Brachial-Ankle Pulse Wave Velocity Predicts New-Onset Hypertension and the Modifying Effect of Blood Pressure in a Chinese Community-Based Population

Abstract

Brachial-ankle pulse wave velocity (baPWV) was proven to be a prognostic indicator of cardiovascular events. However, the modifying effect of blood pressure (BP) on the longitudinal association between baPWV and new-onset hypertension is not well established. This study included 1849 non-hypertensive Chinese subjects from Shougang cohort study during December 2011 to July 2014. BaPWV was obtained using an Omron Colin BP-203RPE III device. Multivariate logistic regression models were used to evaluate associations of baPWV and outcomes. During a mean follow-up time of 2.36 years, 248 (13.41%) developed hypertension. BaPWV independently and gradably predicted the risk of incident hypertension and the SBP level at revisit (odds ratio or β (95% confidence interval) for participants with baPWV in quartile 4 vs. quartile 1: 2.72 (1.54, 4.78) for incident hypertension and 5.92 (4.26, 7.58) for SBP, P for trend: <0.001) after adjusting demonstrated risk factors. Besides, the effects of baseline baPWV on either incident hypertension or SBP at revisit were interactively modified by the level of baseline SBP; the effect size increased as the SBP level decreased. baPWV independently predicted the risk of hypertension and BP progression, modified by the level of SBP at baseline in this Chinese community-based population. The combination of baPWV and SBP can help differentiate the potential high-risk candidates who will develop hypertension quickly and benefit from early diagnosis and treatment.

Predictive Performance and Optimal Cut-Off Points of Blood Pressure for Identifying Arteriosclerosis among Adults in Eastern China

“…Arteriosclerosis measured by baPWV was a strong predictor of cardiovascular mortality [13,22,23]. Thus, the early detection of arteriosclerosis or arterial stiffness could help to assess the risk stratification and reduce the prevalence of cardiovascular events.…”

Association Between Arterial Stiffness and Blood Pressure Progression With Incident Hypertension: A Systematic Review and Meta-Analysis

“…A total of 12 studies (2,14,19,21,(25)(26)(27)(28)(29)(30)(31)(32) were included in the systematic review and meta-analysis (Figure 1). All the included studies were prospective longitudinal studies (follow-up time range: 2 to 10 years) conducted in six countries: five in Japan (25-27, 30, 32), three in China (19,29,31), one in Australia (14), one in Finland (28), one in Italy (2), and one in the United States (21). Records were published between 2008 and 2020 and included a total of 66,180 normotensive subjects (aged 38.0 to 60.0 years).…”

“…Regarding the type of exposure for incident hypertension, nine studies reported on PWV (seven for ba-PWV and two for cf-PWV), eight reported on SBP and five reported on DBP. In addition, five studies (21,(26)(27)(28)31) included two markers (PWV and SBP) and were thus used to calculate the predictive risk value of incident hypertension. Finally, of the total of subjects included, 20,892 (31.6%) developed hypertension during a follow-up period of 2.2 to 10 years (Table 1).…”

Association between remnant cholesterol and arterial stiffness: A secondary analysis based on a cross‐sectional study

“… 1 A large body of evidence has been gathered to show that baPWV, a non‐invasive alternative indicator of arterial stiffness (AS), is an independent risk factor for future cardiovascular disease (CVD), and whose measurement is simple enough to make it easy to be obtained in clinical practice. 1 , 2 , 3 Most studies have shown that the increase of baPWV was related to the occurrence of hypertension, 4 diabetes, 5 cardiac‐cerebral vascular disease and mortality. 6 , 7 Therefore, it is very important to identify the risk factors of baPWV.…”