Abstract P268: High Large and Small Artery Elasticity Indexes Decrease the Risk to Develop Hypertension in Women: Skaraborg Hypertension Project

Abstract

Aims: The aim was to investigate whether non-invasive measurements of the diastolic pulse wave form predicts the incidence of hypertension in population-based cohort. Methods: Longitudinal observational study. Between 2002-2005 a sample of 2816 subjects (1400 men) was randomly invited in a cohort study with the goal to study early detection of risk factors for cardiovascular disease. The cohort was followed up between 2012-2014. The mean follow-up time was 9.9 years (±1.1) and in a representative sample of 1327 subjects the protocol was completed. Body mass index was calculated based on measurements at the study clinic. Blood pressure was measured with participants in supine position twice after five minutes rest and the mean was used in analyses. Hypertension was defined based on JNC 8, and diabetes on WHO criteria from 1999. C1 and C2 were assessed using HDI/Pulse wave CR-2000 (Eagan, MN) and were based on three repetitive measurements within 5 min with the patient in a rested supine position. The mean value of the three measurements was used for the statistical calculations. The association between C1 and C2 and systolic and diastolic blood pressure was investigated with linear regression and possible confounding was adjusted in the multivariable regression models. Results: The 99 women and 103 men with hypertension at baseline were excluded from analyses. During the follow-up 73 new cases with hypertension were found in women and 95 cases in men. Systolic and diastolic blood pressure was significantly higher at follow-up in both men and women (Men: Baseline SBP 120 (12) mmHg DBP 71 (9) mmHg; Follow-up SBP 125 (12) mmHg DBP 73 (9) mmHg- Women Baseline SBP 115 (13) mmHg DBP 67 (8) mmHg; Follow-up SBP 121 (14) mmHg DBP 70 (9) mmHg). At baseline a strong association was found between both elasticity indexes (C1 and C2) and systolic and diastolic blood pressure in both men and women. C1 was strongly and negatively associated with systolic blood pressure after adjustments for age, BMI, and baseline systolic blood pressure in both men and women (Men .β=-.15 p<0.001, Women β=-.10 p=0.007). Similar results were found for diastolic blood pressure. In similar analyses for C2 was also significantly associated with systolic blood pressure at follow up (Men .β=-.11 p=0.007, Women β=-.10 p=0.013). When analyzing incident cases with hypertension we found that both C1 and C2 could predict hypertension in women but not in men in a model including age, BMI and systolic blood pressure at baseline (C1 Men OR=.97 CI .91, 1.04 Women OR=.87 CI=.79, .97 C2 Men OR=.97 CI .84, 1.03 Women OR=.85 CI=.73, .98) Conclusions: This study showed that elasticity indexes are strongly associated with systolic and diastolic blood pressure at follow-up regardless baseline blood pressure at baseline in both men and women. Moreover, high indecxes of artery elasticity C1 and C2 decrease the risk for future hypertension in women.