Arterial Stiffness Is Associated With Increase in Blood Pressure and Hypertension Severity Over Time in Treated Hypertensives

Abstract

BACKGROUND: Hypertension is the principal risk factor for death and disability worldwide, and less than 50% of hypertensives achieve optimal blood pressure (BP) control. Arterial stiffness is associated with risk of developing hypertension in the community. We hypothesized that measures of arterial stiffness would be predictive of increases in systolic (SBP), mean (MAP) and pulse pressure (PP) over time in treated hypertensives. METHODS AND RESULTS: We studied 414 non-Hispanic white hypertensives (mean age 60 8 years, 91% treated, 55% women). Measures of BP and arterial stiffness were obtained a mean of 8.5 0.9 years apart. The average of 3 right brachial BPs, measured with a sphygmomanometer, was recorded. Arterial stiffness (carotid-femoral pulse wave velocity [cfPWV], aortic augmentation index [AIx] and central pulse pressure [CPP]) were assessed using applanation tonometry. Stepwise multivariable linear and logistic regression analyses adjusted for age, time interval, sex, BMI, baseline SBP and DBP, renal function, use of anti-hypertensives and statins, and history of diabetes, smoking, myocardial infarction and stroke were performed to assess the independent associations of baseline arterial stiffness measures with changes in BP over time and with the presence of hypertension progression, respectively.