Abstract
Introduction: Elevated blood pressure (BP) and arterial wall stiffness are key aspects of essential hypertension. However, it is not clear whether elevated BP is a cause or the consequence of arterial wall stiffness or whether they influence each other during the aging process. This study assessed the temporal relationship between BP and arterial wall stiffness in a longitudinal study cohort. Methods: The study cohort consisted of 446 adults (342 whites and 104 blacks; age=32-51 years) enrolled in the bogalusa Heart Study. BP and aorta-femoral pulse wave velocity (PWV) were measured at two time points over 6.8 years. A cross-lagged analysis model was performed to examine the temporal relationship between BP and PWV. Results: Baseline vs follow-up values of systolic BP (113 vs 115 mmHg), diastolic BP (77 vs 80 mmHg) and PWV (5.1 vs 6.9 m/msec) increased significantly over 6.8 years. Systolic and diastolic BP and PWV values were adjusted for age, sex and race and standardized to Z-scores prior to the cross-lagged analysis. As shown in the figure, the difference between the two cross-lagged path coefficients (0.16 vs 0.04) was marginally significant (p=0.071 for difference). The cross-lagged path coefficient (0.15) from baseline diastolic BP to follow-up PWV was significantly greater than the coefficient (0.02) from baseline PWV to follow-up diastolic BP (p=0.05 for difference). In the model with baseline and follow-up BMI included, the difference between the two cross-lagged path coefficients was significant (systolic BP: 0.17 vs 0.03, p=0.035 for difference; diastolic BP: 0.16 vs 0.01, p=0.024 for difference). Conclusions: These findings suggest that elevated BP precedes arterial stiffening, but arterial stiffness does not increase BP in young adults, thereby providing evidence that elevated BP accelerates arterial stiffening process due to increased “wear and tear” on the artery walls and subsequently muscle cell hypertrophy during the period of young adulthood.
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