Arterial stiffness and plasma creatinine in untreated hypertensive patients

Increased arterial stiffness is a common feature of hypertensive subjects with renal failure, independently of age, office blood pressure (BP), and traditional cardiovascular risk factors including atherosclerosis but not diabetes mellitus. Recently a reduction in creatinine clearance was shown to be associated with increased arterial stiffness in patients with normal or elevated BP and mild renal failure, and the association was noted to be stronger in subjects <55 years of age. We wanted to study this relationship in a population of newly recognized hypertensive subjects with preserved renal function using another method to assess arterial stiffness and to see whether it was independent of 24-h BP.

In 263 untreated hypertensive subjects with plasma creatinine <135 micromol/L, 24-h ambulatory BP was measured before any treatment using a validated device enabling automatic measurement of arterial stiffness in parallel. The age median was 48 years in this population. Accordingly the population was split into two groups: those < 48 and those > or =48 years of age.

Arterial stiffness and plasma creatinine were positively and significantly correlated, independently of age, height, gender, traditional risk factors and 24-h BP measurements. A significant correlation was observed whether subjects were younger (< 48 years) or older (> or =48 years).

In untreated hypertensive subjects with preserved renal function, arterial stiffness and plasma creatinine were found to be positively related, independent of age and ambulatory BP, suggesting an independent link between the two parameters at an early phase of hypertensive vascular disease.