Skip to main content
Download PDF
  • Research Article
  • Open access
  • Published:

Analysis of Vascular Aging in Arterial Hypertension — Population-based Study: Preliminary Results

Artery Research volume 25, pages 131–138 (2019)Cite this article

Abstract

Background

Arterial Hypertension (AH) is an uncertain and complex physiopathological disease with the Arterial Stiffness (AS) as one of the main cardiovascular alterations. Pulse Wave Velocity (PWV) is the gold standard marker for assessment of the vascular aging and an important predictor of cardiovascular risk.

Methods

Cross-sectional population-based studies, in the restricted area of Vale do Ogunjá, Salvador-Bahia. Sociodemographic data, through questionnaire and clinical data were obtained. A PWV was evaluated by applanation tonometry using the device SphygmoCor® (AtCor Medical Pty Ltd, New South Wales, Australia). Frequency and descriptive measurements of central and dispersion were obtained, and the Chi-square test to statistical analysis.

Results

PWV presented a higher mean in hypertensive patients (10.0 ± 2.2 m/s). There was a higher prevalence of AS in male individuals with advanced age and presence of risk factors. The prevalence ratio of AS was 3.7 times higher in hypertensive patients (p = 0.002; 95% CI: 1.6–8.5) and 7.5 times higher in patients aged above 40–74 years (p = 0.015; 95% CI: 2.4–23.1).

Conclusion

There was an important relation between AS and increased of PWV in the presence of hypertension. The relevance of this study is associated with the use of non-invasive clinical evaluation of PWV, contributing to improve morbidity and mortality in hypertensive patients.

Highlights

  • Important association between arterial stiffness and arterial hypertension.

  • Prevalence of arterial stiffness in the male gender, advanced age.

  • Prevalence of arterial stiffness with high BMI, dyslipidemia and dysglycemia DM.

  • Arterial stiffness associated to age, schooling level, BMI and arterial hypertension.

References

  1. Beevers G, Lip GYH, O’Brien E. ABC of hypertension: the patho-physiology of hypertension. BMJ 2001;322:912–6.

    Google Scholar 

  2. Magalhães LBNC, de Amorim AM, Rezende EP. Conceito e Aspectos Epidemiológicos da Hipertensão Arterial. Rev Bras Hipertens 2018;25:6–12.

    Google Scholar 

  3. Taler SJ. Initial treatment of hypertension. N Engl J Med 2018;378:636–44.

    Google Scholar 

  4. Perumareddi P. Prevention of hypertension related to cardiovascular disease. Prim Care 2019;46:27–39.

    Google Scholar 

  5. Wu Y, Tai ES, Heng D, Tan CE, Low LP, Lee J. Risk factors associated with hypertension awareness, treatment, and control in a multi-ethnic Asian population. J Hypertens 2009;27:190–7.

    Google Scholar 

  6. Malachias MVB, Souza WKSB, Plavnik FL, Rodrigues CIS, Brandão AA, Neves MFT, et al. 7a Diretriz Brasileira de Hipertensão Arterial. Arq Bras Cardiol 2016;107:1–83.

    Google Scholar 

  7. Araujo DV, Ferraz MB. Impacto econômico do tratamento da cardiopatia isquêmica crônica no Brasil: o desafio da incorporacão de novas tecnologias cardiovasculares. Arq Bras Cardiol 2005;85:1–2.

    Google Scholar 

  8. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet 2005;365:217–23.

    Google Scholar 

  9. Lessa Í, Magalhães L, Araújo MJ, de Almeida Filho N, Aquino E, Oliveira MMC. Hipertensão arterial na população adulta de Salvador (BA) - Brasil. Arq Bras Cardiol 2006;87:747–56.

    Google Scholar 

  10. Mitchell GF. Arterial stiffness and hypertension: chicken or egg? Hypertension 2014;64:210–4.

  11. The Reference Values for Arterial Stiffness’ Collaboration. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘establishing normal and reference values’. Eur Heart J 2010;31:2338–50.

    Google Scholar 

  12. Cunha PG, Boutouyrie P, Nilsson PM, Laurent S. Early vascular ageing (EVA): definitions and clinical applicability. Curr Hypertens Rev 2017;13:8–15.

    Google Scholar 

  13. Greenwald SE. Ageing of the conduit arteries. J Pathol 2007;211:157–72.

    Google Scholar 

  14. Nichols WW. Clinical measurement of arterial stiffness obtained from noninvasive pressure waveforms. Am J Hypertens 2005;18:3S–10S.

    Google Scholar 

  15. Cefalu CA. Theories and mechanisms of aging. Clin Geriatr Med 2011;27:491–506.

    Google Scholar 

  16. Pizzi O, Brandão AA, Magalhães MEC, Pozzan R, Brandão AP. Velocidade de onda de pulso – o método e suas implicações prognósticas na hipertensão arterial. Rev Bras Hipertens 2006;13:59–62.

    Google Scholar 

  17. de Rezende Mikael L, de Paiva AMG, Gomes MM, Sousa ALL, Jardim PCBV, de Oliveira Vitorino PV, et al. Vascular aging and arterial stiffness. Arq Bras Cardiol 2017;109:253–8.

