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Temporal relationship between arterial stiffness and blood pressure variability and joint effect on cardiovascular disease

Hypertension Research volume 47, pages 1133–1143 (2024)Cite this article

Abstract

Although arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV) and blood pressure (BP) significantly correlated, the relationship between baPWV and BP variation (BPV) was unclear. This study aimed to examine the temporal relationship between brachial-ankle pulse wave velocity (baPWV) and systolic blood pressure variation (SBPV) and their joint effect on the development of cardiovascular disease (CVD). This study included 6632 participants with repeated assessments of baPWV and BP during 2006 to 2018. The baseline and follow-up SBPV was calculated as absolute SBP difference divided by mean SBP over sequential visits, using data between 2006–2010 and 2014–2018, respectively. Cross-lagged analysis was used to assess the temporal relation between baPWV and SBPV, and logistic analysis was used to assess the joint effect of baPWV and SBPV on CVD. After adjustment for confounder, the path coefficient from baseline baPWV to follow-up SBPV (β1 = 0.040; P = 0.0012) was significantly had greater than the path from baseline SBPV to follow-up baPWV (β2 = 0.009; P = 0.3830), with P = 0.0232 for the difference between β1 and β2. This unidirectional relationship from baseline baPWV to follow-up SBPV was consistent in patients without hypertension, with isolated systolic, high systolic and diastolic, uncontrolled and controlled hypertension. In addition, participants with high levels of baseline baPWV and follow-up SBPV had greater risk of CVD (odds ratio, 5.82; 95% confidence interval, 2.50–12.60) than those with low-low levels. The findings suggested that arterial stiffness appeared to precede the increase in SBPV and their joint effect is predictive of the development of CVD.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank all study participants, their relatives, the members of the survey teams at the 11 regional hospitals of the Kailuan Medical Group; and the project development and management teams at the Beijing Tiantan Hospital and the Kailuan Group.

Funding

Funding

This work was supported by National Key Research and Development Program of China (2022YFC3600600), Training Fund for Open Projects at Clinical Institutes and Departments of Capital Medical University (CCMU2022ZKYXZ009), Beijing Natural Science Foundation Haidian original innovation joint fund (L222123), Fund for Young Talents of Beijing Medical Management Center (QML20230505), and the high-level public health talents (xuekegugan-02-47).

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Authors and Affiliations

  1. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China

    Xue Tian, Qin Xu, Yijun Zhang, Xue Xia, Penglian Wang & Anxin Wang

  2. China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Xue Tian, Qin Xu, Yijun Zhang, Xue Xia, Penglian Wang & Anxin Wang

  3. Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China

    Xue Tian & Yijun Zhang

  4. Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China

    Xue Tian, Yijun Zhang & Anxin Wang

  5. Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, 57 Xinhua East Rd, Tangshan, 063000, China

    Shuohua Chen & Shouling Wu

  6. Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China

    Anxin Wang

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Contributions

SW, SC and AW conceived and designed the study. XT, QX, YZ, XX, PW contributed to the statistical analysis. SW and XT drafted the manuscript. All authors contributed to collecting data and reviewed/edited the manuscript for important intellectual content. All authors read and approved the final manuscript.

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Correspondence to Shouling Wu or Anxin Wang.

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Tian, X., Chen, S., Xu, Q. et al. Temporal relationship between arterial stiffness and blood pressure variability and joint effect on cardiovascular disease. Hypertens Res 47, 1133–1143 (2024). https://doi.org/10.1038/s41440-023-01541-2

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