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(Circulation. 2002;105:1202.)
© 2002 American Heart Association, Inc.

Clinical Investigation and Reports

Determinants of Accelerated Progression of Arterial Stiffness in Normotensive Subjects and in Treated Hypertensive Subjects Over a 6-Year Period

Athanase Benetos, MD PhD; Chris Adamopoulos, MD; Jeanne-Marie Bureau, MD; Mohamed Temmar, MD; Carlos Labat, BSc; Kathryn Bean, MA MPH; Frédérique Thomas, PhD; Bruno Pannier, MD; Roland Asmar, MD; Mahmoud Zureik, MD PhD; Michel Safar, MD; Louis Guize, MD

From the Centre d’Investigations Préventives et Cliniques (A.B., C.A., J.-M.B., M.T., K.B., F.T., L.G.), Paris; Institut National de la Santé et de la Recherche Médicale U258 (A.B., C.L., M.Z.), Villejuif; Hôpital Manhès (B.P.), Fleury Merogis; Institut Cardiovasculaire (R.A.), Paris; and Hôpital Broussais (M.S.), Paris, France.

Correspondence to Athanase Benetos MD, PhD, Centre d’Investigations Préventives et Cliniques (IPC), 6-14, rue la Pérouse, 75116 Paris, France. E-mail benetos{at}ipc.asso.fr

Background— Elastic artery stiffness, a result of arterial aging, is an independent indicator of cardiovascular risk. The aim of the present longitudinal study was to compare the progression of aortic stiffness over a 6-year period in treated hypertensive subjects and normotensive subjects, and to evaluate the determinants of this progression.

Methods and Results— Data for the present analysis were gathered from 483 subjects who had 2 health checkups at the Centre d’Investigations Préventives et Cliniques, the first one in 1992–1993 and the second one in 1998–1999. Carotid-femoral pulse wave velocity (PWV) was used to evaluate aortic stiffness in 187 hypertensive subjects who were under treatment at the time of the first visit and throughout the follow-up period, and in 296 subjects who were classified as normotensive during the first visit and who remained treatment-free throughout the follow-up period. In both populations, PWV progression was higher in older subjects. Annual rates of progression in PWV in treated hypertensives were significantly higher than in normotensives. Only treated hypertensives with well-controlled blood pressure levels at the time of both visits had a PWV progression similar to that of normotensives. In treated hypertensives, high heart rate and high creatinine during the first visit were associated with an accelerated progression in PWV.

Conclusions— The presence of high blood pressure, high heart rate, and high serum creatinine were the major determinants of accelerated progression of aortic stiffness in treated hypertensives. This is the first longitudinal study to evaluate the determinants of arterial aging over an extended period of time.

Key Words: aging • heart rate • elasticity • hypertension

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