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Published on: June 27, 2025
Arterial stiffness and hypertension status in Afro-Caribbean men
Allison L Kuipers1, Iva Miljkovic1, Emma Barinas-Mitchell1
1Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Insights
In Afro-Caribbean men, stage 1 hypertension is linked to increased arterial stiffness (PWV). Pharmacologic control of hypertension may offer partial protection against elevated PWV, supporting new hypertension guidelines.
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Vascular Biology
Background:
- Individuals of African ancestry face a high risk of hypertensive cardiovascular disease (CVD).
- Early detection of arterial stiffening is crucial for managing CVD risk in this population.
- The 2017 ACC/AHA hypertension guidelines introduced new blood pressure (BP) cutoffs and definitions.
Purpose of the Study:
- To investigate the association between the 2017 ACC/AHA hypertension categorizations and arterial stiffness.
- To assess arterial stiffness (PWV) in Afro-Caribbean men aged 50+ years.
- To evaluate the impact of pharmacologic control on arterial stiffness in hypertensive individuals.
Main Methods:
- Arterial stiffness was measured using brachial-ankle pulse-wave velocity (PWV).
- Hypertension categories were defined according to the 2017 ACC/AHA guidelines and pharmacologic control status.
- Multiple linear/logistic regression analyses were employed to determine associations between PWV, BP, and hypertension.
Main Results:
- Mean PWV was 1609 cm/s, independently correlated with age, SBP, pulse, diabetes, height, and alcohol intake.
- In men ≥65 years, stage 1 or uncontrolled stage 2 hypertension was associated with significantly greater PWV.
- Controlled hypertension showed similar PWV to elevated BP, but both were significantly higher than normal BP.
Conclusions:
- Stage 1 hypertension is associated with increased PWV in high-risk Afro-Caribbean men, supporting the new ACC/AHA guidelines.
- Pharmacologic control of hypertension may offer partial protection against increased arterial stiffness.
- Further longitudinal studies are needed to establish optimal PWV thresholds and treatment timing for CVD prevention.
Objective:
African ancestry individuals are at high risk for hypertensive cardiovascular disease (CVD) and could benefit from early detection of arterial stiffening. We tested the association between the 2017 ACC/AHA hypertension categorizations, which include new blood pressure (BP) cutoffs and a definition for elevated BP, and arterial stiffness in 772 Afro-Caribbean men aged 50+ years (mean 64 years).
Methods:
Arterial stiffness was assessed by brachial-ankle pulse-wave velocity (PWV) using a waveform analyzer. Hypertension groups were based on the 2017 ACC/AHA guidelines and by pharmacologic control status. Multiple linear/logistic regression was used to determine the association of PWV with BP and hypertension.
Results:
Mean (SD) PWV was 1609 (298) cm/s and was independently correlated with age, SBP, pulse, diabetes, height, and alcohol intake (all P < 0.02). After adjusting for these, in men aged at least 65 years, those with stage 1 or uncontrolled stage 2 hypertension had significantly greater PWV than all other groups (all P < 0.05). Men with controlled hypertension had similar PWV to those with elevated BP (P = 0.7); however, this was significantly greater than men with normal BP (all P < 0.05). Patterns were similar, but with smaller effect sizes, in men aged less than 65 years (all P < 0.05 except controlled hypertension versus elevated or normal BP were not significant).
Conclusion:
In these high-risk Afro-Caribbeans: stage 1 hypertension is associated with increased PWV, which supports the new guidelines; and, pharmacologic control appears to partially protect men from increased PWV. Longitudinal studies are needed to determine optimal PWV and timing of antihypertensive treatment for preventing future CVD.
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