Aortic stiffness linked to high blood pressure

By Piriya Mahendra, medwireNews Reporter

Higher aortic stiffness is linked with an increased risk for hypertension, a study in JAMA suggests.

However, initial blood pressure (BP) was not independently associated with risk for progressive aortic stiffening, suggesting that vascular stiffness may be a precursor to, rather than the result of hypertension, say Gary Mitchell (Cardiovascular Engineering Inc., Norwood, Massachusetts, USA) and colleagues.

They found that higher forward wave amplitude (FWA; a measure of vascular stiffness and pressure pulsatility) on arterial tonometry, and higher carotid-femoral pulse wave velocity (CFPWV) in participants of the Framingham Offspring Study during 1998 to 2001 were significantly linked to systolic BP in 2005 to 2008.

The researchers then analyzed a model that included systolic and diastolic BP as well as other risk factors during 1998 to 2001. FWA augmentation index and CFPWV were significantly associated with incident hypertension during 2005 to 2008 in participants without hypertension in 1998 to 2001, at odds ratios of 1.6 and 1.7 for each standard deviation increase in both factors, respectively.

Indeed, there were 338 cases of incident hypertension in 2005 to 2008 out of a total of 1048 participants who did not have the condition in 1998 to 2001. Conversely, BP during 1998 to 2001 was not significantly associated with CFPWV during 2005 to 2008.

In addition, higher resting brachial artery flow and lower flow-mediated dilation during 1998 to 2001 were significantly associated with incident hypertension, at respective odds ratios of 1.23 and 0.80.

Editorialist Debrabata Mukherjee (Texas Tech University, El Paso, USA) thinks that the implications of the current study for prevention may be substantial.

"If prospective studies validate both prevention of hypertension and improved cardiovascular outcomes using lifestyle modifications as well as a combination therapy approach in individuals with vascular stiffness, endothelial dysfunction, or both, before hypertension develops, such a strategy could become a cornerstone of a national preventive strategy," she remarks.

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