Arterial pressure waves were recorded noninvasively from the carotid, radial, femoral, or all three of these arteries of 1,005 normal subjects, aged 2-91 years, using a new transcutaneous tonometer containing a high fidelity Millar micromanometer. Waves were ensemble-averaged into age-decade groups. Characteristic changes were noted with increasing age. In all sites, pulse amplitude increased with advancing age (carotid, 91.3%; radial 67.5%; femoral, 50.1% from first to eighth decade), diastolic decay steepened, and diastolic waves became less prominent. In the carotid pulse, there was, in youth, a second peak on the downstroke of the waves in late systole. After the third decade, this second peak rose with age to merge with and dominate the initial rise. In the radial pulse, a late systolic wave was also apparent, but this occurred later; with age, this second peak rose but not above the initial rise in early systole, even at the eighth decade. In the femoral artery, there was a single systolic wave at all ages. Aging changes in the arterial pulse are explicable on the basis of both an increase in arterial stiffness with increased pulse-wave velocity and progressively earlier wave reflection. These two factors may be separated and effects of the latter measured from pressure wave-contour analysis using an "augmentation index," determined by a computer algorithm developed from invasive pressure and flow data. Changes in peak pressure in the central (carotid) artery show increasing cardiac afterload with increasing age in a normal population; this can account for the cardiac hypertrophy that occurs with advancing age (even as other organs atrophy) and the predisposition to cardiac failure in the elderly. Identification of mechanisms responsible offers a new approach to reduction of left ventricular afterload.

Pulse wave velocity (PWV) was measured by means of transcutaneous Doppler techniques in the aorta, right arm, and right leg of 480 normal subjects of both sexes in urban Beijing, China (age range 3 to 89 years, mean age 41 +/- 20.8 SD); supine blood pressure was recorded in the brachial artery of each subject with standard sphygmomanometric procedures. Serum cholesterol was determined in a subgroup of 79 subjects (age 17 to 85 years, mean 47 +/- 26 SD). PWV (y in cm/sec) was found to vary with age (x, years) at each of the three locations according to the following regression equations: aorta, y = 9.2x + 615, r = .673 (p less than .001); right arm, y = 4.8x + 998, r = .453 (p less than .001); right leg, y = 5.6x + 791, r = .630 (p less than .001). Systolic, diastolic, mean, and pulse pressures were found to increase with age. PWV also increased with mean supine blood pressure but was not related to serum cholesterol (average 4.49 +/- 0.11 [SEM], mmol/l). Compared with that of Western populations, serum cholesterol tended to be lower at all age groups, systolic pressure higher at ages over 35 years, and PWV higher at all ages. Because change in PWV is directly related to change in arterial compliance, these results indicate that aging and not concomitant atherosclerosis (known to be rare in Asian populations) is the dominant factor associated with reduced arterial compliance and increased left ventricular load in these subjects.

Amplification of the pressure pulse between central and peripheral arteries renders pressure values in the upper limb an inaccurate measure of ascending aortic (AA) pressure. Accuracy could be improved by allowance for such amplification. Transfer functions (TF) for pressures between AA and brachial artery (BA): (BATF) and between AA and radial artery (RA): (RATF) were derived from high-fidelity pressure recordings obtained at cardiac catheterization in 14 patients under control conditions, and after sublingual nitroglycerine 0.3 mg. There was no significant difference in BATF under control conditions and with nitroglycerine; hence results were pooled. Control and nitroglycerine results were also pooled to obtain a single RATF. BATF and RATF moduli peaked at 5 Hz and 4 Hz, reaching 2.5 and 2.8 times the value at zero frequency respectively. Frequency-dependent changes in modulus and phase of BATF and RATF were attributable to wave travel and reflection in the upper limb. BATF and RATF were compared to published transfer functions and those derived from analysis of aortic and brachial or radial pressure waves in previous publications. Results were similar. Our BATF and RATF were used to synthesize AA pressure waves from published peripheral pulses. Correspondence was close, especially for systolic pressure which d by 2.4 ± 1.0 (mean ± SEM) mmHg, whereas recorded systolic pressure differed by 20.4 ± 2.6 (mean ± SEM) mmHg between central and peripheral sites. Results indicate that in adult humans a single generalized TF can be used with acceptable accuracy to determine central from peripheral pressure under different conditions. While this process is capable of refinement, it represents an advance on the present practice of assuming that central and peripheral pressures are identical.

Arterial pulse wave velocity, an established index of arterial distensibility, was measured together with arterial pressure in a group of 524 normal subjects of both sexes 2 months to 94 years old (mean age 45.6 +/- 15.3 years [SD]) in rural Guangzhou, China, an area with known low prevalence of hypertension. Fasting serum lipid levels and overnight Na+ and K+ urinary excretion levels were determined in a subgroup of 104 subjects (ages 8 to 88 years). Comparisons were made with data obtained similarly from normal subjects in urban Beijing, an area with known high prevalence of hypertension. Serum cholesterol levels were similar and low in each group (Guangzhou, 4.34 +/- 0.12 mmol/liter [SE]; BEijing, 4.49 +/- 0.11 mmol/liter). Prevalence of hypertension (WHO criteria) was 4.9% (Guangzhou) and 15.6% (Beijing). In Guangzhou subjects pulse wave velocity was consistently lower in the aorta, arm, and leg, and increased to a lesser degree with age compared with Beijing subjects. Regression equations (x = pulse wave velocity [cm/sec], y = age [years]) were as follows: (1) aorta, Guangzhou: y = 5.1x + 533, r = .552, p less than .05; Beijing: y = 9.2x + 615, r = .673, p less than .001; (2) arm, Guangzhou: y = 0.61x + 817, r = .121, p less than .05; Beijing: y = 4.8x + 998, r = .453, p less than .001; (3) leg, Guangzhou: y = 4.43x + 718, r = .512, p less than .05; Beijing: y = 5.6x + 791, r = .630, p less than .001.(ABSTRACT TRUNCATED AT 250 WORDS)