Age, tabagism, arterial hypertension, height and feminine sex are determinants of vascular aging evaluated by the second derivative of the digital photoplethysmogram

Abstract

Objectives: To evaluate the cardiovascular risk (CR) determinants of the arterial function indices obtained by the second derivative photopletysmogram (SDPTG) in a agent population from a private teaching institution of São Paulo. Methods: antropometric and clinical data, arterial pressure (AP) by na automatic device Microlife were obtained from 238 individuals from 28 to 72 years (mean 40,1 ± 9), 105 women / 133 men. The SDPTG was automatically registered by the Dynapulse device through its sensor placed on the 2nd finger of the right hand; from SDPTG were obtained the a, b, c and e waves during the systole and the e wave during diastole and were calculated the b/a, d/a and the aging index (AGI) = [(b-c-d-e)/a], respectively, markers of arterial distensibility, wave reflection intensity and vascular aging. The vascular age (IVS) was estimated from comparison of the AGI data obtained and values of a normal population. The individuals were considered as worse vascular indices if their analysed values were higher than mean plus standard deviation. Arterial hypertension (AH) was defined as AP > 140x90mmHg at the examination or referred by the patient. Results: at the logistic regression, the possibility of high AGI was positively and independently related to age > 50 years (Odds Ratio-OR = 17,24), tabagism (O.R. = 3,82) and feminine sex (O.R. = 6,05); low b/a relation with age> 50 years (O.R. = 6,37), while high d/a was related to feminine sex (O.R. = 3,90). Higher IVS was related to age (OR = 8,85), feminine sex (OR = 4,0), and AH (OR = 2,42). At multivariate analysis, height was related to AGI (Mean Square – MS = 0,701) and D/A (MS = 0,279), while this last parameter was also influenced by diastolic AP (MS = 0,168) and mean AP. Conclusions: the vascular indices obtained by SDPTG are influenced by main CR and other factors to be considered at their analysis. The arterial distensibility (b/a) is related to age, while the intensity of pulse wave reflection to feminine Sex, height and AP. Vascular aging is influenced by AH, tabagism and height.