Influence of Age and Central Hypertension on the Form Factor Needed to Estimate Mean Aortic Pressure, and Its Implications for Pulse Pressure Amplification: A Secondary Data Analysis
Background Mean aortic pressure (MAP) plays a pivotal role in both cardiovascular dynamics and the noninvasive estimation of systolic aortic pressure. MAP can be estimated by adding a fraction of the pulse pressure (PP) to the diastolic aortic pressure, known as the form factor (FF=100×[MAP−diastoli...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-03-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.037064 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850233148093235200 |
|---|---|
| author | Denis Chemla Mathieu Jozwiak Sandrine Millasseau Pierre Attal |
| author_facet | Denis Chemla Mathieu Jozwiak Sandrine Millasseau Pierre Attal |
| author_sort | Denis Chemla |
| collection | DOAJ |
| description | Background Mean aortic pressure (MAP) plays a pivotal role in both cardiovascular dynamics and the noninvasive estimation of systolic aortic pressure. MAP can be estimated by adding a fraction of the pulse pressure (PP) to the diastolic aortic pressure, known as the form factor (FF=100×[MAP−diastolic aortic pressure]/PP). A 41.2% FF is recommended, yet this single value may not adequately account for age‐ and pressure‐related changes in both pressure waveform and central‐to‐peripheral pulse pressure amplification (pulse pressure amplification=peripheral PP/central PP=central FF/peripheral FF). Methods and Results This secondary analysis included data extracted from 11 high‐fidelity invasive pressure studies. Individual data on age, high‐fidelity systolic aortic pressure, diastolic aortic pressure, and time‐averaged MAP were reanalyzed to calculate FF values and assess the influence of age and central hypertension on FF. The pooled data included 320 adults, comprising our own database (n=139). Among them, 97 subjects were initially categorized as “normal,” 82 with hypertension, and 141 with diverse cardiac conditions (median age, 48 years; MAP, 102 mm Hg). The FF value (mean, 44%) decreased with age (r2=0.29, P<0.0001). A value of 50% was most appropriate for the youngest subjects, while FF tended toward 40% in older subjects. FF was lower in subjects with central hypertension (systolic aortic pressure/diastolic aortic pressure ≥130/90 mm Hg; n=169) compared with those without. In both groups, FF decreased with age, showing similar slopes for the FF–age relationship. Conclusions Aortic FF decreased with age and was lower in subjects with central hypertension. Unlike applying a fixed FF, this decline aligned with pathophysiological changes in pressure waveform and pulse pressure amplification, with potential implications for improving MAP estimation. |
| format | Article |
| id | doaj-art-e63a912fca04487c82d02b701204efe8 |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-e63a912fca04487c82d02b701204efe82025-08-20T02:02:58ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-03-0114610.1161/JAHA.124.037064Influence of Age and Central Hypertension on the Form Factor Needed to Estimate Mean Aortic Pressure, and Its Implications for Pulse Pressure Amplification: A Secondary Data AnalysisDenis Chemla0Mathieu Jozwiak1Sandrine Millasseau2Pierre Attal3INSERM UMRS 999, Cardiovascular Physiology Department Hôpital Marie Lannelongue Le Plessis‐Robinson FranceService de Médecine Intensive Réanimation CHU de Nice Nice FrancePulse Wave Consulting Saint Leu La Foret FranceDepartment of Otolaryngology and Head and Neck Surgery, Shaare‐Zedek Medical Center, Faculty of Medicine Hebrew University of Jerusalem Jerusalem IsraelBackground Mean aortic pressure (MAP) plays a pivotal role in both cardiovascular dynamics and the noninvasive estimation of systolic aortic pressure. MAP can be estimated by adding a fraction of the pulse pressure (PP) to the diastolic aortic pressure, known as the form factor (FF=100×[MAP−diastolic aortic pressure]/PP). A 41.2% FF is recommended, yet this single value may not adequately account for age‐ and pressure‐related changes in both pressure waveform and