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Vascular Biomarkers: What is Augmentation Pressure?

Vascular Biomarkers: What is Augmentation Pressure?

Augmentation pressure (AP) is a vital cardiovascular parameter that reflects the additional pressure exerted on the arterial walls due to the reflected wave returning to the heart. It is a critical component in understanding arterial stiffness and overall cardiovascular health.

When the heart pumps blood into the arteries, a pressure wave travels along the arterial tree. In healthy, elastic arteries, this wave moves smoothly. But as arteries stiffen with age or disease, the wave reflects back toward the heart more quickly. This reflected wave superimposes on the forward-moving wave, creating an additional pressure load during systole (the phase of the heartbeat when the heart contracts and pumps blood). This additional pressure is what we call augmentation pressure.

How to Measure Augmentation Pressure

A non-invasive technique called pulse wave analysis (PWA) typically measures AP, and devices like the CONNEQT Pulse can perform this measurement. By analyzing the shape of the arterial pulse wave, the device determines the timing and magnitude of the reflected wave and calculates the augmentation pressure. Higher augmentation pressure indicates stiffer arteries, which are less able to expand and contract with each heartbeat. Elevated AP has been associated with an increased risk of adverse cardiovascular events, such as heart attack and stroke, providing additional prognostic information beyond traditional measures like blood pressure.

Factors Influencing AP

Several factors can influence AP, including age, lifestyle, and medical conditions. Our arteries naturally become stiffer as we age, leading to higher augmentation pressure. Lifestyle choices, such as diet, exercise, and smoking, can all impact arterial stiffness and AP. Additionally, there is an association between conditions like hypertension, diabetes, and chronic kidney disease and increased arterial stiffness and higher AP. Monitoring one’s augmentation pressure can also help tailor medication to improve arterial health. For example, certain medications, such as ACE inhibitors and calcium channel blockers, have been shown to reduce arterial stiffness and lower augmentation pressure.

Maintaining Health Arteries

Maintaining a healthy lifestyle is key to managing augmentation pressure. Regular physical activity, a balanced diet rich in fruits and vegetables, and avoiding smoking can all help keep arteries flexible. Engaging in aerobic exercises, such as walking, running, or swimming, can improve cardiovascular fitness and reduce arterial stiffness. Incorporating foods that are high in fiber, omega-3 fatty acids, and antioxidants can support arterial health. Avoiding smoking is crucial, as tobacco use is a significant risk factor for arterial stiffness and cardiovascular disease.

Home Monitoring for Better Heart Health

In addition to lifestyle changes, regular monitoring of augmentation pressure can provide valuable insights into arterial health. Devices like the CONNEQT Pulse offer a convenient and accurate way to measure AP at home. This type of device also allows individuals to track their cardiovascular health over time. Understanding and managing augmentation pressure can lead to better health outcomes and a reduced risk of cardiovascular events. By taking proactive steps to maintain flexible, healthy arteries, individuals can support their overall well-being and longevity.

Sources

O’Rourke, M. F., Nichols, W. W., Vlachopoulos, C., et al. Augmentation Index as a Surrogate Marker of Arterial Stiffness and Risk in Hypertension. Hypertension. 2002; doi:10.1161/01.HYP.0000028580.33389.50. 

Sharman, J. E., Stowasser, M., Fassett, R., et al. Central Blood Pressure Measurement in the Management of Hypertension. J Hypertens. 2006; doi:10.1097/01.hjh.0000222742.01439.8d. 

Benetos, A., Thomas, F., Bean, K., et al. Role of Modifiable Risk Factors in the Development of Arterial Stiffness in Adults: A Cross-Sectional Study. Hypertension. 2002; doi:10.1161/01.HYP.0000032640.71088.66. 

Vlachopoulos, C., Aznaouridis, K., Stefanadis, C. Prediction of Cardiovascular Events and All-Cause Mortality with Arterial Stiffness. J Am Coll Cardiol. 2010; doi:10.1016/j.jacc.2010.04.052. 

Shimbo, D., Artinian, N. T., Basile, J., et al. Self-Measured Blood Pressure Monitoring at Home: A Joint Policy Statement From the American Heart Association and American Society of Hypertension. J Am Coll Cardiol. 2013; doi:10.1016/j.jacc.2012.12.054. 

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