03483nas a2200433 4500008004100000022001400041245013200055210006900187260001300256300001300269490000700282520226300289653000902552653002202561653001902583653002102602653001502623653002802638653002102666653001102687653001702698653001102715653001702726653003402743653000902777653002102786653001702807653001802824653001802842653001702860653003102877100001702908700001802925700002002943700001702963700001802980700001602998856003503014 2001 eng d a0263-635200aRelation of hemodynamics and risk factors to ventricular-vascular interactions in the elderly: the Cardiovascular Health Study.0 aRelation of hemodynamics and risk factors to ventricularvascular c2001 Oct a1893-9030 v193 a

OBJECTIVE: To investigate the interaction between left ventricular (LV) geometry, carotid structure and arterial compliance in relation to hemodynamic stimuli and risk factors (plasma cholesterol, body mass index, insulin resistance, smoking habit, age, sex and race).

DESIGN: Cross-sectional.

METHODS: Echocardiography and carotid ultrasound were performed in 2375 elderly subjects without signs or history of prevalent cardiovascular disease, diabetes or renal disease (795 men; 298 non-whites; 1215 hypertensive), from the cohort of the Cardiovascular Health Study. Arterial compliance was estimated by the prognostically validated ratio of stroke volume to pulse pressure (SV/PP) as the percent deviation (Delta%) from the value predicted by individual age, heart rate and body weight.

RESULTS: Intima-medial thickness (IMT) was higher in the presence of LV hypertrophy (LVH) in normotensive and hypertensive subjects and was greatest in the presence of concentric LVH. Maximum carotid lumen diameter (CLD) was also higher in the presence of LVH (and was greatest with eccentric LVH, in association with relatively high values for stroke volume). After adjusting for blood pressure, maximum carotid lumen diameter was directly correlated with stroke volume, and IMT to LV mass (all P < 0.001). Similarly, IMT was also related to maximum carotid lumen diameter, independently of prevalent risk factors (P < 0.001). SV/PP-Delta% was reduced in both groups with concentric LV remodeling (both P < 0.0001) or concentric LVH (both P < 0.05). Adjusting for risk factors did not affect these associations in normotensives, but made them insignificant in hypertensives. In normotensives, IMT was inversely related to SV/PP-Delta% (P < 0.001), independently of risk factors, whereas no significant relation was found in hypertensives.

CONCLUSIONS: The magnitudes of carotid intima-medial thickness and lumen diameter parallel levels of LV mass and geometry, and are directly related to stroke volume and arterial stiffness; this interaction is most evident in the presence of normal blood pressure, whereas it is affected by other cardiovascular risk factors when arterial hypertension is present.

10aAged10aAged, 80 and over10aBlood Pressure10aCarotid Arteries10aCompliance10aCross-Sectional Studies10aEchocardiography10aFemale10aHemodynamics10aHumans10aHypertension10aHypertrophy, Left Ventricular10aMale10aReference Values10aRisk Factors10aStroke Volume10aTunica Intima10aTunica Media10aVentricular Function, Left1 ade Simone, G1 aMcClelland, R1 aGottdiener, J S1 aCelentano, A1 aKronmal, R, A1 aGardin, J M uhttps://chs-nhlbi.org/node/664