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Intensive blood pressure control on arterial stiffness among older patients with hypertension

Shuyuan Zhang1,2, Yixuan Zhong3, Shouling Wu4

  • 1National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100037, China.

Chinese Medical Journal
|November 15, 2023
PubMed

Insights

Intensive blood pressure control significantly slowed arterial stiffening in older adults. This approach also reduced cardiovascular disease (CVD) risk in hypertensive patients, particularly those aged 70-80.

Area of Science:

  • Cardiology
  • Gerontology
  • Hypertension Research

Background:

  • Arterial stiffening is a hallmark of aging and hypertension, increasing cardiovascular disease (CVD) risk.
  • The impact of intensive blood pressure lowering on arterial stiffening in older adults remains uncertain.

Purpose of the Study:

  • To evaluate the effect of intensive blood pressure treatment on arterial stiffness progression.
  • To assess the impact of intensive treatment on CVD risk in elderly hypertensive patients.

Main Methods:

  • The Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial randomized 8511 patients (60-80 years) to intensive (SBP <130 mmHg) or standard (SBP 130-150 mmHg) treatment.
  • Arterial stiffness (brachial-ankle pulse wave velocity - baPWV) and CVD outcomes were assessed over a 3-year follow-up in 5339 patients.

Main Results:

  • Intensive treatment significantly reduced the progression of arterial stiffness (baPWV change: 61.5 vs. 98.4 cm/s).
  • Annual baPWV increase was lower with intensive treatment (23.1 vs. 36.7 cm·s -1 ·year -1).
  • Intensive treatment lowered CVD risk, especially in patients aged 70-80 years or with baseline SBP <140 mmHg.

Conclusions:

  • Intensive blood pressure control (SBP 110-130 mmHg) effectively delays arterial stiffening in older hypertensive individuals.
  • This intensive strategy reduces the risk of cardiovascular disease in this population.
Abstract

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