Central blood pressure predicts the development of hypertension in the general population

Although elevated blood pressure results in arterial stiffening, the converse could also be true. Previous studies have suggested that increased arterial stiffness precedes the development of hypertension. Since central blood pressure is augmented following arterial stiffening, the predictive value of central blood pressure for detecting new-onset hypertension was investigated in the general population. A total of 7840 normotensive subjects (male, 4592; mean age, 51 years) were followed up for a median of 4 years, with the endpoint being the development of hypertension. During the actual follow-up period of 31636 person-years, hypertension developed in 2608 subjects. Kaplan-Meier analysis revealed an increase in the risk of hypertension across the quartiles of baseline central blood pressure (log-rank P < 0.001), with incidence rates of hypertension in the first, second, third, and fourth quartiles of 8.8%, 22.3%, 39.9%, and 63.2%, respectively. Multivariate Cox hazard analysis demonstrated an increased hazard ratio of incident hypertension across the quartiles after adjustment for possible factors. Repeating the multivariate Cox hazard analysis with central blood pressure as a continuous variable also identified central blood pressure at baseline as a significant predictor of new-onset hypertension (P < 0.001). These results suggest that central blood pressure is a significant predictor of new-onset hypertension in individuals without hypertension.