AimsCarotid–femoral pulse wave velocity (PWV), a direct measure of aortic stiffness, has become increasingly important for total cardiovascular (CV) risk estimation. Its application as a routine tool for clinical patient evaluation has been hampered by the absence of reference values. The aim of the present study is to establish reference and normal values for PWV based on a large European population.Methods and resultsWe gathered data from 16 867 subjects and patients from 13 different centres across eight European countries, in which PWV and basic clinical parameters were measured. Of these, 11 092 individuals were free from overt CV disease, non-diabetic and untreated by either anti-hypertensive or lipid-lowering drugs and constituted the reference value population, of which the subset with optimal/normal blood pressures (BPs) (n = 1455) is the normal value population. Prior to data pooling, PWV values were converted to a common standard using established conversion formulae. Subjects were categorized by age decade and further subdivided according to BP categories. Pulse wave velocity increased with age and BP category; the increase with age being more pronounced for higher BP categories and the increase with BP being more important for older subjects. The distribution of PWV with age and BP category is described and reference values for PWV are established. Normal values are proposed based on the PWV values observed in the non-hypertensive subpopulation who had no additional CV risk factors.ConclusionThe present study is the first to establish reference and normal values for PWV, combining a sizeable European population after standardizing results for different methods of PWV measurement.

In this population-based cohort, systolic blood pressure, but not diastolic pressure, changes over time aligned with change in sodium excretion, but this association did not translate into a higher risk of hypertension or CVD complications. Lower sodium excretion was associated with higher CVD mortality.

The international database of ambulatory blood pressure in relation to cardiovascular outcome will provide a shared resource to investigate risk stratification by ambulatory blood pressure monitoring to an extent not possible in any earlier individual study.

Abstract-Essential hypertension is a multifactorial disorder and is the main risk factor for renal and cardiovascular complications. The research on the genetics of hypertension has been frustrated by the small predictive value of the discovered genetic variants. The HYPERGENES Project investigated associations between genetic variants and essential hypertension pursuing a 2-stage study by recruiting cases and controls from extensively characterized cohorts recruited over many years ). A meta-analysis, using other in silico/de novo genotyping data for a total of 21 714 subjects, resulted in an overall odds ratio of 1.34 (95% CI: 1.25-1.44; Pϭ1.032 ⅐ 10 Ϫ14). The quantitative analysis on a population-based sample revealed an effect size of 1.91 (95% CI: 0.16 -3.66) for systolic and 1.40 (95% CI: 0.25-2.55) for diastolic blood pressure. We identified in silico a potential binding site for ETS transcription factors directly next to rs3918226, suggesting a potential modulation of endothelial NO synthase expression. Biological evidence links endothelial NO synthase with hypertension, because it is a critical mediator of cardiovascular homeostasis and blood pressure control via vascular tone regulation. This finding supports the hypothesis that there may be a causal genetic variation at this locus. (Hypertension. 2012;59:248-255.) • Online Data Supplement Key Words: genetic epidemiology Ⅲ risk factors Ⅲ genetics association studies Ⅲ NO Ⅲ essential hypertension E ssential hypertension (EH) is a clinical condition affecting a large proportion (25% to 30%) of the adult population and is a major risk factor for cardiovascular and renal diseases. 1,2 It is a complex trait influenced by multiple susceptibility genes, environmental, and lifestyle factors and their interactions. 3 In the last years, huge efforts have been performed in recruiting and genotyping tens of thousands of individuals and meta-analyzing dozens of cross-sectional, population-based studies. In spite of this, the research on the genetics of EH has been frustrated by the small predictive value of the discovered genetic variants and by the fact that these variants explain a small proportion of the phenotypic variation. 4 -13 EH is a late-onset disease and, therefore, the small discovered effect sizes could in part be because of the effect of misclassification, sample selection bias, and inappropriate phenotyping of cases and controls. 9,14,15 The selection of cases and controls may have important effects on the results, because misclassification bias can lead to loss of power. For common traits, such as EH, this bias can be remedied by defining more stringent selection criteria, by recruiting hypernormal controls and adopting a more stringent case definition. 14,15 The HYPERGENES Project pursued a 2-stage study to investigate novel genetic determinants of EH. Cases and controls were recruited from extensively characterized cohorts over many years in different European regions using standardized clinical ascertainment. Particular care was devoted to c...