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Progression of Arterial Stiffness is Associated With Midlife Diastolic Blood Pressure and Transition to Late‐Life Hypertensive Phenotypes

Year: 2020

Type: article

Abstract: Background Hypertension‐associated cardiovascular events are particularly associated with elevated systolic blood pressure ( SBP ) in late life, yet long‐term interactions between SBP , diastolic BP ( DBP ) and arterial stiffness in development of late‐life hypertensive phenotypes remain unclear. Methods and Results In the UK Biobank, we determined associations between arterial stiffness index ( ASI ), SBP , DBP , and their progression, and transition from normotension (<140/90 mm Hg) to hypertension or elevated ASI (>10 m/s). Associations were determined by general linear and logistic regression, adjusted for cardiovascular risk factors and variability of measurements across follow‐ups. Mean values of baseline SBP , DBP , and ASI were determined stratified by deciles of age, blood pressure, and ASI , with CIs determined by bootstrapping. In 169 742 participants at baseline, ASI was more strongly associated with DBP than SBP , before and after adjustment for risk factors (β: SBP , −0.01 [ P <0.001]; DBP , 0.06 [ P <0.001]), while DBP was more strongly associated with progression of ASI (n=13 761; β: SBP, 0.013 [ P =0.01]; DBP , 0.038 [ P <0.001]). Baseline ASI was associated with increasing SBP during follow‐up (β=0.02, P <0.001) but not DBP (β=0.0004, P =0.39), but was associated with a younger age of transition from rising to falling DBP (highest versus lowest quartile: 51.2; 95% CI, 49.9–52.3 versus 60.4; 95% CI, 59.6–61.3 [ P <0.001]). ASI predicted the development of isolated systolic hypertension (odds ratio, 1.30; 95% CI, 1.22–1.39), particularly after adjustment for measurement variability (odds ratio, 2.29). Conclusions Midlife DBP was the strongest predictor of progression of arterial stiffness, while arterial stiffness was associated with earlier transition to a falling DBP . Prevention of long‐term harms associated with arterial stiffness may require more intensive control of midlife DBP .

Source: Journal of the American Heart Association

DOI: 10.1161/jaha.119.014547

Author: Alastair John Stewart Webb

Institutions: John Radcliffe Hospital, University of Oxford

Language: English

Topic: Cardiovascular Health and Disease Prevention

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,750