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      Arterial stiffness is associated with prehypertension in both non-hypertensives and treated hypertensives–A matched case control study

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          Abstract

          Background

          Prehypertension (PHT) is a cardiovascular health risk defined by blood pressure (BP). Arterial stiffness (AS) provides beyond brachial BP inference on vascular ageing and pulse wave analysis (PWA) can measure it non-invasively.We compared association between AS and PHT using age and gender matched case-controls.

          Methods

          This is a sub analysis of previous PWA studies of hypertensives and non-hypertensives. Using oscillometric PWA by Mobil-o-Graph (IEM, Stolberg, Germany), parameters of AS (augmentation pressure and index, reflection magnitude, aortic pulse wave velocity, pulse pressure amplification), brachial hemodynamics (BH), and central hemodynamics (CH; aortic BP, cardiac output related parameters, stroke work) were derived. Age and gender matched case controls were compared as: 1) Nonhypertensives with BP at prehypertensive level (PHT) versus normotensives (NT) ( n = 217 each), 2) Under treatment hypertensives with BP at prehypertensive level (PHT-T) versus untreated, nonhypertensives with BP at prehypertensive level (PHT-UT) ( n = 74 each).

          Results

          PHTs had higher AS, BH and CH than NTs, with statistical significance for all but few parameters. PHT-T had comparable BH but higher AS, CH than PHT-UT with significance for few parameters.

          Conclusion

          Pulse wave analysis derived arterial stiffness is associated with prehypertension compared to normal, after age and gender matching. In hypertensives, arterial stiffness is significantly higher despite being treated to prehypertension level as compared to control. It hints arterial stiffness to be better parameter than brachial BP to study prehypertension.

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          Most cited references21

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          The New ACC/AHA Hypertension Guidelines for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults

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            • Abstract: not found
            • Article: not found

            Arterial stiffness precedes hypertension and metabolic risks in youth: a review

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              • Article: not found

              Arterial stiffness in prehypertension: a possible vicious cycle.

              The pathophysiological abnormalities associated with increased arterial stiffness and/or abnormal pressure wave reflection may play crucial roles in increasing the risk of development of cardiovascular events. On the other hand, prehypertension, defined as a systolic blood pressure of 120-139 and/or a diastolic blood pressure of 80-89 mmHg, is a "danger zone" for the later development of hypertension and is also associated with an increased incidence of cardiovascular diseases and cardiovascular mortality. We discuss the association among arterial stiffness/pressure wave reflection, prehypertension, and the later development of hypertension. Several prospective studies have demonstrated that increased arterial stiffness/abnormal pressure wave reflection are risk factors for the later development of hypertension in subjects with prehypertension. On the contrary, persistence of prehypertention accelerates the age-related increase of the arterial stiffness. Thus, arterial stiffness and prehypertension may be elements of a vicious cycle, and other cardiovascular risk factors, such as aging and abnormal glucose metabolism, may aggravate this cycle. In the future, development of a simple technique to assess large/small arterial stiffness and an effective strategy to reduce arterial stiffness in subjects with prehypertension is warranted.

                Author and article information

                Contributors
                Journal
                Indian Heart J
                Indian Heart J
                Indian Heart Journal
                Elsevier
                0019-4832
                2213-3763
                May-Jun 2024
                12 June 2024
                : 76
                : 3
                : 224-228
                Affiliations
                [a ]Dept of Physiology, Govt Medical College, Bhavnagar, India
                [b ]Govt Medical College, Baroda, India
                [c ]Govt Medical College, Bhavnagar, Gujarat, India
                Author notes
                [* ]Corresponding author. Dept of Physiology, Fourth floor, GMC, Bhavnagar, Jail road, Bhavnagar, Gujarat, 364001, India. drjaymin_83@ 123456yahoo.com
                Article
                S0019-4832(24)00080-4
                10.1016/j.ihj.2024.06.007
                11329018
                38871217
                1da36df1-c94b-4ae2-b622-4383f9109841
                © 2024 Cardiological Society of India. Published by Elsevier, a division of RELX India, Pvt. Ltd.

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

                History
                : 6 January 2024
                : 27 March 2024
                : 10 June 2024
                Categories
                Short Communication

                anti-hypertensive,blood pressure,hemodyanmics,hypertensive,pre-hypertension

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