Author + information
- Julio Chirinos Medinaa,b,
- Josefina Medina-Lezamaa,b,
- Offdan Narvaeza,b,
- Karela Harreraa,b,
- Mardelangel Zapata Ponze De Leona,b and
- Angely Janeth Rondon Rodrigueza,b
Background: Altitude above sea level is a key regulator of cardiovascular function. Arterial stiffening precedes the development of hypertension and is an independent predictor of cardiovascular risk independent of hypertension. Little is known about differences in aortic stiffness between hypertensive populations living at different altitudes above sea level.
Methods: We performed an analysis of baseline data in the INTERVENCION study, a prospective randomized multicenter trial which enrolled subjects with untreated hypertension at low altitude (LA, <2000 m), intermediate altitude (IA, 2000-3500 m) and high altitude (HA, >3500 m) in Peru. At each altitude level, enrollment was stratified by age group and gender to achieve an equal distribution. Carotid-femoral Pulse Wave Velocity (PWV), the gold-standard non-invasive measure of aortic stiffness, was measured with high-fidelity arterial tonometry (Sphygmocor PVx device). We also measured carotid-radial PWV, a measure of muscular artery stiffness.
Results: Age, gender, body mass index and mean arterial pressure in the sample did not differ between altitude levels. There were marked differences in carotid-femoral PWV between hypertensives at LA (8.9±0.3 m/s), IA (9.9±0.3 m/s) and HA (7.7±0.2 m/s), with the highest values found at IA (P<0.0001). In contrast, no significant differences in carotid-radial PWV were found. In a multivariable model that adjusted for various potential confounders, IA, age, male gender and mean arterial pressure were independent predictors of carotid-femoral PWV, with age and IA being the strongest predictors.
Conclusions: At similar levels of mean arterial pressure, hypertensives living at IA above sea level demonstrate marked aortic stiffening relative to hypertensives at low and high altitude. Further research is required to characterize the biologic basis of these differences.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Vascular Medicine: Novel Risk Measures in Arterial Diseases
Abstract Category: 40. Vascular Medicine: Non Coronary Arterial Disease
Presentation Number: 1167-351
- 2017 American College of Cardiology Foundation