Key result
Higher arterial stiffness is linked to ~176% increased risk of new-onset hypertension per SD.
Why the study?
Hypertension and diabetes frequently coexist, but whether the bidirectional longitudinal relationships between arterial stiffness and hypertension are independent of those between arterial stiffness and diabetes was unclear.
Does increased arterial stiffness predict the development of hypertension and diabetes in middle-aged adults?
Cohort (n=3,960)
No
Does increased arterial stiffness predict the development of hypertension and diabetes in middle-aged adults?
Arterial stiffness is a significant predictor for the development of hypertension, but not diabetes, suggesting different pathophysiological roles.
Arterial stiffness may selectively predict hypertension but not diabetes; hypothesis-generating and should not yet change practice.
Background Hypertension and diabetes frequently coexist; however, it has not yet been clarified if the bidirectional longitudinal relationships between arterial stiffness and hypertension are independent of those between arterial stiffness and diabetes. Methods and Results In this 16‐year prospective observational study, 3960 middle‐aged employees of a Japanese company without hypertension/diabetes at the study baseline underwent annual repeated measurements of blood pressure, serum glycosylated hemoglobin A 1c levels, and brachial‐ankle pulse wave velocity. By the end of the study period, 664, 779, 154, and 406 subjects developed hypertension, prehypertension, diabetes, and prediabetes, respectively. Increased brachial‐ankle pulse wave velocity at the baseline was associated with a significant odds ratio (per 1 SD increase) for new onset of prehypertension/hypertension with (2.45/3.28; P <0.001) or without (2.49/2.76; P <0.001) coexisting prediabetes/diabetes, but not for new onset of prediabetes/diabetes without coexisting hypertension. Analyses using the latent growth curve model confirmed the bidirectional relationships between brachial‐ankle pulse wave velocity and hypertension, but no such relationship was observed between brachial‐ankle pulse wave velocity and abnormal glucose metabolism. Conclusions In middle‐aged employees of a Japanese company, while bidirectional relationships were found to exist between increased arterial stiffness and hypertension, such a relationship was not found between increased arterial stiffness and diabetes. Therefore, it appears that increased arterial stiffness may be associated with the development of hypertension but not with that of diabetes.
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Nakano et al. (2022) conducted a cohort in Without hypertension or diabetes at baseline (n=3,960). Increased brachial-ankle pulse wave velocity (baPWV) vs. Lower brachial-ankle pulse wave velocity was evaluated on New onset of hypertension alone (OR 2.76, 95% CI 2.44-3.12, p=<0.001). Increased arterial stiffness (per 1 SD increase in baPWV) was significantly associated with the development of hypertension alone (OR 2.76), but not with the development of diabetes alone.
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