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Blood pressure control and progression of arteriosclerosis in hypertension

Zhe Huang1, Guodong Wang2, Jost B Jonas3

  • 1Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology.

Journal of Hypertension
|January 20, 2021
PubMed

Insights

Maintaining lower blood pressure (BP) and achieving medical BP reduction can slow arteriosclerosis progression. This study found that consistent hypertension significantly accelerates brachial-ankle pulse wave velocity (baPWV) increase in patients.

Area of Science:

  • Cardiovascular Medicine
  • Hypertension Research
  • Arteriosclerosis Studies

Background:

  • Arteriosclerosis, a hardening of the arteries, is a significant risk factor for cardiovascular disease.
  • Brachial-ankle pulse wave velocity (baPWV) serves as a key biomarker for assessing arterial stiffness and arteriosclerosis.
  • Understanding the impact of blood pressure (BP) control on arteriosclerosis progression is crucial for patient management.

Purpose of the Study:

  • To investigate the relationship between blood pressure (BP) levels and control strategies with the progression of arteriosclerosis.
  • To evaluate how different BP states (normal vs. hypertensive) at baseline and follow-up influence the annual increase in baPWV.
  • To determine the effect of BP management on delaying arteriosclerosis in a hypertensive population.

Main Methods:

  • A longitudinal community-based study involving 6552 participants with hypertension.
  • Participants were categorized into four groups based on BP status (normal or hypertensive) at baseline and follow-up.
  • Annual changes in baPWV were analyzed using multivariable models, considering factors like age, BMI, and treatment status, under both JNC7 and ACC/AHA hypertension criteria.

Main Results:

  • The hypertensive--hypertensive group exhibited the highest annual increase in baPWV, regardless of the hypertension definition used (JNC7: 17.32 cm/s; ACC/AHA: 43.54 cm/s).
  • The normal--hypertensive and hypertensive--normal groups also showed significant increases in baPWV compared to the normal--normal group.
  • Both definitions of hypertension indicated a substantial acceleration of baPWV with sustained or intermittent high blood pressure.

Conclusions:

  • Lowering blood pressure and effectively managing hypertension are associated with reduced baPWV progression.
  • Medical intervention to control elevated BP may significantly delay the advancement of arteriosclerosis in hypertensive individuals.
  • Consistent BP control is vital for mitigating arterial stiffness and improving cardiovascular outcomes in patients with hypertension.
Abstract

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