Objective: To examine the effects of aging on the annual changes of the pressure wave reflection (PWR) and central blood pressures (CBPs), prospectively. Background: Such prospective study has not been conducted.

Methods: In 1291 middle-aged men, the first and second peaks of the radial systolic pressure waveform (SBP1 and SBP2), the radial augmentation index (rAI), reflected wave transit time (RWTT) and the brachial-ankle pulse wave velocity (baPWV), were measured twice in a 3-years’ interval.

Results: Subjects were divided into three groups {aged <40 years old (aged 30); ≤40 aged <50 years old (aged 40); and aged≥50 years old (aged 50)}. The change of rAI was higher and that of RWTT was lower in aged 30 group than in aged 50 group (p<0.01), but that of SBP2 was similar among the groups. The change of RWTT, but not that of baPWV, had a significant inverse relationship with that of rAI in all groups (p<0.01). Stepwise multivariate analysis demonstrated that the accounting rate of change of SBP1, but not that of rAI, for the variance in that of SBP2 was increased in a phased manner along with age.

Conclusion: In middle-aged men, aging may differently affect PWR and CBPs. Aging may prolong the time of PWR and blunt that arterial stiffness increases PWR. These phenomena may contribute to the aging-related attenuation of annual increase of PWR. However, aging may not affect the annual elevations of CBPs, because the incident pressure wave may compensate the aging-related attenuation of their elevations by PWR.