P90: Positive Effects of Antihypertensive Treatment on Aortic Stiffness in the General Population

Abstract

Aortic stiffness is strongly related to age and mean arterial pressure (MAP). We investigated whether antihypertensive treatment modulates the association of the aortic pulse wave velocity (PWV) with age and with MAP in the general population. In the Czech post-MONICA, we measured the PWV in 735 subjects (mean age 61.2 ± 7.8 years, 54.1% women, 44.3% on antihypertensive medication). We used a linear regression model to assess the effect of treatment on the PWV.

The independent covariates in our analysis included sex, age, MAP, body mass index, plasma glucose, low-density lipoprotein cholesterol, smoking and observer. The patients receiving treatment were older (64.1 ± 6.7 vs. 58.9 ± 7.8 years), had higher systolic blood pressure (135.9 ± 16.2 vs. 130.1 ± 16.5 mm Hg) and had higher pulse wave velocity (9.1 ± 2.2 vs. 8.2 ± 2.1 ms 1; P for all o0.0001) than untreated subjects.

After adjustment for MAP, the use of treatment modified the association between age and the PWV (regression equations, treated patients 9.68–0.009 age vs. untreated subjects 6.98 þ 0.020 age, difference of regression slopes, F ¼ 11.2; P ¼ 0.0009). In analyses adjusted for age, treatment was associated with a smaller increase of the PWV with MAP (treated patients 9.63–0.006 MAP vs. untreated subjects 7.18 þ 0.010 MAP, F ¼ 10.70; P ¼ 0.0001). These results were driven primarily by subjects whose blood pressure was below 140/90 mm Hg.

In the cross-sectional analysis from a random sample of the general population, antihypertensive treatment was associated with a less steep increase in the PWV with age and the mean arterial pressure.

Table 1 Effect of 12 weeks of Green tea extract intervention or placebo on circulating parameters.

Values are arithmetic means ± SE except for mean differences between groups, which have been adjusted for baseline values. Between-group P values reflect the between-group comparison change-scores from Man Whitney U statistic methodology. *Significant (p < 0.05) within-group change.