Determinants of accelerated progression of arterial stiffness in normotensive subjects and in treated hypertensive subjects over a 6-year period.
BACKGROUND
Elastic artery stiffness, a result of arterial aging, is an independent indicator of cardiovascular risk. The aim of the present longitudinal study was to compare the progression of aortic stiffness over a 6-year period in treated hypertensive subjects and normotensive subjects, and to evaluate the determinants of this progression.


RESULTS
Data for the present analysis were gathered from 483 subjects who had 2 health checkups at the Centre d'Investigations Préventives et Cliniques, the first one in 1992--1993 and the second one in 1998--1999. Carotid-femoral pulse wave velocity (PWV) was used to evaluate aortic stiffness in 187 hypertensive subjects who were under treatment at the time of the first visit and throughout the follow-up period, and in 296 subjects who were classified as normotensive during the first visit and who remained treatment-free throughout the follow-up period. In both populations, PWV progression was higher in older subjects. Annual rates of progression in PWV in treated hypertensives were significantly higher than in normotensives. Only treated hypertensives with well-controlled blood pressure levels at the time of both visits had a PWV progression similar to that of normotensives. In treated hypertensives, high heart rate and high creatinine during the first visit were associated with an accelerated progression in PWV.


CONCLUSIONS
The presence of high blood pressure, high heart rate, and high serum creatinine were the major determinants of accelerated progression of aortic stiffness in treated hypertensives. This is the first longitudinal study to evaluate the determinants of arterial aging over an extended period of time.
Benetos
Athanase
A
Centre d'Investigations Préventives et Cliniques, Paris, France. benetos@ipc.asso.fr
Adamopoulos
Chris
C
Bureau
Jeanne-Marie
JM
Temmar
Mohamed
M
Labat
Carlos
C
Bean
Kathryn
K
Thomas
Frédérique
F
Pannier
Bruno
B
Asmar
Roland
R
Zureik
Mahmoud
M
Safar
Michel
M
Guize
Louis
L
D000375:Aging / Q000097:blood; D000704:Analysis of Variance; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001011:Aorta / Q000503:physiopathology*; D001794:Blood Pressure; D015992:Body Mass Index; D002339:Carotid Arteries / Q000503:physiopathology; D008076:Cholesterol, HDL / Q000097:blood; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D004548:Elasticity; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D013995:Time; D014280:Triglycerides / Q000097:blood
D000959:Antihypertensive Agents; D008076:Cholesterol, HDL; D014280:Triglycerides; D003404:Creatinine