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Published on: May 3, 2018
Brachial-Ankle Pulse Wave Velocity Predicts New-Onset Hypertension and the Modifying Effect of Blood Pressure in a
Yimeng Jiang1, Fangfang Fan1, Jia Jia1
1Department of Cardiology, Peking University First Hospital, Beijing, China.
Insights
Brachial-ankle pulse wave velocity (baPWV) predicts new hypertension risk in Chinese adults. Higher baPWV indicates greater risk, especially when baseline blood pressure is lower, aiding early intervention.
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Biomarker Discovery
Background:
- Brachial-ankle pulse wave velocity (baPWV) is a recognized cardiovascular event predictor.
- The influence of blood pressure (BP) on the relationship between baPWV and new-onset hypertension requires further investigation.
Purpose of the Study:
- To determine if baPWV predicts incident hypertension and BP progression.
- To examine the modifying effect of baseline BP on the association between baPWV and hypertension development.
Main Methods:
- A cohort of 1849 non-hypertensive Chinese adults was followed for a mean of 2.36 years.
- BaPWV was measured using an Omron Colin BP-203RPE III device.
- Multivariate logistic regression analyzed associations between baPWV, baseline BP, and incident hypertension or SBP at follow-up.
Main Results:
- 248 participants (13.41%) developed hypertension during follow-up.
- Higher baPWV independently and progressively predicted incident hypertension (OR 2.72 for Q4 vs. Q1) and SBP increase (β 5.92).
- The predictive effect of baPWV on hypertension and SBP progression was significantly modified by baseline SBP levels, with a stronger effect at lower baseline SBP.
Conclusions:
- BaPWV is an independent predictor of hypertension incidence and BP progression in this Chinese population.
- Baseline SBP levels modify the impact of baPWV on hypertension risk.
- Combining baPWV and SBP measurements can identify individuals at high risk for rapid hypertension development, facilitating timely intervention.
Abstract:
Brachial-ankle pulse wave velocity (baPWV) was proven to be a prognostic indicator of cardiovascular events. However, the modifying effect of blood pressure (BP) on the longitudinal association between baPWV and new-onset hypertension is not well established. This study included 1849 non-hypertensive Chinese subjects from Shougang cohort study during December 2011 to July 2014. BaPWV was obtained using an Omron Colin BP-203RPE III device. Multivariate logistic regression models were used to evaluate associations of baPWV and outcomes. During a mean follow-up time of 2.36 years, 248 (13.41%) developed hypertension. BaPWV independently and gradably predicted the risk of incident hypertension and the SBP level at revisit (odds ratio or β (95% confidence interval) for participants with baPWV in quartile 4 vs. quartile 1: 2.72 (1.54, 4.78) for incident hypertension and 5.92 (4.26, 7.58) for SBP, P for trend: <0.001) after adjusting demonstrated risk factors. Besides, the effects of baseline baPWV on either incident hypertension or SBP at revisit were interactively modified by the level of baseline SBP; the effect size increased as the SBP level decreased. baPWV independently predicted the risk of hypertension and BP progression, modified by the level of SBP at baseline in this Chinese community-based population. The combination of baPWV and SBP can help differentiate the potential high-risk candidates who will develop hypertension quickly and benefit from early diagnosis and treatment.
Related Concept Videos
01:15Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
01:23Assessment of blood pressure in brachial artery(two-step method)
01:21Sites for measruring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.