Relationship of arterial stiffness and central hemodynamics with cardiovascular risk in hypertension.

BACKGROUND: Hypertension is becoming a serious public health problem and non-invasive estimation of central hemodynamics and artery stiffness have been identified as important predictors of cardiovascular disease.

METHODS: The study included 4,311 participants, both sex, aged between 20 and 79 years. Arterial velocity pulse index, arterial pressure volume index (AVI, API, the index of artery stiffness), central systolic blood pressure, central artery pulse pressure (CSBP, CAPP, estimated via oscillometric blood pressure monitor) and 10-year risk score of cardiovascular disease in China (China-PAR) and Framingham cardiovascular risk score (FCVRS) were assessed at baseline. Regression model was performed to identify factors associated with high cardiovascular disease risk stratification. The relationships between CSBP, CAPP and China-PAR, FCVRS were analyzed by restrictive cubic spline functions.

RESULTS: The uncontrolled hypertension group showed the highest values of AVI, API, CSBP and CAPP. In the regression analysis, CAPP and hypertension subtypes were identified as significant predictors of high cardiovascular risk stratification, and CAPP was strongly correlated with API in this cohort. Finally, CSBP and CAPP showed significant J-shaped relationships with China-PAR and FCVRS.

CONCLUSION: Subjects with uncontrolled hypertension present with elevated values of CAPP, CSBP, API, AVI, China-PAR and FCVRS score. CAPP was independently associated with high cardiovascular risk stratification, and there was a significant J-shaped relationship with China-PAR and FCVRS that may identify people with higher cardiovascular risk.