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Eduardo Nunez,
Donna K. Arnett, Peter J. Hannan, H. A. Tyroler, Dan Jones, Moyses
Szklo.
Background: Pulse pressure (PP) is a surrogate of increased
arterial stiffness, and has been associated with adverse cardiovascular
(CV) prognosis. Objective: To assess 1) the magnitude and shape of
the association between PP and age, controlling for traditional risk
factors and 2) differences in the association by gender.
Methods: The Atherosclerosis Risk in Communities Study (ARIC)
is a prospective CV cohort study. A total of 7,399 subjects (ages
44-66 years; men=46.5%), who were free of CHD, reported no use of
blood pressure medication and attended at least one additional visit,
were followed for 2.3-11.9 years. Random-effect regression model (REM)
with first order autocorrelated residual errors was used for the analysis.
Age and Age2 were treated as random effects. Gender, race, field center,
BMI, smoking, and diabetes were included as covariates.
Results: PP in men and women follow the same within-person
trajectory as they move on the steep part of the curve from 40-75
yrs. The difference in 0.2 mmHg (p<0.001) in instantaneous PP slope
that women exhibited compared with men (gender-age interaction) reflects
that the slopes of PP on age began accelerating 4 years earlier in
women (39 vs 43 years in men).
Conclusions: There is positive, curvilinear and independent
relation of age with PP in middle age-elderly subjects, and the gender-age
interaction points to a 4 yrs. lag of men behind women.
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