Treatment-related reduction in arterial stiffness may precede BP lowering

A decrease in arterial stiffness by means of antihypertensive treatment could pave the way of blood pressure (BP) reduction, a study has shown.

To determine whether BP lowering results from reducing arterial wall or vice versa in antihypertensive treatment, the authors examined the relationship between arterial stiffness and BP in patients with treated hypertension.

A total of 3,277 individuals who received treatment with antihypertensive agents and with repeated measurements of brachial-ankle pulse wave velocity (baPWV) and BP during 2010‒2016 from the Kailuan study were included in the present analysis. The authors then performed cross-lagged path analyses to assess the temporal association between BP and baPWV.

The standard regression coefficient from baseline baPWV to follow-up systolic (S)BP after adjusting for potential confounders was 0.14 (95 percent confidence interval [CI], 0.10‒0.18). This was markedly higher than the 0.05 (95 percent CI, 0.02‒0.08) coefficient from baseline SBP to follow-up baPWV (p<0.0001 for difference).

Cross-lagged analysis with changes of baPWV and mean arterial pressure showed similar results. Further analysis revealed a significant difference in the annual rate of change in SBP during the follow-up period across increasing quartiles of baseline baPWV (p<0.0001). On the other hand, the yearly rate of change in baPWV varied nonsignificantly across quartiles of baseline SBP (p=0.2443).

“These findings provided strong evidence that reduction in arterial stiffness through antihypertensive treatment could precede BP lowering,” the authors said.