(Hypertension. 1999;34:201-206.)
© 1999 American Heart Association, Inc.
Scientific Contributions |
Arterial Stiffness and the Development of Hypertension
The ARIC Study
From the Department of Health Evaluation Sciences, Pennsylvania State University College of Medicine, Hershey (D.L.); Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis (D.K.A.); Departments of Epidemiology (D.L., H.A.T., G.H.) and Biostatistics (L.E.C.), University of North Carolina at Chapel Hill; Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC (W.A.R.); and Department of Epidemiology, Johns Hopkins University, Baltimore, Md (M.S.).
Abstract—Decreased elasticity in
large and medium-sized arteries has been postulated to be associated
with cardiovascular diseases. We prospectively examined
the relation between arterial elasticity and the
development of hypertension over 6 years of follow-up in a cohort of
6992 normotensive men and women aged 45 to 64 years at baseline from
the biracial, population-based Atherosclerosis Risk in
Communities (ARIC) Study. Arterial elasticity was measured
from high-resolution B-mode ultrasound examination of the left common
carotid artery as adjusted arterial diameter change (in
micrometers, simultaneously adjusted for
diastolic blood pressure, pulse pressure, pulse pressure
squared, diastolic arterial diameter, and
height), Peterson's elastic modulus (in kilopascals), Young's elastic
modulus (in kilopascals), and ß stiffness index. Incident
hypertension (n=551) was defined as systolic blood pressure
160 mm Hg, diastolic blood pressure 95
mm Hg, or the use of antihypertensive medication at a follow-up
examination conducted every 3 years. The age-, ethnicity-, center-,
gender-, education-, smoking-, heart rate–, and
obesity-adjusted means (SE) of baseline adjusted arterial
diameter change, Peterson's elastic modulus, Young's elastic modulus,
and ß stiffness index were 397 (5), 148 (2.0), 787 (12.7), and 11.43
(0.16), respectively, in persons who developed hypertension during
follow-up, in contrast to 407 (1), 124 (0.6), 681 (3.7), and 10.34
(0.05), respectively, for persons who did not. The similarly adjusted
cumulative incident rates of hypertension from the highest to the
lowest quartiles of arterial elasticity were 6.7%, 8.0%,
7.3%, and 9.6%, respectively, when measured by adjusted
arterial diameter change (P<0.01). One
standard deviation decrease in arterial elasticity was
associated with 15% greater risk of hypertension, independent of
established risk factors for hypertension and the level of baseline
blood pressure. These results suggest that lower arterial
elasticity is related to the development of hypertension.
Key Words: distensibility • hypertension detection and control • cohort studies • ethnic groups
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