Journal
HYPERTENSION
Volume 57, Issue 6, Pages 1108-U153Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/HYPERTENSIONAHA.110.166348
Keywords
wave reflections; augmentation index; ethnicity
Categories
Funding
- National Heart, Lung, and Blood Institute [U01-HL65521]
- South African Medical Research Council
- National Research Foundation of South Africa
- University Research Council of the University of the Witwatersrand
- Santa Maria Research Institute (AQP/Peru)
- National Natural Science Foundation of China [30871360, 30871081]
- Ministry of Science and Technology, Beijing, China [2006BAI01A03]
- Shanghai Commissions of Science and Technology [07JC14047, 06QA14043, 07ZZ32, 08SG20]
- Shanghai Shenkang Hospital Development Centre [SHDC12007318]
- Shanghai Jiaotong University School of Medicine
- European Union [LSHM-CT-2006-037093, HEALTH-F4-2007-201550]
- British Heart Foundation [FS/07/001/21990] Funding Source: researchfish
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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. (Hypertension. 2011;57:1108-1116.). Online Data Supplement
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