| Summary: | For given levels of blood pressure (BP), people with ‘stiffer’ (less distensible) large arteries develop more cardiovascular (CVS) events, as is typical of diabetes. South Asians (SA) develop excess mortality from all CVS disease, African-Caribbeans (AfC) lower overall mortality despite more hypertension & consequent strokes, with excess diabetes in both groups. To unravel these ethnic differences in events, we compared brachial & central BP and indices of arterial stiffness, as integrated markers of general risk factors, in samples of such men.
SA & AfC men aged 40–79y sampled from the European Male Ageing Study had aortic pulse wave velocity (aPWV) measured by a validated method (Arteriograph), and augmentation index (AIx) and estimated central BP by SphygmoCor and Arteriograph.
Mean (±SD) aPWV and AIx were higher among SA (n=42, age: 54±10yr) than in AfC (n=53, 53±10yr): 8.1±1.3 vs. 7.5±1.6m/s (p=0.04) and 19±7 vs. 13±10% (p=0.002), respectively, despite marginally lower brachial BP (124/77 vs. 130/80 mmHg) or central systolic BP by SphygmoCor (116 vs. 118mmHg) or Arteriograph (126 vs. 127mmHg). R2 for the PWV/BP relationship was 20% for AfC, and 33% for SA.
In multivariate analysis, aPWV was 0.6m/sec lower in AfC (p<0.007) adjusting for age, BP, diabetes status, lipid levels and body mass index. SA ethnicity also predicted higher AIx adjusted for these factors plus height.
Conclusion: For given levels of BP, SA men had higher aPWV/AIx than AfC. Arterial stiffness indices may describe total CVS risk better than distending pressures together with other standard RFs.
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