title: Progression of Carotid Arterial Stiffness With Treatment of Hypertension Over 10 Years: The Multi-Ethnic Study of Atherosclerosis.
abstract: Associations with antihypertensive medication classes and progression of arterial stiffness have not been studied in a prospective multiethnic cohort. All participants had hypertension at baseline, defined as blood pressure ≥140/90 mm Hg or use of antihypertensive medications. Medication use and blood pressure were assessed at 5 time points. Young's elastic modulus and distensibility coefficient of the right common carotid artery were obtained by ultrasound at baseline and after a mean (SD) follow-up period of 9.4 (0.5) years. Associations with changes in Young's elastic modulus and distensibility coefficient, baseline antihypertensive medication use, number of visits each medication class was reported, and blood pressure control (<140/90 mm Hg) were assessed using multiple linear regression models. At baseline, mean age of participants (n=1206) was 63.2 (9.0) years (55% female; 35% African American, 19% Hispanic, 12% Chinese). Mean systolic blood pressure was 136.5 (20.6) mm Hg. Greater progression of arterial stiffness was associated with older age, African American ethnicity, and baseline calcium channel blocker use. There were no other associations between changes in Young's elastic modulus or distensibility coefficient and use of other medication classes (all P>0.4). Achieving blood pressure control (<140/90 mm Hg) at all visits was associated with slower progression of arterial stiffness (Young's elastic modulus: β=-790.1 mm Hg, P=0.01; distensibility coefficient: β=7.34×10-4mm Hg-1, P=0.001). Blood pressure control, rather than use of any particular antihypertensive medication class, was associated most strongly with slowing arterial stiffness progression. Over nearly a decade of follow-up, no consistent associations between any specific antihypertensive medication class and progressive carotid arterial stiffening were identified.
authors.affiliation: From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.).
authors.forename: Adam D
authors.initials: AD
authors.lastname: Gepner
authors.affiliation: From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.).
authors.forename: Yacob
authors.initials: Y
authors.lastname: Tedla
authors.affiliation: From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.).
authors.forename: Laura A
authors.initials: LA
authors.lastname: Colangelo
authors.affiliation: From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.).
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Tattersall
authors.affiliation: From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.).
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Korcarz
authors.affiliation: From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.).
authors.forename: Joel D
authors.initials: JD
authors.lastname: Kaufman
authors.affiliation: From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.).
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.affiliation: From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.).
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Burke
authors.affiliation: From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.).
authors.forename: Steven
authors.initials: S
authors.lastname: Shea
authors.affiliation: From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.).
authors.forename: Philip
authors.initials: P
authors.lastname: Greenland
authors.affiliation: From the Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (A.D.G., M.C.T., C.E.K., J.H.S.); Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.T., L.A.C., K.L., P.G.); Departments of Environmental & Occupational Health Sciences and Epidemiology, University of Washington, Seattle (J.D.K.); Department of Public Health Sciences, Wake Forest University, Winston-Salem, NC (G.L.B.); and Department of Epidemiology, Columbia University, New York, NY (S.S.). jhs@medicine.wisc.edu.
authors.forename: James H
authors.initials: JH
authors.lastname: Stein
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D050197:Atherosclerosis / Q000208:ethnology* / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000503:physiopathology; D018450:Disease Progression; D004548:Elasticity; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000208:ethnology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014463:Ultrasonography; D014481:United States / Q000453:epidemiology; D059289:Vascular Stiffness / Q000502:physiology*
chemical_list: D000959:Antihypertensive Agents
keywords: cardiovascular disease; carotid arteries; elasticity; epidemiology; hypertension