Fifty percent of all cardiovascular mortality is attributed to hypertension and, in the majority of cases, this is acquired as an age-related increase in blood pressure. The pattern of this age-related change has been documented in a number of studies. This age-related increase in pulse pressure is particularly marked in peri-menopausal women: younger women tend to have lower pulse pressure than men but in older women the reverse is true. Data from Twins UK show that for both pre-menopausal women and post-menopausal women, a decade of ageing is associated with an increase in pulse pressure.

BHF funding and funding from our NIHR Biomedical Research Centre has allowed us to extend the cardiovascular phenotype in TwinsUK and to include measures of peripheral and central blood pressure, pressure augmentation, arterial stiffness (aPWV) and aortic and large artery dimensions.

These data have already allowed us to make novel observations regarding the contribution of pressure wave reflection and arterial dimensions to systolic and pulse pressure, as well as the genetic and environmental contribution to arterial stiffening and pressure augmentation.