Association between long-term blood pressure control and ten-year progression in carotid arterial stiffness among hypertensive individuals: the multiethnic study of atherosclerosis

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Abstract

Background:

Arterial stiffness was shown to be higher among hypertensive patients with diabetes than those without diabetes and among older than younger hypertensive patients. We examined whether the association between long-term blood pressure (BP) control and 10-year progression in carotid arterial stiffness varies by diabetes status and age.

Methods:

Participants were 906 individuals with hypertension at baseline and three follow-up visits in the Multi-Ethnic Study of Atherosclerosis (mean age 63.7 years, 44% males). Participants with SBP of less than 140 mmHg and DBP of less than 90 mmHg were considered to have a controlled BP. Arterial stiffness was measured using distensibility coefficient × 10−4/mmHg and Young's elastic modulus (YEM × 102 mmHg) at baseline and after a mean of 9.5 years (visit 5). Multiple linear regression model was used for the analysis.

Results:

Having controlled BP at three visits (distensibility coefficient: β = 3.6, P = 0.004; YEM: β = –6.8, P = 0.07) or four visits (distensibility coefficient: β = 2.4, P = 0.04; YEM: β = −6.8, P = 0.05), when compared with having uncontrolled BP at all four visit, was associated with lesser progression in arterial stiffness. In a stratified analysis, arterial stiffness progression was slower only among nondiabetics with controlled BP at three visits (distensibility coefficient: β = 4.3, P = 0.002; YEM: β = −8.8, P = 0.04) or four visits (β = 3.7, P = 0.01; YEM: β = −10.4, P = 0.01) and among those less than 70 years with controlled BP at three visits (distensibility coefficient: β = 4.9, P = 0.004; YEM: β = −10.6, P = 0.01) or four visits (distensibility coefficient: β = 2.9, P = 0.07; YEM: β = -7.6, P = 0.03).

Conclusion:

These findings suggest that controlling BP alone may not be sufficient to slow progression of arterial stiffness among hypertensive patients with concurrent diabetes and elderly hypertensive patients.

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