Effects of Blood Pressure and Sex on the Change of Wave Reflection: Evidence from Gaussian Fitting Method for Radial Artery Pressure Waveform

An early return of the reflected component in the arterial pulse has been recognized as an important indicator of cardiovascular risk. This study aimed to determine the effects of blood pressure and sex factor on the change of wave reflection using Gaussian fitting method. One hundred and ninety subjects were enrolled. They were classified into four blood pressure categories based on the systolic blood pressures (i.e., ≤ 110, 111-120, 121-130 and ≥ 131 mmHg). Each blood pressure category was also stratified for sex factor. Electrocardiogram (ECG) and radial artery pressure waveforms (RAPW) signals were recorded for each subject. Ten consecutive pulse episodes from the RAPW signal were extracted and normalized. Each normalized pulse episode was fitted by three Gaussian functions. Both the peak position and peak height of the first and second Gaussian functions, as well as the peak position interval and peak height ratio, were used as the evaluation indices of wave reflection. Two-way ANOVA results showed that with the increased blood pressure, the peak position of the second Gaussian significantly shorten (P < 0.01), the peak height of the first Gaussian significantly decreased (P < 0.01) and the peak height of the second Gaussian significantly increased (P < 0.01), inducing the significantly decreased peak position interval and significantly increased peak height ratio (both P < 0.01). Sex factor had no significant effect on all evaluation indices (all P > 0.05). Moreover, the interaction between sex and blood pressure factors also had no significant effect on all evaluation indices (all P > 0.05). These results showed that blood pressure has significant effect on the change of wave reflection when using the recently developed Gaussian fitting method, whereas sex has no significant effect. The results also suggested that the Gaussian fitting method could be used as a new approach for assessing the arterial wave reflection.