    Google Scholar 

  18. Nichols WW, Denardo SJ, Wilkinson IB, McEniery CM, Cockcroft J, O’Rourke MF. Effects of arterial stiffness, pulse wave velocity, and wave reflections on the central aortic pressure waveform. J Clin Hypertens 2008;10:295–303.

    Google Scholar 

  19. Vlachopoulos C, Xaplanteris P, Aboyans V, Brodmann M, Cífková R, Cosentino F, et al. The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation. Atherosclerosis 2015;241:507–32.

    Google Scholar 

  20. Ben-Shlomo Y, Spears M, Boustred C, May M, Anderson SG, Benjamin EJ, et al. Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects. J Am Coll Cardiol 2014;63:636–46.

    Google Scholar 

  21. Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol 2010;55:1318–27.

    Google Scholar 

  22. AlGhatrif M, Strait JB, Morrell CH, Canepa M, Wright J, Elango P, et al. Longitudinal trajectories of arterial stiffness and the role of blood pressure: the Baltimore Longitudinal Study of Aging. Hypertension 2013;62:934–41.

    Google Scholar 

  23. Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 2001;37:1236–41.

    Google Scholar 

  24. Boutouyrie P, Tropeano AI, Asmar R, Gautier I, Benetos A, Lacolley P, et al. Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients: a longitudinal study. Hypertension 2002;39:10–15.

    Google Scholar 

  25. IBGE – Instituto Brasileiro de Geografia e Estatística. Censo demográfico 2010: resultados gerais da amostra. Rio de Janeiro: IBGE; 2010.

  26. Meng L, Zhao D, Pan Y, Ding W, Wei Q, Li H, et al. Validation of Omron HBP-1300 professional blood pressure monitor based on auscultation in children and adults. BMC Cardiovasc Disord 2016;16:9.

    Google Scholar 

  27. Takahashi H, Yokoi T, Yoshika M. Validation of the OMRON HBP-1300 upper arm blood pressure monitor, in oscillometry mode, for clinic use in a general population, according to the European Society of Hypertension International. Protocol Revision 2010. Dublin, Republic of Ireland: dabl Educational Trust; 2014, p. 4.

  28. World Health Organization (WHO). Physical status: the use and interpretation of anthropometry. Report of a WHO expert committee. Technical Report Series No. 854. Geneva, Switzerland: World Health Organization; 1995.

  29. Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013;31:1281–357.

    Google Scholar 

  30. Van Bortel LM, Laurent S, Boutouyrie P, Chowienczyk P, Cruickshank JK, De Backer T, et al. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens 2012;30:445–8.

    Google Scholar 

  31. Blacher J, Asmar R, Djane S, London GM, Safar ME. Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients. Hypertension 1999;33:1111–17.

    Google Scholar 

  32. Omboni S, Posokhov IN, Rogoza AN. Relationships between 24-h blood pressure variability and 24-h central arterial pressure, pulse wave velocity and augmentation index in hypertensive patients. Hypertens Res 2017;40:385–91.

    Google Scholar 

  33. Lovic D, Kallistratos MS, Poulimenos L, Skyrlas A, Stojanov V, Jakovljevic B, et al. Pulse wave velocity: retrospective analysis in a Balkan normotensive and hypertensive population: a study of 9923 patients. Angiology 2018;69:59–64.

    Google Scholar 

  34. Ato D, Sawayama T. Factors associated with high brachial–ankle pulse wave velocity in non-hypertensive and appropriately treated hypertensive patients with atherosclerotic risk factors. Vasc Health Risk Manag 2017;13:383–92.

    Google Scholar 

  35. Hansen TW, Staessen JA, Torp-Pedersen C, Rasmussen S, Thijs L, Ibsen H, et al. Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population. Circulation 2006;113:664–70.

    Google Scholar 

  36. Muxfeldt ES, Fiszman R, Castelpoggi CH, Salles GF. Ambulatory arterial stiffness index or pulse pressure: which correlates better with arterial stiffness in resistant hypertension? Hypertens Res 2008;31:607–13.

  37. Smulyan H, Asmar RG, Rudnicki A, London GM, Safar ME. Comparative effects of aging in men and women on the properties of the arterial tree. J Am Coll Cardiol 2001;37:1374–80.

    Google Scholar 

  38. Cunha PG, Cotter J, Oliveira P, Vila I, Boutouyrie P, Laurent S, et al. Pulse wave velocity distribution in a cohort study: from arterial stiffness to early vascular aging. J Hypertens 2015;33:1438–45.

    Google Scholar 

  39. Alves RF, Silva RP, Ernesto MV, Lima AGB, Souza FM. Gênero e saúde: o cuidar do homem em debate. Psicol Teor Prát 2011;13:152–66.

    Google Scholar 

  40. Merz AA, Cheng S. Sex differences in cardiovascular ageing. Heart 2016;102:825–31.

    Google Scholar 

  41. de Oliveira Alvim R, Santos PCJL, Bortolotto LA, Mill JG, da Costa Pereira A. Arterial stiffness: pathophysiological and genetic aspects. Int J Cardiovasc Sci 2017;30:433–41.

