SECOND DERIVATIVE OF THE FINGER PHOTOPLETHYSMOGRAPHY PREDICTS THE RISK OF FUTURE DEVELOPMENT OF HYPERTENSION IN MIDDLE-AGED MALE POPULATION

Abstract

Objective: Increase in arterial stiffness deteriorates blood pressure (BP) control. Therefore, increased arterial stiffness is thought to be a risk factor for incident hypertension. We reported that indices of arterial stiffness obtained from second derivative of the finger photoplethysmography (SDPTG) is cross-sectionally associated with several cardiovascular risk factors including BP and future cardiovascular risk. The aim of the present study is to test whether indices obtained from SDPTG predict future development of hypertension in middle-aged male population. Design and method: SDPTG was measured in 902 non-hypertensive men (mean age 44±6 years) at an annual medical checkup in a Japanese company. The development of hypertension was followed for a maximum of 4 years. Two indices of arterial stiffness (b/a, an index of large arterial stiffness; d/a, an index of structural and functional properties of the systemic arterial tree including the peripheral circulation) were calculated from the SDPTG waveforms. A Cox proportional hazards model was used to examine whether b/a and d/a were independent predictors of future development of hypertension. Results: During a follow up period, 124 subjects developed hypertension, defined as systolic/diastolic BP >=140/90 mmHg or use of antihypertensive medications. The hazard ratio for future development of hypertension was significantly increased in the lowest quartile of d/a compared with the highest quartile (2.86, 95%CI 1.59–5.15, p=0.001) after adjusting for multiple potential confounders. However, b/a did not show significant hazard ratios for future development of hypertension. Conclusions: The d/a, but not b/a, could predict the risk of future development of hypertension in this study population. The measurement of d/a may be useful for identify high-risk subjects for future development of hypertension.