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Original Study| Volume 21, ISSUE 6, P720-725, June 2020

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Impact of Stiffer Arteries on the Response to Antihypertensive Treatment: A Longitudinal Study of the SardiNIA Cohort

Published:December 26, 2019DOI:https://doi.org/10.1016/j.jamda.2019.11.014

      Abstract

      Objectives

      Carotid-femoral pulse wave velocity (PWV), an index of arterial stiffness and a proxy of arterial aging, has been reported to be an independent determinant of cardiovascular health. Whether the effects of antihypertensive treatment vary in the presence of accelerated arterial aging (stiffer artery, ie, PWV >10 m/s) has not been established. We tested this hypothesis in a longitudinal study in a large community-dwelling population.

      Design

      Longitudinal population study with repeated measures.

      Setting and Participants

      Study population consisted of a cohort of 6011 volunteers (2546 men and 3465 women, age range 14-101 years; 15,011 observations over a median follow-up of 6.8 years) participating in the SardiNIA Study.

      Measures

      Repeated measures of PWV, blood pressure (BP), and metabolic risk factors and the antihypertensive medication trajectories of BP and PWV over time were assessed via mixed effects models.

      Results

      Antihypertensive treatment significantly affected the trajectory of BP in both participants with (−0.47 ± 0.20 mmHg/y, P = .02) and participants without stiffer arteries (−0.47 ± 0.07 mmHg/y, P = .001). They also affected the trajectory of PWV in participants with stiffer artery, independent of the BP values.

      Conclusions and Implications

      Antihypertensive treatment is effective in reducing both BP and PWV in older individuals with stiffer arteries.

      Keywords

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