title: Pulse wave velocity is an independent predictor of the longitudinal increase in systolic blood pressure and of incident hypertension in the Baltimore Longitudinal Study of Aging.
abstract: OBJECTIVE
  This study sought to evaluate whether pulse wave velocity (PWV), a noninvasive index of arterial stiffness, is a predictor of the longitudinal changes in systolic blood pressure (SBP) and of incident hypertension.
  
  
  BACKGROUND
  Although arterial stiffness is believed to underlie, in part, the age-associated changes in SBP, particularly at older ages, few longitudinal studies in humans have examined the relationship between arterial stiffness and blood pressure.
  
  
  METHODS
  Pulse wave velocity was measured at baseline in 449 normotensive or untreated hypertensive volunteers (age 53 +/- 17 years). Repeated measurements of blood pressure were performed during an average follow-up of 4.9 +/- 2.5 years.
  
  
  RESULTS
  After adjusting for covariates including age, body mass index, and mean arterial pressure, linear mixed effects regression models showed that PWV was an independent determinant of the longitudinal increase in SBP (p = 0.003 for the interaction term with time). In a subset of 306 subjects who were normotensive at baseline, hypertension developed in 105 (34%) during a median follow-up of 4.3 years (range 2 to 12 years). By stepwise Cox proportional hazards models, PWV was an independent predictor of incident hypertension (hazard ratio 1.10 per 1 m/s increase in PWV, 95% confidence interval 1.00 to 1.30, p = 0.03) in individuals with a follow-up duration greater than the median.
  
  
  CONCLUSIONS
  Pulse wave velocity is an independent predictor of the longitudinal increase in SBP and of incident hypertension. This suggests that PWV could help identify normotensive individuals who should be targeted for the implementation of interventions aimed at preventing or delaying the progression of subclinical arterial stiffening and the onset of hypertension.
authors.affiliation: Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21225, USA. NajjarSa@mail.nih.gov
authors.forename: Samer S
authors.initials: SS
authors.lastname: Najjar
authors.forename: Angelo
authors.initials: A
authors.lastname: Scuteri
authors.forename: Veena
authors.initials: V
authors.lastname: Shetty
authors.forename: Jeanette G
authors.initials: JG
authors.lastname: Wright
authors.forename: Denis C
authors.initials: DC
authors.lastname: Muller
authors.forename: Jerome L
authors.initials: JL
authors.lastname: Fleg
authors.forename: Harold P
authors.initials: HP
authors.lastname: Spurgeon
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.forename: Edward G
authors.initials: EG
authors.lastname: Lakatta
mesh_terms: D000375:Aging; D015142:Baltimore; D001783:Blood Flow Velocity; D001794:Blood Pressure; D015992:Body Mass Index; D003971:Diastole; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D013599:Systole; D013997:Time Factors