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. 2021 Mar 26;13(7):10075-10086.
doi: 10.18632/aging.202764. Epub 2021 Mar 26.

The 2017 ACC/AHA stage 1 hypertension is associated with arterial stiffness: a prospective analysis

Shanshan Liu  1   2 , Shujing Wu  1   2 , Jingya Niu  1   2 , Ruizhi Zheng  1   2 , Lizhan Bie  1   2 , Zhuojun Xin  1   2 , Shuangyuan Wang  1   2 , Hong Lin  1   2 , Zhiyun Zhao  1   2 , Mian Li  1   2 , Tiange Wang  1   2 , Min Xu  1   2 , Jieli Lu  1   2 , Yuhong Chen  1   2 , Yiping Xu  3 , Yufang Bi  1   2 , Weiqing Wang  1   2 , Guang Ning  1   2 , Yu Xu  1   2
Affiliations

The 2017 ACC/AHA stage 1 hypertension is associated with arterial stiffness: a prospective analysis

Shanshan Liu et al. Aging (Albany NY). .

Abstract

Objective: To examine the association between stage 1 hypertension defined by the 2017 American College of Cardiology and American Heart Association (ACC/AHA) guideline and risk of developing arterial stiffness.

Methods: During 2010-2015, 4595 adults aged ≥40 years without cardiovascular disease were followed up for a median of 4.3 years. BP levels at baseline were categorized into normal, elevated, stage 1 hypertension, and stage 2 hypertension. The development of arterial stiffness was defined as a normal brachial-ankle pulse wave velocity (ba-PWV) at baseline and an increased ba-PWV at follow-up.

Results: Compared with participants with normal BP, participants with stage 1 hypertension had a 1.48-fold increased risk of developing arterial stiffness [odds ratio (OR) =2.48; 95% confidence interval (CI) =1.59-3.85] after adjustment for cardiovascular risk factors. The association was more evident in adults aged 40-59 years (OR =4.08; 95% CI =2.06-8.08) than that in those aged ≥60 years (OR =1.47; 95% CI =0.81-2.67). A systolic BP 130~139 mmHg was significantly associated with arterial stiffness independent of diastolic BP (OR =2.90; 95% CI =1.86-4.52). Stage 1 hypertension either at baseline or at follow-up was associated with increased risks compared with normal BP at both baseline and follow-up.

Conclusions: The 2017 ACC/AHA stage 1 hypertension was significantly associated with higher risks of arterial stiffness.

Keywords: 2017 ACC/AHA guideline; arterial stiffness; cohort; stage 1 hypertension.

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Conflict of interest statement

CONFLICTS OF INTEREST: The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Proportions (%) of participants developing an increased ba-PWV in different blood pressure categories. 2017 ACC/AHA blood pressure categories (A); systolic blood pressure categories (B); diastolic blood pressure categories (C). SBP, systolic blood pressure; DBP, diastolic blood pressure; Ba-PWV, brachial-ankle pulse wave velocity.
Figure 2
Figure 2
Risks of developing an increased ba-PWV in association with blood pressure changes during follow-up. The OR (95% CI) was adjusted for age, sex, education, current smoking, current drinking, physical activity, body-mass index, fasting plasma glucose, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, estimated glomerular filtration rate, and urinary albumin-to-creatine ratio. Forty-eight participants had missing data on BP measurements during follow-up and were not included in the analysis. BP, blood pressure; SBP, systolic blood pressure; DBP, diastolic blood pressure; Ba-PWV, brachial-ankle pulse wave velocity; OR, odds ratio; CI, confidence interval.
Figure 3
Figure 3
Flow chart of the selection of study participants. Ba-PWV, brachial-ankle pulse wave velocity.
See this image and copyright information in PMC

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