Work

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

Year: 2025

Type: article

Abstract: 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 ( r 2 =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.

Source: Journal of the American Heart Association

DOI: 10.1161/jaha.124.037064

Authors: Denis Chemla, Mathieu Jozwiak, Sandrine Millasseau, Pierre Attal

Institutions: Hôpital Marie Lannelongue, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Hebrew University of Jerusalem

Language: English

Topic: Cardiovascular Health and Disease Prevention

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,810