Arterial stiffness and hypertension status in Afro-Caribbean men

Abstract

Objective: African ancestry individuals are at high risk for hypertensive cardiovascular disease (CVD) and could benefit from early detection of arterial stiffening. We tested the association between the 2017 ACC/AHA hypertension categorizations, which include new blood pressure (BP) cutoffs and a definition for elevated BP, and arterial stiffness in 772 Afro-Caribbean men aged 50+ years (mean 64 years). Methods: Arterial stiffness was assessed by brachial-ankle pulse-wave velocity (PWV) using a waveform analyzer. Hypertension groups were based on the 2017 ACC/AHA guidelines and by pharmacologic control status. Multiple linear/logistic regression was used to determine the association of PWV with BP and hypertension. Results: Mean(SD) PWV was 1609(298) cm/s and was independently correlated with age, systolic BP, pulse, diabetes, height, and alcohol intake (all P<0.02). After adjusting for these, in men aged ≥65 years, those with stage 1 or uncontrolled stage 2 hypertension had significantly greater PWV than all other groups (all P<0.05). Men with controlled hypertension had similar PWV to those with elevated BP (P=0.7); however, this was significantly greater than men with normal BP (all P<0.05). Patterns were similar, but with smaller effect sizes, in men aged <65 years (all P<0.05 except controlled hypertension versus elevated or normal BP were not significant). Conclusions: In these high-risk Afro-Caribbeans: 1) stage 1 hypertension is associated with increased PWV, which supports the new guidelines; and, 2) pharmacologic control appears to partially protect men from increased PWV. Longitudinal studies are needed to determine optimal PWV and timing of anti-hypertensive treatment for preventing future CVD.

Association between Arteriosclerosis and Uncontrolled Blood Pressure in Patients with Essential Hypertension: Cross-Sectional Observational Study Results of the BEST Study

“…They found high CF-PWV was associated with a trend towards increasing cardiovascular risk in both non-hypertensives and hypertensives, a finding that may support the crucial importance of arteriosclerosis in both populations. The results of the present study showed that the higher level of arteriosclerosis was independently associated with uncontrolled hypertension, which was consistent with other studies in specific population, such as in men [4] and in patients with chronic kidney disease [5]. In the study, we also found independent associations between uncontrolled hypertension and male, TC, BMI, FPG, and creatinine in all models.…”

“…A large community-based study from China found that age-related increase in BP seemed to be largely mediated by age-related change in arterial stiffness status assessed by brachial ankle artery pulse wave velocity (ba-PWV), and baseline arterial stiffness was associated with subsequent BP, rather than the opposite direction [3]. Furthermore, previous studies found that patients with uncontrolled hypertension had significantly greater ba-PWV in men aged ≥65 years [4] and had a higher ba-PWV or carotid radial pulse wave velocity in patients with chronic kidney disease ( n = 82) [5].…”

<p>Relation Between Aortic Stiffness Index and Distensibility with Age in Hypertensive Patients</p>

“…Moreover, Aortic stiffness has been considered as a subclinical target organ damage with prognostic value in hypertensive patients. 3,4 A number of studies proposed that increased aortic stiffness is associated with persistent hypertension in some subjects. 5,6 This vicious circle between HTN, aortic stiffness/distensibility and heart failure would be continued without any intervention whereas, early detection and appropriate interventions can reduce these complications.…”

Quantifying carotid stiffness in a pre-hypertensive population with ultrafast ultrasound imaging

“…Besides, a recent study in African-Caribbean males aged ≥ 65 years showed that arterial stiffness, quantified by brachial-ankle pulse wave velocity, was markedly higher in PHT individuals than in NBP individuals but indistinguishable from patients with HT [21]. Our previous studies have shown that increases in PWV-ES assessed by ufPWV were consistently synchronized with age, even in a young population of 30-39 years old [18].…”