1.4 Childhood Determinants of Early Adult Arterial Stiffness in Different Ethnic Groups

Left ventricular diastolic function declines with aging and hypertension. It is well known that elevated blood pressure results in increased arterial stiffness. The study aims to determine the relationship between arterial stiffness and left ventricular diastolic function in general population. Methods We recruited 303 (mean age, 46.9 years; 167 women, 155 normotensives) members of randomly recruited families. Normotension and hypertension were diagnosed based on both office and ambulatory blood pressure measurements, or history of antihypertensive treatment. Pulse wave velocity (PWV), peripheral and central pulse pressure (pPP; cPP) were evaluated by means of pulse wave analysis. Left ventricle (LV) diastolic function was determined by measuring transmitral (early (E) and late (A) diastolic peak velocities and E/A ratio) and pulmonary (peak systolic (S) and diastolic (D) velocity and S/D ratio) flow velocities and diastolic velocities of septal and lateral mitral annulus (E’ wave and E/E’ ratio) obtained in tissue doppler. Additionaly we measured left atrium diameter (LAd). Results After adjusting for relatedness, pPP, cPP and PWV were negatively associated with E/A, and positively with E/E’ and S/D (P < 0.001). In multivariate analysis the most closely related parameters were: cPP with E/E’(β = 0.04, P = 0.001), cPP with S/D (β = −0.004, P = 0.011), and pPP with E/E’ (β = −0.03, P = 0.003). Additionally pPP was associated with LAd (β = 0.058, P = 0.011). In hypertensives pPP and cPP related both to E/E’ and S/D (p < 0.01). Conclusions Our study suggested that increased arterial stiffness as estimated by pulse pressure measurement might be considered as a determinant of left ventricular diastolic dysfunction.