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. 2019 Aug 20;8(16):e013019.
doi: 10.1161/JAHA.119.013019. Epub 2019 Aug 15.

Relationship Between Brachial-Ankle Pulse Wave Velocity and Incident Hypertension According to 2017 ACC/AHA High Blood Pressure Guidelines

Seung Jae Lee  1 , Alberto Avolio  2 , Dae Chul Seo  1 , Bum Soo Kim  1 , Jin Ho Kang  1 , Mi Yeon Lee  3 , Ki-Chul Sung  1
Affiliations

Relationship Between Brachial-Ankle Pulse Wave Velocity and Incident Hypertension According to 2017 ACC/AHA High Blood Pressure Guidelines

Seung Jae Lee et al. J Am Heart Assoc. .

Abstract

Background Arterial stiffness predicts both cardiovascular events and incident hypertension. However, whether brachial-ankle pulse wave velocity (baPWV) is predictive of incident hypertension based on the 2017 American College of Cardiology/American Heart Association (ACC/AHA) High Blood Pressure Guidelines has not been established. We performed a large cohort study to investigate whether incident hypertension could be predicted from baPWV measurements as a measure of arterial stiffness, even when applying updated hypertension criteria. Methods and Results A total of 10 360 Korean adults who underwent baPWV examination during a health-screening program between 2010 and 2016 were enrolled. Hypertension was defined according to the 2017 ACC/AHA Guidelines as 130/80 mm Hg. Cox proportional hazard analysis was used to assess the risk of incident hypertension according to baPWV quartiles. The mean age of the study subjects was 40.2 years and 75.6% were men. During the follow-up period (median 2.17 years), 2000 subjects (19.3%) developed hypertension. The subjects in the highest baPWV quartile group showed an increased risk of hypertension compared with the lowest baPWV quartile group as confirmed by multivariate adjusted hazard ratios of 1.64 (95% CI 1.41-1.89; P<0.001) in men and 12.36 (95% CI 4.41-34.62; P=0.005) in women. The increased risk of developing hypertension was consistent after adjusting for several confounding factors. Conclusions Arterial stiffness measured by baPWV is associated with incident hypertension according to the updated 2017 ACC/AHA Guidelines and is a useful independent predictor of incident hypertension among relatively healthy people.

Keywords: arterial stiffness; atherosclerosis; brachial‐ankle pulse wave velocity; hypertension.

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Figures

Figure 1
Figure 1
Flowchart summarizing the study population. BP indicates blood pressure.
Figure 2
Figure 2
Kaplan–Meier Curves for incident hypertension according to baPWV in men and women. baPWV indicates brachial‐ankle pulse wave velocity.
Figure 3
Figure 3
Incident hypertension rate by quartiles of baPWV and quartiles of baseline systolic blood pressure. baPWV indicates brachial‐ankle pulse wave velocity; SBP, systolic blood pressure; PY, person‐years.
Figure 4
Figure 4
Subgroup analyses of incident hypertension according to baPWV. baPWV indicates brachial‐ankle pulse wave velocity; BMI, bone mass index, HOMA‐IR, homeostasis model assessment of insulin resistance; hsCRP, high‐sensitity C‐reactive protein.
See this image and copyright information in PMC

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