    Google Scholar 

  42. Wildman RP, Mackey RH, Bostom A, Thompson T, Sutton-Tyrrell K. Measures of obesity are associated with vascular stiffness in young and older adults. Hypertension 2003;42:468–73.

    Google Scholar 

  43. Storch AS, de Mattos JD, Alves R, dos Santos Galdino I, Rocha HNM. Methods of endothelial function assessment: description and applications. Int J Cardiovasc Sci 2017;30:262–73.

    Google Scholar 

  44. Wildman RP, Farhat GN, Patel AS, Mackey RH, Brockwell S, Thompson T, et al. Weight change is associated with change in arterial stiffness among healthy young adults. Hypertension 2005;45:187–92.

    Google Scholar 

  45. Kubozono T, Miyata M, Kawasoe S, Ojima S, Yoshifuku S, Miyahara H, et al. High pulse wave velocity has a strong impact on early carotid atherosclerosis in a Japanese general male population. Circ J 2017;81:310–15.

    Google Scholar 

  46. Dumor K, Shoemaker-Moyle M, Nistala R, Whaley-Connell A. Arterial stiffness in hypertension: an update. Curr Hypertens Rep 2018;20:72.

    Google Scholar 

  47. McEniery CM, Spratt M, Munnery M, Yarnell J, Lowe GD, Rumley A, et al. An analysis of prospective risk factors for aortic stiffness in men: 20-year follow-up from the caerphilly prospective study. Hypertension 2010;56:36–43.

    Google Scholar 

  48. Safar ME, Asmar R, Benetos A, Blacher J, Boutouyrie P, Lacolley P, et al. Interaction between hypertension and arterial stiffness: an expert reappraisal. Hypertension 2018;72:796–805.

    Google Scholar 

  49. Cecelja M, Chowienczyk P. Dissociation of aortic pulse wave velocity with risk factors for cardiovascular disease other than hypertension: a systematic review. Hypertension 2009;54:1328–36.

    Google Scholar 

  50. Smulyan H, Lieber A, Safar ME. Hypertension, diabetes type II, and their association: role of arterial stiffness. Am J Hypertens 2016;29:5–13.

    Google Scholar 

  51. Kim EJ, Park CG, Park JS, Suh SY, Choi CU, Kim JW, et al. Relationship between blood pressure parameters and pulse wave velocity in normotensive and hypertensive subjects: invasive study. J Hum Hypertens 2007;21:141–8.

    Google Scholar 

  52. Farro I, Bia D, Zócalo Y, Torrado J, Farro F, Florio L, et al. Pulse wave velocity as marker of preclinical arterial disease: reference levels in a Uruguayan population considering wave detection algorithms, path lengths, aging, and blood pressure. Int J Hypertens 2012;2012:169359.

    Google Scholar 

  53. Avolio AP, Chen SG, Wang RP, Zhang CL, Li MF, O’Rourke MF. Effects of aging on changing arterial compliance and left ventricular load in a northern Chinese urban community. Circulation 1983;68:50–8.

    Google Scholar 

Download references

Author information

Author notes

  1. Both authors contributed equally to this work.

Authors and Affiliations

  1. Preventive Cardiology Department, Faculdade de Tecnologia e Ciências (FTC), Salvador, Brazil

    Juan Jailson Oliveira Almeida Costa, Roberta Castro de Araújo Cunha, Antonio de Assis Oliveira Alves Filho, Larissa Ribeiro Bessa, Rodrigo Lins Sant’Ana de Lima, Alana dos Reis Silva, Brenno Araújo e Souza, Catarina de Almeida Viterbo, Mariana Barreto Requião, Daniele Brustolim, Diorlene Oliveira da Silva, Lucélia Batista Neves Cunha Magalhães & Cecília Freitas da Silva Araújo

Authors
  1. Juan Jailson Oliveira Almeida Costa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Roberta Castro de Araújo Cunha
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Antonio de Assis Oliveira Alves Filho
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Larissa Ribeiro Bessa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rodrigo Lins Sant’Ana de Lima
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Alana dos Reis Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Brenno Araújo e Souza
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Catarina de Almeida Viterbo
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mariana Barreto Requião
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Daniele Brustolim
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Diorlene Oliveira da Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Lucélia Batista Neves Cunha Magalhães
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Cecília Freitas da Silva Araújo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lucélia Batista Neves Cunha Magalhães.

Additional information

Peer review under responsibility of the Association for Research into Arterial Structure and Physiology

Data availability statement: The data was collected from December 2016 to May 2019 (12.05.16 to 05.31.19).

Rights and permissions

This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Costa, J.J.O.A., de Araújo Cunha, R.C., de Assis Oliveira Alves Filho, A. et al. Analysis of Vascular Aging in Arterial Hypertension — Population-based Study: Preliminary Results. Artery Res 25, 131–138 (2019). https://doi.org/10.2991/artres.k.191201.001

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2991/artres.k.191201.001

Keywords

Artery Research

ISSN: 1876-4401

Contact us