig: atl: Identification of Distinct Arterial Waveform Clusters and a Longitudinal Evaluation of Their Clinical Usefulness. aug: au: Sluyter, John D. Hughes, Alun D. Camargo, Carlos A. Thom, Simon A. McG. Parker, Kim H. Hametner, Bernhard Wassertheurer, Siegfried Scragg, Robert Camargo, Carlos A Jr affil: From the School of Population Health, University of Auckland, New Zealand sug: subj: Arterial Pressure Physiology Hypertension Physiopathology Brachial Artery Physiopathology Arterial Pressure Drug Effects Human Female Diagnosis, Cardiovascular Hypertension Drug Therapy Antihypertensive Agents Therapeutic Use Male Prospective Studies Aged, 80 and Over Aged Antihypertensive Agents Pharmacodynamics Middle Age Hemodynamics Validation Studies Comparative Studies Evaluation Research Multicenter Studies Scales Funding Source Aged, 80 & over Aged: 65+ years Middle Aged: 45-64 years Female Male ab: Clustering of arterial blood pressure (BP) waveform parameters could summarize complex information into distinct elements, which could be used to investigate cumulative (nonredundant) associations. We investigated this hypothesis in a large, adult population-based study (ViDA trial [Vitamin D Assessment] trial). To interpret the clusters and evaluate their usefulness, we examined their predictors and associations with cardiovascular events. In 4253 adults (mean age 65 years; 55% male) without a prior cardiovascular event, suprasystolic oscillometry was performed, yielding aortic pressure waveforms and several hemodynamic parameters. Participants were followed up for 4.6 years (median), accruing 300 cardiovascular events. Principal component analysis reduced 14 arterial waveform parameters to 3 uncorrelated factors that together explained 90% of the variability of the original data. Factors 1, 2, and 3 appeared to represent BP pulsatility, mean BP, and wave reflection, respectively. Across 6 antihypertensive drug classes, there were no differences in brachial systolic (P=0.23) and diastolic (P=0.13) BP; but there were significant variations in factor 3 (P<0.0001), especially for β-blocker use. The first and third factors were positively associated with cardiovascular events (multivariable-adjusted standardized hazard ratio [95% CI]=1.33 [1.18-1.50] and 1.15 [1.02-1.30], respectively), whereas the second factor had a J-shaped relationship, with a nadir corresponding to a brachial diastolic BP of ≈75 mm Hg. In conclusion, BP pulsatility, mean BP, and wave reflection are prognostically meaningful, distinct aspects of arterial function that can be used to summarize physiological variations in multiple arterial waveform parameters and identify truly cumulative associations when used as cardiovascular risk outcomes. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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