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Role of Vascular Adaptation in Determining Systolic Blood Pressure in Young Adults.

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Yu, Shikai 
Middlemiss, Jessica E 
Nardin, Chiara 
Hickson, Stacey S 
Miles, Karen L 


Background Two individuals can have a similar pulse pressure (PP) but different levels of systolic blood pressure (SBP), although the underlying mechanisms have not been described. We hypothesized that, for a given level of PP, differences in SBP relate to peripheral vascular resistance (PVR); and we tested this hypothesis in a large cohort of healthy young adults. Methods and Results Demographic, biochemical, and hemodynamic data from 3103 subjects were available for the current analyses. In both men and women, for a given level of PP, higher SBP was associated with significantly higher body weight, body mass index, heart rate, and PVR (P<0.05 versus those with lower BP for all comparisons). Moreover, stratifying individuals by quartiles of PP and PVR revealed a stepwise increase in SBP from the lowest to highest quartile for each variable, with the highest SBP occurring in those in the highest quartile of both PP and PVR (P<0.001 for overall trend for both sexes). PVR was also increased with increasing tertile of minimum forearm vascular resistance, in both men (P=0.002) and women (P=0.03). Conclusions Increased PVR, mediated in part through altered resistance vessel structure, strongly associates with the elevation of SBP for a given level of PP in young adults. An impaired ability to adapt PVR appropriately to a given level of PP may be an important mechanism underlying elevated SBP in young adults.



cardiac output, hemodynamics, minimum forearm vascular resistance, peripheral vascular resistance, pulse pressure, Adaptation, Physiological, Adolescent, Adult, Age Factors, Blood Pressure, Cross-Sectional Studies, Female, Humans, Male, Upper Extremity, Vascular Resistance, Young Adult

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J Am Heart Assoc

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Ovid Technologies (Wolters Kluwer Health)


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British Heart Foundation (None)
Cambridge University Hospitals NHS Foundation Trust (CUH) (unknown)
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
NIHR Cambridge Biomedical Research Centre