Abstract P364: Baseline and Change in Blood Pressure Are Associated With Central Arterial Stiffening and Pressure Pulsatility in Older Adults: The Atherosclerosis Risk in Communities Study - Neurocognitive Study (ARIC-NCS)

Abstract

Background: Greater central arterial stiffness and pulsatility predict target organ small vessel disease and all-cause mortality. Understanding change in artery stiffness and pulsatility and their determinants has implications for prevention. Reports of the temporal association of blood pressure with arterial stiffness and pulsatility are conflicting. Objective: Characterize the prospective association of blood pressure with changes in arterial stiffness and pulsatility in a population of older black and white adults. Methods: This is a preliminary analysis of 864 adults (508 women; 164 black; mean age 74 years) examined in both visits 5 (2011-2013) and 6 (2016-2018; n=4,215 expected) of the population-based ARIC-NCS. At both visits, certified staff measured arterial stiffness (carotid-femoral PWV (cfPWV), brachial-ankle PWV (baPWV)) and pulsatility (central pulse pressure (cPP)). Associations of baseline (visit 5) and annual change in SBP, diastolic blood pressure (DBP), and central SBP (cSBP) with the annual change in PWV and cPP were evaluated by multivariable linear regression. We adjusted for age, sex, race-center, and visit 5 heart rate, body mass index, smoking status, hypertension medication, and type 2 diabetes. Results: Over the 5 years between visits, cfPWV increased by 28 cm/s/y, baPWV increased by 28 cm/s/y, and cPP increased by 0.62 mmHg/y. Higher baseline SBP, DBP, and cSBP were associated with lower annual change in cfPWV, baPWV, and cPP (Table). Higher annual changes in SBP, DBP, and cSBP were associated with greater annual change in cfPWV, baPWV, and cPP. Their effect on annual change in cfPWV, baPWV, and cPP were ~double that of the baseline measures. Conversely, baseline PWV was not associated with annual changes in blood pressure. Conclusion: Annual changes in SBP, DBP, and cSBP are modifiable traits that were positively associated with change in arterial stiffness and pulsatility. Lowering blood pressure, therefore, may reduce the progression of arterial stiffness among older adults.