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Arterial stiffness and hypertension status in Afro-Caribbean men

Kuipers, Allison L.a; Miljkovic, Ivaa; Barinas-Mitchell, Emmaa; Cvejkus, Ryana; Bunker, Clareann H.a; Wheeler, Victor W.b; Zmuda, Joseph M.a

doi: 10.1097/HJH.0000000000001909

Objective: African ancestry individuals are at high risk for hypertensive cardiovascular disease (CVD) and could benefit from early detection of arterial stiffening. We tested the association between the 2017 ACC/AHA hypertension categorizations, which include new blood pressure (BP) cutoffs and a definition for elevated BP, and arterial stiffness in 772 Afro-Caribbean men aged 50+ years (mean 64 years).

Methods: Arterial stiffness was assessed by brachial–ankle pulse-wave velocity (PWV) using a waveform analyzer. Hypertension groups were based on the 2017 ACC/AHA guidelines and by pharmacologic control status. Multiple linear/logistic regression was used to determine the association of PWV with BP and hypertension.

Results: Mean (SD) PWV was 1609 (298) cm/s and was independently correlated with age, SBP, pulse, diabetes, height, and alcohol intake (all P < 0.02). After adjusting for these, in men aged at least 65 years, those with stage 1 or uncontrolled stage 2 hypertension had significantly greater PWV than all other groups (all P < 0.05). Men with controlled hypertension had similar PWV to those with elevated BP (P = 0.7); however, this was significantly greater than men with normal BP (all P < 0.05). Patterns were similar, but with smaller effect sizes, in men aged less than 65 years (all P < 0.05 except controlled hypertension versus elevated or normal BP were not significant).

Conclusion: In these high-risk Afro-Caribbeans: stage 1 hypertension is associated with increased PWV, which supports the new guidelines; and, pharmacologic control appears to partially protect men from increased PWV. Longitudinal studies are needed to determine optimal PWV and timing of antihypertensive treatment for preventing future CVD.

aDepartment of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

bTobago Health Studies Office, Scarborough, Tobago, Trinidad and Tobago

Correspondence to Allison L. Kuipers, PhD, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, A543 Public Health, Pittsburgh, PA 15261, USA. Tel: +1 412 624 2781; fax: +1 412 624 7397; e-mail:

Abbreviations: ACC/AHA, American College of Cardiology/American Heart Association; baPWV, brachial–ankle pulse-wave velocity; BP, blood pressure; CVD, cardiovascular disease; PWV, pulse-wave velocity; THS, Tobago Health Study

Received 27 March, 2018

Accepted 23 July, 2018

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