Relationship of Arterial Stiffness with Hypertension and its Management in a North-Indian Population Free of Cardiovascular Disease

Volume 1, Jan 2012

Ravi R Kasliwal, Manish Bansal, Rahul Mehrotra, Naresh Trehan; Gurgaon, India

Background: Arterial stiffness is an important prognostic marker for cardiovascular (CV) events in many patient subsets, especially in hypertensives. However, the relationship between hypertension and arterial stiffness has not been adequately studied among Indians

Methods: One hundred forty-four individuals who were free of CV disease were included in the study and subjected to clinical examination, biochemical investigations, and arterial stiffness assessment. Right and left brachial-ankle pulse wave velocity (baPWV), carotid-femoral pulse wave velocity (cfPWV), and augmentation index (AIx), estimated using PeriScope® device, were used as measures of arterial stiffness.

Results: Mean age of the subjects was 45.7„b11.6 years and 75.7% were males. Of the 144 subjects, 101 (70.1%) were found to have hypertension. All arterial stiffness parameters (cfPWV, right and left baPWV, and AIx) were significantly elevated in patients with hypertension (993.4 ± 382.6 cm/sec, 1430.7 ± 593.0 cm/sec, 1534.1 ± 347.4 cm/sec, and 20.0 ± 10.9% respectively in hypertensives and 799.5 ± 188.8 cm/sec, 1175.9 ± 277.7 cm/sec, 1331.1 ± 214.4 cm/sec, and 10.8 ± 10.7% respectively in nonhypertensives, p <0.01). Both systolic and diastolic blood pressure (BP) had significant correlation with cfPWV, right and left baPWV, and AIx. Although, the hypertensive patients with controlled BP (<140/90 mmHg) still had increased arterial stiffness as compared to non-hypertensives with normal BP, they had much less stiff arteries as compared to those with elevated BP levels , even if they were not previously known to be hypertensives. 

Conclusions: The present study shows that in North-Indian subjects without known CV disease, arterial stiffness is significantly increased among hypertensives and is positively correlated with both systolic and diastolic BP. All measures of arterial stiffness improve with control of BP. Assessment of arterial stiffness may thus be helpful in tracking vasculoprotective effects of antihypertensive therapy in clinical practice.

Key Words: Arterial stiffness; augmentation index; cardiovascular disease; hypertension; pulse wave velocity