title: Association between long-term blood pressure control and ten-year progression in carotid arterial stiffness among hypertensive individuals: the multiethnic study of atherosclerosis.
abstract: Arterial stiffness was shown to be higher among hypertensive patients with diabetes than those without diabetes and among older than younger hypertensive patients. We examined whether the association between long-term blood pressure (BP) control and 10-year progression in carotid arterial stiffness varies by diabetes status and age.
  
  
  
  Participants were 906 individuals with hypertension at baseline and three follow-up visits in the Multi-Ethnic Study of Atherosclerosis (mean age 63.7 years, 44% males). Participants with SBP of less than 140 mmHg and DBP of less than 90 mmHg were considered to have a controlled BP. Arterial stiffness was measured using distensibility coefficient × 10/mmHg and Young's elastic modulus (YEM × 10 mmHg) at baseline and after a mean of 9.5 years (visit 5). Multiple linear regression model was used for the analysis.
  
  
  
  Having controlled BP at three visits (distensibility coefficient: β = 3.6, P = 0.004; YEM: β = -6.8, P = 0.07) or four visits (distensibility coefficient: β = 2.4, P = 0.04; YEM: β = -6.8, P = 0.05), when compared with having uncontrolled BP at all four visit, was associated with lesser progression in arterial stiffness. In a stratified analysis, arterial stiffness progression was slower only among nondiabetics with controlled BP at three visits (distensibility coefficient: β = 4.3, P = 0.002; YEM: β = -8.8, P = 0.04) or four visits (β = 3.7, P = 0.01; YEM: β = -10.4, P = 0.01) and among those less than 70 years with controlled BP at three visits (distensibility coefficient: β = 4.9, P = 0.004; YEM: β = -10.6, P = 0.01) or four visits (distensibility coefficient: β = 2.9, P = 0.07; YEM: β = -7.6, P = 0.03).
  
  
  
  These findings suggest that controlling BP alone may not be sufficient to slow progression of arterial stiffness among hypertensive patients with concurrent diabetes and elderly hypertensive patients.
authors.affiliation: aDepartment of Preventive Medicine, Northwestern University, Chicago, Illinois bDivision of Cardiovascular Medicine, University of Wisconsin Madison, Madison, Wisconsin cJohn Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Yacob G
authors.initials: YG
authors.lastname: Tedla
authors.forename: Adam D
authors.initials: AD
authors.lastname: Gepner
authors.forename: Dhananjay
authors.initials: D
authors.lastname: Vaidya
authors.forename: Laura
authors.initials: L
authors.lastname: Colangelo
authors.forename: James H
authors.initials: JH
authors.lastname: Stein
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.forename: Philip
authors.initials: P
authors.lastname: Greenland
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000150:complications / Q000208:ethnology / Q000503:physiopathology*; D001794:Blood Pressure / Q000187:drug effects; D002340:Carotid Artery Diseases / Q000209:etiology / Q000503:physiopathology*; D003920:Diabetes Mellitus / Q000503:physiopathology; D018450:Disease Progression; D055119:Elastic Modulus; D005006:Ethnicity; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D059289:Vascular Stiffness