central‐to‐peripheral pulse pressure amplification (pulse pressure amplification=peripheral PP/central PP=central FF/peripheral FF). Methods and Results This secondary analysis included data extracted from 11 high‐fidelity invasive pressure studies. Individual data on age, high‐fidelity systolic aortic pressure, diastolic aortic pressure, and time‐averaged MAP were reanalyzed to calculate FF values and assess the influence of age and central hypertension on FF. The pooled data included 320 adults, comprising our own database (n=139). Among them, 97 subjects were initially categorized as “normal,” 82 with hypertension, and 141 with diverse cardiac conditions (median age, 48 years; MAP, 102 mm Hg). The FF value (mean, 44%) decreased with age (r2=0.29, P<0.0001). A value of 50% was most appropriate for the youngest subjects, while FF tended toward 40% in older subjects. FF was lower in subjects with central hypertension (systolic aortic pressure/diastolic aortic pressure ≥130/90 mm Hg; n=169) compared with those without. In both groups, FF decreased with age, showing similar slopes for the FF–age relationship. Conclusions Aortic FF decreased with age and was lower in subjects with central hypertension. Unlike applying a fixed FF, this decline aligned with pathophysiological changes in pressure waveform and pulse pressure amplification, with potential implications for improving MAP estimation.https://www.ahajournals.org/doi/10.1161/JAHA.124.037064central blood pressurecentral hypertension, pulse pressure amplificationform factorpulse pressuresystolic aortic pressure |
| spellingShingle | Denis Chemla Mathieu Jozwiak Sandrine Millasseau Pierre Attal Influence of Age and Central Hypertension on the Form Factor Needed to Estimate Mean Aortic Pressure, and Its Implications for Pulse Pressure Amplification: A Secondary Data Analysis Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease central blood pressure central hypertension, pulse pressure amplification form factor pulse pressure systolic aortic pressure |
| title | Influence of Age and Central Hypertension on the Form Factor Needed to Estimate Mean Aortic Pressure, and Its Implications for Pulse Pressure Amplification: A Secondary Data Analysis |
| title_full | Influence of Age and Central Hypertension on the Form Factor Needed to Estimate Mean Aortic Pressure, and Its Implications for Pulse Pressure Amplification: A Secondary Data Analysis |
| title_fullStr | Influence of Age and Central Hypertension on the Form Factor Needed to Estimate Mean Aortic Pressure, and Its Implications for Pulse Pressure Amplification: A Secondary Data Analysis |
| title_full_unstemmed | Influence of Age and Central Hypertension on the Form Factor Needed to Estimate Mean Aortic Pressure, and Its Implications for Pulse Pressure Amplification: A Secondary Data Analysis |
| title_short | Influence of Age and Central Hypertension on the Form Factor Needed to Estimate Mean Aortic Pressure, and Its Implications for Pulse Pressure Amplification: A Secondary Data Analysis |
| title_sort | influence of age and central hypertension on the form factor needed to estimate mean aortic pressure and its implications for pulse pressure amplification a secondary data analysis |
| topic | central blood pressure central hypertension, pulse pressure amplification form factor pulse pressure systolic aortic pressure |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.037064 |
| work_keys_str_mv | AT denischemla influenceofageandcentralhypertensionontheformfactorneededtoestimatemeanaorticpressureanditsimplicationsforpulsepressureamplificationasecondarydataanalysis AT mathieujozwiak influenceofageandcentralhypertensionontheformfactorneededtoestimatemeanaorticpressureanditsimplicationsforpulsepressureamplificationasecondarydataanalysis AT sandrinemillasseau influenceofageandcentralhypertensionontheformfactorneededtoestimatemeanaorticpressureanditsimplicationsforpulsepressureamplificationasecondarydataanalysis AT pierreattal influenceofageandcentralhypertensionontheformfactorneededtoestimatemeanaorticpressureanditsimplicationsforpulsepressureamplificationasecondarydataanalysis |