Arterial Stiffness and the Development of Hypertension

Author:

Liao Duanping1,Arnett Donna K.1,Tyroler Herman A.1,Riley Ward A.1,Chambless Lloyd E.1,Szklo Moyses1,Heiss Gerardo1

Affiliation:

1. From the Department of Health Evaluation Sciences, Pennsylvania State University College of Medicine, Hershey (D.L.); Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis (D.K.A.); Departments of Epidemiology (D.L., H.A.T., G.H.) and Biostatistics (L.E.C.), University of North Carolina at Chapel Hill; Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC (W.A.R.); and Department of Epidemiology, Johns Hopkins University, Baltimore,...

Abstract

Abstract —Decreased elasticity in large and medium-sized arteries has been postulated to be associated with cardiovascular diseases. We prospectively examined the relation between arterial elasticity and the development of hypertension over 6 years of follow-up in a cohort of 6992 normotensive men and women aged 45 to 64 years at baseline from the biracial, population-based Atherosclerosis Risk in Communities (ARIC) Study. Arterial elasticity was measured from high-resolution B-mode ultrasound examination of the left common carotid artery as adjusted arterial diameter change (in micrometers, simultaneously adjusted for diastolic blood pressure, pulse pressure, pulse pressure squared, diastolic arterial diameter, and height), Peterson’s elastic modulus (in kilopascals), Young’s elastic modulus (in kilopascals), and β stiffness index. Incident hypertension (n=551) was defined as systolic blood pressure ≥160 mm Hg, diastolic blood pressure ≥95 mm Hg, or the use of antihypertensive medication at a follow-up examination conducted every 3 years. The age-, ethnicity-, center-, gender-, education-, smoking-, heart rate– , and obesity-adjusted means (SE) of baseline adjusted arterial diameter change, Peterson’s elastic modulus, Young’s elastic modulus, and β stiffness index were 397 (5), 148 (2.0), 787 (12.7), and 11.43 (0.16), respectively, in persons who developed hypertension during follow-up, in contrast to 407 (1), 124 (0.6), 681 (3.7), and 10.34 (0.05), respectively, for persons who did not. The similarly adjusted cumulative incident rates of hypertension from the highest to the lowest quartiles of arterial elasticity were 6.7%, 8.0%, 7.3%, and 9.6%, respectively, when measured by adjusted arterial diameter change ( P <0.01). One standard deviation decrease in arterial elasticity was associated with 15% greater risk of hypertension, independent of established risk factors for hypertension and the level of baseline blood pressure. These results suggest that lower arterial elasticity is related to the development of hypertension.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Internal Medicine

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