Background: The temporal relationship between arterial stiffness and systolic blood pressure (SBP) is not completely defined and may be bidirectional. While arterial stiffness increase pulse pressure, hypertension may damage the vessels leading to higher arterial stiffness. Objective: To investigate whether arterial stiffness measured by carotid femoral pulse wave velocity (cfPWV) at the baseline of the ELSA-Brasil cohort study (2008-2010) predicts SBP in the second examination (2012-2014), independently of baseline SBP.
Methods: A total of 9,626 adults from ELSA-Brasil, free of cardiovascular diseases and use of antihypertensive medication at baseline (45.1% men, age range: 35-74), with valid measures of cfPWV and SBP in both examinations were included. Blood pressure was measured three times after a resting period of 5 min and the mean of the last two readings was used. The following variables were used for adjustments: age, sex, race, education, total cholesterol/HDL, body mass index, diabetes, smoking, alcohol intake, level of physical activity, use of antihypertensives at second examination and baseline SBP. Multiple linear regression models were used.
Results: The mean follow-up period was 3.9 years (SD: 0.57, range: 2-6 years). In the univariate analysis, a 1m/s increase in cfPWV at baseline was associated with a mean increase in SBP in the second examination of 4 mmHg (95%CI: 3.8; 4.1, p <0.001). After considering all the adjustment variables, the association of cfPWV at baseline with SBP in the second examination remained statistically significant (β =0.6; 95%CI: 0.4; 0.6, p <0.001).
Conclusion: Higher arterial stiffness is an independent predictor of a longitudinal increase in SBP after a mean follow up of 3.9 years, suggesting that higher arterial stiffness may predict hypertension and may be used to identify individuals at higher risk of developing hypertension.